Programs being cut to make up for shortfalls.

Since 2007, the Kitsap County Health District has been on the front lines of the battle with declining revenues and the expectation to maintain the same levels of service.

Its 2009 proposed budget is no different as more staffing positions and programs are slated to be eliminated including the El Centro de la Familia outreach program, which was spared last year because of a sizable donation by Texas Rangers baseball team pitcher Vicente Padilla.

The proposed budget will be voted on at the Dec. 2 Kitsap County Board of Health meeting at the Norm Dicks Government Center in Bremerton.

“These budget cuts will be felt throughout the community,” said Dr. Scott Lindquist, director of the Kitsap County Health District. “Our funding shortfalls have meant year after year, there have been unavoidable cuts in vital services.”

In addition to the 350 Spanish-speaking families, who were served by El Centro in 2007, 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 throughout the county, are being eliminated, impacting residents from Port Orchard to Kingston and everywhere in between.

When it comes to deciding on budget reductions, district spokesman Scott Daniels said three objective criteria are used to prioritize programs:

• Is it a legally mandated activity or service?

• Is it a public health priority approved by the Board of Health, or is it a director’s administrative priority?

• Does it require significant discretionary funds?

A “yes” answer to the first two questions indicates the program or service is a priority, Daniels said. However, a “yes” answer to the last question indicates a lower priority.

“El Centro, for example, is not identified as a high priority program using these criteria and, as a result, it is identified for reduction,” he said. “What is significant now, however, unlike in years past, budget reductions are now impacting priority programs like the Welcome Home Baby Program. Although it is a health priority, its budget does not contain sufficient revenues to fully sustain it.”

While there is always a glimmer of hope for programs slated for elimination to be saved at the last minute, Daniels said it is highly unlikely.

“At this ‘late hour,’ the only way to save any of the programs or staff slated for elimination is for new revenues to be offered or identified,” he said. “The health district has significantly reduced staff and services over the past four years — we are 23 fewer FTEs (full-time employees) than we were in 2005 — and we don’t have much leeway anymore to shift funding around due to our goals of protecting public health, retaining mandated services and addressing health priorities.”

The only answers in the long run are additional funding for public health and prevention-related services and activities from the federal and state governments, he said.

The cost of continually cutting programs and services will have a ripple effect throughout the community, he said.

“Without investments in public health prevention activities, we as a society end up paying higher costs down the road for law enforcement, juvenile detention, jails and treatment for substance abuse and chronic health problems,” Daniels said. “Welcome Home Baby is good example of that. Without a strong statewide public health system — we are one of 34 local public health jurisdictions around the state — the public will face a higher risk of communicable disease.”