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Page 4 <br /> As .inflation ontinues upward , more and more people are being excluded from the <br /> for-profit medical service non-system. The demands on our department for preventative <br /> clinical services up. Therefore, we either turn people away or provide less of <br /> something else. M ts t Likely, we will have to decrease our home nursing visits next <br /> year. This will 'adually result in more chronic disease, maternal and child health <br /> problems. With,l s community services the high morbidity statistics for Northern <br /> Orange County is a tilt chronic diseases and infant mortality will ,predictably,not <br /> decrease. It is highly predictable that, for instance, some persons suffering strokes <br /> associated with undiagnosed , untreated hypertension will become a public burden along <br /> with their families. <br /> This Department has the vision and desire to become aggressive and proficient <br /> enough to .impact public expenditures by preventing problems rather and simply picking <br /> up the incredible oasts after-the-fact. We have picked up momentum and are presently <br /> progressing at an unprecedented rate. Holding-the-line will be disastrous to us. <br /> We do not want to become a lethargic organization. <br /> RELATED ISSUE <br /> A key issue in olving non--local Hands used by this department must be decided. <br /> Paraphrasing Neal Erans; if program X generates revenue, then that revenue should <br /> be used to offset t e local, costs of program X. Sam Gattis indicated.i.fhat this policy <br /> would not prohibit using new revenue unrelated to existing programs tira'open a new <br /> service, if paid fob totally by the new (non-local tax) revenue. <br /> The problems wth these sentiments from my point of view are: (A) public health <br /> program 1lindi.ng is not .that categorical, and the expectation is for us to finance new <br /> efforts by ne;j rev itng prQpr 2M; (H) given the depressed <br /> level of non- oval Nndin� we could never expand our services , all could hope to <br /> do is decrease our local at x hand dependency by a smallish margin."* <br /> By the accepti g the populist sentiment above, the Commissioners will guarantee <br /> exclusion of this d partment from upwards of 70% of all possible Federal health programs <br /> and a few of the St to programs. This will guarantee that the bulk of this departments' <br /> reso€arces will come mom :local property taxes. <br />