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Manatee health department skirts U.S. trend

The Manatee County Health Department has skirted a national trend that has seen local health departments across the United States reduce staff and cut services because of budget shortfalls.

But as Florida and Manatee County governments continue belt-tightening, local health officials are struggling to avoid joining the ranks of the nearly half of departments surveyed by a national group that made cuts during the second half of 2009.

Manatee health department Administrator Jennifer Bencie Fairburn said her organization is “planning for the worst, hoping for the best” as it prepares next year’s budget.

Local health officials are waiting to make sure Gov. Charlie Crist signs the 2010-11 state budget — the deadline is Friday — and watching a legislative proposal that could streamline operations at the Florida Department of Health.

Manatee County also is looking to trim $24 million from its budget thanks to an expected tax revenue shortfall. The Manatee Health Department receives about 10 percent of its funding from the county. The state provides most of the rest, along with some federal grant funds.

“It’s a national trend, not something unique to Florida. We’ll continue to work to combine our efforts to maximize resources that are available to us,” Bencie Fairburn said. “In general, we are confident right now that we’re in a stable position depending on what happens with the state budget in Tallahassee and with the (state health) department.”

Nationwide, 721 local health departments surveyed early this year by the National Association of County & City Health Officials have suffered the loss of 23,000 jobs, either through layoffs or attrition, since 2008. Half of those surveyed cut back service they provide the public in the past six months.

The survey raised a warning flag that continued staff and budget cuts could compromise health services, especially disease prevention and early child development.

The Manatee County Health Department, one of 20 Florida departments to participate in the survey, saw its total budget rise from $9.6 million in the 2008-09 fiscal year to $10.4 million in the 2009-10 fiscal year, according to public information officer John Burns. But much of that increase came from $566,000 the department received to fight H1N1 flu and $26,763 in federal stimulus funds.

The number of employees at the Manatee department also increased in 2009, from 155 in January to 174 in December. But that increase also was attributable to H1N1 flu funds: The 19 temporary workers hired for flu vaccinations accounted for the difference.

The survey indicated health department job losses across the country would have been even worse if not for one-time funding like H1N1 flu money and federal stimulus. While 38 percent of the health departments reported a lower budget in 2009 compared to 2008, the number increased to 53 percent if the one-time funding was subtracted.

Forty-six percent of the departments surveyed were affected by job losses, including layoffs and attrition, during the second half of 2009. That represented 8,000 jobs lost and, combined with two earlier surveys, brought the cumulative total to 23,000 job losses since January 2008.

Fifty percent of the health departments surveyed made cuts to at least one program area during the second half of 2009. Twenty-eight percent made cuts to three or more program areas.

Of those that cut programs, 25 percent cut disease prevention services, and another 25 percent cut maternal and child health services, according to the survey.

“We are getting farther and farther away from true prevention,” according to a comment from an anonymous survey respondent. “To stop disease we do contact tracing rather than education and screening. To stop waterborne illness we respond to bad water tests rather than work to make all wells safe. We respond to Child Protective Services referrals rather than run parenting classes.”

Here, the county health department contracts with Manatee County Rural Health Services for primary care, maternity, dental and HIV/AIDS case management. That has helped the local department keep its prevention services intact.

“We’re unique in that we don’t do primary care here like they do in other areas of Florida. Our primary focus is on environmental and prevention efforts,” Bencie Fairburn said.