SANTA CRUZ — This year, as California recovers from the most difficult months of the pandemic, it is expected to have a budget surplus of nearly $76 billion. This stands in stark contrast to the fiscal year 2020-2021, when the state saw an expected deficit of $54 billion.
Despite the extra money, a coalition of local health jurisdictions and advocacy organizations called California Can’t Wait — which has been asking the governor’s office for $200 million more a year since before Gavin Newsom’s election — is expecting to be let down again.
“We have seen first-hand throughout the COVID-19 pandemic the devastation that underfunding local public health departments can have on communities across the state,” the dozens of coalition members, including County of Santa Cruz Health Services Agency, said in a letter to the governor on April 6. “One lesson that must not be lost is that local health departments are instrumental in protecting lives and avoiding excess social and economic disruption. Simply put, we cannot continue to neglect this vital role.”
The introduction statement in the May revision of the state budget shows that Newsom and his team understand health systems were stressed during the health crisis. Yet, not a single dollar of the surplus will go to the four areas health officials stressed need funding, Santa Cruz Health Officer Dr. Gail Newel told the Sentinel on Friday.
“A $76 billion surplus and he still can’t find $200 million?” Newel said with an incredulous tone. “It’s just astonishing … it’s really a drop in the bucket for what we need to rebuild public health.”
Workforce development, improved infrastructure and technology around communicable diseases, an exploration into health equity issues and intersectional study of health and climate change have long been underfunded, the health officer added.
“It became apparent during this pandemic, (there’s a) need to look at health equity and disparities and have some meaningful engagement with our diverse communities around the effects of systemic racism and become a better partner,” Newel said. “We haven’t forgotten about racism as a public health issue.”
Approximately $3 million is being set aside in the budget — set to be accepted and implemented over the summer according to the dedicated, interactive website — for an assessment of the state’s response to the pandemic. There is no timeline for the assessment included; the action, additionally, contradicts the request from the California Can’t Wait coalition to act now rather than later.
“We have the opportunity and the obligation to rectify this only with the state’s commitment to ongoing funding. California can’t wait until the next public health crisis hits,” the letter from the coalition says. “California must invest and rebuild the public health infrastructure now.”
There is money allocated for behavioral health programming for children and young adults and improved access to health care plans for all, but local health jurisdictions are only mentioned in the 281-page budget summary in relation to the work they accomplished in partnership with the state. First, there is a mention of collaboration with the California Department of Public Health and Blue Shield of California to create a vaccine data tracking system. Later, the budget references the partnership between jurisdictions and the state in the context of the state’s vaccine equity efforts and positive vaccine messaging.
“We all have seen how poorly our IT systems work and reporting systems,” Newel said. “In fact, we had to spend huge amounts of money to hire private companies like Blue Shield to come in and manage the data when that really could be done internally if we had a better infrastructure system for that.”
Relying on a ‘rescue’
Newel said she believes that Newsom feels funding for local health jurisdictions is not needed because of the federal response money each one received.
Newel’s suspicion appears to be correct, as the May revision lists a “technical correction” from the March 2021 fiscal update. The department of finance’s expectation for total project costs decreased $2.7 billion in the two-month time frame due to response activities, such as statewide testing and contact tracing — tapering off at a quicker pace than anticipated.
“A technical correction is being made to remove funding to local health jurisdictions for testing, contact tracing, and vaccinations that was added in the March 2021 fiscal update for consistency with how other local assistance funding is treated,” the budget summary reads before giving a breakdown of where American Rescue Plan funding will go.
The issue with relying on federal, not state, funding to support local health jurisdictions and their departments is that federal funds are so specific, Newel explained.
“It has to be COVID-related but we have so many unaddressed and neglected areas,” Newel said of the available funding. “We can’t hire folks to fill (our) empty positions, can’t use the federal funds cause they’re short-term so we can’t hire full-term positions with that money. It’s not going to help rebuild our workforce at all.”
Newel said she and her colleagues are applying for every applicable grant they can.
“There are specific grant resources available for specific programs. We get federal funding specific to maternal child health, for example, and grant funding to help support our syringe services program,” she said. “Most of our funding in public health is actually grant funding… we need overall improved funding.”
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