In what Kitsap County Health District Director Dr. Scott Lindquist called “the dismantling of the public health system,” the Kitsap County Board of Health approved the agency’s 2009 budget, which was highlighted by program cuts and fee increases.

Yet, only a handful of community members showed up to the meeting Tuesday morning to express their concerns about the potential impacts on the county’s quality of life.

“We have to be very concrete in terms of what the impact of these cuts will be,” Central Kitsap Commissioner Josh Brown said, echoing the concerns of the board and health district staff.

In its 2009 budget, the district eliminated two full-time employee positions and increased service charges for its on-site sewage, water, and solid and hazardous waste programs by 8 percent as well as service charges for its food and living environment programs by 18 percent.

Also eliminated are El Centro de la Familia, an outreach program which serves local Spanish-speaking families, and positions with the district’s First Steps and Welcome Home Baby programs, which help low-income pregnant women get the health and social services they need to be healthy mothers and have healthy babies.

Lindquist said the district is operating with staffing levels from 14 years ago and funding levels from a decade ago, and if funding levels continue to decrease “it cannot be done.”

“In June 2009 is when I think we will hit the wall,” he said, adding that King County and Snohomish County are only funding some of their programs for six months due to budget constraints.

A bipartisan state committee recommended that public health in Washington state needed a $100 million influx from the state Legislature, but only received $20 million during the last legislative session, he said.

“What we’re hearing from the Secretary of Health is that we’re looking at a 20 percent cut,” he said. “This is not survivable.”

The Health District isn’t the only agency struggling with budget issues during these tough economic times, North Kitsap Commissioner Steve Bauer said.

However, Bauer said he agreed with Brown that the health district must find ways to clearly communicate its situation to not only legislators, but the general public.

“It’s got to be something people can touch and feel,” he said. “This is important for us to do.”

If potential cuts are expected by June, the board needs to start looking for more funding and begin developing a plan in January, Bauer said.

As the district has coped with its ongoing financial struggle for the past eight years, the district staff has prioritized services in proposing program cuts without impacting its mandated functions, but any further cuts will mean having to prioritize priorities, Lindquist said.

“I think the fortunate thing for us in Washington state is that the mandates are built around the fundamentals,” he said. “I think the pillars of public health are still intact.”