County's welfare budget pinched

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A tough economy is putting a dual squeeze on Davison County’s poor and his department’s budget, says Davison County Welfare Director Steve McClure.

Topping the list of cash demands for poor relief is indigent heath care.

So far this year, health care for the uninsured at Avera Queen of Peace Hospital has cost the county $146,859 — nearly $27,000 more than the $120,000 budgeted. The county also budgets an additional $60,000 a year for miscellaneous health-care costs. That money covers bills for X-rays, specialists and Sioux Falls hospitals. To date, $69,179 has been spent on that budget line.

“If a bill comes in and a patient qualifies for county assistance, we have to pay it,” McClure said, estimating that his budget has increased between 10 and 20 percent since 2009. The county’s responsibility for the poor is set in state law.

Despite the high costs, McClure said the county actually gets only a small percentage of health-care claims.

“About 75 percent of indigent patients who show up at the hospital never apply for county assistance,” he said. They either pay the hospital directly, or other agencies if their account is referred for collections.

Incidentals keep rising, too.

“We’re getting an increasing number of requests for assistance with utilities and rent and requests from transients for gas money or temporary lodging,” he said. “The money just isn’t out there like it was,” he said.

The demands have already forced the county to supplement its $251,650 poor-relief budget by roughly 20 percent this year.

With most of a quarter remaining in the 2010 budget year, the county commissioners in September approved a $52,109 transfer from the county’s $300,000 contingency budget to bolster welfare-related expenditures. About $4,000 of that amount went to pay for August court-appointed attorney fees for cases involving abused and neglected children.

The “abused and neglected” budget line — a line separate from poor relief — was $12,000 for 2010.

Since that $4,000 supplement, the county received bills for another $11,900. That means the commissioners have to make another supplement to make it through the year, Kiepke said.

“The $12,000 estimated budget was not out of line,” said Auditor Susan Kiepke, because no expenditures have been close to that amount in recent years for abused and neglected children. The county spent $8,681 in 2009, $16,251in 2008, $11,000 in 2007 and $2,826 in 2006.

The need for mental health services is also increasing.

Kiepke said $18,000 was budgeted to care for the mentally handicapped in 2010. She estimated that another $15,000 will be needed before the end of the year.

The budget line for mental committals and hearings also went over the budgeted $31,618. Kiepke estimated an additional $25,000 to $30,000 will be needed in 2010.

“It’s way more than has ever been spent out of that budget,” she said. The highest previous budget line for mental committals was $28,805 in 2005.

“We anticipated that that budget line would be up because of the economy,” Kiepke said, “but nobody expected it to go up that much.”

The problems facing the county are not only from the living, but the deceased.

County-paid funerals cost $6,855 in 2002, soared to $27,515 in 2007 and cost $15,848 and $17,500, respectively, in 2008 and 2009. McClure said $25,000 was budgeted for 2010 and, with three months remaining in the year, just $5,000 remains in that budget line.

The county paid $244,193 for poor relief in 2008 and $328,190 in 2009, leaving open the question of whether a budget of $251,650 for 2010 was poor planning.

“I don’t think so,” Kiepke said. “There was a general expectation that there would be additional poor relief needed, but there was no way to predict that the budget would rise by the amount it did. These things are very unpredictable.”

The commissioners have budgeted $309,350 for poor relief in 2011, McClure said.

The need is understandable, he said.

“When you make $7.50 an hour and you pay $2.50 an hour for child care, that doesn’t leave much to live on,” McClure said. “Ninety percent of these folks can’t afford health insurance. And that’s what causes everything to increase.”

Tags: davison county, county budget, steve mcclure, indigent health care, avera queen of peace hospital, susan kiepke, news