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Public Health ailing from uncertain funding
Island County’s Public Health Department is suffering from symptoms that seem to be part of a statewide condition — unpredictable funding and rising costs.
To help remedy the situation, Island County leadership is taking a closer look at public health programs during upcoming budget talks.
“We’ll have a conversation about if we want to have dedicated funds (for Public Health),” said Island County Commissioner Jill Johnson.
Public Health oversees a wide range of services including maintaining birth and death records, HIV/AIDS testing, and monitoring the county’s wells and aquifers for toxins.
These programs are primarily funded by state and federal grants, along with fees for services like immunizations and septic system inspections.
But grants are not always issued each year and collecting fees for services can be unpredictable.
“The way we’re funded is very complex,” said Public Health Director Keith Higman. “We’ve evolved into a system that is funded by fees, grants and local contributions. One of the things they (commissioners) are getting frustrated with is that it’s unpredictable. Grants go up, go down, or go away.”
As the cost of equipment and staff has increased, that has created a budgetary shortfall in recent years.
“It is completely frustrating in the sense that you can’t control that funding source on a local level,” said Johnson. “It’s variable and completely out of our control.”
During last year’s budget process, the commissioners gave Public Health $415,000 —about 15 percent of its budget — to make up the difference.
Like most Island County departments, Public Health experienced deep budget cuts after the 2008 recession.
Higman said he cut 37 percent of the budget over an eight-month period, which translated to the loss of eight positions.
Two of those positions were reinstated but lack of funding thwarted Higman’s attempts to continue to build back the department.
As the county begins its budget process for 2015, Higman and county commissioners are looking at ways they can lend some stability to Public Health.
At a recent work session, Higman outlined for commissioners the options of coming up with some type of dedicated funding, such as a per capita amount or a percentage of the current expense fund, or even pushing for help on a state level.
Higman said seeking legislative help on a state level is not an overnight process.
“You need to find a champion in Olympia, a chair of a committee with some seniority, to pitch this,” Higman said. “Timing is everything and sponsorship is everything.”
Commissioner Helen Price Johnson, who has advocated for various county initiatives in Olympia over the years, agrees that the issue is bigger than Island County.
“This is not unique to Island County,” Price Johnson said. “It’s a statewide issue. I don’t think it’s something we’re going to be able to solve locally.”
She stressed the importance of Public Health programs, especially during unexpected emergencies like the pertussis and swine flu outbreaks in past years.
“When public health is needed, there really is no substitute,” Price Johnson said.
While Johnson said she agrees with Price Johnson’s push for a statewide change, she believes the short-term solution is going to need to come from a county level.
“This is the option we have,” Johnson said. “We need a designated funding source. I feel like you fund it like any other priority. If we want the services Public Health is providing, we need to put money toward that from current expense (fund). That’s how we do every other department.”
The county’s Public Health Department is broken up into three divisions.
Assessment and Healthy Communities applies for grants, gathers and analyses data, plans and organizes community health activities and programs, and provides staff for citizen health boards.
Community and Family Health operates the county’s Women, Infants and Children program, oversees infectious disease control, does HIV/AIDS testing and education, and maintains birth and death records among other services.
Environmental Health provides septic system inspection services, monitors the county’s aquifers and wells for quality, maintains the county’s solid waste program, provides shellfish resources, issues outdoor burn permits, and handles pollution control and correction.