The scene last Friday at the Auburn Public Health Center wasn’t especially dramatic. Just a handful of people, mostly public health workers, waving signs and wearing red shirts that said “these cuts can kill.” There was no yelling, no cops, no tear gas, no rubber bullets. But if the constant bleating of car horns was any indication, the demonstrators' message hit home.
Those fatal cuts, set to take place soon at King County Public Health, would affect the roughly 50,000 people who use the county’s health services, mostly for maternity support, family planning and for the Special Supplemental Nutrition Program for Women, Infants and Children, or WIC. Clinics in Auburn, Federal Way, Greenbridge in White Center and Northshore in Bothell are on the chopping block. Primary care services in Columbia City and Northgate are to be transitioned from the county health department to other care providers. Overall, the cuts would result in more than 200 layoffs.
This has not gone over well.
“There’s a fraction of the population who believes that people don’t need help, that anyone can pull themselves up by the bootstraps,” says Christina Enriquez, who was at the demonstration on Friday and who has been a public health nurse at the Auburn clinic for 29 years. “The truth is, everybody needs a hand up. Everybody needs support. Poverty is not a crime. Homelessness is not a crime. It’s a situation. And communities need to step up.”
Enriquez, a third-generation Mexican-American, does home visits on the Muckleshoot reservation and in Buckley and Enumclaw. She knows what her clients are going through. When she was 12, she and her family were migrant workers in Moxee in Central Washington. Back then, she says, “I didn’t know that I was poor or that I was disadvantaged as a migrant worker.”
But later, she learned how to use the services that public health offered. While she was in nursing school — pregnant and surviving on her student loans — and later as an unemployed single mother, she met with a public health nurse twice a month and depended on WIC. “As a single parent I had no luxury,” she says. “I had no money to buy fresh foods and vegetables. I lived off top ramen and milk until I got into WIC. I’ve used all these services. I know what it’s like to go hungry, I know what it’s like to be isolated and need a friend.”
Handling King County’s current budget bungle is Interim King County Public Health Director Patty Hayes, who assumed the head post just a few weeks ago, after Dr. David Fleming stepped down. After helping more than 165,000 King County residents sign up for the Affordable Care Act, Fleming said in a statement that he had come to the realization that “my personal plans and needs don’t allow me to make the long-term leadership commitment that this organization now requires.”
Now Hayes has to do the dirty work of balancing a $365 million budget that currently faces a $15 million shortfall per year for the next two years. It’s a situation that has no winners, just different shades of losers. And there appears to be no magician pulling money out of a hat to save the day.
According to a post on the department’s website, King County Public Health’s budget woes began 14 years ago, growing out of two voter-approved initiatives in two years. The initiatives, both sponsored by Tim Eyman, were I-695, repealing the motor vehicle excise tax and I-722, capping state and local property taxes that had previously helped fund public services (both measures were overturned in court but legislators later approved key features of the initiatives).
Public health has had increasing financial troubles over the past decade for a variety of reasons, including the recession and a budget unable to keep up with inflation and rising labor costs. More recently, federal payments for Medicaid patients have been steadily declining for the past several years, effectively halved, from $14 million in 2008 to $7 million last year.
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