LANSING – When the House Appropriations Community Health Subcommittee was first briefed on the governor’s budget in February, officials from the department said a crisis for local public health operations was emerging. On Friday, the panel was told now is the time for the state to invest in public health services, including family planning.

Cathy Raevsky, president of the Michigan Association for Local Public Health, said it simply boils down to resources becoming less and less available for locals, while they are the ones who are ultimately held accountable.

Raevsky told the subcommittee there is a direct relationship to the increase in birth rates when unemployment rises, as has been the case in Michigan. Teen pregnancy increased in the state in 2006 for the first time since the early 1990s, and Raevsky said about 50 percent of those births are covered by Medicaid.

The governor’s budget calls for reductions in family planning services, but Raevsky said the state should be doing just the opposite.

Ted Westmeier, health officer for the Jackson County Health Department, said as state funding becomes thinner, they have had to shift local dollars to fund programs the state mandates. He said they want to be held harmless from any more budget cuts and he asked lawmakers to reinstate all revenue sharing for counties.

Rep. Alma Wheeler Smith (D-Salem Twp.) said it’s unfortunate she has heard this testimony for too many years.

Smith said she is surprised local units of government haven’t sued the state for not funding the programs it mandates locals provide. With the state getting federal stimulus dollars, Ms. Smith said lawmakers should help them fund these types of programs because local groups are on the frontline.

“When you don’t have the resources and the personnel, we have totally handcuffed you,” she said.

Rep. Kevin Green (R-Wyoming) argued it’s not that lawmakers don’t want to fund these programs, it’s just a fact that there are only so many dollars available. He asked Ms. Raevsky which services are most dangerously underfunded so legislators can prioritize spending needs.

Raevsky said she would ask her association to provide a list at its meeting next week, but argued the list will have to look at programs not just receiving reductions in the proposed budget, but those that already have been cut in previous years.

Green also asked her group whether private companies or non-profits offer some of the same services as local public health departments. He said that would allow locals to focus resources for services not provided anywhere else.

But Raevsky said at least in terms of communicable disease, local public health departments are the only ones providing services.

In Kent County where she works, Raevsky said there are other entities that provide the WIC program, but they too are faced with strapped funding scenarios and have been reducing services. In those cases the caseload, which is typically a population with more barriers to language or transportation issues, is usually transferred to local public health departments, she said.

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