Budget Blues, by Frances Smith

It's budgeting time for next year, and we are trying to figure out how to continue public health services in Coos County, with the available funding. Budget hearings are likely to occur in May, with adoption of the county budget in June. We recently participated in an assessment, along with all the other county health departments in Oregon, to compare our capacity to meet national standards for local health departments. We found that we need 8 additional positions to do the work to meet basic standards. Eight is also the number of positions that we have lost since FY 2006/07, or about 20% of our workforce, so it's clear that we have a deficit. The most recent cut in services is our maternity case management program. The Medicaid reimbursement is too low, and we lack other funding to provide the service. It's hard to let go of a prevention program that helps pregnant women, because the consequences of a healthy (or unhealthy) pregnancy are lifelong.

Funding for public health is a mix of federal, state, and local tax dollars, plus private grants, fees, and donations. Local tax dollars are in short supply, and the expected demise of the federal timber payments to counties is a significant factor in cuts for many county services. The money we receive from the state and federal government for family planning, WIC, communicable disease control, immunizations, HIV prevention, and other programs is determined by legislators and political agendas. We are hoping the importance of public health programs is not lost in the scramble for tax dollars, and that the future holds promise for a stable base of funding. In the meantime, we are continuing to serve thousands in our community....