4/16 Board of Health Mtg
Greetings all who care about healthcare—
As I always say, these are my notes, not authoritative minutes. I am always open to corrections, and this week I have a correction to the JH Commissioner's meeting notes from March that relate to the discussion of the proposed JH levy lift:
The dates you gave are all for 2026, this year. The funds however won’t be available until 2027. It’s on the agenda next week to consider an August or November 2026 date.The current levy is only $.05/$1,000. My wife and I pay $38 per year. We can go as high as $0.75, so that’s where the $70 more per $100,000 of property value came from. In addition, the tax revenue we collect now is less than $500,000 per year and is NO WHERE NEAR the charity care we give. Our total bad debt, charity care and other discounts is $12million per year.
A huge thanks to everyone who has supported Friends of Public Health, either by donations or handing out flyers. Friends of Public Health won a Public Health Heroes Award for the work, but if you read about the budget cuts that are coming, our Public Health Dept will be facing a tough next few years, along with every other public entity and every other health-related entity. (I really want to editorialize here on all the easy ways to fix this—tax the rich, end the capital gains tax cuts, end the stock-buyback loophole that has created the super-rich who pay nearly nothing in taxes, implement universal healthcare, and amend the WA constitution—but I'll skip it for now.
April 16 Board of Health Meeting
Public Comment:
I commented on a recent newspaper article about possible delays in the arrival of Title X funding from the federal government, noting that if there is a delay, the community would want to know about it. (Angela comment: See answer below in the Dr. Berry section.) I also cited a Wall Street Journal article with the first tranche of analysis on the number of people dropping their ACA health insurance plans because of the loss of federal subsidies to make insurance premiums more affordable. Nationally, around 14% of Americans did not pay their first monthly premium bill, which effectively cancels their health insurance. (Angela comment: In a separate conversation I had with one of the healthcare providers at PH, she noted that they are seeing a slight increase in the number of patients coming in.)
The Agenda and minutes were approved.
Public Health Update:
Governor Ferguson has signed the operating budget. The letter the Board of Health was working on last month regarding Foundational Public Health Services (FPHS) funding was sent to the Governor and to the 24th LD legislators. Rep. Adam Bernbaum noted that funding should be better the year after next (2028). The tax revenue from the vaping tax was not set to support only Foundational Public Health Services funding, so this means $21 million in funding will be lost statewide for the fiscal year starting in July. There was a read out on the Connectivity Fair. PH was present for the Friday Youth Summit, the CHA/CHIP project was present to demonstrate a survey as a word-cloud and introduce the CHA dashboard. PH will have multiple retirements in the coming year, and there is a county-wide hiring freeze.
JH Report:
There will be a blood drive on Wednesday, May 6 from 0900-1500. Kees briefed on the JH update on the SANE program (Angela Comment: see the notes from the March 13 JH Commissioner’s meeting - email Angela if you want a fresh copy). JH is preparing for the 2027 Medicaid cuts and is looking at doing a levy lift to help pay for the increased charity care that JH will provide (Angela Comment: JH’s look at the numbers has resulted in an estimate that 3,000 people in the county will lose access to health insurance due to Medicaid and ACA cuts. This was reported several months ago at a JH meeting). Kees also briefed on the continued budget struggles of OMC.
Dr. Berry:
We have moved out of the Covid, RSV, and flu season. All three are still present in the county but not in high numbers. There has been a recent Covid death in the county, a person in their 60s who was undervaccinated. PH is tracking measles - there are 1,700 diagnosed cases in the US, but they are being undercounted. Idaho has no reported cases but the virus is present in the wastewater, which demonstrates that the disease is in circulation. Anyone traveling with an infant over age 6 months can get vaccinated if they know they are traveling to an area with a measles outbreak. There is one pertussis case in Jefferson related to the outbreak in Mason County. Regarding the Title X funds, there has not been a delay that they know of but they will report it to the community. The state received the notice of Title X late, but the state was prepared when it hit and they were able to distribute the money to the counties on time.
PH Funding Discussion:
There was a long discussion of the sections of HB 2442 that speaks specifically to public clinics and how FPHS reductions from the state might be offset in other places. April 27th is a working meeting for the Board of Health on how the funding might look locally. HB2442 contains 10 different spending packages, and the public health clinic is one line of it. The best guess of how the law will play out is that it will allow counties that run public health clinics to do a one-time jump in the property tax to a new level of 5 cents for every $1,000 specifically for the county-run public health clinics for low-barrier access to healthcare. They are asking the Department of Revenue for guidance on the pathway forward. The funds won’t be available until 2027. This bill (now law) contains other components related to other topics including schools, childcare, environmental impacts, etc. There was a question on when the County Commissioners would make a decision on this property tax and when the budget would hit. The answer on the budget was Jan 1, 2027. (Angela Comment: Jan 1, 2027 is also the date on which the Medicaid work requirements go into effect.) There are different mechanisms for each of the 10 funding areas, so it will not always be property tax increases. It was noted that WA’s regressive tax structure will always disproportionately harm people at the lowest income levels.
Further details on the budget cuts to Foundational Public Health Services:
(Angela Comment: Apple shared a spreadsheet I couldn’t see from where I sat.) The 2026 shortfall FPHS funding was $3.4 million for the whole state. Jefferson’s share of this was $130,000. The state asked for counties with an underspend to send money back, and some counties were able to. Because of this shortfall from the state, PH ended their core unhoused program and ended a water capacity core team. For the next fiscal year, 35 health departments over 39 counties will lose $21 million. There is a working group at the state level to look at how to approach the cuts in an equitable way depending on populations, income, disease prevalence, and a number of other factors. The committee will look at how these cuts get implemented. There will be a discussion of the coverage of essential and nonessential services, and the working group is trying to figure out how to do the cuts. As planned, the system will hit smaller counties harder. There will be things that have to get cut. The list of things that PH is legally mandated to do does not include all the things that PH care deeply about. There was a question on how small rural populations can comment to help influence and inform the discussions. The working group consists of PH officials from all sizes of PH departments. The smaller counties are pushing back against the influence of the larger counties. (Angela Comment: If the cuts to the next fiscal year budget ($21 million) are in any way proportional to the cuts to this fiscal year’s budget (130k/3.4 million), then PH’s budget could potentially lose around $803,000.)
They then moved into the Public Health Heroes awards. The list of those selected are here. Thanks to everyone who worked on the Friends of Public Health fundraisers last winter and this year. You are truly making a difference in the lives of the young people in this community.
Update on the High School Design-Build project:
The PT School District is using the same firm that did the design-build on the hospital. The Lincoln Building will be coming down in June. The space where the Lincoln Building is now will be the bus loop route. Blue Heron’s School-Based Health Clinic got the funding needed to move the clinic into their permanent space.
Future Agenda Topics:
There is a need to keep talking about FPHS funding as the situation becomes more clear. There should be a finance and budget update at each meeting. The opioid settlement funding just went through the deliberation process. There should be a bylaws review at some point, as they have not been reviewed in roughly 3 years. There was a discussion of a Board of Health 101 for the community so that folks know what the Board of Health is and what it does. There should be more discussions on the possible new sales tax to benefit children and families.
