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Protestors hit the streets to say 'nuts' to potential closure of King County Public Health Center in Auburn

If it happens, said Nadia Bucio, she and others like her will lose something vital.

That dire possibility put Bucio, a mother of four in her mid-30s, out on a sidewalk in the stifling heat of an early August afternoon, alongside dozens of other sign wavers and petition gatherers protesting the potential closure of the King County Public Health Center in Auburn.

"I'm out here because they are talking about closing the clinic," Bucio said, standing a patch of green under a tree outside the clinic at 901 Auburn Way North, trying to make her voice heard above the passing cars honking horns in support. "It's going to affect a lot of us."

Bucio relies on the services the Auburn clinic offers, such as family planning, the maternity support services program — a home-visiting and clinic-based program that gives pregnant women and mothers the support they need to have healthy babies — and WIC, a supplemental food program for women, infants and children.

"I get WIC for my kids. I have a 3-year old, and I also come to family planning. It is very important," Bucio said.

It is, say county officials, but the problem is that financial support for public health services has been petering out for the last 10 years.

And now, given an annual $15 million shortfall, they say they may have to close clinics in Auburn, Federal Way, Bothell and White Center.

Although King County has not made any final decisions, its proposal calls for shifting services onto the shoulders of community organizations as they make reductions to services that have suffered cuts in federal and state funds.

Hannah Welander, a former public health nurse and a nurse representative, was one of the organizers of last week's protest.

"King County Health Department has constantly had budget problems because of the motor vehicle excise tax that ended when Tim Eyman's initiative went through, and the Public Health Department really hasn't gone after cities to help support them, and we've encouraged them to do so. Our hope is that they will now start doing that, and I believe that is in process," Welander said.

"More than 10,000 families receive services at the Auburn clinic every year, so we feel that this is going to be a huge loss already. Many people that walked by here today said, 'Yeah, I was on WIC, my boy was on WIC,' moms, dads, everybody. So we think that over 50,000 people will lose services if all of those clinics get shut down, and that's too much.

"...They might have to go to Kent, if Kent stays open. But we don't know what next year will bring. It's been slowly eroding and eroding and eroding. We used to have a lot of visiting home health nurses, and now they've been eroded away, too," Welander said.

According to a county press release, ever since voters repealed the major source of funding for Public Health 14 years ago, and a voter-approved cap on property taxes restricted the remaining source of local, flexible funding, finances for Public Health—Seattle & King County have been precarious,

County officials say they had been able to patch the gap in recent years by "creating efficiencies, spending one-time reserves, securing outside grants and special funding, and reducing staff – including a major round of layoffs in 2009."

Now, however, they say, reductions to federal payments for administering Medicaid and other cuts, have them up against the wall.

"We've run out of rabbits we can pull from our hat," said Dr. David Fleming, director and Health Officer for Public Health — Seattle & King County. "To operate with a balanced budget, we may be compelled to reduce staffing and services."

If the King County Council adopts the reductions in November, those six centers could feel the blow. While the Northshore Center would close, one of its satellite clinics would remain open.

County officials say they made the site-closure proposals with the goal of maximizing services to as many clients as possible. While support services for pregnant women and children and for family planning will be lost at these locations, they will continue to be offered at six other locations in King County, including Kent, Renton and Eastgate, Fleming said.

Altogether, the proposed reductions could lead to more than 200 layoffs. EMS and restaurant inspections would be not be affected.

Fleming said the department's top priority now is to preserve the core, irreplaceable functions that only Public Health is able to provide.

Most Public Health funds come from grants, levies or fees that are dedicated for specific purposes, and cannot be shifted to other services. For example, emergency medical services (EMS) are funded by levy dollars that can only be used for EMS. Restaurant inspections are paid for by fees.

The proposed cuts would not impact all areas of Public Health. Most will occur in three areas that rely on more general funding: Public Health Centers, Prevention Services, and services provided through the Director's Office/Administration.

Two of those centers – in Columbia City and North Seattle – would transfer primary care services to other healthcare organizations, as health reform has made it more feasible for providers to take on more patients. The department is in discussions with NeighborCare and Harborview/UW Medicine to make those transitions in 2015.

Budget proposals will be forwarded to the King County Executive, who will balance competing County needs and limited revenues, and work to preserve the most essential services

The King County Council adopts a final budget in November

All current services will be maintained at Public Health Centers while decisions about the budget are in process.

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