The Register Citizen (Torrington, CT)
State funds lower amid pandemic
As health directors across the state said they’re scrambling to adjust to ever-changing, ever-increasing responsibilities to provide services during the coronavirus pandemic, the state has given local health departments and districts less funding than is spelled out in state statute.
Health directors said they learned recently that their grants from the state will be 8.5 percent less than what is statutorily outlined. That’s slightly better than the 10 percent cut last year, but less than many had hoped for.
“We didn’t expect them to cut our funds so much,” said East Shore District Health Department Director Michael Pascucilla, whose agency is the health department for East Haven, Branford and North Branford.
“If you think about it, it’s kind of madness that they’re cutting local public health funding when we’re working with people who are getting sick” with COVID-19, Pascucilla said .
According to state statute, the state is supposed to provide funding of $1.85 per capita for regional health departments representing at least three municipalities and $1.18 per capita for health departments serving municipalities with 50,000 or more people.
Municipalities with fewer than 50,000 people and regional health districts serving fewer than three municipalities receive no funding from the state.
“Even at full funding, at $1.85, it’s one of the lowest per capita funding rates” in the nation — and “it’s not enough,” Pascucilla said. “We really need state support. It’s an investment in public health . ... I think it’s time that the state make a better investment.”
Wallingford Director of Health Stephen Civitelli, who took over July 1 as new president of the Connecticut Association of Directors of Health, said it’s good to see that the state didn’t cut municipal health departments any further, “but they’re still not paying” what is spelled out in state legislation.
“They’re just not meeting the statutory obligation,” he said of the state.
At the same time, local health departments and health districts are facing “a huge increase” in responsibility, he said.
“We have executive orders that we have to interpret, we have reopening guidelines that we have to interpret, we have all the regular things that we do that we have to interpret,” Civitelli said.
The association, in a recent letter to members of the legislative Appropriations Committee, said that facing a host of threats, including COVID-19, “We cannot continue to protect the health of the communities you represent if you do not invest in our public health infrastructure!
“The State investment in local governmental public health is abysmal,” the letter said. “The statutory annual rate of $1.85 per person for the departments that receive funding, is less than the cost of a cup of coffee. To make
“The issue is that the legislature enacted an appropriation that is less than the full formula,” he said. “This is common across a variety of programs where the legislature has enacted statutory formulas that in future years cannot be fully funded due to the competing needs of state government.” Chris McClure, state Office of Policy and Management
matters worse, local health departments have not received the $1.85 in several years as the line item has been underfunded.
“... We appreciate and understand the fiscal challenges the State faces,” it said. “However, we urge you to consider the value of the work that local health departments are doing every day and the consequences the State faces if our capacity to address these emerging threats continues to diminish. Please ensure that health departments are fully funded so we can adequately serve the people you represent.”
Chris McClure, spokesman for the state Office of Policy and Management, said the appropriation through the state Department of Public Health to local and district departments of health “was funded at exactly 90 percent of the aggregate full statutory formula amounts in this past fiscal year.”
“For the current fiscal year, FY 2021, the appropriation adopted through the biennial budget is exactly the same dollar amount as in FY 2020,” he said.
This year’s appropriation works out a little better for local health districts and departments — 91.5 percent of what’s spelled out in the statutory formula — “after adjusting for population changes, and grant eligibility,” McClure said. One town is losing its grant based on a declining population, he said.
“The statute instructs the Commissioner to prorate the grant awards downward in any year in which the appropriation falls below the statutory formula grant amounts,” McClure said.
“The issue is that the legislature enacted an appropriation that is less than the full formula,” he said. “This is common across a variety of programs where the legislature has enacted statutory formulas that in future years cannot be fully funded due to the competing needs of state government.”
For pandemic-related responsibilities, “local districts of health have received direct funding from DPH through federal monies made available to us this year due to the pandemic,” McClure said. “Local municipalities can also access the OPM Municipal COVID Relief Fund program to support reimbursement of costs.”
