Officials: ACA repeal could ‘negatively’ affect health funds

March 09--SANFORD -- Repealing the Affordable Care Act without a proper replacement could leave the Lee County Health Department in the lurch on funding certain programs, according to county officials.

The loss of funds could come if the Prevention and Public Health Block Grant funds, which are part of the ACA and given annually as a block grant, are not part of a replacement. According to county Health Director Heath Cain, the total loss could be $53,988 a year which is directed to the county's Healthy Communities Program, immunization programs and HIV/STD services.

"We're looking for an answer basically about where that funding or block grant will be supplanted," Cain said. "That's where we are. There's a lot of information coming from the news right now. I understand both sides of the dynamic. We just want what's best for the citizens here. We want to be able to provide those services. Eliminating those funding mechanisms creates some challenges when it comes to budget time."

The Healthy Communities Program is an outreach effort that focuses on educating the community on issues such as obesity, physical activity and tobacco-free living. The HIV/STD services offers screenings and referrals, while state-mandated immunizations are offered at the health department's offices on Hillcrest Drive.

According to a 2015 report, the Lee County Health Department saw an increase in the rates of all sexually-transmitted diseases, particularly chlamydia, gonorrhea, HIV and syphilis. The report stated that 274 Lee County residents had chlamydia, while 76 had gonorrhea, both jumps from 2014.

Cain said losing funding for these programs would have a "negative impact."

"We're all looking for ways to improve the community's health," he said. "If these services are not available, we'd have to find other mechanisms to make them available."

In response to these concerns, the Lee County Board of Health sent a letter, approved by the Lee County Board of Commissioners, to the county's Congressional delegation -- Sens. Thom Tillis and Richard Burr and Rep. Mark Walker -- urging them to consider the ramifications of repealing ACA.

"If the Prevention and Public Health funds within the ACA are eliminated without considering the impact it will have on these important public health initiatives, the overall health of Lee County will suffer," wrote Dr. Diane Schaller, the health board's chairwoman and a veterinarian at Willow Creek Animal Hospital. "Local public health services will be negatively impacted by the elimination of these critical infrastructure funds. In light of recent national and international concern around communicable disease outbreaks, it is imperative to continue and even increase funding of local public health programs focused on protecting the public's health, improving quality and reducing the cost of healthcare."

At the commissioners' meeting Monday, board members unanimously approved sending the letter to the Congressional delegation. It was expressed that, if the ACA-related funding was taken away, the board would have to find a way to redirect funding from other areas to these programs.

"A lot of people make a lot of decisions that don't seem to take into account how it impacts local governments," said Commissioner Robert Reives. "In those matters that are very serious as it relates to health, we wind up having to figure out a way to make these things (work)."

Board chair Amy Dalrymple referenced the possibility of having to fund the mandated immunization program without help from state or federal government, adding, "Unfunded mandates add up."

For Cain, it's a matter of keeping the public healthy and keeping quality of life up.

"The point that I would want to stress more than anything else is public health is a specific need in the community no matter what area of the community you're looking at," he said. "Any kind of negative impact creates challenges in providing the services we need as a county health department. It puts greater stress on community and the county in general when we don't have the funding available."

Reach Staff Writer Zachary Horner at 919-718-1217 and on Twitter at @Zachary_Horner.

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