Snohomish Health District faces over $4 million budget shortfall; 35 workers to be laid off

The Snohomish Health District is facing a $4.4 million budget shortfall that could jeopardize programs to fight communicable diseases and promote maternal and child health. Administrators say 35 employees will likely be laid off in November as part of the first round of cuts.

The reductions come as health departments around the state face similar funding crises. The economic slowdown has meant plummeting tax revenues for the state and local governments that fund public health at the same time rising medical costs make it harder for families to afford private care.

King County announced in July that it may have to close some public-health clinics because of a loss of $10 million in county funds. Tacoma-Pierce County Public Health Department cut $1 million earlier this year and expects to cut another $1 million next year. Clark County Public Health Department faces $2.4 million in cuts next year.

"We're decimating our ability to provide health services to the public," said Rick Mockler, deputy director for the Snohomish Health District. The Board of Health is expected to take action on the proposed cuts Sept. 9.

The budget crisis is particularly bitter for the Snohomish Health District because until this year it had a reserve fund to meet an economic downturn or public-health emergency. In 2004, city and county elected officials that make up the district's 15-member board directed the district to spend down its $7.4 million in savings.

Dr. Ward Hinds, who retired as health officer for the district in 2007, said the county, which hadn't increased funding for the district in a decade, said it wouldn't provide additional money as long as the district had such a large cash reserve.

"We always thought it was prudent to maintain the reserves to weather a financial storm. Now it sounds as though our predictions came to pass," Hinds said.

But Snohomish County Councilman Dave Gossett, who has served on the Health Board since 2002, said the Health District should have made cuts to staff and programs as its spending continued to exceed revenues over the past several years.

"They have a long history of saying they were in trouble when they weren't and not planning well when they were," Gossett said.

Snohomish County, which in 2008 provided $3 million of the district's $23 million budget, is facing its own deepening financial crisis. Earlier this week, officials were told that the projected shortfall for 2009 had grown from nearly $4 million to $9 million.

County Executive Aaron Reardon on Monday directed other elected officials and department heads to not fill open positions without prior approval from the finance department. He also restricted overtime and temporary help and said all out-of-state travel requests must be authorized by his office.

Public health enjoyed a dedicated stream of revenue from motor-vehicle excise taxes until 1999, when those were repealed by voters in Initiative 695. The Legislature backfilled 90 percent of the lost funds but did not increase funding in subsequent years even as health care and labor expenses rose. In addition to the county and the state, Public Health receives funds from grants and sales-tax revenue.

At the health-district offices in Everett recently, several young mothers waited with their newborns for appointments with public-health nurses. Snohomish County doesn't operate primary health-care clinics, as does Public Health — Seattle & King County, but they do provide immunizations, prenatal services and nurse-family partnerships for the first three years of an infant's life.

Indeed, some of the responsibilities most identified with public-health departments — detection and prevention of communicable diseases such as tuberculosis, whooping cough and chlamydia, restaurant and water-quality inspections and early-childhood development — are all funded by state and local dollars and so are most vulnerable to budget cuts.

"The real tragedy is that these programs are central to what public health ought to be doing," said Health Officer Dr. Gary Goldbaum, who took over for Hinds in 2007. Goldbaum noted that reducing his staff of 260 by 35 employees will save only about half the estimated $4.4 million shortfall. The total number of layoffs, he said, "could be much, much higher."

Public-health nurse Barbara Bly started with the Health District in 1979. Since then, she said, the county's population has grown and become more diverse at the same time the number of doctors who provide prenatal care has decreased.

Bly said the nursing staff are worried about their jobs, but more worried about the services they offer.

"If you eliminate nurses, you're eliminating important programs for the community. We'd like to see the community stay as healthy as possible."

Lynn Thompson: 206-464-8305 or lthompson@seattletimes.com