Amid budget cuts at both the federal and state level, the Spokane Regional Health district is at risk of losing funding.
The local agency provides awareness of public health issues and direct services through its opioid treatment program. The district is anticipating a balanced 2025 budget of an approximately $57.6 million coming in and out of the agency. But as cuts are proposed and carried out by federal agencies and Washington state government, planning for the future is uncertain.
"We're monitoring and have identified all of our projects that potentially could be impacted. And so we are - everyone's kind of waiting and watching," health district Finance Director Kim Kramarz said at a health board meeting last week.
The health district is anticipating $7.8 million in indirect federal grants during 2025. These funds come from the federal government but typically pass through other agencies on the way to a local health district. About half of these funds to the district come from the Department of Health and Human Services through the Center s for Disease Control and Prevention .
A proposed budget cut being considered by the Republican-led U.S. House of Representatives would axe $1.8 billion from the CDC, and approximately a tenth of the CDC staff has been fired amid President Donald Trump's efforts to reduce the federal government's workforce.
"CDC cuts, Health and Human Services cuts would be a big, significant impact to the health district," Kramarz said at last week's meeting.
Some analysts have suggested that a proposed plan to cut taxes and the federal budget could reduce Medicaid spending by billions of dollars. The Spokane Regional Health District receives $9.4 million from Medicaid and Medicare collectively. Those dollars help fund the district's opioid treatment services and its HIV program.
While the status of federal funding remains uncertain, the state budget proposed by Washington Gov. Bob Ferguson likely would cut health district funding. If passed, the budget would cut funding to "foundational public health services" by more than $100 million statewide - from $255 million a year to $130 million a year.
At a news conference last week, Ferguson said the proposed cuts would leave public health spending far above what it was before the COVID-19 pandemic.
"I understand how important these programs are," he said. "So yes, we are scaling that back, but it is still a dramatic increase just in the last four or five years on our investments in that program. But given our budget constraints, we need to dial that back a little bit."
The health district receives $6.1 million dollars from that program each year, and the proposed cut would reduce that funding by 14%, Kramarz said. The health district also receives another $20.5 million in state grants, but it is unclear what the full impact of the proposed cuts could be.
"We haven't been formally notified of any specific reductions, but we're well aware of the changes happening at the state and at the federal level," Kramarz said.