CHARLESTON, W.Va. — The 49 local health departments in West Virginia will have to operate with 25 percent less funding for basic health services if Governor Earl Ray Tomblin’s proposed reduction to state aid for those departments remains in the final 2017 budget.
“We were anticipating a five, maybe ten percent cut which would have hurt, but would be survivable,” said Dr. Lee Smith, health officer and executive director of the Monongalia County Health Department.
“This, I think, is going to create some real difficulties for, particularly, the smaller health departments.”
Smith was in Charleston Wednesday for an emergency meeting of the executive council for the West Virginia Association of Local Health Departments.
The meeting was organized in response to what adds up to a $4,000,000 total cut to the current funding level for health departments in the new budget submitted to the Legislature under the line item for state aid for local and basic public health services like environmental health, epidemiology, communicable diseases, health promotions and surveillance.
State Chief Health Officer Rahul Gupta said that health systems statewide have to become more modern.
“We’re currently operating in a 19th century apparatus. We really have to take this opportunity to modernize into a 21st century system of operations,” he said. “That realize billing for services, electronic health records, getting accreditations ready. Ultimately that results in a self-supporting system.”
Going forward, leaders of local health departments are being told to hold meetings to discuss the possible reduction and how it could affect local citizens and health department functions.
Each department has been charged with developing a contingency plan for absorbing the cut, if Tomblin cannot be persuaded to reconsider using statewide data that’s being gathered.
In Randolph County, Linda Sanders, administrator for the Randolph-Elkins Health Department, estimated the proposed reduction would add up to a loss of $60,000 annually in funding.
“That’s a large cut, 25 percent, when you look at the budget and other programs weren’t cut that much,” she said, asking, “Where is the health of West Virginia if you cut basic public health services?”
In addition to state aid, funding sources for local health departments include county and municipal support, service fee income, grants and fundraising.
Julie Miller, administrator and nurse practitioner for the Boone County Health Department, said county level funding in Boone County has been reduced by between 45 percent and 47 percent this year.
“When you’re in public health, you learn how to work miracles,” she said when asked how the department was still operating. “We’re there to protect.”
Officials with local health departments have been involved in the response to the 2014 Freedom Industries chemical spill in Kanawha County, tuberculosis outbreaks, vaccinations and health care training regarding potential Ebola outbreaks, as examples.
They’re charged with inspecting food establishments and work to ensure that hotels, nursing homes, day care centers and other facilities are operated in ways the protect the public’s health.
“If public health is working correctly, it will always be in the background. The only time you see public health in the foreground is when there’s some sort of problem,” Smith noted.
“People take it for granted until, like in Kanawha County, they had the water thing or you have a large disease or a food outbreak. You don’t have those things because local health departments are doing their jobs,” she said.
“They’re doing what they’re supposed to do — protect the public.”
Gupta said that with the impending budget shortfall, the whole state has to work together.
“We’ve got to become better stewards of public resources and improve effectiveness of our work, while enhancing efficiencies,” Gupta said. “We’ve seen the state’s budget challenges; that’s no secret. We haven’t hit a bottom yet and we’ve all got to do more with less. Across communities, every West Virginian is being impacted by these challenges.”
It’ll likely be March before West Virginia lawmakers finalize the 2017 state budget. Tomblin does have line item veto power.