Public health funding: Feds giveth but the states taketh away

Public health officials didn't expect budget cuts after government promises to shore up the system following the World Trade Center and anthrax attacks.

By Victoria Stagg Elliott, AMNews staff. Oct. 28, 2002.

Public health departments throughout the country are experiencing an infusion of federal funds for bioterrorism preparedness. But in an unexpected twist, that new money may have made it easier for some cash-strapped state and local governments to slash their public health budgets.

In many cases, the state and local cuts are completely overwhelming the benefit of the federal funds, leaving public health departments in worse shape.

For example, in rural Larimer County, Colo., the Dept. of Health and Environment will gain 1.4 positions because of the new bioterrorism funds but will eliminate 15 positions because of state cuts, said Adrienne LeBailly, MD, MPH, the department's director. Her $6 million annual budget will receive $100,000 in federal money but lost $700,000 in state funding.

"We're eliminating dollars for public health programs that ... will impact more lives and prevent more deaths and injuries and diseases than will ever happen from bioterrorism in our state," she said.

The county will hold a referendum later this year to try to raise money to replace the lost state funds, and, if it passes, the cuts will be reversed. But for the time being, the department has just reduced the family planning and childhood immunization programs. More than 200 women will not have access to birth control. One thousand children will not be able to get immunized at the public clinic.

Public health systems in other areas are hurting as well. In Los Angeles County, officials already have closed 11 health centers and four school-based clinics this year and are talking about closing two of their six public hospitals. In Illinois' DuPage County, a suburban area west of Chicago, a substance abuse program for women and an abstinence education program for the schools have been chopped. [...]