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    Tight budgets force cuts to King County Public Health

    Clinics in Auburn, Federal Way, White Center and Bothell are on the chopping block. Bad news for the 50,000 people who rely on them for care.
    Auburn protestors register their dismay at looming cuts to King County's public health services.

    Auburn protestors register their dismay at looming cuts to King County's public health services. Credit: Zachariah Bryan

    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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    Posted Thu, Aug 28, 5:11 a.m. Inappropriate

    But at least the County still has money and has placed a priority for a Foot Ferry. Toy boats over toddlers.


    Posted Thu, Aug 28, 9:46 a.m. Inappropriate

    So levy a tax on junk food, fast food and/or cigarettes to fund public health. $15 million a year is nothing.


    Posted Thu, Aug 28, 6:55 p.m. Inappropriate

    Tax the poor to pay for their healthcare? Kind of like a 'user fee' then.


    Posted Mon, Sep 1, 6:56 p.m. Inappropriate

    I think we need a tax on "progressive" yuppie smugness. I'd say $1,000 a head, and double if you ride a bicycle.


    Posted Thu, Aug 28, 9:56 a.m. Inappropriate

    Disregarding the issue of whose silo of money is whose, what I see is that we have sidewalks, dedicated bike lanes, painting on street surfaces and special signage for bicyclists, and all the money the transit mavens can figure out how to spend for all kinds of transportation, not to mention stadia, and a new parks district for Seattle so the wealthy can have the waterfront of their dreams, but the electeds cannot, or will not, divert or prioritize some of that money to assist the poor with necessary health care. No wonder many are disgusted with government. I think we should be taking care of human health first.


    Posted Thu, Aug 28, 10:46 a.m. Inappropriate

    If the County health district has enough money to "conduct home visits on the Mukleshoot Reservation" the County health district has enough money. Maybe too much.


    Posted Thu, Aug 28, 11:15 a.m. Inappropriate

    City, county, and state government do NOT lack for money. If a program is curtailed, it's because the "progressives" don't like it.


    Posted Thu, Aug 28, 2:39 p.m. Inappropriate

    How interesting that people don't understand that money earmarked by the legislature or the federal government cannot be spent on anything else. I think some commentators should take a civics course where they might learn these things.


    Posted Thu, Aug 28, 8:13 p.m. Inappropriate

    If the "progressives" who run King County wanted to keep the clinics open, they'd do it. Instead, they'd rather buy more bike lanes and stripe crosswalks. Everything for the yuppies.


    Posted Thu, Aug 28, 9:53 p.m. Inappropriate

    King County has a "general fund" that they can do whatever the heck they want with. If they wanted to pay for public health they would. King County (along with other local municipalities) put levies on the ballot to pay for basic services while diverting existing tax money to pet projects. Its a joke and my fellow Seattleites fall for it every time.


    Posted Thu, Aug 28, 11:23 p.m. Inappropriate

    Obamacare will solve all of this. He told us so! Change we can believe in.


    Posted Fri, Aug 29, 8:34 a.m. Inappropriate

    It'll solve part of it. There will be less reliance on public health clinics by people who now have insurance who couldn't afford it before. I thought that it was interesting that there wasn't much in the article about whether or not the patients served by the clinics were going to regular primary care clinics now.

    I did find an article that said that the number of patients being seen in some public health clinics in Arkansas dropped by 75% since Obamacare started. Those patients are now going to regular doctors.


    Posted Sat, Aug 30, 6:29 p.m. Inappropriate

    "the number of patients being seen in some public health clinics in Arkansas dropped by 75% since Obamacare started. "

    Wanna bet they'll want more money for public clinics anyways?


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