The county government’s role in public health has changed after about $540,000 in cut positions and canceled programs.
But there’s disagreement over what that means for Sedgwick County’s health and well-being.
County health director Adrienne Byrne-Lutz said the county’s main goal is making sure community health needs are met, whether that’s through the public or private sector.
“If it means that the health department doesn’t provide some of the services it historically has: that’s okay,” Byrne-Lutz said. “We have a great public health system in place in Sedgwick County. It’s only getting stronger.”
But physicians and nonprofits in the county say local government is shying away from a leadership role in public health, with detrimental effects.
“Our board remains very concerned about the recent cuts to core basic health initiatives that we feel are the responsibility of our county government,” Sedgwick County Medical Society executive director Jon Rosell said.
Changes to the public health department in the 2016 adopted Sedgwick County budget have settled in as September draws to a close. The county cut about $539,069 in programs that measure health data and provide health education, immunizations, cancer screenings and maternal services meant to combat infant mortality.
Since the budget passed Aug. 12, the county has been shifting employees to take on different tasks and talking with private sector and nonprofit groups about partnership opportunities. Byrne-Lutz said the county has been able to largely maintain the services provided before the budget cuts, such as immunizations and cancer screenings.
While Rosell said the county has done a good job to try to minimize the cuts’ effects on the public, he said the cuts have shifted responsibility away from the county.
Health program changes
While several programs lost county funding, Byrne-Lutz says only one program has ceased to exist altogether.
A health promotion program that encouraged workplace wellness and fitness at about 70 local businesses was cut from the 2016 budget. It has yet to be picked up by any nonprofit or private group.
“There’s not anyone at this point able to go in there because it was a free service that we offered,” Byrne-Lutz said.
Byrne-Lutz says the county will continue to provide immunizations through its health department. The budget reduced immunization program funding by $89,088.
Another $38,787 in county funding was cut for a support staff member who would help a mobile nurse with immunizations at several Wichita-area sites for mothers and children in the federal Women, Infants and Children (WIC) nutritional program.
The mobile nurse may get help from other county staffers during less busy times, Byrne-Lutz said.
“When we’re able, we’ll pull someone and have them go with the nurse,” she said. “When not, (the nurses) will go by themselves and just have to handle everything, which could slow the process down a little bit. But (patients) are still getting immunized.”
Waiting times may be affected by the loss of immunization staff, Byrne-Lutz said.
“The only time where there might be a little bit more of a wait would be during flu season and back-to-school, but we’re not even sure how much that’s going to affect,” she said.
The budget also cut a position tied to the Early Detection Works program, which provided cervical and breast cancer screenings to low-income residents. But Byrne-Lutz says other staff at the county’s West Central clinic have picked up the workload.
“So we have one less medical assistant, but we have other medical assistants that we’re able to draw upon at that location to assist with these clients,” Byrne-Lutz said.
But Anne Nelson, executive director of Central Plains Health Care Partnership, a medical nonprofit, said those support staff are still crucial to quality health care.
“Support staff hold programs together and organize and schedule and do things that free up those direct service staff that are clinically trained like nurses,” Nelson said.
Out of the eight positions cut in the budget, three people were laid off, Bryne-Lutz said. The other five found work in another part of county government or elsewhere.
Commissioner Jim Howell said the important takeaway is that preventative services are still available to county residents.
“Screenings are still available and being performed. Immunizations are still happening as always. They’re not substantially changing from the consumers’ viewpoint,” Howell said.
‘Not in Sedgwick County’
Sedgwick County will finish its community health assessment plan for 2015. That plan collects data on major public health problems facing Sedgwick County.
But the county cut its tax-funded part for the 2016 community health improvement plan, which identifies strategies to address those major health problems.
“We’re not going to be able to lead that anymore because of not having a devoted person to do that,” Byrne-Lutz said. “… We’re not going to be able to lead like we have in the past.”
She said the improvement plan will continue with the county playing less of a leadership role.
“We’re going to still be very involved because we’re still going to be the warehouse, the central depository for data,” Bryne-Lutz said. “And we’ll still work with our partners.”
Rosell said that’s something the medical community is most concerned about.
“Historically, it’s always been the county health department that leads that effort and that remains true across the state and remains true across the country. But not in Sedgwick County,” Rosell said. “We’re trying to figure out who steps up to do that work.”
“In this leadership void, some other organization is going to step up and take the lead and will be responsive to what our community needs and wants,” Rosell said.
The Medical Society has done something like that before, Rosell said.
In February, the Medical Society took over a federal health grant that county commissioners rejected by a 3-2 vote. The grant, administered through the Kansas Department of Health and the Environment, is meant to help reduce the rates of obesity, diabetes, heart disease and stroke.
But other nonprofit leaders said they doubted nonprofits can fill what has been cut by the county.
“The health department is positioned in the community uniquely,” Nelson said. “No one nonprofit has that community footprint.”
Pat Hanrahan, United Way of the Plains President and CEO, said nonprofits still face a sluggish fundraising environment to take on additional programs.
“The funds just aren’t there to replace large chunks of county money,” Hanrahan said.
Rosell said the budget cuts have galvanized local health groups into being more active on their education and advocacy efforts.
“This current 2016 budget discussion has been a wake-up call,” Rosell said.
And Bryne-Lutz said the health department will still play a key role in working with nonprofits.
“The focus is on our residents so as long as their needs are getting met … that’s the important thing.”