Next week, the House will debate the state budget for fiscal year 2014, which begins July 1st. The budget proposed by the House Ways and Means Committee would lead to further cuts to the Department of Public Health, continued dismantling of primary prevention programs, and little to change the fraying infrastructure of protections that we all rely on every day.
Here are just a few examples:
- Tobacco. Cuts would further reduce smoking prevention and cessation services. Where Massachusetts was once a national model, our program has been cut by nearly 70% in the last 4 years. These further cuts would occur at a time when we are about to raise tobacco taxes significantly.
- Mass in Motion. State funding for Mass in Motion is proposed to be cut, which could lead to the loss of impactful programs in 14 communities with a total population of 1 million people.
- Environmental Health. Our food protection program has only half the number of inspectors recommended by the FDA.
- Health Care Quality. There is a 5 month backlog of complaints regarding health care facilities due to staffing shortages.
MPHA’s complete statement on the budget proposal is here.
If we speak up together in support of public health funding, we can make a difference. Please contact your state representative this week and ask them to support budget amendments to restore funding for public health.
A list of MPHA priority amendments is below and can be downloaded here. In addition to amendments to address funding shortages, please ask your representative to support Rep. Lewis’ amendment (#131) to address the tax differential on cigars and smokeless tobacco as a way to reduce youth tobacco usage and to support increased and regular funding for the Prevention and Wellness Trust Fund.
For additional information on these amendments or for other questions about state public health funding, please contact Maddie Ribble at email@example.com.
Thank you for your advocacy!
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MPHA House Budget Amendment Priorities
(Download this list here: MPHA FY14 House Amendment Priorities)
Environmental Public Health Services (4510-0600)
Amendment #124 – Rep. Lewis at $4,391,414, Amendment #267 – Rep. Speliotis at $4,391,414
The Bureau of Environmental Health safeguards many of the most basic structures we rely on daily – the quality of the air we breathe, safety of the food we eat, cleanliness of the water we drink, and minimization of harmful exposures including pesticides and radiation. These programs – cut by 18% since FY09 – have been chronically underfunded. This funding would allow for the hiring of 16.5 FTE inspectors, focused on food protection, indoor air quality, water quality, medical waste, and childhood lead poisoning. Impacts of past cuts include:
- The elimination of more than 50% of the food inspectors who conduct inspections of food manufacturers and wholesale establishments, a staffing level that is half of the federal FDA performance standard. There has also been a significant reduction in monitoring and support for local board of health inspections of restaurants. A report by the State Auditor in 2007 found severe deficiencies in food protection activities; current funding levels are below those at the time of the report’s release.
- A significant backlog of requests for indoor air quality assessments at elementary and middle schools, as well as other public facilities with potentially-dangerous air quality due to mold and other contaminants. There is typically a backlog of several dozen requests from across the state.
Health Care Safety and Quality (4510-0710) | Amendment #425 – Rep. Steven Walsh at $7,826,326
The Bureau of Health Care Quality and Improvement is central to the state’s goal of promoting health care cost containment and high quality care. Cuts totaling 27% since FY09 have left serious gaps in capacity to inspect, license, and respond to complaints at health care facilities, as well as to perform new responsibilities mandated under the 2012 cost containment law. DPH currently licenses more than 6,000 health care facilities and handles approximately 14,000 consumer complaints each year. There is currently a 5 month backlog of complaints, which can jeopardize patient safety and result in uncoordinated inspections in which investigators are unaware of pending complaints against facilities. This funding will allow for the hiring of 8 FTEs focused on facility inspections, compliance, and enforcement of quality standards.
Health Promotion & Disease Prevention (4513-1111) | Amendment #356 – Rep. Sánchez at $3,354,315
Funding is proposed to be cut by an additional 31%, which would result in a cumulative loss of 85% since FY09. The cut would put $5.7 million in federal and private matching funds at risk. This includes $5.2 million in lost federal funds for breast, cervical and colorectal cancer screening, leading to the elimination of screening services for 7,500 women. In addition, private matching funds toward the Mass in Motion municipal leadership grants could be lost, causing obesity prevention programs to no longer reach 1 million residents in 14 municipalities. These programs help keep residents healthy and control health care costs.
