1. Sequestration: What is it? What does it mean to our community? Board of Health Briefing August 22, 201 John Wiesman, MPH Director, Clark County Public Health Vancouver, Washington

2. Sequestration To sequester means to take something away until a debt has been repaid Federal budget = across-the-board cuts to most programs (defense and nondefense) on January 2, 2013

3. Budget Control Act of 2011 Non Defense Discretionary

4. The Cuts Part 2 Sequestration - 10 years of additional cuts $110 billion a year $55 b in Defense $55 b in Non Defense Many, but not all, low-income entitlement programs are exempt Medicaid, SNAP, TANF, SSI, Pell Grants, UI, some childcare, most child welfare Part 1 Spending caps were put in place on discretionary spending for both defense and non defense programs. $1 trillion in cuts over 10 years.

5. Dollar Impact Clark County Public Health receives $2,285,802 a year in Federal funding (25% of our budget). Sequestration = at least an 8.4% cut At least $192,000 a year in additional cuts

6. Sample Human Impacts In Clark County: 400 fewer babies and children getting access to dental care 280 fewer children vaccinated against disease 22 persons lose HIV case management 7 families having children with special health care needs lose services 1,459 infants, women, and children are dropped from WIC nutrition program

7. Sample Human Impacts In Washington State: 303 Head Start jobs lost and 1,456 fewer children served 1,372 fewer women screened for cancer 4,451 fewer children receive their vaccinations 1,259 domestic violence victims not served 4,141 fewer admissions to substance abuse treatment

8. Sample Human Impacts In United States: 5 million fewer families served for maternal and child health services 659,476 fewer people tested for HIV 211.958 fewer children vaccinated $270 million less funding for home heating and cooling assistance 112,190 domestic violence victims not served

9. At the core As local public health, all the cuts above us (Federal and State), roll down to us We have already cut $5.5 million annually (33% of our budget) And Eliminated 71 positions (47% of our staff) Nationwide: 40,000 public health jobs have been cut already (20% of the workforce)

10. Risks from Additional Cuts Public safety Healthy starts for children Health care costs increase even faster

11. The Ask Encourage our Federal elected officials to find a solution other than sequestration. Thank You.