Public Health Without WIC?

Let’s try to follow this logic:

• Pennsylvania receives a $400 million annual windfall from the national tobacco settlement agreement;

• Governor Ridge commits the entire amount to making Pennsylvanians healthier; and

• As the money is divided up, our very best public health program for low-income women and children is left out of the discussion.

Bizarre? You bet! But that’s just what has happened in Harrisburg over the course of the past year. The PA Association of WIC Directors met with the Governor’s staff and Department of Health officials last June 23^rd to present their case for a small share of the tobacco funds. And that was the end of that! A proven program that saves about $2.50 in medical costs for each dollar spent didn’t even get to first base.

Why not? Part of the problem is that the Department of Health, which administers WIC, failed to go to bat for it. Part of the problem is that the Governor’s proposal leaves no room for "the little guys" to compete for funds. And part of the problem is that policymakers have ignored the fact that WIC works for healthy babies by encouraging pregnant women to stop smoking!

Meanwhile many WIC programs are struggling through a second consecutive year of budget cuts. Bev Wilson, Director of the WIC Program in York County, has seen her budget shrink by 15 percent since 1998. Many of her costs are fixed and Wilson is determined not to close satellite offices. Her only choices are staff reductions (five positions, a 20 percent cut) and low wages ($5.70 an hour for high school graduates, $9.18 an hour for nurses and dieticians).

Is this any way to run Pennsylvania’s finest public health program?

Joyce Dodge, Director of the WIC Program in Allegheny County, reports difficulties similar to those experienced in York County. Because of funding reductions, Dodge has cut staff by 25 percent over the past three years and can afford to pay newly hired professional dieticians only $17,000 annually. Supervisory WIC staff in Allegheny County haven’t had a raise in three years, and Dodge has been forced to close neighborhood offices.

Statewide Pennsylvania’s federal funding for WIC’s health and nutrition services dropped by $1 million (about 3 percent) in 1999. This year about half of that was restored, but current funding is still $500,000 below the 1998 level. During that time total WIC participation has fallen by 8 percent. But that decrease was almost entirely in the number of children served. The number of infants in the program, and the number of pregnant and breastfeeding women, is virtually unchanged over the past five years.

There’s lots of good stuff in the Governor’s plan: tobacco prevention and cessation (15 percent); a health insurance plan for the uninsured (40 percent); expanded community-based services for older adults (15 percent); research (10 percent); health care-related economic development (5 percent); and an endowment (5 percent). But there’s no room for WIC.

The best hope at this point appears to be SB 1270, authored by Senator Tim Murphy (R-Allegheny County). It would divide tobacco settlement funds four ways: health insurance for the uninsured (20 percent); health research (20 percent); an endowment (15 percent); and regional health boards (45 percent). The regional health boards would allocate the funds based on an assessment of local needs and priorities. Among those priorities would be the promotion of practices to manage and reduce high-risk pregnancies and premature births.

This year’s allocation of the tobacco settlement funds will create the pattern for allocations in future years. The final plan, which will be adopted in May, should include space for WIC to compete. Readers are encouraged to contact their representatives with the message: make room for WIC.