WORTHINGTON -- Earlier this week, Nobles County commissioners agreed to send letters to U.S. Senators Amy Klobuchar and Al Franken, as well as Rep. Tim Walz, regarding the possibility of significant federal budget cuts specific to health and human services.
The 8.4 percent, across-the-board cuts would occur Jan. 1 if Congress does not enact a plan to reduce $1.2 trillion from the national debt through the Budget Control Act.
The failure to act would result in the loss of federal revenue to every state. In Minnesota, more than $69.3 million in cuts are targeted to programs ranging from Head Start to senior nutrition, special education, Title 1, Job Corps and Veterans employment and training. The cuts to public health programs alone could total more than $8.1 million.
"Public health has suffered a lot already," said Stacie Golombiecki, Nobles County Community Services interim director. She was alerted to the possible cuts -- the result of sequestration -- in a call to action request from the National Association of County and City Health Officials (NACCHO) in late August.
Golombiecki presented county commissioners on Tuesday with draft letters to federal legislators outlining the challenges to county programs if the funding is lost.
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Estimates provided by the Senate Appropriations Subcommittee on Labor, Health and Human Services and Education show five million families nationwide would be denied prenatal care, well child services, oral healthcare and comprehensive care through clinics, home visits and school-based health programs through the Maternal and Child Health block grant. Nearly 212,000 children would not receive vaccinations to prevent diseases, and more than 48,800 women would not be screened for cancer.
"When you look (at) the list, all of these cuts are going to affect our community in some way," Golombiecki said.
In Nobles County, the letter states, "we serve the highest percentage of foreign born people in the state of Minnesota. We obtain WIC dollars, Maternal Child Health special project funds, TANF (Temporary Assistance for Needy Families), public health preparedness and child and teen check-up dollars through the federal government for a large number of families."
Janet Howard, Nobles County's public health supervisor, said the local agency receives approximately $26,000 a year in federal funding for the Maternal and Child Health program.
"One of the concerns I have, especially when it gets to essential services for people in need, is if the states have less federal resources, they're going to have to make some of that up with their state-funded programs," Howard said.
Without federal dollars, and knowing that state budgets are also tight, the concern is that some programs just won't be funded.
Take, for instance, the Community Services block grant. The federal money is used to assist vulnerable children and adults, and is the primary source of funds for that type of programming.
Golombiecki said it would be difficult to provide those services with any cuts in federal funding, but she has yet to explore alternative sources for grants.
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Childhood immunization funds are another concern.
"Right now we have two agreements with the state for uninsured children and underinsured and uninsured adults," Howard said. "That vaccine is provided to us, and we can only charge an administrative fee."
Private clinics have already stopped providing vaccinations for the underinsured, covering instead those on medical assistance or patients who can provide third party billing, she added.
Most grants that are available to public health and human service agencies are program specific, which Howard said leaves agencies with a lack of revenue for general operating. That's where counties step in to help fund health and human services budgets.
In 2013, Nobles County Community Services, which includes public health, human services and corrections, has outlined a budget of $7,106,085.
"Most of the services we provide are mandated," Golombiecki said. "We've already gotten down to what are the mandated services over the last few years."
While the local agency has managed cuts, some rather significant in recent years, both Howard and Golombiecki say there are still some avenues they can pursue if funding is cut further.
"There are many collaborative efforts between counties, and with limited resources, I think it's a good strategy," Howard said.
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As the letters make their way to legislators and Community Services continues to look at alternative funding options, the hope of Golombiecki and Howard is that legislators will come together in the next few months to avoid the sequestration.
Daily Globe Reporter Julie Buntjer may be reached at 376-7330.
