Physicians, educators and medical students, one after the other, stepped onto the podium at two budget hearings with a common message to county commissioners: Avoid cuts to public health programs.
The 2016 Sedgwick County budget adopted last week averted $266,099 in cuts to two health programs meant to improve access to care, especially among low-income residents.
Jon Rosell, executive director of the Medical Society of Sedgwick County, said the cuts to “core, fundamental public health functions” would have ramifications for the county.
“We’re very concerned about the result of those cuts,” Rosell said. “They won’t be immediately apparent, but in time, we will certainly feel the effects of these cuts in multiple different ways.”
The health department will lose $539,069 in programs that measure health data and provide health education, immunizations, cancer screenings and maternal services meant to combat infant mortality.
“We see first-hand, every day, the effects of chronic disease, poor lifestyle choices and other health-care related issues that research has proven public health initiatives can positively impact,” Rosell said.
One recent study said the health cuts are a matter of life and death for some Sedgwick County residents.
But commissioners say the most important programs were spared and that the cuts were necessary given the county’s strained revenue.
“When you look at the individual decisions that are made throughout this whole budget, there is a rationale and a reason behind it,” Chairman Richard Ranzau said during the budget’s adoption.
‘Phasing out services’
County health officials say they will start shutting down programs that didn’t get funding.
“We will be phasing out services in the next six weeks and will dialogue with community partners about ways to meet as many of the public health needs as possible,” said county health department director Adrienne Byrne-Lutz.
The health navigator program was the only health department program that got full funding after it was originally recommended to be cut. It provides health care access information and materials to residents through one-on-one conversations or in group settings at churches or civic organizations.
Several programs will end, including health promotion and health educator programs that were intended to encourage residents to make healthy lifestyle choices.
The budget also cut a program that provided breast and cervical cancer screenings for women ages 40 to 64 who are underserved or uninsured, and a specialty immunizations program aimed at low-income families participating in the federal Women, Infants and Children nutritional program.
“It’s removing one point of access for many in our community to be able to determine the presence, or lack thereof, of cervical or breast cancer,” Rosell said.
In all, the budget will cut eight county health positions. Those workers will receive three months of benefits with the first month including salary.
“Their last day of employment will be (at) the end of September,” Byrne-Lutz said.
In the 2015 budget, the health department had the equivalent of about 150 full-time employees.
Byrne-Lutz said the county will complete its community health assessment for 2015.
But tax funding for next year’s assessment was eliminated.
Rosell said the assessment is a basic yardstick for measuring the health of the community and the effectiveness of health programs and initiatives.
“How do we know if our communities are getting healthier if we don’t measure it?” Rosell asked. “That was the sole purpose of the community health assessment.
“Unfortunately, 10 years from now, we’ll look back at this time, and there will be gaps in our data,” Rosell said. “We will not be able to measure how healthy or unhealthy this community was.”
Byrne-Lutz said the county will continue to provide breast and cervical cancer screenings and immunizations. But she said the loss of three support staff members related to those programs will have an impact.
“Waiting times will increase, especially during peak times such as back-to-school immunizations and flu season,” Byrne-Lutz said.
‘The new normal’
The budget passed by a 3-2 vote, with Commissioners Jim Howell and Karl Peterjohn supporting a version proposed by Ranzau.
Commissioners Dave Unruh and Tim Norton voted against it, saying the cuts were too deep and unnecessary.
The majority of commissioners defended the cuts, including those in the county’s health funding. They said tough decisions are required in a “new normal” of stagnant tax revenue.
“The things that are left over in cuts to the health department don’t touch people,” Howell told The Eagle.
Commissioners said the county is still heavily invested in improving public health.
“We’re still spending over $11 million in the health department,” Ranzau said.
They said the impact of cuts to health screenings and immunizations is overblown.
“This is just a move towards efficiency,” Howell said. “Anybody who wants to get immunizations in Sedgwick County can do so with the program in the proposed budget.”
Rosell said the most important thing is that people will still be able to get screenings and immunizations through the health department or elsewhere.
“If, by collapsing three specific immunization programs into one, we use our tax dollars more efficiently, we applaud that,” Rosell said.
But, he said, by and large, the local medical community is “scratching their heads” at the cuts to public health.
“I think there’s a general disbelief that those programs will be eliminated,” Rosell said. “They’re that basic and fundamental to a community public health initiative.”
▪ Eliminate health promotion program: $156,251
▪ Reduce immunizations program: $89,088
▪ Eliminate one position in Healthy Babies program: $77,562
▪ Eliminate free health screenings program: $57,119
▪ Eliminate tax-funded part of community health assessment: $48,634
▪ Eliminate health educator program: $46,628
▪ Eliminate immunization program to reach WIC families: $38,787
▪ Reduce Project Access funding: $25,000
Human services cuts
▪ Eliminate Challenging Behaviors program: $85,480
▪ Eliminate contract with KANSEL: $84,500
▪ Eliminate foster grandparent program: $23,326
▪ Reduce Non-Profit Chamber of Service funding: $10,000
▪ Eliminate funding for Envision: $6,400