Is It The Beginning Of The End

July 18, 2009
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Starting this month, the Kent County Health Department will have to do more with less — or just do less. Either choice isn’t particularly pleasant.

July marks the beginning of the fiscal year’s final quarter for the department, and KCHD will face those three months with $188,567 less in state funding than what it expected to receive at the start of the year last October.

The department, like every other county-run health department in the state, had its state funding cut in May following an executive order from Gov. Jennifer Granholm that sliced more than $53 million from the Department of Community Health’s budget. Of those cuts to the state health department was one for $1.53 million, funds that are targeted to county departments to provide core services.

But it could get worse. Chances are good the budget reductions made to the last three months of the 2009 fiscal year will be implemented for the entire 2010 fiscal year. If that becomes the case, the county’s health department can anticipate state funding to drop by more than $750,000 for the upcoming year that begins Oct. 1.

“Everything that we’ve been told tells us that we can anticipate those cuts remaining and that there will also be additional dollars that will be reduced,” said Cathy Raevsky, KCHD administrative officer.

The reductions were made as an effort to lower the $1.3 billion deficit in the state’s general operating fund. The governor’s executive order removed $221.8 million worth of spending from the budget. Only the $97 million in cuts to the Department of Human Services topped the reduction made to Community Health. In all, Granholm’s directive sliced funding to 18 agencies.

The biggest cut locally will be to KHCD’s core services. Restaurant inspections, sexually transmitted disease control, and the evidence-based home nursing program that provides care to low-income, first-time parents and child will suffer.

Vision and hearing screening, private and Type II groundwater oversight, on-site sewage disposal management and immunizations will also be hit hard by the funding reductions, as will communicable disease control, at a time when many health experts feel that the H1N1 virus, also known as the swine flu, will resurface later this year.

“To have those cuts come through during a swine flu epidemic when we were the epicenter for the state, that would take resources out of our ability to work those kinds of cases,” said Raevsky.

“The other thing that I’m upset about is years ago, before my time, this county got a big, black eye for the work that was being done in infant-mortality disparities. We have turned that corner. Those disparities are shrinking and the funds to do that work were eliminated. The Nurse Family Partnership and the infant mortality were the two areas where we were working to reduce disparities between white infants and black infants,” she added.

Almost $203,000 was cut statewide from the state’s funding for prenatal care outreach and service delivery support. Over the course of a full fiscal year, that reduction would exceed $800,000. Another $350,000 in cuts was made to immunizations in the governor’s order, which comes to $1.4 million for a fiscal year.

Besides putting core services in serious jeopardy for the future, the cuts come at a time when the county felt the state wasn’t picking up its fair share of the tab for those offerings in the first place.

Raevsky told HQ last year that counties across Michigan were trying to get Lansing to keep the pledge it made to fund core services at a 50-50 ratio with counties. As of early 2008, the state was only supplying about a third of the dollars that county departments needed for those services, according to the Michigan Association for Local Public Health.

The cost to all county-run departments reached $523 million three years ago, which marked a 33 percent increase for the local agencies in that expense over a decade. As far as Raevsky is concerned, cutting funding even more adds a fiscal insult to an already festering financial injury.

The cuts means KCHD will eliminate at least 10 positions from its staff; those job losses come on top of the 70 the department has shed since 2003.

“When I came to this department, there were about 350 (employees), so that’s about a quarter of the entire staff,” said Raevsky of the 80 or so layoffs.

“And I don’t know what’s going to happen with our county dollars because counties are in trouble too.”

The KCHD budget for 2009 totals $26.6 million. Nearly $9.6 million of that amount, or 36 percent, comes from the county’s general operating fund. The county’s appropriation for this year was up by almost $1.6 million from the $7.9 million it gave KCHD in 2008.

Raevsky said she spoke with County Administrator and Controller Daryl Delabbio about the lost state dollars. But she also knows that the county may be facing a $15 million deficit for the general operating budget in 2010, meaning there will be few if any additional dollars available for her department.

“It’s really not a happy time. It was right after people had spent virtually their entire weekend here at the office over swine flu, and that’s the people the state is basically saying to cut those positions or cut funding to those resources. It’s not just the folks in Kent County, but it’s folks all over the state,” she said with a tone of frustration in her voice.

“It’s rough times everywhere and they’re getting rougher, and they’re going to get rougher still. When it’s going to start getting really ugly is going to be in the future, not what it’s been in the past.”  HQ

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