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Federal Way Council opposes potential closure of Public Health Center
The Federal Way City Council unanimously passed a resolution on Tuesday opposing the closure of the Federal Way Public Health Center.
Due to a $15 million annual shortfall in King County’s budget, officials with Public Health — Seattle & King County proposed a 2015-16 budget that calls for the closure of four Public Health facilities located in Federal Way, Auburn, Bothell and White Center.
“The current proposal leaves an area of great need completely unserved,” said Federal Way Mayor Jim Ferrell in a news release. “The Federal Way and Auburn clinics serve 24,000 poor women and infants who have nowhere else to go. As someone who was raised by a single mother, I cannot accept that the county’s best proposal is to abandon these low-income moms and their kids.”
If the King County Council passes this budget in November, the Federal Way Public Health Center will no longer be able to provide maternity support, the Women, Infants and Children (WIC) supplemental nutrition program and family planning to the approximate 13,700 people who use the clinic’s services annually. Additionally, 38 employees at the clinic will lose their jobs.
“South King County … has one of the highest rates of poverty in all of King County and one of the highest rates, if not the highest rate, in the state, and Federal Way and Auburn are certainly a big part of that,” said Multi-Service Center CEO Robin Corak at the Council meeting.
While Public Health clinics will remain open in downtown Seattle, Lake City, Bellevue, Renton and Kent, Councilwoman Lydia Assefa-Dawson pointed out upcoming King County Metro bus cuts will make it even harder for low-income families to access health care.
“I’m concerned our people won’t be served,” she said, adding the impact to sick children will reach beyond their health into school attendance and potentially their future success.
According to a city memorandum, more than 90 percent of the Federal Way Public Health Center’s clientele have incomes below 200 percent of the federal poverty line, 73 percent are people of color, 7 percent are homeless, 59 percent of family planning clients are uninsured, 20 percent of those who are pregnant and served by the maternity support services are involved with drugs or alcohol and 11 percent of client visits require an interpreter.
There’s also a fear that pregnant women and families who cannot afford preventative care may neglect health issues until it’s too late and they end up in the emergency room, driving up costs, Councilwoman Susan Honda said.
“A little problem will become a big problem,” Honda said at the meeting. “I used to be a registered nurse and we needed to stop the little problems from becoming big problems and the only way we can do that is to be giving preventative care.”
Patty Hayes, Public Health’s interim director, told the Council she, too, did not want to see the Federal Way or Auburn clinics shut down.
“My background is moms and kids. You don’t have anybody more passionate, there’s a number of people in this room who can affirm this, there’s nobody more passionate for moms and kids than me,” she said, citing her extensive background in maternal child health. “I have really stepped in to work as hard as I can to see a way forward on this with new partnerships, creativity, cost reduction, whatever we can do because I do not want to see this clinic shut down here. You have my commitment on that.”
Hayes presented the dire budget situation to the Council, admitting Public Health has nearly run out of options.
“It’s a very unfortunate and heart wrenching situation,” she said.
For some time, Public Health - Seattle and King County has been forced to make extreme cutbacks and scramble for state and federal funding. But this year the situations leading up to this biannual budget could be described as the “perfect storm.”
More than 10 years ago, voters repealed a major source of funding for Public Health when they voted for a cap on property taxes.
In previous years Public Health officials filled gaps by spending reserves, making cuts to programs, laying off hundreds of staff and securing outside grants and federal funding.
Coupled with a hit from the Great Recession, the policy for federal reimbursement for Medicaid Administrative Claiming changed, which cost them millions of dollars in potential funding.
To retain the Federally Qualified Health Center status Public Health officials needed to keep two primary care clinics open -- the Bellevue location and downtown Seattle location. Without the status reimbursement rates would be too low to provide any clinical services at all.
Public Health officials also proposed clinics with dental services remain intact because there is a huge need for dental services and they cover costs.
“Our dental program is much needed throughout the County with the bringing back of adult medicaid,” said TJ Cosgrove, the director of Public Health’s Community Health Services division. “… The dental program is performing at a level that allows us to shrink our gap. There’s high volume and revenue in that program. To eliminate dental would make our gap worse.”
Alternatively, moving a dental program from one facility to another is expensive and would offset current clientele, Keith Seinfeld a spokesman for Public Health said.
The Renton, downtown Seattle and Lake City locations all have dental while the Kent Public Health Centers don’t provide dental services.
But why does Kent get two Public Health clinics when south King County cities don’t get any in this budget proposal?
Cosgrove said they think of the Kent Public Health centers as one center with two locations. He said the location near Birch Creek was initially a satellite location where staff and part time programs moved back and forth between the two.
“Well, what happened with Birch Creek is the satellite became so robust,” Cosgrove said. “[Closing it] wouldn’t get us very far in terms of savings, it’s a small program. A lot of the overhead costs associated with the larger Kent [Public Health Center] would still be here.”
Closing Kent as a whole would also be expensive and mean even deeper cuts, according to former Public Health - Seattle and King County director David Fleming in a message to his staff back in June before stepping down Aug. 11.
Hayes, only two days on the job at the time of the meeting, said now is the time for creativity. To avoid losing a satellite clinic associated with the Auburn Public Health Center, Hayes said the Muckleshoot tribe recently partnered with the county to save those services.
But with the Federal Way Public Health Center operating on a $1.15 million annual gap, funding the center for the city is unlikely without some outside help or partnerships.
“When I spoke with Executive Dow Constantine, I was struck by something he said,” Ferrell said. “He said he does not believe in no-win scenarios and neither do we. We’re going to try to find some common ground and some win-win scenarios. … I want to make sure the areas that are most affected don’t bare the full brunt. There’s got to be a middle ground that perhaps we can reach.”
City of Federal Way spokesman Chris Carrel said while it’s important to note the city taking an official policy position on the opposition to the closure, “this is all really new” and the issue has only come at the community in recent months leaving very little time to take action.
“We’ve started discussions with the county, Hayes met with the mayor on Friday and a lot more meetings and discussions are coming up quickly,” he said. “Part of the dynamic here is the mayor touched on the approach that’s being suggested is a city by city approach. ‘Federal Way, if you want to save your clinic, let’s have that discussion. Auburn, let’s have that discussion.’ But the city is interested in pulling in a broader discussion that is county-wide.”
While it’s unlikely for cities such as Mercer Island or Newcastle to support funding a south King County Public Health Center, Carrel admits the city of Federal Way cannot afford to foot the $1 million bill at this time.
“The constraint here locally is the City Council has consistently put a significant amount of funding into social services and protecting the most vulnerable in our population,” Carrel said. “We don’t have spare resources to ride to the rescue. It’s going to take other resources.”
In addition to the four proposed clinic closures, Public Health officials are also proposing the Columbia City and North Seattle centers transfer their primary care services to other hospitals. The budget proposal also calls for reductions in the Community Health Services regional programs, Administration/ODIR and Prevention programs.
South King Fire and Rescue chairman of the board of commissioners, Bill Gates, said the commissioners would be discussing the clinic closure at their Aug. 26 meeting in which they plan to prepare a similar resolution in support of the city’s.
For more information, visit www.kingcounty.gov/healthservices/health/budget.aspx.
Public Health Center supporters wear T-shirts that state “Danger, these cuts can kill,” at the Council meeting on Tuesday. Bruce Honda, contributed photo