A Kansas Health Institute report released Sunday estimates that the proposed health cuts in the Sedgwick County budget could contribute to 65 preventable deaths each year.
The Kansas Health Institute, a Topeka-based nonprofit, estimated the number of deaths.
Commission Chairman Richard Ranzau said he thought the study was reckless and irresponsible.
“It’s just a bunch of political rhetoric of trying to push their agenda of more government in health care,” he said.
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He later added: “It’s easy for them to sit up in Topeka in their ivory tower and pontificate about what’s going on down here.”
But in an interview late Friday about the report, Commissioner Jim Howell, who is the swing vote on most budget cuts issues, said he wants to restore some of the health funding, including some for Project Access, which provides health care to uninsured, low-income families.
Right now, proposed cuts to health and human services amount to $910,374. The county commissioners will finalize the 2016 budget on Wednesday.
“There are real people behind these decisions, not just bureaucratic government programs and employees that want cuts without any consequences,” said Gianfranco Pezzino, author of the study and a senior fellow for the Kansas Health Institute, a nonpartisan organization that researches health policies.
Over time, the cuts could lead to two additional diabetes deaths, five additional infant deaths, 17 additional cancer deaths and 41 additional heart disease deaths in Sedgwick County each year, according to the report.
Pezzino said he came up with the estimate using methodology from a national study about the relationship between public health spending and preventable deaths by Health Affairs, a health policy research journal.
He said that although some preventive health programs save money down the road, some aren’t driven purely from a financial perspective.
“Other public health interventions are really more about reducing the pain and suffering rather than reducing budgets,” he said.
Pezzino said public health is not always in the business of saving money but rather saving lives.
But Ranzau said he does not see any evidence the budget cuts would lead to loss of life, citing the report’s limitation section.
The report addresses two limitations: It cannot pinpoint what year people might start dying due to lack of services, and it doesn’t account for local variations. The local and national studies estimate the death rates based off a 13-year average.
The data do not indicate the difference in death tallies year after year but rather a compilation of deaths over time.
“I can’t predict the future,” Pezzino said, adding that it would take time for some of the effects to play out. Nonetheless, he said, he consulted with the author of the national report to make sure the localized study was an appropriate use of the model.
“In my mind, it’s not so much about if you’re going to see 41 deaths next year compared to 17,” Pezzino said. “The important part is the message that’s behind it. When you do make these kind of cuts, you can expect real consequences on real people. This has an impact on the lives of the people in that community.”
Ranzau said if the Kansas Health Institute finds the programs important, it should get the money from the Kansas Health Foundation, which funds the institute.
“I want to see them put their money where their mouth is,” Ranzau said.
Howell said he plans to vote to fully restore funding for the health navigator program, which was slated for a $91,099 cut. But he wants to change the name to health coordinator.
He also said he plans to vote to reinstate some funds for Project Access, a program that donates medical care to uninsured, low-income residents. The county’s proposed budget eliminated the entire $200,000 originally earmarked for the program, which is about a quarter of the program’s total funding.
Howell said he did not want to publicly state a dollar amount he is considering for Project Access.
Howell said he supports funding those two health programs because they have a direct connection to patients. He said the other health programs being cut do not have what he describes as a direct connection to patients.
Commissioners are divided on the budget’s major goals, mainly the county’s shift to paying cash, rather than borrowing money through bonds, for roads and bridges.
Part of that divide also includes a disagreement over what are and are not core services of county government. Commissioners Dave Unruh and Tim Norton say public health is a core government service. Ranzau, Howell and Commissioner Karl Peterjohn have placed emphasis on roads and bridges.
The county plans to cut more than $500,000 in cultural and recreation funds, around $1 million in funds for health and human services and almost $1.8 million on economic development from 2015 funding levels.
The proposed budget originally included a property tax drop of $512,094. That would have saved homeowners of a $100,000 house $1.37 a year.
That has since changed. Commissioners have backed away from a property tax decrease to create a cushion in the budget. Now the question is who gets the half a million dollars.
The recommended budget includes cuts to economic development coalitions, nonprofits, the health department and cultural organizations, as well as reshaped county commitments to the Sedgwick County Zoo and Exploration Place.
Unruh has been outspoken in his support of public health, saying that any additional county money should first go to the health department.
Health officials say the proposed $48,634 cut to a county health assessment program could jeopardize grant funding for other health programs in the county.
The assessment is a collection of county health data that establishes health priorities and progress measurement in a Community Health Improvement Plan. The county health department produces the plan every three years; the current plan expires in December.
Janet Hamous, executive director for the Wichita Business Coalition on Healthcare, said health programs use the data to show progress and justify funding needs.
Without the Community Health Improvement Plan, she said, health programs would have to compete for grants with communities that do have a plan in place.
“The work that would be done as a result of that plan might not occur, and those patients that would have benefited would lose those benefits,” she said.
Ranzau, in the first public hearing, told Hamous he met with some physicians who did not think more government needed to be in health care.
Hamous said the coalition is working toward more private industry in health care but that the county is in the best position to produce the county health assessment.
For example, she said, the county is best equipped to calculate the number of obese residents.
“I don’t understand the value of it,” Howell said. “It does not touch people. It might get grants, but it doesn’t touch people.
“The value of the improvement plan is not that extraordinary. The document is not that necessary in and of itself.”
Peggy Johnson, executive director of the Wichita Medical Research and Education Foundation, said government does play a key role connecting health organizations in Wichita.
“A well-funded and well-developed health department doesn’t have to do all the programs themselves, but they become the convener of groups to form coalitions, who make changes in our community,” she said. “I do see that as being the role of the government – to be the convener.”
Contributing: Daniel Salazar of The Eagle