Public health contracts reopened

Dietetic intern Kirsten Fox measures Issiah Randle, 4, as part of the county nutrition program at the Clark County Center for Community Health on Thursday. Issiah’s mother, Satricha Randle, watches with her other sons, Xavion Sanchez, 2 months, and Treyvon, 3. (ZACHARY KAUFMAN/The Columbian)

Lydia Fifita, 27, takes a second to wrangle her kids (from left) Manoa, 4, and Demetrius, 3, while she sits down with nutrition assistant Rosalia Gustin, right, as part of the county nutrition program at the Clark County Center for Community Health on Thursday November 13, 2008. The county can't afford to keep doing the program, so they're trying to recruit a nonprofit to take it over.(The Columbian/Zachary Kaufman)

Satricha Randle, right, and her son Issiah, 4, center, watch her baby, Xavion Sanchez, gets weighed in, as part of the county nutrition program at the Clark County Center for Community Health on Thursday November 13, 2008. The county can't afford to keep doing the program, so they're trying to recruit a nonprofit to take it over.(The Columbian/Zachary Kaufman)

County health workers’ pain could be local nonprofit groups’ gain.

What’s still unclear is how sweeping changes at Clark County Public Health might affect the single moms, foster kids, HIV patients and others who now rely on the county for food, medical treatment and counseling.

Pinched by falling state and federal grants, the county health department is preparing to slice its staff by a third and instead pass along $2.1 million in annual contracts to nonprofit organizations that would provide the same services at less cost.

“Their salaries for their staff are lower, their benefits packages are not as extensive as ours and generally their overhead costs are lower,” Public Health Director John Wiesman said.

The changes, which Wiesman hopes will be finished in 2009, would cut the affected programs’ costs by 29 percent — about $800,000 annually.

Some of the six programs affected would probably remain in the county’s Public Health Center on Fourth Plain Boulevard near Interstate 5.

But different — less expensive — hands would do the work.

“For every one staff member I have, we have 20 volunteers,” said Susan Stoltenberg, executive director of Impact Northwest, one of several nonprofit outfits that might apply to take over the county’s Women, Infants and Children nutrition program. “If there’s any change that folks notice, it would be more community faces in the WIC program.”

In general, Stoltenberg said, volunteers wouldn’t be able to take on the duties that skilled county workers do now.

But she said it’s a good thing when volunteers are around to help.

“That empowers the community,” she said. “Though I’m a Democrat, I’m in favor of degovernmentalizing any service that is bringing volunteers and the community together in delivering that service.”

Wiesman said the county health department will work with the State of Washington to make sure services continue to meet state standards.

It’s the state, not the county, that will ultimately award the contracts. That’s why the changes aren’t triggering clauses in county labor agreements that forbid the direct outsourcing of workers’ duties.

“We’re not looking to have less services provided,” Wiesman said. “We’re looking to transfer this and have the same quality.”

Wiesman said the health department’s budget crunch began with a 1999 ballot issue that eliminated the motor vehicle excise tax.

The state Legislature didn’t fully replace that money. For a while, federal homeland security grants helped the county balance its budget, but those grants have been shrinking.

Local taxpayers are aiding the health department’s transformation. In January, when money stops flowing from of state and federal taps, the county’s general fund will put up $1.4 million to cover the department’s costs until all the contracts are handed off.

The county may not be able to find nonprofit groups to pick up all the services it’s seeking to drop.

If that’s the case, Wiesman said, he’ll ask county commissioners if they want to spend local tax revenues to keep the service operating.

Meanwhile, he said, what’s left of the health department may have more time to focus on what he sees as its core mission: pushing for environmental changes such as healthier diets or pedestrian-friendly neighborhoods.

“When the economy turns around again and there’s actually money, then we will be positioned to take on that new work,” Wiesman said.

Michael Andersen: 360-735-4508 or michael.andersen@columbian.com.