Looking to spend the state’s exceptional budget surplus on correcting the most widespread financial impact of the pandemic, California Governor Gavin Newsom pledges to pay most taxpaying adults $ 600 while pledging to pay all outstanding rental and utility bills .
But last month left out the governor’s $ 267.8 billion budget proposal: money to rebuild local health authorities whose staff shortages and fragmented funding were exposed by the coronavirus, hampering a more coordinated response to the crisis.
Now health officials are joining forces and trying to convince Newsom and the state legislature to give them an unprecedented injection of cash. Her campaign, titled “California Can’t Wait,” is targeting $ 400 million annually in a variety of roles including $ 200 million in recruiting and $ 35 million in recruiting and retaining Employees.
“When things are going well in public health, you often don’t hear about them,” said Michelle Gibbons, executive director of the County Health Executives Association of California. “COVID has highlighted many areas where public health has been decimated without adequate human resources.”
The Democrat-dominated state legislature has included the money in its budget proposal, partly because lawmakers believe the state will be able to spend more money than Newsom in the next few years. Legislators are expected to vote on their budget next week, but it won’t go into law unless they can reach an agreement with Newsom.
Newsom didn’t say why it didn’t raise the money for public health officials, but rather reiterated its support for health care in general – including spending $ 300 million on public hospitals and providing government-funded health insurance for some low-income adults who live in the country illegally.
“I wasn’t shy about my health care support,” Newsom said.
Newsom has a $ 3 million budget for a review to “assess the state’s response to public health,” adding that its government “has a duty to translate lessons into actionable guidelines over the next year “.
That angered some local health officials, and Gibbons said Newsom’s budget would “repeat the same mistakes California made before COVID-19, leaving local health officials too understaffed and understaffed to deal with daily public health threats” .
California sends money to local governments to pay for the public health and health of the needy or people who do not have insurance and cannot afford medical care. State funding for public health and the health of those in need declined by more than $ 138 million between 2006 and 2020, according to the County Health Executives Association of California.
However, the decline was due to the state taking full responsibility for the cost of penniless health care after the federal affordable care law went into effect, said HD Palmer, California Treasury spokesman.
“This decision, approved by lawmakers, took these costs off the counties’ books,” Palmer said.
California has 61 local health departments scattered across the state and employing hundreds of doctors and nurses whose job it is to think about what makes people sick and how to prevent it.
These people fight viruses like Ebola and Zika while they work to contain small outbreaks of measles and other infectious diseases. These include sexually transmitted diseases, tuberculosis, and even the plague – an age-old disease that killed a third of Europe’s population in the Middle Ages, but was isolated in South Lake Tahoe last year.
Their work is often so far removed from the public consciousness that it does not fit into the political debates in the state capital. That changed last year when terms like “contact tracing” and “morbidity” came into vernacular and changed the way people think and speak about public health.
Prior to the pandemic, Alameda County had just seven people whose job it was to “track contacts” or study how and where people got infected with a dangerous disease so they can try to isolate it and prevent it from spreading. This job became critical in the early days of the coronavirus pandemic.
“We could have been better prepared if we already had more investment and infrastructure with educated people and community connections to reach the people we need to reach,” said Colleen Chawla, director of health services for the Alameda County Agency. “It’s not the kind of work that can happen overnight.”
Today the agency has 140 contact tracers, an achievement that has been achieved in part by pulling people away from other jobs. But when they did, the county forfeited the grant money used to fund these jobs and left a void in their budget. This hole has been filled with federal coronavirus aid money – money that will no longer be available in the future.
In 1991, the California legislature shifted public health responsibility to the counties. The state sends money to local governments for this every year, but that money has been going down in recent years.
Local health departments also receive federal funds, but there are strict rules on how they can spend it. A county could use a federal grant to hire people, but only if they are researching a specific disease: for example, HIV, tuberculosis, or tobacco-related diseases.
“It’s difficult to coordinate a broader approach when you’re stuck in those buckets like tobacco, sexually transmitted diseases,” Gibbons said.
Negotiations between Newsom and the legislature are ongoing. Chawla said many recognized the difficulty of responding to the coronavirus pandemic with limited resources. But she said there should be no excuses for the next public health crisis.
“Who will forgive us when we are in this position again?” She said.
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