Hypothetical health cuts delivered

Public health services in Island County will suffer when the budget axe falls in 2003, though Health Director Tim McDonald said on Thursday his department is seeking to keep immediate impacts to a minimum.

At the request of the Island County Commissioners, McDonald has drawn up a proposal for enacting the 11 percent cuts expected to hit government departments across the board. Under McDonald’s preliminary proposal, the departments of Environmental Health and Nursing & Personal Health would be the hardest hit, losing about $19,000 and $45,000 respectively.

Not wanting to appear defeatist, McDonald nonetheless warned that, compared to this year’s cuts (approximately $33,000), plus the loss of funding expected in the coming years definitely will translate into decreased services to the public at large.

“We’re past the easy cuts,” McDonald said. “We’ll do the best we can, and look at cuts that do the most good for the most people. There will be impacts, though.”

The health department expects to lose almost $65,000 in county funding next year, which McDonald called “a relatively trivial amount of money” compared to the heavy cuts that are certainly coming at the state level. Perhaps the most dreaded loss of state revenue would be the expected removal of the Motor Vehicle Excise Tax replacement funds, which amounts to a loss of $76,701 for the county’s Nursing Services.

Other state grants in jeopardy are those for Child Protective Services ($22,188), Alcohol Treatment Services ($20,000) and Developmental Disabilities Activities, which is slated to lose $200,000, or almost half its total budget.

“The state and county have a very fixed and decreasing capacity to raise revenue,” McDonald said, “and, on the other hand, an increasing set of needs and demands.”

He said legislative changes in the way health departments are funded have left counties without any way of generating revenue for public services. Because cities no longer contract with Island County for health services, “counties are totally left holding the public health funding bag,” he said.

Recent initiatives such as I-695 and I-747 have removed taxing authority, and with the loss of so-called I-695 or MVET backfill money, the voters and legislature have “put counties in a real pickle,” McDonald said.

And this, he added, “in an atmosphere where all the county’s funds are being reduced, too.”

According to McDonald, Island County in particular is faced with big budget problems due to its situation as a rural region of rapid population growth.

“There are two factors in Island County that make it a little more difficult,” he said. “First, we just keep growing. And the second factor is relative to other counties in our region, we don’t have a good revenue source,” he said, in so far as there are no significant commercial districts or heavy industries on the island that would provide a solid tax base.

“I don’t see any light at the end of the tunnel,” McDonald said regarding the current budget crisis and the county’s ability to generate additional revenue. “The fact of the matter is we’re going to have to provide services with less money. You really can’t review this and not see that.”

Because the health department is mandated to serve the public-at-large in the areas of providing, for example, clean water and food and response to outbreaks of communicable diseases, cuts in service are bound to impact everyone. However, McDonald said, the economic realities of decreasing government services conceivably will have more severe affect among the poor, who might not be able to afford such things as immunization.

“Some of these lost services are going to hit those with low incomes harder,” he said. “If you’re wealthy, you just buy the service from someone else.”

This in turn “pokes a hole in the concept of population service,” McDonald adds, in that anyone who can’t afford to get inoculated against an outbreak of a particular illness puts everyone at risk.

“The whole community is going to be exposed to the disease,” he said.

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