The Public Health clinic in Bothell faces closure as Public Health-Seattle & King County faces a $15 million shortfall per year for the next two years.

“We’ve run out of rabbits we can pull from our hat,” said David Fleming, director and health officer for Public Health. “To operate with a balanced budget, we may be compelled to reduce staffing and services.”

The agency’s biggest budget challenge is with its Public Health centers, where expenses have outpaced revenue. This has created an approximately $10 million annual gap in both 2015 and 2016, according to the agency’s website.

As a result, much of the agency’s cuts will occur at the centers. Public Health proposes to close four of its 10 public health clinics: Federal Way, Auburn, Northshore in Bothell and Greenbridge in White Center.

The Bothell clinic at 10808 NE 145th St. serves more than 4,200 clients per year and employs 17 total staff, said Keith Seinfeld, Public Health public information officer.

“We sent out our budget proposals this month and should have a final answer from King County Council in November,” Seinfeld said.

Finances for Public Health—Seattle & King County have been precarious ever since voters repealed the major source of funding for Public Health 14 years ago, and a voter-approved cap on property taxes restricted the remaining source of local, flexible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

This gap was partially patched 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, reductions to federal payments for administering Medicaid and other cuts have pushed the agency past a tipping point.

“But those federal reductions account for about half of the current deficit,” Seinfeld said.

Reductions would impact a range of core public services – such as reducing the capacity for disease investigations, and curtailing Public Health work on tobacco and obesity prevention.

“This is painful and, like you, I’m concerned about our clients,” wrote Fleming in a message to staff. “We’ll work with our communities to try to find ways to mitigate some of these cuts, but at the end of the day, this is likely to result in a loss of services for some of our clients.”

Altogether, the proposed reductions could potentially lead to more than 200 layoffs.

EMS and restaurant inspections will not be impacted. Seinfeld said the department’s top priority is preserving 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.

The Bothell clinic offers family planning services and reproductive health care that includes HIV and STD screening and pregnancy tests; maternity support services and maternity screening; and a teen clinic that provides education and services for pregnancy prevention and for pregnant, parenting and at-risk teens.

Seinfeld noted maternity support services account for most of the visits at the Bothell clinic, as well as other Public Health clinics.

“The good news for Bothell area clients is that we already have created a partnership in that location,” Seinfeld said. “We have worked with HealthPoint at their new Bothell facility and currently offer both MSS and WIC at that location.”

Public Health is looking into the idea of creating a Satellite Team based out of Eastgate Public Health Center.  It would provide rotating staff at Northshore’s current satellite clinics at HealthPoint Bothell and in Carnation, and potentially add other satellite clinics through additional partnerships. This would result in an elimination of services for roughly 40 percent of the WIC/MSS clients served by Northshore PHC, according to Seinfeld.

For more information, visit www.kingcounty.gov/healthservices/health/budget.aspx.