MORGANTOWN — Over the course of about 12 days in January, the Monongalia County Health Department followed along as news out of Charleston, then Washington, cast uncertainty on two of its primary funding sources – federal grants and direct state aid.
Tackling the more immediate concern first, Gov. Patrick Morrisey announced on Jan. 16 that his administration was projecting a $400 million budget deficit.
MCHD leadership is now awaiting the Feb. 12 release of the governor’s budget to see exactly how he intends to eliminate that shortfall.
“We’re going to find out his support of funding for public health. That’s going to be a big step,” MCHD Executive Director Anthony DeFelice said.
DeFelice sits on the legislative committee for the West Virginia Association of Local Health Departments. He said the body was attempting to sit down with Morrisey’s budget director before the spending plan went public.
Devan Smith, the health department’s chief financial officer, said it’s ultimately a waiting game at this point.
“What they do with that [shortfall] remains to be seen. It seems as though tax increases are not on the table. In fact, tax decreases may be on the table. So, really, the only avenue is to cut costs,” Smith said. “We’ll see when this budget is proposed and it goes through the legislature where those cuts are going to come from.”
State aid for health departments is derived from a mix of data points including population, poverty rate and access to health care, among others.
It’s already a sensitive subject for health departments, which were expecting a 10% bump in allocations for the current fiscal year to help cover increases in costs like public employee insurance. Instead, funding levels were held in place, then ultimately cut when the threat of a $465 million federal COVID clawback triggered across-the-board reductions.
That clawback never materialized – nor did the lost funding, at least initially.
“Afterwards, we had to fight to basically get our funding reinstated. So we want to stay ahead of this,” DeFelice said.
As for the federal funding freeze spelled out in a Jan. 27 memo from the White House Office of Management and Budget – then rescinded the following day – DeFelice said the memo may have been pulled back but the executive order behind it still stands.
“So, this has still got to play out. My personal opinion is that this will play out over months in court. I’m not sure. We’ll follow it, but I’m not sure in the short term that this is going to affect us,” he said.
DeFelice estimates that 40% of the health department’s overall budget is tied to federal dollars, noting that number comes from a variety of sources to the entire suite of MCHD programs.
“I don’t think the spigot is going to turn off. I think what you’ll most likely see are some cuts to some budgets, and maybe redirecting where they want the money to go. So, they might move it from global warming to cyber security, just as an example. I still think the funding is going to be there,” he said. “We’ve looked into our contracts and federal grants that the administration wanted to stay away from – global warming, DEI – I don’t think we have very much of that. So, I would say our risk was small, even if our funding was looked at today.”
Even so, Health Officer Dr. Brian Huggins said the department needs to insulate itself from these fluctuations as much as possible. He said he’s exploring the addition of services like drug screening and occupational health as a means of increasing revenue and furthering the public health mission.
“We have to be prepared so that moving forward, some of these grants, some of these projects may not be there,” he said. “So, my goal is to do what we can to become more financially secure and independent.”
