County plans to shed some health services

Squeezed between shrinking funding and expanding costs, public health officials are proposing staff cuts and the transfer of several programs to community partners.
It's all part of what John Wiesman, executive director of Clark County Public Health, calls the stark reality of a $4.8 million budget shortfall - 13 percent of the $36 million that would be needed to continue current services for 2009 and 2010.
Wiesman posed the key question - "How do we do the least damage?" - last week to a public health advisory group.
After previous rounds of cuts, "We believe every service is essential," ­Wiesman said.
Health officials hope to shift some programs to other groups. The department's leadership team evaluated 32 programs, and identified six top candidates:
• HIV outreach and HIV counseling and testing.
• Some emergency preparedness (recruiting Medical Reserve Corps volunteers, outreach to vulnerable populations).
• Home-visiting nurse services for some at-risk families and children.
• Support for foster children.
• Family-planning nursing service at the Community Services Office.
• The Women, Infants and Children nutrition program.
WIC is a high-visibility program that serves 15,000 women and children a year here, and also puts more than $5 million into the local economy.
But it isn't necessarily mandated for public health, Wiesman said. Nonprofit agencies, with smaller payrolls and lower overhead, might be better able to run the program with existing funding, he said. That's happened in other parts of the state.
"We'll start in the next week or two, seeking partners," Wiesman said.
"But nonprofits also are pinched," he added. "We'll have to see how real this is."
There is another issue with that partnership process: Even in a best-case scenario, it won't be an immediate handoff.
"We want one-time, one-year funding through 2009 to find partners and make a responsible transition," he said.
On the personnel side, job cuts could reduce the staff by a third, ­Wiesman said.
The department proposes cutting the equivalent of about 20 full-time positions by the end of the year; 34 more full-time slots are candidates for cutting by the end of 2009. That's 54 full-time equivalents in a work force of about 148.
Clark County is not alone, Wiesman said. Other public-health departments around the state are going through the same process, and "some are starting reductions immediately."
Budget-cutting is only a short-term response, Wiesman said. Something must happen to improve funding, or else Clark County and its counterparts across the state will have to repeat the exercise.
"We will still be looking to the Legislature for funding, or in two years, we will be $3 million in the hole," he said.
A formal budget proposal must be completed by November, Wiesman said. After public review, it will be considered by the county commissioners in December.


Update

• Previously: Two months ago, local public health officials said they were looking at a $4.8 million shortfall for 2008-2009.
• What's new: Clark County Public Health has proposed reducing staff and transferring several programs to other community organizations.
• What's next: A formal proposal must be completed by November for public review and consideration by county commissioners. update rail partners

Tom Vogt can be reached at 360-735-4558 or at
tom.vogt@columbian.com
.