Health districts alarmed at continued underfunding during pandemic
Connecticut has been underfunding local health districts for years, compared to the $1.85 per capita the state is supposed to give under state statute, and health directors were unhappy to learn Monday that they will continue to be underfunded for the fiscal year that began Wednesday.
"This pandemic has made it clear that Connecticut's history of cuts to local health is irresponsible and dangerous," Steve Mansfield, director of health for Ledge Light Health District, wrote in a letter Wednesday to the legislature's Appropriations Committee, asking for help.
He continued, "The statutory allocation to local health districts of $1.85 per capita is inadequate to perform the activities associated with the delivery of the ten essential public health services required by statute. To make matters worse, this already low amount has been underfunded in recent years."
Ledge Light — which covers East Lyme, Groton, Ledyard, Lyme, New London, North Stonington, Old Lyme, Stonington and Waterford — gets money from the state but receives most of its funding from municipalities, grants and fees.
Mansfield said Ledge Light supports "a huge amount of our activities with grants," but he's concerned for health districts that get minimal grants and are therefore more reliant on municipal and state funding.
On Monday, health districts got a letter from the state Department of Public Health saying their funding from the state is being reduced by 8.5%, compared to the statutory level of $1.85 per resident of the health district.
For example, with a population of 151,295, Ledge Light should be getting $279,895.75. But the state is giving the district $256,140.09.
That's $2,345.79 more than what the state gave Ledge Light for the fiscal year that just ended, when the state underfunded districts by 10%. According to a spreadsheet Mansfield provided, Ledge Light was funded below $1.85 per capita for four of the past five years.
Uncas Health District — which covers Bozrah, Franklin, Griswold, Lebanon, Lisbon, Montville, Norwich, Preston, Salem, Sprague and Voluntown — is getting $168,541.68 from the state this year, with a population of 99,553.
The overall dollar amount to health districts is the same this fiscal year as it was last year, Office of Policy and Management Secretary Melissa McCaw explained in an email to legislators. The funding level increased from 90% to 91.5% because of population changes and one town losing its grant due to a declining population.
McCaw explained that when the appropriation falls below the statutory amount, the statute instructs the DPH commissioner to decrease the grants. "The issue is that the legislature enacted an appropriation that is less than the full formula," she wrote.
The General Assembly passes biannual budgets, meaning the budget passed in June 2019 covers the fiscal year that just ended and the current one.
Sen. Cathy Osten, D-Sprague, co-chair of the Appropriations Committee, said the legislature wanted to undo the cuts — a decision she said was made in OPM — and make the health districts whole this year. But the legislative session was cut short by the pandemic.
McCaw said that between stimulus dollars from DPH, the Municipal Coronavirus Relief Fund Program through OPM, and Federal Emergency Management Agency reimbursements, local public health districts "have strong financial support."
Patrick McCormack, director of health for Uncas Health District, said his district has received only $5,600 in federal coronavirus funding so far through DPH, and that went toward overtime, travel and modest supplies. Mansfield said Ledge Light is receiving only $40,463 of the $20 million the state has received for pandemic response.
Mansfield and McCormack both said the 8.5% reduction was news to them on Monday. Mansfield said he budgeted for a 10% cut, while McCormack said the Uncas Health District board projected only a 5% cut when doing budget planning in March.
"Our hope was that there would be a discussion at the state level as to how to keep us whole, under the circumstances," McCormack said.
McCormack said Uncas Health District typically gets about 12% of its budget from the state, 40% from member municipalities, 35% from grants, 12% from fees, and 1% from other income.
While the state funding is $1.69 per capita this year, municipalities contribute $6.81 per person to Uncas Health District, while Ledge Light bills its municipalities $7.37 per person.
'This is a marathon, not a sprint'
Sen. Heather Somers, R-Groton, a ranking member of the state's Public Health Committee, voiced concern that municipalities would have to increase their contributions.
She acknowledged that the state is not in a good fiscal position because of the pandemic and revenues are down because people aren't working, but she questioned why the upcoming $350 million in raises to public employees can't be delayed, as has happened in other states. She feels that money could be reallocated to health districts.
"Of all the places to look for a reduction, the priority seems to be very skewed with this choice," Somers said, later adding, "God forbid we have another surge in the fall."
While the state notes that funding this year is consistent with last year's appropriation, McCormack noted that "this year is not consistent with any year we've had before, due to the pandemic. I think what it comes down to is we feel we serve a critical role right now. I mean, we're already underfunded, and our feeling is, this is a marathon, it's not a sprint."
He rattled off a list of new functions Uncas Health District has had to perform during the pandemic: responding to 11 member towns about prevention guidelines and reopening strategies, working with day care providers, generating new data, doing contact tracing, delivering personal protective equipment.
And this is on top of non-coronavirus-related activities health districts still need to do.
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