In summary

Lawmakers and the governor must look ahead and plan for a public health system that is not just adequate, but second to none.

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By Kim Saruwatari, Special to CalMatters

Kim Saruwatari is the president of the County Health Executives Association of California and public health director for Riverside County.

Vowing that California would never again confront a crisis without a robust public health system in place, the Legislature last year approved a $300 million annual boost in funding for public health agencies that are our frontlines in countering communicable disease and preventing chronic illness.

There was just one catch: The funding would not begin until this year.

Now, the year to fund public health has finally arrived. And in case anyone thought evidence of the need would be diminished by now, the rise of the omicron variant of COVID-19 has dispelled such thoughts.

It’s time for lawmakers and Gov. Gavin Newsom to deliver on their promise to rebuild our decimated public health workforce and infrastructure so that we can continue to combat the spread of COVID – and be prepared for the next public health crisis before it hits.

Last year’s budget agreement was a major step toward rebuilding our defenses against disease, but the needs are great. This year, looking at a budget surplus of tens of billions of dollars, lawmakers and the governor must look ahead and plan to provide for Californians a public health system that is not just adequate, but second to none.

The COVID crisis has taught a lesson that must never be unlearned: When our public health infrastructure is allowed to deteriorate, lives are needlessly lost.

The investments that were committed last year – and must be delivered this year – will begin to reverse a decade of decline in funding for local health departments that slowed our response to COVID-19 and allowed devastating health inequities to persist.

While confronting COVID-19 through testing, vaccinations, education, contact tracing and other means remains front and center in delivering public health services, other diseases have not deferred to the virus that dominates the news.

The pandemic has not slowed – and, indeed, as a result of reduced testing may have sped up – a troubling, years-long rise in sexually transmitted diseases, among others. Previously undiagnosed chronic diseases, notably diabetes, are being revealed as people undergo treatment for COVID-19.

County agencies across the state are being called upon to protect and promote public health in myriad ways: Childhood disease prevention. Maternal and infant health. Tobacco prevention. Chronic disease management and prevention. Lead poisoning detection. HIV/AIDS testing and treatment. None of these can be neglected, even as the public health response to COVID-19 continues.

In addition to revealing the dispiriting results of insufficient past spending on public health, the pandemic has taught us other lessons. In the pursuit of more equitable delivery of services, best practices have been refined.

Local public health departments have conducted outreach and education to populations that have historically been underserved, many in partnership with community based organizations. Local public health departments coordinate efforts and resources to community based organizations to ensure investments are maximized, reach the areas with highest need and eliminate redundancy.

Increased investment will enable local public health agencies that are mandated to provide services and held accountable for performance outcomes to extend and strengthen those partnerships, using data to deploy resources and strategies to address the health needs of all communities.

We know that with the rise of the omicron variant and the devastating impacts of COVID-19 on the unvaccinated, that the COVID crisis is far from over. Local public health agencies, although weary after nearly two years of battling this contagion, are committed to redoubling efforts to slow its spread.

These front-line workers know that no matter what the future course of COVID-19 may be, California can never again let its guard down. The state can no longer afford to invest in public health only during a crisis.

This is the year for state leaders to deliver on the investments that were promised last year. It’s time to not just manage this crisis, but to build the framework that will prepare us for the next.

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