When the Chattanooga-Hamilton County Health Department does its job, the results are measured by what doesn't happen, administrator Becky Barnes says.

No one applauds when they don't get sick after eating out, when their babies get extra nutrition or their moms and dads don't come down with the flu.

But Barnes said such services and others might be reduced or lost altogether if the county cuts the department's funding in the coming budget year.

That could happen because a 45-year-old sales-tax agreement between Chattanooga and Hamilton County is about to expire. About $8.8 million of the health department's $21 million budget comes from that agreement.

Barnes said the limbo leaves the department unable to complete its annual budget request, which is due before the county's budget hearings in May.

"We are in a holding pattern somewhat," Barnes said. "I guess we're preparing a budget right now but, in our minds, we're preparing other budgets."

Kelci Kelly brought her 21/2-month-old daughter, Emma, to the health department Friday for shots. As Kelly calmed her squalling child, she said the department helped her family in a pinch.

The family's insurance recently changed and she needed a place to get her daughter essential vaccinations to prevent illnesses that people don't hear much about any more, like polio.

Barnes said many people don't realize how much of an impact the department has in the county, but it's considerable.

Health department investigators scour restaurants for contamination and inspect hotels and motels for cleanliness, she said. Its 300 workers do everything from assisting in disaster preparations to giving flu shots to tracking infectious diseases such as tuberculosis.

"Public health achievements are to prevent something from happening," Barnes said. "The biggest thing is to prevent. We're on defense all the time. We're not scoring points."

Scare tactics

Hamilton County Mayor Jim Coppinger has warned agencies that are jointly funded by the city and county that the county won't give them any money if the sales-tax agreement is not renewed.

Chattanooga Mayor Ron Littlefield and City Council Chairman Manny Rico say Coppinger is using scare tactics to get the city to renew the agreement. City officials say the county is responsible under state law to fund the health department.

Rico also noted that the county has plenty of money in its reserve fund to give to the jointly funded agencies.

"When the county has an $85 million reserve fund, there should be no problem," Rico said.

Coppinger said he's not interested in tapping reserve funds and there's no support on the County Commission for a tax increase to make up the difference.

"There's no strategy here," Coppinger said. "It's very much the reality of the way things are; that's the way budgets work."

Barnes said she's taking Coppinger, who is her boss, at his word.

"I have been at the health department for 31 years," she said. "I've never been more concerned than I am now."

A nightmare

Coppinger said slashing local support could cost the health department another $10 million in matching state and federal dollars for a variety of programs.

"It's like a horrible nightmare," Barnes said. "If we had to make large cuts, it would be a very carefully thought-out process regarding what we have to do, what we can afford to do and what are the most important priority things for our community."

Barnes didn't speculate about what services would stay and what would be cut. She said some department programs aren't considered essential, but are nice to have.

One is an adult home visitation program in which health department workers check periodically on elderly residents to help them stay in their homes instead of going to nursing homes. That program isn't supported by any grant money, she said.

Cuts also could force some county residents to seek services such as Women, Infants and Children, a supplemental nutrition program, in adjacent counties, Barnes said.

Shared concern

The Chattanooga-Hamilton County Regional Health Council is a partnership organization with the health department that helps with health assessments and planning. Coppinger said he plans to speak to the council today about the funding issue. Rico is a board member.

Health council board Chairman Howard Roddy was director of the health department from 1981 to 1998. Now a vice president at Memorial Health Care System, he said he is concerned about the future of the health department.

Roddy urged the city and the county to work through their disagreement.

"The thought of having approximately $10 million cut out of the budget would be devastating to the citizens of Chattanooga and Hamilton County," Roddy said.

He said 93 percent of people served by the health department live in the city of Chattanooga, but Barnes said it's not that simple. For services in which the department tracks residency, 65 percent of recipients are in Chattanooga, she said.

Littlefield's spokesman, Richard Beeland, said that, no matter what percentage of people using the health department live in the city, 100 percent of them live in the county.

"The county has a legal obligation to fund the health department," Beeland said. "If they're not willing to live up to that obligation, that's their call."