GRAVES COUNTY, Ky. — Anna Senter is a mother of two with a full time job.

"I sometimes work six days a week," she said.

She admits things get a little hectic.

So, she brings her family to the health department when she can. Sure, there is always a little bit of a wait but she likes the staff and the services they provide.

But it turns out both the staff and services are on the chopping block.

Directors from local health departments are back home after spending Tuesday in Frankfort where they learned they will have to tighten their belts even further. Cuts in federal dollars have hit the states and they are trickling down to local departments.

Purchase District Health oversees the departments in Ballard, Carlisle, Hickman, Fulton and McCracken counties.

Administrators said they hope grant dollars will soften the blow. But they are also re-evaluating services to see what already exists in the community and can be dropped within the departments

In Marshall County, they are starting by eliminating three positions.

Noel Coplen, director of the Graves County Health Department, said he will not be replacing two nurses who left. He hopes not to cut hours of remaining staffers.

"My staff have said if we need to reduce hours, they're willing to do that," he said.

But despite a state cut of $65,000, Coplen said he is determined not to cut hours.

"Everybody's going to work hard and do the best they can to see these people," he said. "Hopefully, there's not going to be a lapse in the services."

He's not the only one with that hope. Pople like Anna Senter and her family depend on these services.

"Cut something else," she said. "Don't cut the health department. We really need the health department. Everybody does."

Coplen believes his department will survive this latest round of cuts. He said for the past year, they have been reducing and eliminating unnecessary programs. But he said he does worry about Medicaid providers.

Coplen told Local 6 his department has not been paid by Kentucky Spirit, Wellcare and Coventry in the past six months. Missing out on those dollars, he said, could mean more cuts.