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Public Health - Seattle & King County

Public Health budget update

Updated Wednesday, September 24, 2014 at 04:09 PM

If you have comments about the proposed budget, you may email them to public.health@kingcounty.gov or leave a voicemail message at 866-852-3004. Your comments will be forwarded to the King County Executive's Office.


Public Health pursuing solutions to federal, state budget cuts
Health reform enables transition for some services, but serious reductions loom
2014 Adopted Public Health Budget Pie Chart
Proposed reductions would come primarily from the two areas in red. Click image to enlarge for details.

A decade of dwindling financial support has taken its toll on King County's public health services – and now a $15 million annual shortfall is forcing difficult choices. A strategic proposal calls for transitioning some services to community organizations, while making regrettable reductions in services where federal and state funds have been cut.

Finances for Public Health—Seattle & King County have been precarious ever since voters repealed the major source of funding for Public Health 14 years ago, and a voter-approved cap on property taxes restricted the remaining source of local, flexible funding.

This gap was partially patched in recent years by creating efficiencies, spending one-time reserves, securing outside grants and special funding, and reducing staff – including a major round of layoffs in 2009. Now, however, reductions to federal payments for administering Medicaid and other cuts have pushed the agency past a tipping point.

To operate with a balanced budget, Public Health will need to reduce staffing and services.

If adopted by the King County Council in November, the proposed reductions could lead to major changes at five Public Health Centers.

Two of those centers – in Columbia City and North Seattle – would transfer primary care services to other healthcare organizations, as health reform has made it more feasible for providers to take on more patients. The department is in discussions with NeighborCare and Harborview/UW Medicine to make those transitions in 2015.

Greenbridge will stay open through a partnership with Planned Parenthood of the Great Northwest. This partnership will allow WIC/MSS services to continue to be provided by Public Health staff at Greenbridge. However, Public Health staff will no longer be providing family planning services at the site. Family planning services will be available to clients through Planned Parenthood, which will be consolidating its West Seattle clinic in Greenbridge and leasing the space. This partnership preserves essential services for clients.

Federal Way was proposed to close, but thanks to wage concessions made by Public Health staff and support from the City of Federal Way, the Center will remain open.

Unfortunately, inadequate funding means two other Public Health Centers may have to close: in Auburn and Northshore in Bothell. While the Northshore Center would close, one of its satellite clinics would remain open.

Site-closure proposals were made with the goal of maximizing services to as many clients as possible. Support services for pregnant women and children will continue to be offered at seven other locations in King County, including Seattle, Federal Way, Greenbridge, North, Kent, Renton and Eastgate. Family Planning will continue to be offered at Federal Way, Eastgate, and Kent, with service provided by Planned Parenthood at White Center Public Health Center at Greenbridge.

Prevention services also face reductions

More broadly, reductions would impact a range of core public services – such as reducing the capacity for disease investigations, and curtailing Public Health work on tobacco and obesity prevention. (For more examples and details, see additional links above.) Core public health work serves the entire community to improve the health and well-being for everyone. Some of these services and activities include:

  • Infectious disease control;
  • Chronic disease and injury prevention;
  • Public information that people need to stay healthy,
  • Data collection and assessment to understand health status of all residents
  • Work to build partnerships and plan for the transformation of the health and human services system to meet the demands of a post-Affordable Care Act environment.

EMS and restaurant inspections not impacted

Most Public Health funds come from grants, levies or fees that are dedicated for specific purposes, and cannot be shifted to other services. For example, emergency medical services (EMS) are funded by levy dollars that can only be used for EMS. Restaurant inspections are paid for by fees.

The proposed cuts would not impact all areas of Public Health. Most will occur in three areas that rely on more general funding: Public Health Centers, Prevention Services, and services provided through the Director's Office/Administration such as administration, assessment, community partnership development and public information/communications.

Public Health’s financial picture remains difficult in the long term. The state did not fully replace the loss of MVET funding over 10 years ago and the funding the Department does receive from federal and state sources is static or declining. Public Health will continue to carefully manage of its budget through delivering efficient, quality, and innovative services. Ultimately, though, to avoid additional eliminations of clinical services and core public health services that keep the whole community healthy, we need a new, adequate and stable source of funding.

Read more about the Executive's budget for Public Health.

Timeline:

  • The King County Executive's budget has been forwarded to the King County Executive
  • King County Council will adopt a final budget in November
  • All current services will be maintained at Public Health Centers while decisions about the budget are in process

The health department has been providing crucial services to the community for 125 years, protecting health, preventing injuries and chronic diseases, and providing access to quality care. That mission will continue in a changing funding environment.