Addressing Tax Differential for Small Cigars and Smoking Tobacco and Increasing Funding for the Prevention and Wellness Trust Fund | Amendment #131 – Rep. Lewis
Recent House and Senate revenue packages raised taxes significantly on cigarettes and smokeless tobacco products. However, cigars and loose tobacco were subject to a much smaller increase, which creates a price incentive for youth to choose these products, especially the candy-flavored cigars that are heavily marketed to children. This amendment would increase taxes on cigars and smoking tobacco, but would exempt premium cigars which do not pose significant risk to youth. The additional revenue would be dedicated to the Prevention and Wellness Trust Fund to combat preventable health conditions and reduce health care costs.
Tobacco Prevention and Cessation (4590-0300) | Amendment #645 – Rep. Hecht at $8,500,000
Funding is proposed to be cut by an additional 5%, which would result in a cumulative loss of 69% since FY09 – this in a year when the state will be generating increased revenue from tobacco taxes. With the expected passage of a $1.00 cigarette tax increase, an estimated 25,000 current adult smokers will quit smoking. Many will call the DPH’s QuitLine for help. To meet the increased demand and to provide adequate support to smokers who wish to quit, DPH will need additional resources. Additional resources are also needed to restore smoking cessation campaigns targeted to high-use populations, such as veterans and their families, people with low-incomes, and those with behavioral health diagnoses. Funding will also be used to prevent youth use of tobacco products. The tobacco industry continues to aggressively market new and inexpensive tobacco products (small flavored cigars and smokeless tobacco) popular with youth. Restoring funding for tobacco cessation and prevention will help smokers quit and will help keep the next generation free of nicotine addiction and all of the health and cost consequences that it brings.
Registry of Vital Records Retained Revenue (4518-0200) | Amendment #725 – Rep. Garlick at $675,000
The House Ways and Means budget would cut allowable retained revenue by 21%. The Registry of Vital Records and Statistics (RVRS) currently earns over $1.5 million of fee revenue from various services it provides relative to issuing certified copies of birth, marriage and death certificates. RVRS is currently authorized to retain $675,000 of that revenue for ongoing operations at the Registry. The balance is deposited into the General Fund. Twenty programs rely on the Vital Records systems to provide services, including daily data feeds supporting Universal Newborn Hearing Screening, Newborn Metabolic Screening, a pregnancy initiative (PRAMS), the Immunization Registry, MassHealth enrollment, CDC, and the Social Security Administration.
State Laboratory and Communicable Disease Control (4516-1000)
Amendment #346 – Rep. Sánchez at $12,631,936, Amendment #544 – Rep. Smizik at $14,900,000
The State Lab is responsible for:
- testing of samples for influenza, tuberculosis, salmonella, lead poisoning, bioterror agents, food and insect-borne diseases, and other hazards
- routine surveillance and quality assurance of disease reporting by physicians, hospitals and laboratories
- training in disease surveillance, reporting criteria, data quality, investigation, and control for local health departments
- investigation of and intervention in response to disease outbreaks
- helping local health departments respond to communicable disease threats
The Hinton Lab is comprised of 17 separate laboratories. Since revelations about misconduct at the drug lab (now housed with the State Police) surfaced, the independent Association of Public Health Laboratories, as well as federal agencies, have conducted inspections and assessed the procedures and quality assurance protocols at the 17 remaining labs. All have been found to be operating at high level of quality and fully up to professional standards. The lab has been cut by 23% cut since FY09.
Public Health Critical Operations and Essential Services (4510-0100)
Amendment #333 – Rep. Sánchez at $18,756,508
This line item – cut 18% since FY09 – supports critical DPH services and staff across the Department, including emergency preparedness, environmental health assessments, implementation and enforcement of regulations, reducing disparities in health care, and monitoring and inspections of nursing homes, food safety, and water quality. Additional capacity is needed to address the development and enforcement of legally mandated public health regulations, including new regulatory responsibilities for pharmacies and health professionals.