January 23, 2012 11:11:00 AM
By JERRY MITCHELL
JACKSON -- Legislative budget writers want to slash the state general fund appropriation for the state Department of Health to $20.7 million -- the lowest level it has seen since 1990, when it received $20.3 million.
That recommendation comes at a time when the state ranks first in the nation for adult obesity, teen birth rate and infant mortality; second for hypertension; and third for diabetes and cancer death, according to the 2012 Public Health Report Card the department and the Mississippi State Medical Association released last week.
In addition, last year, 28,943 new sexually transmitted disease cases were reported in Mississippi, including 550 from the virus that causes AIDS.
If the $20.7 million budget is approved, "it would devastate the critical functions of the Health Department," said Dr. Luke Lampton, chairman of the state Board of Health.
"The state would pay a huge price in infant mortality, in HIV prevention and treatment if we don't fund the department at its basic, functional level."
He said the cuts would actually go much deeper because much of state funding goes to match federal funds, which provided $169 million last year -- more than half the department's $351 million budget.
Health Department officials say they need $30 million just to meet basic needs and another $6 million to match a $13 million Ryan White grant, which would provide HIV-related services for those who lack health care coverage or can't afford to pay for treatment.
Fifteen years ago, when the Health Department ran out of funds for the Ryan White program, it was on the verge of cutting 660 Mississippians off of their only source of life-sustaining drugs.
If lawmakers fail to provide $30 million in funding, "are they actually going to have to shut down the Health Department?" asked Sen. Terry Burton, R-Newton, vice chairman of the Senate Appropriations Committee. "Fire nurses? Every agency always asks for more."
He said the funding may be more like $28 million, but he wants to see all the department's figures.
"We can't look at any one budget like the Health Department," he said. "We've got to look at the overall amount for spending."
Besides the general fund, the Health Department gets $27 million in state funds targeted for specific purposes: maternal and child health care, an early intervention program and child therapeutic services, and rural health care.
The state budget starts with education, which takes up 60 percent of that spending, Burton said. Of the 40 percent that remains, "what do we do with the Health Department?" he asked. "We can only give them so much and fund everything else."
He said it's possible "we might be able to come up with special funds to fill in a hole here and there."
State Health Officer Dr. Mary Currier said if the department doesn't receive $30 million, services will have to be cut.
"The number of Mississippians we serve is 2.9 million -- the entire population," Currier said.
The department operates 99 clinics, providing health care for thousands of Mississippians. The clinics also give vaccines for children and adolescents as well as flu vaccines for all ages.
Across the state, officials inspect drinking water and places that serve food to the public to make sure they are safe. Officials also test and track diseases, managing outbreaks.
State Rep. Steve Holland, D-Plantersville, said he voted against the $20 million recommendation, saying the department desperately needs the $36 million.
"This is no time to turn our backs on them when they are making progress," he said. "We can't live without the Health Department."
Lampton said the quality of the state's health system "is what differentiates us from the Third World. States around us spend four times more than we do."
In fiscal 2010, the Health Department received about $29 million in state funding -- less than a tenth of the $325 million that Alabama has for its state public health budget.
Only Montana, Nevada, New Hampshire, North Dakota and South Dakota spend less on their public health budgets than Mississippi. All have smaller populations.
In fiscal 2011, Mississippi's Health Department received $25.9 million in funding. To make up the shortfall, the department was able to use $4.3 million in leftover tobacco funds. In fiscal 2012, the department received $26.5 million in funding and made up the shortfall with $4.1 million in leftover tobacco funds.
Now that all the leftover tobacco funds have been exhausted, the department faces the possibility of even deeper cuts -- with no way to make up the shortfall.
"We're going to have to be funded at a higher level just to maintain basic services," Lampton said. "I'm very hopeful the legislative leadership will look at this problem in its complexity, and funding will be provided."
Lack of funding would have a devastating impact on the department, which is turning the corner in a number of areas and now ranks No. 1 in childhood immunizations, he said. "We're making progress, but we've got to be funded to keep making progress."
Health Department officials are hoping for a reprieve.
"That ($20 million) is a starting process," said Mike Lucius, senior deputy and chief administrative officer for the department's Office of Health Administration. "We're anxious to see what those numbers hit at."
Because the federal government typically doesn't give out its money up front, the department could face another issue with cash flow, he said. The department could find itself having to make up $6 million to $8 million in federal funds before they arrive, he said.
The increased need for money comes at the same time the state is seeing slower growth with general revenue expected to grow only 1.3 percent, down from last year's 2.3 percent.
On top of that, because of the loss of federal funds, the state budget is $300 million less than last year, Burton said. The Health Department is responsible for oversight in areas some Mississippians may not realize, Currier said. For instance, department officials provide revolving loans to enable cities and others to update their water systems.
The department inspects hospitals, nursing homes and many other entities, including tattoo parlors, she said. "If we are successful, nobody knows about us."
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