Mills County Public Health Works To Maintain Services Despite Budget, Staffing Cuts

Mills County Public Health is making changes to its program offerings following budget issues and staffing cuts.

Programs lost in the cuts included the NEST Program for pregnant women and young families, as well as the Circles 4 Support community dinners. For a few months, the Community Health Worker Program was also removed.

Following a recent partnership with Jennie Edmundson Hospital, the CHW program has been reinstated. Community health workers help community members navigate healthcare systems and resources, and provide insight on social determinants of health.

Agency Administrator Katelyn Murtfeld, BSN-RN, says MCPH worked to maintain services even with decreases in staffing made earlier this year by the Mills County Board Of Health.

“I do feel like for as many people that were laid off, those are really the only programs that were eliminated,” Murtfeld said. “Really, most of the cuts were administrative.”

Currently, there are 10 MCPH employees, six full time and four part time.

Many programs remain, including essential nursing services like immunizations, childhood lead poisoning prevention, blood pressure clinics, reportable disease follow-ups and public health emergency preparedness.

Family and community support programs, including home health aide services, homemaking, car seat safety, and Parents as Teachers, are also still available. Finally, there are still environmental programs like safe sharps disposal and mosquito surveillance, along with educational outreach.

In addition to changes in staffing and programs, MCPH will now be offering limited programs to Fremont County. This will exclusively involve essential nursing services. Both counties will maintain their own boards of health that jointly oversee public health operations.

“I’m hoping down the road that we can expand and get additional programs, but for right now, we’re working within their very limited budget,” Murtfeld said.

To fulfill the financial implications of this arrangement, state public health funding for both counties will be combined and given to MCPH on behalf of both boards.

“Now we just have the one contract for both counties, one claim every month, one quarterly report for different things like one so it’s all just streamlined through one funding source,” Murtfeld said. The portion of Fremont County tax dollars that is allocated to these services will also be paid to MCPH.

The majority of MCPH programs are funded through grants and outside sources.  The Mills County Board Of Supervisors has approved an $880,110 budget for MCPH for the 2025-2026 fiscal year, which begins July 1, with no more than $275,000 of that funding coming from county tax dollars. MCPH’s budget for the current fiscal year is $1,209,928, including $500,000 of county tax dollars.

Historically, the Fremont County Board of Health fulfilled its requirements for community services and needs through a hospital contract, but those programs were unexpectedly ended. While this particular partnership is new and more expansive, relationships between counties have existed previously.

“There’s always been a lot of contracting out for different services. It just goes back to the Board of Health. It’s their responsibility to ensure that somehow they’re being provided, whether it’s through Mills County or through a separate agency,” Murtfeld said.

Mills County contracts some services through Jennie Edmundson Hospital, FireFly, and Pottawattamie and Page County. Fremont County has also previously contracted from other organizations or county entities.

Murtfeld believes partnerships like these allow public health services to expand their efforts without losing independence through expansive regional coalitions.

“The biggest thing is trying to really strengthen rural public health and making sure that services are accessible,” Murtfeld said. “Long term, we’ll have more access and then stronger, more efficient public health programs in all the rural counties.”