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Public health agencies may lose federal, state funds

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The north country’s county public health agencies are bracing for a double dose of cuts to their programs and services, as they face potential reductions at the state and federal levels.

Jefferson, Lewis and St. Lawrence counties’ public health agencies may not know what the bottom-line dollar impact will be of those cuts, but officials said they know change is coming.

“I’ve been waiting to see a good analysis come out from a reputable organization,” said Susan J. Hathaway, St. Lawrence County Public Health director. “What do we do for our 2014 budgets? Our process in St. Lawrence County starts in May. How do we plan?”

St. Lawrence County Public Health operates with an annual operating budget of about $10 million, but that amount most likely will decrease once effects of federal sequestration and state budget cuts finally filter down to the agency. Although its impact has yet to be discovered at the local level, federal sequestration means there could be an 8 to 10 percent cut to programs funded at the Centers for Disease Control and Prevention, according to the American Public Health Association.

That could translate into a decrease in immunizations for children and adults, a reduced availability of HIV tests, decreased ability to investigate multistate outbreaks, a reduction in public health staff and elimination of some research projects. The American Public Health Association also reported that cuts to Medicare would be limited to provider payment cuts up to 2 percent.

Ms. Hathaway said the CDC cuts may trickle down to St. Lawrence County Public Health and affect the number of vaccines provided through the federal Vaccines for Children Program.

Lewis County Public Health Director Carol A. Paluck said there also are proposed cuts to emergency preparedness.

“It’s all really tentative,” Mrs. Paluck said.

Any federal cut, coupled with Lewis County Public Health’s loss of the $40,000 Susan G. Komen for the Cure grant because that funding dried up and state budget cuts will leave the agency providing fewer opportunities for Lewis County residents to keep up on their preventive health care.

Because the agency did not receive the Komen grant, it had to cancel its newly formed cancer navigation program, which would have helped guide patients through their cancer struggles.

Mrs. Paluck said she is unsure how the federal cuts will play out for its $3.5 million annual budget, especially since federal funds pay for Lewis County Public Health’s Cancer Services Program screening and diagnostics for patients.

In Jefferson County, the picture is just as uncertain and bleak. Jefferson County Public Health Service Director Ginger B. Hall said as of April 1, Medicare claims for the county public health agency’s home health care will be affected beyond the general 2 percent cut to Medicare programs.

“We’re episodic, so we will go for 60 days at a time,” she said. “Fee-for-service Medicare, which we’re not, will be a 2 percent cut. I don’t know what will happen to us because we’re episodic.”

Mrs. Hall said she is still evaluating how federal sequestration could affect other areas of the agency’s $8.3 million annual budget, but she said home health care also will be affected at the state level as the whole system goes through change.

Any federal funding changes through the CDC will be filtered through to county public health agencies by the state Department of Health, Ms. Hathaway said. Having gone through cuts from the department before, Ms. Hathaway said, St. Lawrence County Public Health is “down now to basically providing mandated programs.”

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