Health dept. delivers layoff notices; maternity services hardest hit

King County public-health managers Thursday notified 123 employees — nearly 10 percent of the department — that they will lose their jobs at the end of February unless the state restores funding for a highly-regarded pregnancy-health program.

Public Health Director David Fleming, who warned employees earlier this week of the impending layoffs, said they are a response to a $23 million reduction in support for King County health programs approved by the Legislature last month.

About half of those receiving layoff notices are nurses. Also at risk of losing their jobs are interpreters, administrative staff, managers, social workers, dental assistants and community-health workers.

Most of the layoffs are in Maternity Support Services, a program that works to improve infant survival and health among 30,000 low-income women and babies.

The county made some cuts to the program Jan. 1 because of its own budget problems. The state cuts, which would slash state support in half, are to take effect March 1.

The Snohomish Health District will lay off or reduce hours of seven employees next week, Health Officer and Director Gary Goldbaum said. The Snohomish County Council shifted money from an intensive program for high-risk families to the district's maternity-support program known as First Steps to keep that service alive in the face of state cuts.

Patty Hayes, executive director of WithinReach, an advocacy group for maternal and child-health programs, said state-supported maternity programs have reduced medical and cognitive problems associated with low-weight births to teenage mothers.

"This is the beauty of the research that has emerged: that when we intervene with these high-risk moms, not only do they deliver healthier babies, but if we help them for a while afterwards they know how to be a family. That doesn't happen anywhere else," Hayes said.

The Legislature also has approved a 30 percent cut in Medicaid reimbursements to county and private clinics that primarily serve low-income people. That $10 million cut could result in the closure of most or all of the county's public-health clinics, Fleming said, but he hasn't yet ordered layoffs because he's hopeful the Legislature will restore those dollars.

The clinics provide services for 120,000 clients, although most primary care to poor people in King County is provided by private nonprofit community-health centers.

The cuts to Maternity Support Services and Medicaid reimbursement to clinics, adopted in the 2010-11 supplemental budget, would be continued for two more years under Gov. Chris Gregoire's proposed biennial budget.

The Snohomish Health District, which doesn't provide primary medical care, wouldn't be directly affected by the reimbursement cut but private community-health clinics would, Goldbaum said.

The state cuts follow three years of service reductions resulting from King County's own budget problems. Public Health — Seattle & King County has eliminated immunization clinics, child-care nurse visits outside Seattle and outreach to homeless pregnant women with alcohol or drug problems; closed a teen clinic in Kent; and reduced other services.

Fleming appeared before two state House committees Thursday to discuss recommendations from the Puget Sound Health Alliance and the Governor's Workgroup on Health Care Reform that he said could save enough money to keep clinics open.

Among those recommendations are expanding use of generic drugs and reducing cesarean sections and unnecessary CT scans and MRI's.

If the state changed its Maternity Support Services guidelines to allow funding of educational and support groups for moms, instead of just individual services, Fleming said, tax dollars would be used more effectively.

"The sad thing" about cutting maternity support and clinic care, Fleming said, is it means more low-birthweight babies will be hospitalized and other patients will receive care in emergency rooms at higher costs.

Cutting "measures that are proven to be lifesaving and cost-saving just doesn't make any sense," Fleming said. "Instead, we need to be working creatively with the state to come up with innovative alternatives."

King County Executive Dow Constantine, in a statement, called the cuts "devastating" and said he would work with the state "to reinvent how we protect public health."

Tina Maestas, a Maternity Support Services nurse, said in a statement issued by the Washington State Nurses Association she is concerned about possibly losing her job but also concerned about her clients. "I don't know what to tell them about these funding cuts. It breaks my heart," she said.

Keith Ervin: 206-464-2105 or kervin@seattletimes.com