Public health advocates say fewer poor Utahns will get the medical services they need from antibiotics to control the spread of tuberculosis to diabetes check-ups to homeless care because of state budget cuts.
The Utah Department of Health recently awarded $806,000 in Primary Care Grants, a 32 percent drop from the $1.2 million it awarded last year. State lawmakers have cut funding in three of the past four fiscal years.
While 37 programs applied for the state funds, only 29 received the money, leaving eight empty-handed.
The Fourth Street Clinic had requested $50,000 and learned Monday it received nothing, meaning it may be unable to serve nearly 200 people this year.
The loss of the funds means "the state is no longer funding primary care services for homeless Utahns," said Jennifer Hyvonen, clinic spokeswoman.
At one time, the clinic received as much as $175,000 from the state, but that amount had declined significantly in recent years. Still, the money was enough to cover costs of providing primary care to 176 people, who account for 352 clinic visits.
Now those people are "in jeopardy of not being served," Hyvonen said. "If public funding is decreasing, the only way to make that up is to look to the private sector for funding sources, or you serve fewer people."
Just 17 percent of patients seen by staff at the Fourth Street Clinic have health insurance, typically Medicaid.
"The homeless community is one of the most vulnerable of the medically underserved," Hyvonen said. "If our patients do not have access to primary health care, they will never move out of homelessness."
And easily prevented and treated illnesses, such as the flu and colds, are also more likely to spiral into serious health crises that end up with an even more costly trip to the emergency department, she said.
The Fourth Street Clinic's annual budget is $6.6 million; last year, it served 5,300 people, who made 26,600 clinic visits.
The Southwest Utah Public Health Department, which serves residents of Beaver, Iron, Washington, Garfield and Kane counties, also lost $50,000 for its tuberculosis control program. The money had paid for doctor appointments, chest X-rays and the six- to nine-month regimen of antibiotics for uninsured or poor people who test positive and are infectious.
Last fiscal year, the health department treated 26 people. Since July, the health department has been working with five patients "who are now left hanging as there are no funds to serve them," department spokesman Dave Heaton said.
The cuts "greatly reduce our ability to keep that risk of transmission low for TB," he said, adding that the department may shift funds from elsewhere to cover the TB program because the disease can be fatal. "That's something you don't want out there spreading in the community."
The Midtown Community Health Center lost two pots of funding: $50,000 for primary care services in Clearfield, which provided care for 283 people, and nearly that much money for mental health services in Ogden. The mental health money covered medication management for 650 people.
"It will hurt," Executive Director Lisa Nichols said. She added her clinics have received funds for a decade. The wholesale cut was "really a surprise to us."
The Utah Navajo Health Systems also lost $37,580, meaning it can offer fewer home visits and fewer presentations on diabetes. Outreach workers would visit newly diagnosed patients, encouraging them to take their medications and to eat right and exercise. Dennis Hammond, the center's chief financial officer, said it had proven to help those patients keep their diabetes under control.
Marc Babitz, director of the health department's division that include primary care grants, said making the cuts were difficult. Primary care reduces health care costs in the long run, he said.
"It breaks my heart to say we can't fund a program," he said. "But reality is reality."