What's at stake: Public health budget cuts

While discussing the state of public health in Oklahoma with a House health appropriations subcommittee, Health Commissioner Terry Cline warned that “Oklahoma is about to become the public health joke of the country.” With Oklahoma standing at 49th in overall health outcomes, ranking above only Mississippi, additional cuts to the Oklahoma  State Department of Health (OSDH) could drop the state’s public health ranking to the very bottom.

The committee has asked all agencies to report how they would be affected by additional cuts of 10, 15 or 20 percent in FY ’11. For OSDH, a 10 percent cut would equate to a $6.8 million funding drop.

Such additional reductions, according to a budget document distributed by the  Department, will continue to erode Oklahoma’s public health infrastructure, impacting vital departmental services, and increasing  the state’s vulnerability to disaster and disease:

State appropriated reductions at this level will continue to erode the public health infrastructure across the state, impacting services that are imperatives of the department.  Specifically, infectious disease control and emergency preparedness and response depend on a minimum level of infrastructure to mount a rapid and effective response.  While the department has been able to meet the challenges presented thus far, erosion in the clinical nursing infrastructure over the past few years has left the State vulnerable.  Continued reductions in this infrastructure may result in reduced response times and the inability of the department to protect the citizenry from natural or man-made disease occurrences and disasters.

The department plans to introduce a few cost saving measures that would adversely impact core health services. These measures would mostly reduce agency staff. Departmental duties of vacant positions will be absorbed by remaining staff, slowing department responsiveness across the board, and impacting vital clinical and  social services.

Staff reductions and other measures will impact clients of various social supports across the state. These include staff reductions in clinical nursing services. Each county nurse serves about 2,000 Oklahomans per year. Six nurses have already accepted voluntary buyout offers, and their vacancies in the county Health departments of Creek, Garfield, McIntosh, Pottawatomie and Pushmataha counties will potentially affect about 12,000 clients. Drops in administrative support positions within Family Health Services will affect programs like Supplemental Nutrition Program for Women, Infants and Children (WIC) and Maternal and Child Health Program (MCH).

The department is planning to overhaul the Child Guidance system, which provides behavioral health services for young children. The Department plans to eliminate 23 Child Guidance specialists staff positions, along with the elimination or reduction of various Child Guidance Clinics. In counties where services are to be eliminated or reduced, 2,745 individual clients were served in 2009.

Reductions to the clinical nursing infrastructure may impact the state’s ability to protect citizens from natural or man-made disease occurrences and disasters. Other reductions in staffing to the Acute Disease Service have contributed to the agency’s inability to conduct approximately 675 disease investigations within the expected response time, and an inability to review, update, or create 200 fact sheets, educational materials and bulletins provided to 5,700 health care providers and the general public. Furthermore, additional fees are proposed for influenza vaccinations and for tuberculosis investigations, including skin tests and x-ray consultations.

The regulatory and licensing functions of the Health Department are also being eroded by staffing reductions. For example, the Department expects processing time for licensing applications for barbers, alarm companies and other businesses to increase by approximately 33 percent. The length of time it will take to issue Nurse Aide registration is expected to increase by 20 percent, while the response time for complaints about long-term care facilities will be slowed by 25 percent. Without adequate staffing, the ability of regulated professions to receive timely and efficient service from the state will diminish and Oklahomans will be at greater risk that complaints and threats to public health will go unaddressed for a longer period of time.

Although staff reductions may meet the immediate needs of responding to budget cuts, the long-term effect for Oklahomans is grim in terms of maintaining the public health infrastructure. The elimination of 295 positions since 2008 means a loss of 15 percent of the public health infrastructure for our state.The reduction or loss of health services will greatly impact the health of infants, children, persons with disabilities, and the elderly.


Oklahoma Policy Insititute (OK Policy) advances equitable and fiscally responsible policies that expand opportunity for all Oklahomans through non-partisan research, analysis, and advocacy.

7 thoughts on “What's at stake: Public health budget cuts

  1. I believe that if we do become “the laughing stock of the nation” with health care it will only make us even with the prison system. We need to continue with treatment for substance abuse and addiction at all costs. Isn;t there someone that can fix this? Or do we allow the whole state to go down at once?

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