July 17, 2008
Public health services in jeopardy from King County budget shortfall
Legislature must act on stable funding source for public health
The projected shortfall in King County’s general fund could jeopardize a variety of public health programs including disease control and direct care at public health clinics, according to the chair of the King County Board of Health who today called for action by the state Legislature to authorize a long-term, stable funding source for public health programs across the state.
“Public health supports services that are critical to the fabric that holds our community together, and King County’s funding is the foundation on which these services are built,” said Councilmember
Julia Patterson, chair of the Metropolitan King County Council and chair of the
Board of Health. “This is not just a King County problem, this is a statewide problem, and the state Legislature must provide a stable revenue source for public health.”
T
he budget for Public Health is $193 million, of which $31.8 million is supported by the King County general fund. However, with King County projecting a $68 million gap between revenues and expenses in its 2009 budget, Public Health is preparing for a reduction of at least $10 million in services in 2009, with more cuts likely in the following years if no long-term, stable funding solution is found.
“This is the bottom rung of the safety net,” said Dr. Bud Nicola, member of the Board of Health. “Without these services, people have nowhere else to go.”
When voters adopted Initiative 695 in 1999, they also repealed a major source of funding for public health in this state – the Motor Vehicle Excise Tax – and the state Legislature has not identified a permanent source of revenue to replace it, whether from state funds or some form of local option. Since then, local governments have backfilled the gap from their general funds, with some lesser, temporary funds from the state that haven't met the rising costs of providing critical public health services or the additional decline of federal funding.
"Public health is the preemptive strike against disease among our entire community,” said Scott Armstrong, President and CEO of Group Health Cooperative. “Public health is pivotal to our efforts to improve health and reduce healthcare costs. We all benefit when communicable disease outbreaks are prevented. Our community is a better place because we've worked together with strong leadership from our Public Health department to assure all of our children get the care and coverage they need to thrive."
Patterson, Nicola and Armstrong spoke at a news conference at the Columbia Public Health Center that preceded an afternoon meeting of the Board of Health, where members discussed potential strategies for addressing the public health budget crisis.
Services at risk of cuts due to the County’s general fund shortfall include those that provide direct care for vulnerable populations and those that protect the general public.
Direct care for vulnerable populations: In 2007, 143,025 people were served in Public Health Centers, of whom 107,096 were below the poverty line. 44,657 people had no insurance, and 77,554 visits required interpretation services. Critical health services for vulnerable populations include:
• Family Support Services: Assures that babies are born with the best opportunities to grow and thrive by providing assessment, education, skills-building and case management services to at-risk pregnant women and families with children. 32,869 people served.
• Family Planning: Reduces unintended pregnancies and reduce/prevent STDs by providing family planning and STD screening and treatment to low income women, men and teens. 16,577 people served.
• Immunizations: Protects against the spread of communicable diseases by providing immunizations to children and adults. 30,080 people served
• WIC: Improves pregnancy outcomes and children’s health, growth and development through food vouchers and healthy food and nutrition education. 46,789 people served through Public Health sites.
• Oral Health: Prevents dental disease and resultant poor health in low-income people by providing preventive or restorative dental care. 20,088 people served.
• Primary Care: Improves health and reduces disease in low-income, vulnerable populations by providing access to a medical home, preventive screening, obstetric care, acute and chronic healthcare services. 17,266 people served.
Protection for the general public: Critical health protection programs for the general public include:
• Communicable Disease Control: Investigates and prevents communicable diseases and provides prevention services for HIV/AIDS, sexually transmitted diseases (STD), and tuberculosis. Public Health investigates over 6,000 notifiable condition reports annually, and manages and treats approximately 140 cases of TB. In 2007, Public Health’s STD Clinic diagnosed 25 percent of all HIV cases in King County.
• Child Care Health: Improves the health and safety of children in child care programs, through services such as multidisciplinary consultation (nursing, nutrition, mental health), and health and safety training for child care providers. In 2007 the program made 4,901 visits to childcare facilities, and served 4,352 childcare providers through 198 trainings.
• Environmental Health Fee-Based Programs: Protects residents from diseases and other hazards by ensuring clean drinking water, controlling nuisances like rats and mosquitoes, collecting local hazardous waste, and inspecting more than 10,000 food establishments, including 900 schools and non-profits.
• Medical Examiner’s Office: Tracks and investigates sudden, unexpected, or unnatural deaths and performs other essential services for the criminal justice system. The Medical Examiner assumed jurisdiction over 2,123 deaths in 2007.
Exact details of proposed Public Health reductions will be known when the King County Executive submits his 2009 Executive Proposed Budget to the King County Council in mid-October.
