PUBLIC HEALTH
The price of health Keeping Texas healthy is costly BY CRYSTAL CONDE Maintaining an adequate local public
health infrastructure is increasingly difficult in the wake of budget cuts. Last summer, the Lubbock City Council proposed outsourcing surveillance, sexually transmitted disease (STD), and immunization services to trim about $1.2 million from the city’s budget for 2012–13. In response to the plan, many Lubbock physicians, health pro- fessionals, medical students, resi- dents, and Lubbock-Crosby-Garza County Medical Society Alliance members rallied to advocate for public health services to remain under one roof within the City of Lubbock Health Department. (See
“Keeping Lubbock Healthy,” Janu- ary 2012 Texas Medicine, pages 39–43.) Attempts by Lubbock city offi- cials to outsource clinical health services for efficiency could sig- nal a statewide trend, according to W.S. “Chip” Riggins Jr., MD, MPH, executive director and lo- cal health authority of Williamson County and Cities Health District (WCCHD).
Department of State Health Services (DSHS) Regional and Local Health Services Division, says state appropriations to local health departments for services such as immunizations, tuberculosis (TB), and STD prevention haven’t changed much for fiscal year (FY) 2012, which runs from September 2011 to August 2012.
“I believe that if public health
“I think it’s clear that regardless of what happens with health care reform, funding the medical mod- el alone can’t create healthy com- munities or ensure that we reach our community goals for health and reduction of health dis- parities. Our local public health agencies need to be made secure enough in their role and funding to serve as facilitators of a collaborative and proactive process to continuously improve the health of their communities,” said Dr. Riggins, a member of TMA’s Council on Science and Public Health.
James Morgan, MD, assistant commissioner of the Texas
agencies continue to be funded to be the safety net for clinical, communica- ble, indigent health care ... we will see communities struggle.”
A broad look at the budget shows immunization funding re- mained the same from FY 2010- 11 to FY 2012–13 at $169.7 mil- lion. HIV/STD prevention funds dropped $28.5 million from FY 2010–11 ($362.6 million) to FY 2012–13 ($334 million). Funding for TB falls under the infectious disease program, which went from $84 million in FY 2010–11 to $81.6 million in FY 2012–13. Dr. Morgan notes that “any
reductions in funding at the pro- gram level — infectious disease, for instance — don’t necessarily translate to reductions in local health department contracts.” “While DSHS has seen a re- duction in the amount appropri- ated under the HIV/STD preven- tion strategy, for example, there won’t be a major change in the amounts contracted with local health departments for STD ser- vices, or immunizations or TB for that matter,” he said.
State and federal funding for family planning, which some health departments provide, as
well as federal funding for emergency preparedness and pre- ventive health, is another story. The state budget for family planning services went from $111.5 million for FY 2010–11 to $37.9 million for FY 2012– 13, including federal funds. DSHS isn’t aware of any additional
February 2012 TEXAS MEDICINE 41
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