Last week, Washington state Senate Republicans unveiled their $43 billion, two-year budget blueprint and allocated no additional dollars for foundational public health services. Zero. Zip. Nada.
On Monday, House Democrats followed with their own proposal, a $44.6 billion budget that includes good news for the state Department of Health and all of us who rely on it. There is $36 million in new money to be allocated among the 35 local public health jurisdictions, and an additional $4 million to modernize and address health inequities among residents.
John Wiesman, the state’s health secretary, was pleased with the House majority’s budget. “It’s recognition of the essential work we do to protect Washington’s families and communities from communicable diseases and other health threats.” While he believes the state has a $300 million public health funding gap, he’s a realist.
Consider it a down payment on legislation the House passed earlier this month asking state and local health agencies to collaborate on a 21st century public health plan, setting minimum standards for protection and a schedule for improving programs.
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Wiesman says the Senate budget proposal, by contrast, would cripple DOH’s capacity to keep the state safe.
While we can’t put a precise number on how much more money is needed to tackle growth in public health concerns, we can safely say it’s well above the GOP’s zero — particularly at a time when mumps and measles outbreaks serve notice that the Puget Sound area’s mobile, cosmopolitan population is vulnerable to infectious diseases.
In 2016, with a budget of $175 million, Washington DOH investigated nearly 30,000 communicable disease cases, saw to it that 85 percent of kindergartners were immunized and monitored 21,000 water systems, among a host of other duties.
As Wiesman told The News Tribune Editorial Board last week, “There’s nothing on that list people don’t care about.” But he said he’s told the governor he can no longer guarantee all public health responsibilities are met.
These days, Olympia has eyes only for McCleary, the Supreme Court decision ordering full funding of basic education within a year. Lawmakers are toiling to find at least $1.5 billion in additional revenue for schools. Naturally, they’re a little distracted.
But the lack of bipartisan political and financial support for public health is worrisome. The state’s paramount duty to provide K-12 education gets vastly more complicated as soon as a serious infectious disease emerges in classrooms or lead shows up in school water fixtures.
Surely communicable and chronic disease control, injury prevention, foodborne and waterborne illness safeguards, maternal and child health should be represented somewhere on the GOP’s priority list.
Must we trot out the old proverb that an ounce of prevention is worth a pound of cure?
Let’s not wait for the stink, the crisis, the next hospital superbug or animal-to-human transmitted disease. It’s the Legislature’s job to prepare a state for all challenges, not just the ones subject to daily fines issued by the Supreme Court.
During the recession starting in 2008, funding for local health departments took a hit; bigger counties like Pierce saw budgets cut by 10 to 20 percent; six counties saw their health budgets cut in half.
Dr. Anthony Chen, director of the Tacoma-Pierce County Health Department, says those reductions were an impetus for innovation: Face-to-face food handlers’ licensing classes went online, video phones made up for staffing shortfalls, and local agencies consolidated resources.
But adaptation and entrepreneurship go only so far. As Chen told the TNT ed board, diseases have no regard for timing or borders. A crisis in another county — such as tuberculosis, Legionnaires’ disease or a potentially deadly strain of avian flu — could become a crisis in our own backyard.
Over the next several weeks, state lawmakers will negotiate their priorities for 2017-18. Let’s hope core public health services are among them.