InsideOut at City Hall

by Annise D. Parker

A HEALTHIER DEPARTMENT

The condition of the strapped city health division improves

Despite city budget cuts, the health department is beginning to heal itself, with more help from city council members.

I say this staring at a stack of budget amendments submitted by my 13 colleagues. This year, the stack reflects more attention to the health department. How many amendments will be passed this month with the final FY04 budget remains uncertain. But the vital signs are definitely improving.

Health department budget work sessions have grown increasingly tense over the past two years. Some council members grimaced when they saw health clinic client numbers drop while the wait to see a doctor soared from 13 days in 1999 to a whopping 49 days in FY03. Next year’s wait is expected to be 35 days. That is still appalling, but a step in the right direction.

Traditionally, the department has not been a top priority with a majority of councils or city administrations. Compared to many major cities, Houston has contributed few general fund dollars to fight medical crises like HIV/AIDS, Hepatitis C, and the health needs of the uninsured and indigent. “Can you find more efficiencies?” council members would ask health department director Dr. M. des Vignes-Kendrick. “What about more grants?” Seldom did we hear, “Wouldn’t prevention and education be cheaper in the long run than treatment?”

This year, the city’s $40 million budget shortfall has forced even more cuts. Dr. Kendrick replied with efficiencies, staff reductions, and consolidation. I am hopeful that the biggest program cuts, notably the continued closing of the Riverside clinic, can be remedied through new community proposals and some additional general fund dollars.

HIV/AIDS and Hep C

Other program cuts still hamper HIV/AIDS and Hep C efforts. One of my amendments asks the administration to identify all possible sources—general fund, grants, Community Development Block Grants (CDBG)—for increased HIV/AIDS and Hep C funding. I am working with the health department to fine-tune the numbers.

Last year, the administration found $100,000 more for the local HIV/AIDS effort. The general fund contribution has rarely exceeded $200,000. But that $100,0000 does not appear in this year’s budget. Council member Ada Edwards has done an outstanding job of heading the city/county task force on HIV/AIDS in the African-American community, but additional funds are needed to support this critically needed effort.

The city has almost run out of grant funds for Hepatitis C prevention and care and is applying for two new grants. The nation’s fourth largest city should not be totally dependent on grants to fight the country’s most common blood-borne infection. This liver disease, caused by the Hep C virus (HCV), is about four times more prevalent than HIV/AIDS and can actually be cured if caught in time. Unfortunately, most people are not aware they are infected. Education and testing is the key, and the city needs to play a major role, especially through city clinics.

Hep C is spread through exposure to HCV-infected blood through IV drug use, transfusions, high-risk sex, and contaminated tattooing or body-piercing equipment.

Hep C activists, headed by Forward Times editor Ed Wendt with assistance from activist Ray Hill, had been pushing for a Hep C task force. I and several other council members had urged the mayor to appoint one. But in early June, with no response from the mayor and commitments from four mayoral candidates, activists temporarily withdrew the request.

The city can still test high-risk people at clinics by using funds earmarked for communicable diseases. A grant that will run out in November funds only 5,000 tests over a four-year period through community organizations and the mobile health department van. It is estimated that about 2 percent of the population carries the Hep C virus (about 70,000 in Harris County). Although about one-third of those would be eligible for treatment through the hospital district (if they had been tested), only about 170 people are being treated.

Like police and fire, the health department’s mission is public safety—life and death issues. The department is responsible for a wide variety of public safety issues that affect all Houstonians: food inspections and training, animal control, and disease surveillance. How many people are aware that the department enforces federal and state air pollution regulations and operates an ambient air-monitoring network?

The city’s many uninsured and indigent residents depend on city services for immunizations, prenatal care, lead-paint testing, and other care offered through city clinics. It’s high time the health department was treated with the same respect as police and fire and not as the poor relation who is supposed to live off grants.

Annise Parker is serving her third term in Houston City Council At-large Position 1 and has announced her candidacy for city controller. To receive her bi-monthly email newsletter, contact annise.parker@cityofhouston.net or call 713/247-2014. Her website is www.ci.houston.tx.us/city govt/council/1.

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