State Budget Could Reduce

Health District Reimbursement

By John Voket

Health District Director Donna Culbert has been following the gyrations over a proposed state budget very closely this year, because the final outcome will likely affect her ability to continue offering some public health outreach programs and services in the coming year.

And, if approved as proposed, the latest budget drafts from both Governor M. Jodi Rell and the Democrats who control both the state house and senate would strip all but one neighboring district of all state funding, compromising regional initiatives aimed at addressing and reducing Lyme disease, cardiovascular illness, substance abuse, and even emergency preparedness in the face of “a certain escalation in H1N1 or swine flu going into the winter.”

In January of this year, Ms Culbert said the Newtown Health District, which includes Roxbury and Bridgewater, along with many other town agencies, had to endure an aggressive and challenging budget process.

“It was a painful, humbling process, where an attempt was made to strike a delicate balance between maintaining the district’s operation and keeping the cost to taxpayers at an absolute minimum,” Ms Culbert recalled. “The final call was to bring the local budget request in a 95 percent of the previous 2008-2009 budget.”

Then, she said, more grim news came that state per capita funding that comes to municipal health departments and health districts through the Connecticut Department of Public Health would also likely be cut, and could even be completely eliminated.

“Since then the proposed final numbers were, and still are, a moving target,” she told The Bee Wednesday. “Fortunately for Newtown, State Rep Chris Lyddy is an active member of the Public Health Committee, and has been working hard on our behalf keeping me apprised of the action and updating me as changes keep coming in the per capita funding.”

But the latest word from Rep Lyddy brought devastating news for many surrounding towns, and what might be described as comparatively good news for Newtown, which was still slated to get some funding, however reduced.

“At this moment, it looks like it could be an approximate $10,000 cut,” Ms Culbert said. “It’s also a compound cut.”

Last November, when the local health district’s budget was originally prepared, Ms Culbert was assured that state funding to the district would at least stay flat.

“What’s important to me is that there is not much flexibility in the existing district budget to sustain more cuts,” she explained. That is because she already tendered voluntary budget reductions factoring in a flat reimbursement for the 2009-2010 fiscal cycle that began July 1.

“Layoffs are not an option at this time,” she said. “I’ve been around here for 13 years and in the private sector for ten before that, so I know that good help is hard to find.”

Ms Culbert said there may be plenty of “bodies” to fill positions previously affected by layoffs, but what she has in her current district staff is “invaluable — completely qualified, experienced, professional, dedicated employees. They fully understand and embrace the responsibilities of public health, along with its parallel responsibility of customer service.”

That means additional budget cutting to meet the reductions currently on the table at the state level will result in “significant reductions or the elimination of this year’s health education,” which Ms Culbert said includes efforts to educate the community at a variety of levels on the risks and opportunities for prevention and health promotion.

She said programming cuts would be required in the areas of tick-borne disease prevention, cardiovascular disease education, seasonal flu prevention, heart health initiatives, substance abuse and injury prevention, programs to encourage healthy habits, and even emergency preparedness.

“Our ability to afford medical supplies, primarily provided for local nurses and seasonal flu shot programs for folks who cannot afford, them will be compromised,” Ms Culbert said. In addition, paying to analyze water samples from investigations of potential pollution problems, water supply issues, or wastewater disposal will be affected.

In an email message, Rep Lyddy said while there was no reduction in funding to local and district health departments between the latest Appropriations Committee plan and SB 1801 — the latest Senate proposal — there was a reduction in funding to health departments that totaled $1.1 million between SB 1801 and SB 6365, which was the Appropriations Committee budget voted out of committee in April.

For Newtown, Rep Lyddy explained, it means Newtown will see a reduction in the $2.08 per capita in funding it gets for Newtown residents.

“It is now recommended [Newtown will] receive $1.85 per capita in funding. This is a bit of a hit; however, [it] reflects the fiscal crisis we are currently in,” Rep Lyddy wrote. Ms Culbert added that the hit is even more substantial for residents of the district in Roxbury and Bridgewater, because the per capita reimbursement for those towns is $2.43.

Rep Lyddy said because Newtown became a multitown health district in 2006, its funding was not reduced as drastically as local health departments that have not pooled together with other towns that operate as a district.

“These nondistrict health departments, referred to as part-time or full-time health departments, saw even more reductions in funding,” Rep Lyddy said. “As you remember, I worked hard with the chairs of the Public Health Committee on SB 1801 to ensure Newtown’s health district was protected and not stretched further than it already is. I think the noise I made on the Public Health Committee, and the letters your professional organization submitted sent a clear message that we should promote and acknowledge those districts already pooling resources, not strike them down.”

Rep Lyddy concluded saying the governor and legislature are working together to encourage health departments to pool together to save on administrative costs and overhead to create greater efficiencies.

“I think Newtown is a poster child for this type of initiative,” he said.

Ms Culbert said the elimination of funding to 18 health departments including neighboring Bethel, New Fairfield, New Milford, and Ridgefield could negatively impact more than a half-million state residents. In Newtown’s district, she is most concerned about the likelihood that the H1N1 or swine flu will return “with a vengeance” this fall, and the district communities will be less equipped to prevent or deal with a more severe outbreak because of the impending reimbursement reductions.

Ms Culbert said she will maintain her vigil, keeping a close eye on the eventual budget ramifications.

“I’m afraid there’s not much leeway here; we are looking at reduced services.”