Public health is a budget casualty

Sac’s top doc, Glennah Trochet.

Sac’s top doc, Glennah Trochet.

While talking with Dr. Glennah Trochet, Sacramento’s public health officer, last week about the recent new report of tick-borne illness (see “Small bites, big diseases,” SN&R Frontlines), we also had a chance to talk about the budget for public health. The news is not good. Funding for the public health officer’s staff and operations comes from Sacramento County’s general fund, with the various cities also chipping in a little, and from state and federal sources. A good deal of the prevention funding comes from matching grants, which require some funding to be in place in order to qualify for more.

And the recent budget crunch has hit public health hard.

We’ve lost 60 percent of our staff in the last two years,” Trochet told me. “We’ve lost a good deal of support from the county general fund.”

She reminded me of our conversations about the possibility of an influenza pandemic last fall (see “Superflu!” SN&R Feature; October 15, 2009), and how she’d explained the “surge plans” that her department had in place if we had a worst-case scenario, with one-third of the citizens sick at the same time.

Those surge plans are toast. “We certainly do not have the surge capacity that we have planned for,” Trochet told me, “and all of these surge plans will have to be adjusted.”

The public health department held flu-vaccination clinics last fall and winter, which were provided at no cost for the most vulnerable patients. “In all that activity from December and January for flu clinics, we used a lot of volunteers, but we also had a number of employees that are no longer with us,” Trochet said. There’s no sign that funding will be restored any time soon, and that has implications for everyone’s health. The public health officer’s staff is the first line of defense in any public health emergency, including outbreaks of infectious disease. Right now, the area is seeing an uptick in cases of whooping cough, potentially deadly for children, and no walk in the park for healthy adults. A bad flu season or an outbreak of food-borne illness could seriously tax the county public health officer’s ability to respond.

“It’s going to be very challenging if we have a public health emergency that requires us to use one of those plans,” Trochet said.

She’s pretty calm, a good thing in a public health doctor. County residents, however, should think seriously about doing some shouting about cuts to this program—it is one of the basic needs we all share, and one that only government can fulfill.

Compiled from Kel’s Hot Flash.