How will 15% city budget cut affect care?

Infant mortality rates citywide fell to historic lows last year.

But Cincinnati Health Commissioner Noble Maseru told The Enquirer babies will be put in jeopardy if a 15.3 percent cut to the health department in the city's proposed budget isn't erased.

The health department would have to slash staff from its Home Health Program, whose staff educates new mothers and does welfare checks on home-bound elderly.

"The evidence clearly demonstrates that our home visitation efforts work and if lost our infant mortality rate reduction will be reversed," Maseru said.

Also on the chopping block: sanitarians who do food investigations, sewer baiting, swimming pool inspections and bed bug inspections, among other things.

The department's 17 health clinics are safe from cuts.

Mayor John Cranley promised there would be no layoffs – and there won't be.

Vacant positions won't be filled, though. In the case of the health department, that means a reorganization that will result in service cuts.

The proposed budget would be the latest in a long series of cuts to the health department, which has 176 fewer positions than it did in 2000, according to an Enquirer analysis made just before the 2013 election.

Vice Mayor David Mann, who in 1972 was chairman of the Board of Health, said he considers the health department's work a basic service.

"I ... am interested in what it would cost to keep those jobs and where we would get the money," Mann said. "There is still time to talk about this."

City Council members are discussing the 2015 budget, with an eye on passing it the first week of June.

Health officials are expected to make the case against cuts at council's Budget and Finance Committee meeting Tuesday.

Eliminating cuts in one place must be balanced with cuts elsewhere in the city's $358.2 million operating budget.

Eleven of the city's 18 departments are being asked to make cuts.

The Health Department's total all-funds budget is $40 million. The general fund portion of the budget would drop from nearly $21.5 million this year to $18.2 million – a 15.3 percent decrease.

Latisha Amison is urging council to keep the health department's budget intact.

The 38-year-old Westwood woman knows firsthand how important home health services are.

Nine months ago after the birth of her son, Damarjay, health department nurse Traci Lewis noticed immediately Amison was suffering from postpartum depression.

In recent years, Amison's husband, mother and sister had died.

Lewis, who has worked for the health department almost 14 years, sent a weekend shift nurse to check on Amison the next day and then again the following Monday.

Lewis, along with social worker Melanie Williams, directed Amison to a faith-based counseling service and made follow-up visits until the health workers thought Amison was safe.

"I was feeling down and depressed. It was hard coming home with a new baby," said Amison. She cares for 10 children: her brother's four children, her five and her granddaughter. "I couldn't have found the resources on my own."

The city workers reunited last week with their former patient in Amison's tidy home on a quiet side street.

"She had so much inner strength she didn't know she had," Williams said. "I helped her find it."

Maseru, proud of his staff's work, says there are other home visit services, but none like his.

Many won't serve the city's poorest neighborhoods, and even if they do it tends to be for one visit only.

"You can't accomplish much in one visit," Lewis said.

"You have to build trust," Williams added.

For 2013, the city recorded the lowest rate of infant mortality in the modern age, 9.9 deaths per 1,000 live births – down from 13.3 deaths per 1,000 live births from 2006 to 2010.

Despite the recent drop, the city's infant mortality rate remains well above the nation's, with several initiatives aimed at reducing deaths.

Maseru monitored what was happening to mothers served by the city's health clinics and then partnered with two major delivery hospitals, public health clinics and home visitation programs to slice into the death rate.

Not only did the infant mortality rate drop, unsafe sleep deaths fell from 11 in 2012 to five last year.

"We attribute the home visits as being integral to the reductions," Maseru said. ⬛

Cuts ahead

Home Health Program

What it does: The program provides home visits to new and expecting mothers and their children and to home-bound adults.

The cuts: Home Health has 14 positions; the proposed budget would leave nine, a 36 percent reduction.

What it means: Home visits would drop from 200 a month to 125 a month. The health department warned adult patients would face the risk of hospitalization or death. Infant deaths and premature births would increase. Other nonprofit home-health agencies don't have the resources to absorb these low-income patients and in many cases don't serve areas where they live because of perceived dangers and insurance barriers.

Environmental Programs

What it does: These workers oversee food safety, including restaurant inspections, respond to home-health complaints, do pest control and swimming pool inspections. The staff of this program, already hit hard by cuts, is the lowest in 20 years.

The cuts: Environmental health currently has 26 positions approved. If the proposed budget is passed, it would leave 19, a 27 percent reduction.

What it means: Staff would be reassigned leading to complaint response delays; a state mandated inspection of all pools is put a risk and mosquito population testing for West Nile would end.