Which health department programs are at risk if the county budget is approved Tuesday?

OTTAWA COUNTY — A whirlwind budget process for Ottawa County is expected to come to a close Tuesday with the Board of Commissioners set to vote on the fiscal year 2024 budget.

In meetings throughout the past two months, much of the discussion has focused on the Ottawa County Department of Public Health. An initial budget request from the department was significantly reduced, then backfilled in certain areas to meet state minimum requirements.

County administration, including Board Chair Joe Moss, Vice Chair Sylvia Rhodea and Administrator John Gibbs, have said the budget returns OCDPH to “pre-COVID budget levels.”

In 2021, Moss and Rhodea co-founded Ottawa Impact, a group of far-right fundamentalists disgruntled over school mask mandates during the COVID-19 pandemic. The group now controls six seats of the 11-member board.

Initially, Moss suggested cutting the general fund contribution back to $2.5 million, but the budget has since been altered to add some funding back to meet state minimum requirements.

The budget passed in committee Tuesday, Sept. 19, represents a 20 percent reduction in the general fund allocation to OCDPH from the previous year.

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One significant cut remaining is a $393,000 reduction in health education and nutrition and wellness funding.

Administrative Health Officer Adeline Hambley has said that, although an initial look at budget documents show a slight increase for health education, it doesn’t tell the full story. She said health education and nutrition and wellness were combined into one program, but the funding only supports one or the other — meaning both budgets have been halved.

The initial budget request asked around $800,000 for the two programs, but the current budget provides about $421,000. Hambley said the current proposal is a 48 percent decrease for both programs.

Programs funded through that line item, and thus at risk of reductions, include Ottawa Food, substance use prevention and suicide prevention.

Gibbs said Tuesday it’s a “programmatic decision,” on what gets cut, meaning OCDPH would decide how funds in the health education line item are spent. Deputy Health Administrator Marcia Mansaray said that’s not an easy decision to make.

“When you cut something in half, you can do everything a teeny tiny bit, or a couple things really well,” she said. “How do you choose? What kind of criteria do you use to see what’s important when you have a week to do it?

“We’re working through that, knowing that there are people’s livelihoods, and literally lives … that could be impacted by the decision we make. Also just what kind of community are we if we take those services away, what kind of community does that make us?”

Another concern is the number of epidemiologists the department will have under the proposed budget. Currently, OCDPH has four epidemiologists. That number will be decreasing, but there’s a question if it will be to two or three.

One epidemiologist is funded through a COVID-related grant, all of which are being phased out of the OCDPH budget by county administration. The version of the budget approved Tuesday removes the grant, but also lists a reduction of one full-time epidemiologist under new changes, leading Hambley to believe only two would be left in the department.

This is, Hambley said, below the best practice standard of 1-1.4 epidemiologists per 100,000 residents, as Ottawa County has around 306,000 residents. When asked about this Tuesday, Gibbs said the budget accounts for three epidemiologists and only the grant-funded position would be cut.

Hambley said “that would be great news” if that were the case. Gibbs’ claim, however, conflicted with the most recent budget posted before the meeting.

In an email to commissioners following Tuesday’s meeting, Hambley said the budget appeared to use the funding from the third epidemiologist position to backfill funding that had been cut from the Miles of Smiles dental program.

Hambley said that allowing OCDPH to maintain the grant-funded epidemiologist would be a possible solution to keeping three epidemiologists in the department. She also explained the need for epidemiologists in the county.

“Epidemiological capacity is vital for setting up data systems, deployment of containment activities, and reporting case statistics and response information back to the community,” Hambley wrote. “Without Epidemiology, there may be less robust response to emerging disease threats and reduced access to timely information by the public.”

Because epidemiological services are mandated by the state, if the county drops to two, it could lead to an intervention by the state.

What programs are involved?

There are several programs included in the newly combined health education line item, including Ottawa Food, the Suicide Prevention Coalition and substance use disorder prevention.

Established in 2010, Ottawa Food is a collaboration between more than 40 agencies and individuals in Ottawa County working to provide access to healthy, local and affordable food.

Its efforts include gleaning and produce donation programs at local farmers markets, which have combined to provide over 24,000 pounds of food this year alone, and a Pick for Pantries program where residents can donate a portion of produce they pick.

Ottawa Food also hosts an online search engine for residents to look up local food resources and a Local Food Resource Guide that is printed and distributed twice each year. It also helps run the Lakeshore Food Rescue program with Community Action House, which combats food waste in the county by redirecting food to households experiencing hunger in Ottawa County.

The Suicide Prevention Coalition works with community partners and stakeholders to address suicide in the county. Initiatives include the Blue Envelope program that trains school staff in the county to respond to youth showing signs of contemplating suicide, promoting the Be Nice program and QPR suicide prevention training and partnering with Ottawa County Veterans Affairs to promote suicide prevention in the veteran community.

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Substance use prevention programs include providing TIPS training for local businesses and restaurants to prevent intoxication, drunk driving and underage drinking, classes on preventing alcohol and drug use in minors and vendor education to reduce youth access to alcohol and nicotine.

The work for these programs, and the connections with community partners, are driven by staff members leading the efforts. But with the proposed budget cut, staffing would have to be reduced.

“These people are experts at launching a new solution for a newly identified need,” Mansaray said. “It’s getting these programs started, keeping them rolling. When just one organization is doing something that is affecting everyone, it’s not very effective. Often, when you have a government organization willing to own responsibility for it and bring in the community, you get so much more impact. It really is important. It’s just not going to happen otherwise.”

What’s next?

The Ottawa County Board of Commissioners meets Tuesday evening, Sept. 26, with the official budget adoption expected to take place ahead of the new fiscal year that begins Oct. 1.

Mansaray said the department has been reluctant to take action toward next steps, as the budget has frequently changed. Once a final vote happens, OCDPH will evaluate how to move forward with its given budget.

“If it stays cut in half, it’s going to have impacts,” she said. “Once we understand clearly what those are, we will communicate them to the community.”

Mansaray said initiatives that are labor-heavy will likely be looked at for cuts. An example she gave is Senior Project Fresh, which provides coupons to seniors in the county to be spent on fresh produce. Although some seniors are able to go out and shop themselves, others have food delivered by OCDPH staff.

“Over the years, we’ve been able to build in capacity to bring food to them,” Mansaray said. “It’s really fulfilling for the workers and the seniors. It’s something we care a lot about, but we might not be able to do it (under the proposed budget).”

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Regardless of what programs and staff are cut, Mansaray said it’s those who need services the most that will likely be hit hardest by the cuts.

“The people who are struggling most are always the ones who are impacted hardest,” she said. “We will really be trying to, number one, keep our community healthy and safe. That’s what our job is, what we exist for.”

— Contact reporter Mitchell Boatman at mboatman@hollandsentinel.com.

This article originally appeared on The Holland Sentinel: Which OCDPH programs are at risk if current county budget is approved?