Governor backtracks on plan that would've taken millions from county Public Health

Public health officials in Santa Barbara County and elsewhere are celebrating recent changes in Gov. Gavin Newsom’s proposed budget, which originally included a plan to take funding from several counties to provide health care coverage to undocumented residents.

Earlier this year, Gov. Newsom proposed a plan to divert millions of public health dollars from 39 counties to expand Medi-Cal coverage to young adult immigrants ages 19 to 25, regardless of their legal status. Medi-Cal already covers eligible immigrant children under age 19 regardless of status.

Santa Barbara County was included in the proposal, and county Public Health Department Director Van Do-Reynoso said her department would have lost $2.1 million of its budget for fiscal year 2019-20 as part of the plan. That would have been a huge loss for the county’s Public Health Department, which Van Do-Reynoso said runs on an average annual budget of about $3 million total.

“We were really worried about what it would mean in terms of what we could do here,” Do-Reynoso told the Sun, adding that her department fully supports the effort to provide health care to undocumented residents. “But not at the cost of public health services.”

The funding losses would have made it more difficult for the county to investigate and survey a number of current public health issues, including the county’s increasing rates of sexually transmitted infections and tuberculosis, many strains of which are proving to be multi-drug resistant.

As a result of Newsom’s initial plan, Do-Reynoso said the county Public Health Department would have also seen reductions in laboratory testing and analysis necessary for disease control and environmental health activities, reductions in health education programs, less support for mental health work and human trafficking victims, and the loss of the ability to leverage state funds to attain federal matching funds.

Newsom’s proposal would have hit Santa Barbara County and a few others particularly hard because of a funding formula change made in 2013, which left Santa Barbara County with only enough funding for core public health services. In 1991, Santa Barbara County and other counties were given health realignment dollars in an effort to expand health services to “indigent” and undocumented immigrant populations.

But in 2013, much of that funding was redirected back to the state when Medi-Cal was expanded to cover portions of those populations, Do-Reynoso said. The reasoning, she said, was that with more people covered and getting regular health screenings, public health departments would need fewer dollars to provide services.

Santa Barbara County was labeled a “60/40,” because its Public Health Department gave 60 percent of its budget back to the state in 2013 as part of the redirection, and kept 40 percent.

Along the same line of thought as 2013, Newsom’s recently proposed redirect assumed that county costs would decrease because of the latest Medi-Cal expansion to cover undocumented adults aged 19 to 25. However, Do-Reynoso said Santa Barbara County does not currently cover undocumented indigents because of the changes made in 2013, thereby creating no opportunity for decreased costs.

Santa Barbara County’s Public Health Department and others in similar situations—including Sacramento, Placer, and Stanislaus counties—spoke out against Newsom’s initial proposal, speaking at public meetings, writing letters, and developing fact sheets showing the potentially dire effects the plan could have on public health services.

Newsom recently announced changes to the plan, which would now divert significantly less total funding and from only 35 counties; Santa Barbara and the three other counties that opposed the original plan are not among the agencies to lose funding.