The News-Gazette

Health agencies in Danville, elsewhere in Illinois, hold out hope for federal money

Tuesday, June 29, 2010

DANVILLE – People keep calling and asking, why aren't you open on Fridays any more?

Steve Laker, administrator of the Vermilion County Health Department, answers by reminding people of the deep budget cuts that forced the county health department to begin closing one day a week and discontinue many of its services – among them testing for pregnancy and sexually transmitted diseases, Friday TB and STD clinics, family planning clinics and blood-lead testing.

"'Where are you?'" Laker says callers ask, especially about those Friday services. "Well, we're not there anymore, and neither is the clinic."

Vermilion County is among the many local health departments that have been forced to make deep cuts since the recession began choking off their funding sources.

The state of Illinois currently owes the Vermilion County Health Department $800,000, Laker said, and he doesn't have any idea when any of that money will arrive.

The Rock Island County Health Department – another local health department in Illinois that is cutting many of its services, among them smoking cessation, STD testing, vision and hearing screening for kids and breast and cervical cancer screening for uninsured women – is waiting on $900,000 worth of overdue payments from the state, Assistant Administrator Theresa Foes said.

Rock Island County health officials hope these program cuts are temporary, Foes said.

"We don't have enough money to make payroll with these delayed payments, and we're borrowing against the tax levy we get and we're using all that up, and we just can't go on with the level of service we had," she added.

For Vermillion, Rock Island and other local health departments in the same boat, there is a sliver of hope for a some federal money in the second half of this year's $500 million allocation from the Prevention and Public Health Fund that was created by the health care reform bill, the Patient Protection and Affordable Care Act.

The first half of this year's allocation will be spent on boosting the primary care work force, and the second half announced last week will be used to support disease prevention activities and to develop the nation's public health infrastructure.

"We're hopeful that money might help us," Foes said.
Laker said it's something for local health departments like his to keep an eye on, "but it's that old adage, the devil is in the details, and nobody knows any details yet."

That second $250 million will be divided into four areas, according to the U.S. Department of Health and Human Services: $126 million for community and clinical prevention, $70 million to support local and state public health infrastructure, $31 million for data collection and analysis and $23 million for public health training.

The National Association of County and City Health Officials, which represents the nation's 2,800 local health departments, had recommended the year's entire $500 million and next year's $750 million allocation be spent on core public health infrastructure expenses, community preventive and wellness services, prevention task forces, prevention and wellness research and CDC infrastructure.

The organization wanted to see the highest amount – 44 percent of the money this year and next year – go to community preventive and wellness services.

NACCHO Executive Director Robert Pestronk said this year's $250 million for public health and prevention will have to stretch way too far to make much of a dent in any one local health department's budget.

"None of this will be very much to replace the losses that local health departments have sustained," he said.

Between January 2008 and December 2009, 23,000 of the 155,000 jobs in local health departments across the nation have been lost as a direct impact of the recession, he said.
"And those effects are not done," he added. "We're still hearing and probably will hear for another year-and-a-half to two years of additional staff losses as communities adjust their budgets."

Even if all next year's allocation and the higher allocations coming in subsequent years are spent on public health, Pestronk advises viewing that money in the framework of the multi-trillion dollars America is spending on medical care every year.

The Centers for Medicare and Medicaid Services projected U.S. health care spending would reach $2.5 trillion last year.

Meanwhile, services and programs that keep people from getting sick in the first place remain a hard sell on every level, Pestronk said. People don't tend to miss them until they get sick on water from wells and food from restaurants that don't get inspected and disease outbreaks that may have been prevented.

"Everybody should be able to get fixed when they're broken, but part of what is needed is trying to keep people from getting broken in the first place," he said.