Between the slightly higher grant, new federal dollars available through the state Department of Public Health, the OPM CRF program for municipalities and FEMA reimbursement, local health departments “have strong financial support available,” McClure said.
Neither of the two Appropriation Committee co-chairwomen, state Rep. Toni Walker, D-New Haven, and state Sen. Cathy Osten, D-Sprague, could immediately be reached for comment.
Osten told The Day of New London that the legislature wanted to undo the cuts and fully fund local health departments and districts, but the pandemic cut the legislative session short in March.
Stratford Director of Health Andrea Boissevain said the smaller grant from the state means Stratford will get $55,116 from the state rather than the $61,321 it would get according to the statute. Stratford also is losing money because it has 378 fewer people than last year, she said.
Any drop in funds means the Health Department hires fewer people — at a time when it needs to hire more, she said. The Stratford Health Department has an annual budget of about $1 million, including roughly $700,000 from the town and $300,000 in grants — including the state grant.
“Really our biggest resource and asset to the department are people,” Boissevain said. “I use that money to pay for part-time public health nurses, a health educator, a part-time secretary. We also use it for an after-hours food inspector.”
New Haven Director of Health Maritza Bond said her department is “mandated to respond to a lot of regulatory responsibilities and the mandated funds continue to be reduced.”
“There are some fiscal concerns across the state, and managing the state budget I think it’s critical that we start investing in public health,” Bond said. “So reducing our funding by any percentage impacts us as a whole ... in the ability to respond” to the challenges the pandemic presents.
She said the last time the state provided full, statutory funding was 2017-18. For New Haven this year, that means the department will get $140,000 from the state, not the $154,000 the statute calls for.
Meanwhile, because of the coronavirus, “we’ve had to develop an entire infrastructure . ... When we had our first positive case, had to establish an infrastructure to identify cases, focus on isolating and quarantining individuals, establish a procedure and infrastructure for contract tracing” and provide public health nurses.
In addition, “We’ve had to ramp up and scale up on personal protective equipment” and “establish an infrastructure for reopening phases” for restaurants, hair salons, nail salons and child care facilities, among others, she said.
“It’s just such a critical time in public health,” Bond said. “It’s a global pandemic and its really critical that as we’re responding to the pandemic, the powers that be respond” with appropriate fiscal support, she said.
Even some of the communities that aren’t getting any funding at all say it’s important for the communities that do get support to get what they need.
“Part of the issue is, they’ve been underfunding public health for many years,” said Mark Cooper, director of the Westport Weston Health District, which doesn’t get funding because it only provides services to two municipalities. At least three is required for state funding.
He said it’s critical for the state to provide support at a time of an unprecedented health crisis. “Because of COVID-19 activities, I’ve had to hire part-time people that I didn’t have to hire before,” Cooper said. “... It is critically important right now.”
Stephen Mansfield, director of health for Ledge Light Health District, the local health department for New London and eight other eastern Connecticut communities with a combined population of 151,295, said Ledge Light should be getting $279,895 from the state, but the state is providing $256,140.
“This isn’t a new thing, the cutting. It’s been going on for a while,” Mansfield said. “I don’t know why, in the middle of a pandemic, the governor’s office would want to cut funding to local health departments.”
State officials say “It’s flat-funding. You’re getting the same as last year,” Mansfield said. “Well, last year was a cut, too.”
Ledge Light, which has a $2.4 million annual budget, serves a vast swath of the Connecticut shoreline from the Rhode Island border to the Connecticut River, including East Lyme, Groton, Ledyard, Lyme, New London, North Stonington, Old Lyme, Stonington and Waterford.
“I budget for this,” Mansfield said. “Every year I build into my budget a 10 percent cut in state funding ... because it’s understood that public health is undervalued and underfunded and I have to make sure that” the shortfall will be covered.
“This isn’t new,” he said. “What’s new is that the governor’s office is cutting the funding for public health departments in the middle of a pandemic.”