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Tallahassee, FL – The House budget eliminates all funding for the Healthy Start coalitions, which have reduced Florida's infant mortality rate by 20 percent. As Margie Menzel reports, House leaders say the county health departments can contract out those services instead, but critics say no one else can or will do the job.
"With the economics the way they are and more people being unable to afford private insurance, this would be just the worst possible time to eliminate the Healthy Start program. Plus, it would eliminate a lot of jobs."
Charles Mahan is an obstetrician, dean emeritus of the College of Public Health at the University of South Florida, and a former Florida deputy secretary of health. He helped get Healthy Start off the ground in 1991.
"We were one of the worst in the country when we started," said Mahan, "and we brought it back down to the bottom of the top third of the country."
Now, a generation later, Florida's infant mortality has been reduced by one-fifth. But House leaders say they'll save $4 million by shifting the funds for the state's 31 Healthy Start coalitions to the county health departments. Rep. Denise Grimsley, R-Sebring, says the cuts are to administration, not care.
"We did not cut direct services. We are still funding those," said Grimsley. "We did not reduce that at all."
Currently, 25 of Florida's 67 county health departments don't provide prenatal care. Grimsley says they can contract out those services, so access to care won't be affected.
"As you know, I represent many small counties, too, and if I felt that way, we wouldn't be putting this reduction forward," Grimsley said.
But critics say no one else can or will step up to Healthy Start's role.
"What I see with Healthy Start is they are really attacking a problem," said Sen. Evelyn Lynn, R-Ormond Beach. "There's no way the Department of Health could do that job - not to the extent and the success that Healthy Start is doing it."
The Senate has maintained Healthy Start's funding, and Lynn says she'll fight for it in the budget reconciliation process. Mahan says the Healthy Start coalitions bring in $32 million annually through their public-private partnerships.
"For a small amount of state money, they leverage $30 or 40 million extra through writing grants or getting other community groups to get involved, hospitals, etc. And that just never happened before they came along," he said.
Above all, Mahan said, infant mortality and maternal health outcomes are under threat.
"About a third of the county health departments don't do prenatal care anymore, with all the budget cuts they've gotten," he said. "You could eliminate Healthy Start, but no one would pick it up."
In 2009, Healthy Start served nearly 180,000 women and more than 193,000 infants.