Public Health – Eliminate City Funding for Tuberculosis Clinics

Savings: $1.4 million

 

The 2011 City Budget provided 31 positions and $4 million to fight the spread of Tuberculosis (TB).[1]  The City funds three TB clinics operated by the Department of Public Health (CDPH) and one additional clinic that is operated by Heartland Health Outreach, Inc.  As shown in the table below, in 2009, the City spent approximately $1.56 million in City funds on these clinics and, in 2010, it spent $1.2 million. City spending is detailed in the table below. In addition to City funding, the City receives a $2.1 million grant to monitor TB from the federal government.[2]

Spending Category

2009 Spending

2010 Spending

West Side Center for Disease Control

$921,139

$437,428

Uptown TB Clinic

$354,293

$400,314

Englewood TB Clinic

$243,165

$264,566

West Town TB Clinic

$37,108

$104,696

Total

$1,555,705

$1,207,004

Source: Financial Management and Purchasing System (categories are based on budget cost center)

Under this option, the City would eliminate City funding for its TB program, saving $1.4 million and eliminating 13 budgeted positions,[3] leaving $2.1 million and 18 budgeted positions funded by the federal government for the City’s TB services.

Proponents might argue that the number of TB cases in the City has been steadily declining (as shown in the table below) and thus the City no longer needs to devote City funds to fight TB.

Year

# of Cases

Cases per 100K people

2000

398

13.7

2001

377

13

2002

382

13.2

2003

339

11.7

2004

308

10.6

2005

329

11.4

2006

287

9.9

2007

258

8.9

2008

214

7.4

2009

202

7

Source: 2009 Cook County Tuberculosis Surveillance Report

Opponents might argue that the rate of people with TB in Chicago remains higher than the national average and thus, it is important for the City to maintain its clinics and TB monitoring program in order to prevent future TB outbreaks.   Additionally, Chicago remains especially vulnerable to TB because it has relatively larger immigrant and minority populations, both groups that have disproportionately higher incidences of TB than the national average.[4]

 

Others might argue that while there is no matching requirement in the federal grant for the City to receive the funds, the federal government wants recipients to assume part of the cost of the program.[5] Thus, eliminating City funding may jeopardize the federal grant.

Budget Details

Dept: Public Health, 041 Bureau:  Public Health, 2020
Fund: Corporate Fund, 0100 Approp Code: Multiple
The appropriation is located on pg. 115 and the position schedule is on pgs. 124 and 125 of the 2011 Annual Appropriation Ordinance.

http://www.cityofchicago.org/content/dam/city/depts/obm/supp_info/2011BudgetOrdinance.pdf

 


[2] City of Chicago. “2011 Annual Appropriation Ordinance.” pg. 454.

[3] This assumes that 3 positions in Section 3340- West Side Center for Disease Control are related to the TB program.

Source: City of Chicago. “2011 Annual Appropriation Ordinance.” pg. 124.

[4] Kaiser Health Disparities Report. “U.S. TB Rate in 2008 at Record Low; Minority, Immigrant Populations Remain Disproportionately Affected, CDC Report Says”. March 23, 2009.

[5] Catalog of Federal Domestic Assistance. “Tuberculosis Prevention and Control and Laboratory Program.” Formula and Matching Requirements. https://www.cfda.gov/?s=program&mode=form&tab=step1&id=4b2e0fb77a065917754443adcf923092