State health aid to county omitted

Molly Ball

Friday, Jan. 28, 2005 | 11:07 a.m.

A longtime state budget item that local health officials hoped would bring nearly $2 million to Clark County's efforts to address diseases such as cancer and asthma in the coming two years does not appear in Gov. Kenny Guinn's proposed budget.

The county's top health official, Dr. Donald Kwalick, expressed dismay at Thursday's meeting of the county Health Board over the disappearance of state health aid to counties.

Kwalick told the board that the county and its lobbyists, along with Washoe County, would push to "get health aid to counties reinstituted in this biennium."

Only Clark and Washoe have health districts at the county level. Health programs in the rural counties are directly administered by the state.

In Clark County, officials were counting on spending the money on tracking, managing and educating the public about chronic diseases, Kwalick said. The county Health District currently has no program for continuous monitoring of these illnesses, though it does have such a program for communicable diseases like West Nile virus, hepatitis and the flu.

"We do have to get the resources with which to have a chronic disease prevention and control program," Kwalick told the board.

The governor's office pointed out that the funds in question are a drop in the bucket compared to the big picture of substantial proposed increases in health funding.

Guinn's budget proposes about $276 million in new spending on health and human resources, spokesman Greg Bortolin said. That's more than 100 times the approximately $2.5 million the counties are complaining about not getting.

"This is really a progressive area," Bortolin said of the resources the governor proposed devoting to public health, especially mental health.

Martha Framsted, spokeswoman for the state Health Division, said the state had programs for many individual diseases, often funded by federal grants, but not a program for chronic diseases in general.

Historically, health aid to counties had a fixed funding level of $1.10 per capita, allotted based on population, Kwalick said. In the mid-1990s, that was cut in half to 55 cents per person.

During the last legislative session, facing a budget crunch, the program was slated to be cut entirely. But the counties persuaded the Legislature to preserve the budget item by putting just $100 toward it, with the implicit promise that it was a worthy program that would return to full funding once state coffers were less stressed, Kwalick said.

The legislators voted to preserve the item with the token $100 because "many of us felt that it would be appropriate, when economic times got better than they were two years ago, to put more into that account," said Assemblywoman Sheila Leslie, D-Reno, who chairs the Assembly's Health and Human Services committee and also serves on the Ways and Means committee.

Leslie said she supported restoring the item. "We will have a hearing on that line item, the counties will testify, and we will vote on whether to fund it," she said.

"For me, it would be a priority," she added. While the amount of money is not large from the perspective of total state spending on human resources, "To the counties it's an important source of revenue to do really vital public health projects."

Kwalick said local health departments in many parts of the country get 25 to 50 percent of their funding from their respective states, but in Nevada the number is less than 1 percent.

The Clark County Health District, which had estimated expenditures of about $48 million in fiscal 2003-2004, gets about one-third of its budget from fees for services; about one-third from county funds; and about one-third from federal monies, Kwalick said.

Some of the federal funds are distributed by the state government, but it is not state money, he noted.

Assembly Majority Leader Barbara Buckley, D-Las Vegas, said the county's proposed use for the missing money was an important one.

"It's amazing how much certain diseases cost Nevada, whether it's the human cost or the health-care cost," Buckley said.

She noted, "if you can control someone's asthma rather than have repeat visits to the emergency room, you save a lot of money in the long run. Success in managing diabetes can prevent amputations."

archive