Contra Costa Health Cuts Stem from Budget Shortfall

By Richard Brenneman
Tuesday April 18, 2006

Faced with a budget crisis, the Contra Costa Health Department has proposed $12.8 million in cuts that would eliminate 88 jobs and reduce some key services. 

The job figures don’t include cutbacks in positions filled by contract workers from private agencies and health care providers. 

The largest cuts—$5.5 million—would come from the department’s enterprise fund, moneys that can be used for a variety of program services. 

Other specific cuts of $2.7 million would come from mental health services, $2 million from public health and $811,853 from alcohol and other drug services programs. 

“The cuts were necessary because of a shortfall in anticipated county revenues,” said county Health Director Dr. William B. Walker. 

“The cuts will hurt, but they’re not a fatal blow. We are not closing any clinics or removing any people from eligibility,” he said, “although the cuts may result in longer waiting lists.” 

Contra Costa County is unique in California in the level of services it provides residents, offering a county health plan with a sliding premium scale that covers families and individuals at up to 300 percent of the official poverty level—or a $58,000 annual income for a family of four. 

“Residents can get care in clinics, hospitals and labs and prescriptions from our pharmacies. We had over 400,000 outpatient visits at our clinics last year,” Walker said. 

While the cuts come from funds allocated through the county’s general fund, the largest share of the department’s $684 million budget comes through mandated programs funded by the state and federal governments. 

The department employs a staff of 3,500. 

Similar cuts have been mandated in all other branches of county government, Walker said. 

County hospital staff positions earmarked for cuts include the Director of Nursing, the symptom control coordinator, the chief of CardioSupport Services, the head of the Clinics Dental, the assistant lab manager, two part-time anesthesiologists, three part-time surgeons, the ambulatory care clinic coordinator and seven hospital security officers (including the assistant chief). The proposal would also slash funds for hiring contract radiologists. 


Mental health cuts include: 

• Two mental health clinical specialists at the West County Children’s Mental Health Outpatient Clinic and three similar positions at the East County clinic. 

• Closure of Summit Center, a facility that provides court-ordered treatment for up to 20 boys with serious emotional disturbances—a measure that could wind up costing the county more through placement in private or state facilities. 

• Reduction in psychiatric services at the Chris Adams Girls’ Center, the Orrin Allen Boys’ Ranch and Juvenile Hall through the elimination of one psychiatrist, the reduction in hours for a second and elimination of a clinical mental health specialist assigned to juvenile probation. 

• Elimination of funds for art therapy and housing coordination services for the mentally ill in the East County. 

• Elimination of the program’s disaster plan coordinator. 


Public health positions and programs slated for cuts include: 

• Elimination of the equivalent of 1.25 public health nurse positions, which would eliminate home visiting services to 141 of the country’s most medically vulnerable infants. 

• Elimination of 2.8 community health worker positions would reduce outreach and enrollment programs for health coverage and cut plans to deliver the services through school districts and churches. 

• Cutbacks in the operation of the Health of Wheels program, a savings of $337,000 that would reduce immunizations, checkup and treatment of minor illnesses and injuries in Western Contra Costa County. 

• Reduction in public health nursing care for foster children and services provided by the Women’s, Infants and Children’s program 

• Elimination of 24 clients from the list of AIDS cases managed by the department and reduced testing for the disease. 

• A $226,000 cut eliminating 1.5 public health nurse positions that will result in decreased monitoring and follow-up of tuberculosis patients. 

• A $125,000 cut to the department’s Homeless Outreach program that would halve the services available to the urban homeless throughout the county and eliminate 2,000 contacts a year. 

Clerical and accounting positions are also slated for cuts. 

The county would also close outpatient pharmacies in Richmond, Pittsburg and Martinez, eliminating 16 positions in the process. Residents will still be able to receive their prescriptions through contracts arranged with private pharmacies, Walker said. 

One of the cuts for alcohol and drug abuse treatment programs is a $35,333 reduction in funds for Neighborhood House, a substance-abuse facility in North Richmond. The department’s substance-abuse program manager would also be eliminated. 

Another $152,000 would be taken from domestic violence programs education and training services. 

“Hopefully, we won’t have do this again next year,” Walker said. “State revenues and property tax funds were not increasing fast enough to meet projections.””