NTF worksheet: douglascounty120.doc. 8-19.

. Much of the budgetary material we examined during this budget cycle from various departments resembled public relations pieces rather than informative budget material. Understanding that many county employees work at their duties diligently, we were not interested in reading “puff pieces.” We suggest that county commissioners require of all departments headed by appointees and advise all departments headed by elected officials to use the same template with line items, showing specific expenditures for personnel and operations for every department division. I refer you to pages found in the City of Omaha and Omaha Public School District budgets (see attachment). It was impossible for us to analyze adequately many county department budgets simply because of lack of information available.
With a 5.3% hike in the FY 2019-2020 budget, the increased property tax hike on a $250,000 home will total $37.50 yearly.

COUNTY HEALTH CENTER. The design and construction of the justice center expansion and perhaps a new juvenile detention facility will cause a property tax increase for several years or longer. The budget includes $6.6 million for the detention center. To counter the fiscal impact of this eventuality, we recommend that county commissioners immediately utilize suggestions from Health Management Associates,* which conducted an analysis for the county several years ago, and our taxpayer group. The Health Center has hemorrhaged over $16.8 million taxpayer dollars since 2018. Its budget for FY 2019-2020 is $34.6 million. Cutting costs here could decrease the fiscal impact on county taxpayers from the justice center expansion. We note that Health Center revenues are lower this fiscal year, adding to the deficit.
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Close units at the Health Center, e.g., health care services for which elimination would not otherwise increase county costs.
*Service only subsidized patients that the county is legally required to service.
Refuse transfers from other nursing facilities.
*Adopt stricter admissions policies.
*Alter the inpatient/outpatient ratio at the health center.
*Renegotiate union contracts under threat of privatization.
*Make unionized Health Center employees pay a larger share of their health care premiums.
Ask Health Center staff for budget cut suggestions.
*Levy a portion of property taxes on non-profit hospitals and their satellite locations (legislature permission required).
*Lobby the legislature to decrease the number of mandated services and programs required.
*Lobby the legislature to loosen certificate of need requirements, so that a facility can expand room for patients.
*Contract out a service if cheaper, e.g., ENCOR.
*Outsource/privatize payroll, housekeeping, pest control, and transportation.
*Outsource entire management of the facility, which would end dumping from other nursing facilities.
Eliminate dietary services and beauty shop.
Contract with another hospital for necessary mental health services.
*Encourage home-based care services by lobbying for changes in state law.
*Scour more intensely for third-party liability payments.
Update the pharmacy computer system to better track drug costs and revenues, thus lessening purchasing costs.
*The pharmacy should purchase drugs with other, private purchasing entities to lessen acquisition costs, which presently are too high. Consider interlocal agreement.
Alter pharmacy walk-in and phone-in hours to better accommodate customers.
*If unable to lower costs, contract out pharmacy services.
*Optimize reimbursements from state government.
Change coding procedures to access higher Medicare and Medicaid payments.
Accelerate working with federal Dept. of Veterans Affairs to provide services for vets at a higher reimbursement rate than that received from Medicaid.
*Staff the outpatient clinic with less costly professionals, e.g., APRNs.
Streamline patients going through outpatient clinic to lessen personnel time required.
A day treatment program would avoid inpatient stays.
*Reports should produce financial information at the dept. level with enough detail, so that management can make better decisions based on costs and revenues precisely noted for each division.

Its budget would increase by 25%. A positive that this office secured newer furniture at no cost as excess property. However, this office failed badly by leasing new computers that were not compatible with existing monitors.
NTF Recommendations:
Lobby legislature to remove state mandates on this department and pay for increased incurred costs.
If this office requires additional space, site it in the justice center expansion area instead of leasing more space.
Allow every employee in this and other departments either a land line phone or cell phone but not both.

This department budget came in $23,882 under budget for its current year appropriation. Fewer funds spent on mileage, printing services, and equipment. Its requested budget for FY 2019-2020 is less than the target set by the Finance Dept.
NTF Recommendation:
Offer an incentive reward for this and other departments that come in under budget for the fiscal year.

Its budget is $31,000 under budget. A record high admissions rate in May, 2019. Summer peak of admissions still high. Pre-trial inmates had a 93% compliance rate. Instituted a hiring committee because of delays in hiring. Wants more employees to cut overtime costs. More revenue incoming from ICE and U.S. Marshal Service.
NTF Recommendations:
Publicize hiring nationwide.
Hire more regular employees to cut overtime costs, which have doubled.

