Even after having to respond to a measles outbreak that garnered national attention, Clark County Public Health will receive a fraction of the funding for outreach advocated by health officials and local tribes.
At a recent Clark County Board of Health meeting, Clark County Public Health Officer Dr. Alan Melnick said the state plans to spend up to $22 million on foundational public health services through 2021, an amount that falls far short of a $100 million request made by a group of county health departments, the Washington Department of Health and local tribes.
Foundational public health services, or FPHS, are the core services public health offers to protect and enhance community health. Those services include communicable disease control, environmental public health and health assessments such as the Healthy Youth Survey.
Of that $22 million, Clark County Public Health’s next two-year allocation for FPHS is expected to come in close to the $519,140 it received in the previous biennium.
“This doesn’t come close to what we need to adequately provide services that are foundational,” Melnick said in a phone interview Monday.
Melnick said the measles outbreak highlighted how a lack of state funding can come back to hurt people on the back end.
He said schools often don’t have the resources to focus on health outreach, and it’s difficult for Public Health to assist when they lack state funding. Melnick said poor funding is also hindering work done to reverse the rising rates of STDs and being able to expand work on monitoring local bodies of water.
While the state has authorized $22 million in funding for the next biennium statewide, even that number will likely fall short, Melnick said. The plan is for $10 million to come from the state’s general fund, with another $12 million to come from revenue generated through Washington’s new vape tax.
However, the vape tax is only projected to generate $17.2 million over the next two years, and that money will be shared with the Andy Hill Cancer Research Endowment — which means FPHS funding will be closer to $8.6 million from the vape tax. That puts the total funding, vape tax and general fund, around $18.6 million.
Once that money is shuffled to various earmarks — $2 million for the state health department, $3 million for public health in King County, etc. — about $9 million will be left for FPHS, essentially the same amount as last biennium.
One positive is that the funding will be ongoing, Melnick said, so foundational health services should be authorized to receive the same amount of funding in the future, and the projected revenue from the vape tax is expected to rise.
In an interview after the board of health meeting, Melnick said Public Health has been “historically underfunded,” and “there’s lots of people trying to get funding for lots of different things.”
“Whenever you ask for funding, you’re competing with a lot of other initiatives,” he said. “The point we’re trying to make, and as a society the issues we have, is we don’t put enough funding into prevention — and foundational public health services, a lot of that is prevention work. It’s always an uphill battle.”
While Clark County was reimbursed for all but $40,000 of the $864,679 spent on outbreak response, more funding could put the county in a better position to stem or stop future outbreaks or other threats to health. That would also benefit the state, which foots the bill for most of Clark County’s measles reimbursement.
Melnick said he doesn’t view the lack of funding as frustrating, but he does view it as one of the challenges of his work. He said Public Health will continue to do the best they can with the resources they have for now.
“We’re going to continue to ask for funding,” Melnick said. “The outbreak was inevitable and we need resources in place to prevent these things from happening again.”