Public Health Cuts Could Cost City its Own Health Department

By Riya Bhattacharjee
Thursday March 11, 2010 - 05:18:00 PM

A special City Council workshop on cuts to Berkeley’s Public Health funds revealed some hard truths Tuesday, including the possible threat of losing the city’s independent health department. The 5:30 p.m. meeting began with Berkeley’s Budget Manager Tracy Vesely briefing the council on the $14.6 million deficit the city faces in 2010-2011, including a $3 million shortfall in the Public Health Department.  

Vesely added that there were additional cuts to mental health funds—somewhere in the vicinity of $2 million—which was still being determined. 

The city hopes to tackle the gap by eliminating at least 27 employees and generating new revenue, along with imposing hiring freezes and letting vacant positions go unfilled, among other things. 

City Manager Phil Kamlarz said that he would bring back a detailed plan to balance the budget at the March 23 council meeting. 

Created more than 100 years ago, the Berkeley health department is the second oldest health department in California and offers programs in public, mental and environmental health, 

Located in six sites throughout the city, Public Health has a staff of 100 and manages a $12 million annual budget. 

State grants ($5 million) make up the biggest chunk of funding, followed by the city’s General Fund ($3.5 million) and other sources. 

The city’s Health Officer, Janet Berreman, told the council that the effect of state cuts would be felt “across the board.” 

Programs that have been hit by the state budget cuts include Maternal Child and Adolescent Health, Targeted Case Management, HIV-AIDS and Black Infant Health, which the city promised to continue at the last council meeting. 

Berreman said that 90 percent ($10.6 million) of the Public Health budget went toward personnel. 

“We didn’t get to a 25 percent shortfall overnight,” she said, listing the economic downturn, state budget cuts and structural deficiencies as contributing factors. “We don’t know what future cuts can come through.” 

Berreman said Public Health was determined to tackle the problem by introducing structural changes, increasing coordination and efficiency and grouping together similar services. 

Even then, she said, Berkeley residents should brace for “longer wait times, delays, lower intensity of service, decreased capacity for surveillance and assistance and less help for MediCal recipients.” 

Public Health nurse referrals and home visits, Nurse of the Day calls, clinic services and chronic disease prevention will also be trimmed. 

The Public Health Division was recently in the news for vaccinating thousands of citizens for free against the H1N1 virus. 

Berreman said Public Health was also implementing hiring freezes, reducing temporary and hourly employees and discontinuing funding to community-based organizations. As many as 18 positions are in danger of being eliminated, she said. 

“It’s an ongoing discussion, a very difficult discussion, a discussion every city is having, at least in California,” said City Manager Phil Kamlarz. 

Berkeley Mayor Tom Bates described the situation as “fearful.” 

“We have to be as flexible as we can, and not take on any commitment we can’t fulfill,” he said. 

Most councilmembers described the news as discouraging. 

“It’s a catastrophic problem,” said Councilmember Gordon Wozniak. “It means you just can’t do business as usual.” 

Wozniak warned that if the cuts jumped any higher, Berkeley might not even be able to afford its own health department anymore. 

“This department could just slide into oblivion,” if Alameda County takes over, Wozniak said. 

Councilmember Max Anderson said that “although the notion of the county taking over services might provide some economic relief, the quality of the services we provide are very difficult to duplicate in a county operation.” 

Besides, he said, “the county is not in a great shape either.” 

“It’s being hit by cuts from the state, we need to look for other revenue streams,” he said. 

Bates stressed that the city wanted “health care to remain local.” 

Councilmember Darryl Moore asked whether services provided by Public Health—such as the Berkeley High School Health Center—received any financial incentives from recipients. 

“Well they [Berkeley High] pay for one nurse and the space,” Berreman replied. 

“I assume the program is bigger than that?,” Moore asked, to which Berreman replied yes. 

“It’s one of those services which we assumed the program would pay for itself,” Kamlarz said. 

Berkeley mental health care worker Michael Diehl said cuts to mental health funds would only lead to more homelessness. 

Diehl said programs such as the Berkeley Free Clinic were already in jeopardy of losing funding. 

One bright spot, Berreman said, was that President Barack Obama’s Health Care Bill includes substantial support for public health infrastructure. “So it would only help us,” she said. The President has called for a vote March 18.