Requested appropriations are 22% higher than last year and $85,709 higher than target set by Finance Dept. Revenues not keeping pace with expenditures. Productivity enhanced by use of project management and time tracking software.
NTF Recommendation:
Conduct an internal audit to find out why a need for increased appropriations.

NTF Recommendations
Send offending teens to work at private contractors instead of screening them and sending them to JAC. United Way hires wayward juveniles to keep them out of jail.
Put juvenile offenders on public work details in the City Parks and Public Works Departments.
Refer illegal aliens to the immigration service (ICE).

The 1.5c increase in the property tax levy would cover new expenses incurred by the Juvenile Justice detention center. However, a current lawsuit may delay or stop this venture.
NTF Recommendation:
With a lawsuit pending, delay the final vote on the budget until shortly before budget is due at the state level, in September.
A positive is that the fiscal information for this center will be a separate fund, so that taxpayers more easily can track costs.

75% of its budget paid to DotComm for IT services; $10,000 additionally requested to pay for increased DotComm expenses. Incoming revenues dropped by about 50%. Requested General Fund budget would rise 28%, $17,396 over target set by Finance Dept.
NTF Recommendations:
Outsource department IT services to a private company if competitive.
Require parents who ask for system assistance for ungovernable youth to pay for referrals.
Continue services which cut more expensive detention services.
Caution that this department should not seek to substitute for parental behavior discipline. No nanny government supervision in loco parentis.
Require referrals to pay for their own interpreters. 3 of 13 staff members now offer interpreter services.

Misdemeanor case load is rising, 4.7% and 1% in each of the last 2 years, and its felony case load rose 12% and 5% in the last 2 years respectively. Yet, its juvenile cases dropped by 315 the last year. Utilizes several cost-saving measures, e.g., finding alternative placements for adults and juveniles outside incarceration, sharing laptops, not paying optional fees.
NTF Recommendation:
Conduct an internal audit to find out why a need for increased appropriations.

This dept. seeks a less than 1% hike in its budget though $147,892 higher than targeted by Finance Dept. Additional funding needed for increased demands of juvenile justice system. Increase in revenues is matching increase in spending.
NTF Recommendations:
Alter Juvenile Court mandate regarding short time to locate and serve.
Request school districts to pay a larger proportion of costs of school resource officers.
Hire private security firms for civic center security and courthouse entrance security.
Deputies could use video conferencing for court appearances.

There are many places where the county can reduce or eliminate unnecessary expenditures. The following are items from only 3 weeks from June and July this summer, showing Vendor, Item, Deptment, & Amount:
Cubby’s: Gift cards, Community Services, $300
ETR Associates: Condom power (200), Health Dept., $92
ETR Associates: Pocket guides on hot sex -200, Health Dept., $176
Ideal Pure Water: Water coolers, Several depts., $thousands
Kreative Element: Social media, Treasurer, $1,320
Language Line Services: Interpreter services, Corrections, $320.45
Lutheran Family Services: Behavior health consultant, Health Dept., $4,200
Lutheran Family Services: Interpreter services, Health Dept., $265.36
Lutheran Family Services: Interpreter services, $213.75
NE Assoc. of Behavioral Health Orgs.: Membership dues, Community Mental Health Center, $6,180
Universal Peace Foundation: Yoga, Corrections, $1,000
American Bar Association: Group membership dues, Several judges, $1,195
1st National Bank: Walmart gift cards, Pre-release program, $1,000
1st National Bank: 2 Harvard Business Review yearly subscriptions, Juvenile Justice, $99.00
Nat. Association of Criminal Defense Attys.: Annual membership dues, Public Defender, $145.00
Propio Language Services: Interpreter, Several depts., $453.43
Solid Waste Assoc. of North America: Membership dues< Environmental services, $268.00
Assoc. of Government Accountants: Membership dues, County Clerk, $110.00
Panera Bread Co.: $268.56

• Decrease travel expenses with accompanying costs for lodging and meals.
• Send fewer employees to training workshops and conferences.
• Eliminate step increases in pay and substitute merit pay increases.
• Purchase equipment and materials through interlocal agreements.
• Look for cheaper risk insurance, as this cost has skyrocketed.
• Reduce appropriations to the Tourism fund ($4 million) and return it to the General Fund to reduce budget pressures.
• Require or advise every department to use a common template that offers more detailed annual budget information.
• Eliminate non-mandated functions.

Research, documentation, and analysis for this issue paper done by Nebraska Taxpayers for Freedom. This material copyrighted by Nebraska Taxpayers for Freedom, with express prior permission granted for its use by other groups in the NE Conservative Coalition Network. 8-19. C

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