Fourteen Carroll County Health Department employees will receive formal notice today that they will lose their jobs in 90 days, spokesman Larry Leitch said.
Budget cuts have hit the core of the department, eliminating clinics and reducing public education and testing for AIDS and other communicable diseases.
"Children are the real victims" of the cuts, department director Janet W. Neslen said.
The cuts represent "the dismantling of the health department of Maryland," said Richard B. Isaac, director of the Environmental Health Bureau.
Yesterday, five health department officials detailed for the county commissioners how the latest state budget cuts will affect the department, which provides nursing, environmental and other health services to county residents. The cuts took effect yesterday.
Various nursing and health services will be eliminated or reduced, but environmental health services could stay intact if the county maintains its current funding, raises some fees and levies new fees.
Dr. Neslen asked the commissioners to give the department about $1.89 million in the coming fiscal year -- the same amount the county contributed last year.
The department lost $1.1 million in state money in the past two years, said Thomas Lewis, director of administration.
Last year, 93 people lost their jobs because of state cuts. As of July 1, the department employed 204 full-time-equivalent employees, Mr. Leitch said.
The health department, which also receives federal money and grants and collects fees, has a total budget of $7.5 million to $8 million, he said. More layoffs and program reductions are possible if the county cuts its portion of the funding, Mr. Leitch said.
Commissioners Donald I. Dell and Elmer C. Lippy did not guarantee that they could maintain current funding, but they gave health officials approval to send their proposed budget to state health officials. Commissioner Julia W. Gouge did not attend the meeting.
Mr. Lippy, who said last week that the county should look to outside agencies when making cuts, said he may rethink his position.
"I can't countenance all these cuts" to the health department, he said.
In the nursing bureau, the state cuts mean six nursing employees will lose their jobs.
The cuts will eliminate school hearing and vision screenings and audiology, ear-nose-and-throat and neurology clinics, Nursing Bureau Chief Donna Hopkins said.
The cuts also will mean reduced hours in walk-in and immunization clinics and reduced investigations and follow-ups to communicable disease outbreaks, she said.
In July and August, the department immunized 1,800 people, and last year, provided hearing and vision screenings to 10,800 students, Ms. Hopkins said.
"These are all seen as real core activities to public health," she said.
Edwin Davis, director of pupil services-special programs for the Board of Education, said state law mandates the screenings, meaning the schools will have to find a way to offer the service.
In the environmental health bureau, eight employees will lose their jobs, meaning it will take longer for other workers to issue permits and conduct inspections, Mr. Isaac said. The bureau's top priorities are preventing the spread of rabies and other communicable diseases, he said.
The bureau also inspects well and septic system sites, food service facilities, water supplies and landfills, among other things.
Health officials proposed increasing seven existing fees and adding seven new fees in order to maintain services after the state cuts. This would raise an additional $156,075.
Raising the fee for percolation tests -- done to determine whether a septic system is feasible on a property -- from $35 to $100 would be the largest money-maker, bringing in $71,000. Last year, the department did 1,100 of these tests.
County developer Jeff Powers, president of the Carroll Chapter of the Home Builders Association of Maryland, said the cuts mean it will be more expensive and take longer to build a home.
The fee increases ultimately are passed on to consumers, he said.
"It's another fee making affordable housing in Carroll County nearly impossible," Mr. Powers said.
Possible cuts to mental health and addictions programs in the health department were undetermined yesterday, Mr. Leitch said.