The county’s planned budget cuts to local health services drew withering criticism Wednesday from a member of the public health advisory board and public interest attorneys. During the Sacramento County Board of Supervisors’ second day of final budget hearings, critics charged that the cuts were unlawful and decided in a “closed-door” process.

The supervisors are planning more than 360 layoffs and cuts to numerous county programs to address a budget gap in excess of $54.5 million.

Wednesday’s hearing addressed proposed cuts to health services in numerous areas including immunizations, California Children’s Services, Community Health Promotion & Infectious Disease Prevention, Community Disease and STD Control & Epidemiology and Pharmacy and Support Services.

Ann Edwards-Buckley, director of the county’s Department of Health and Human Services, said planned cuts to the California Children’s Services program would affect 300 children. “There will be 300 children per year that won’t receive medically necessary physical or occupational therapy,” Buckley told the Supervisors.

Stephen Goldberg, a staff attorney with Legal Services of Northern California, told the supervisors that proposed cuts were being considered for programs that are mandated by law. “The California Children’s Program is specifically for disabled children,” Goldberg said. “The scope of the CCS program is mandatory.”

Also at Wednesday’s meeting, a member of the Sacramento County Public Health Advisory Board said the advisory board and community health clinics are “terribly disappointed” with the planned cuts. Marty Keale, who represents community clinics on the advisory board, harshly criticized the county’s process of budgeting for public health.

“From start to finish, that process has been dominated by closed-door decision-making, based largely on rushed, narrowly defined data collection and analysis,” he said. "And now we all face the mess that’s being presented to you today.”

Nav Gill, the county’s chief operations officer, disagreed. “From our side, it’s still a very collaborative process,” he said. Many of the proposed cuts are based on recommendations from county staffers, he said.

Jim Hunt, the acting director of the Countywide Services Agency, also responded to Keale’s comments. Hunt said that he and Buckley have been active participants in the Sacramento Healthcare Improvement Project. They have pushed the agenda of how the county “should reshape healthcare delivery for the Medi-Cal and population and uninsured in Sacramento County,” Hunt said.

Keale said his complaint did not concern that project. “Our issue has been with the budget process — strictly the budget process,” Keale said.

Supervisor Roger Dickinson said reform is needed to address the county’s problems with its public health programs. “This hearing to me just punctuates the point that we have an unsustainable scheme at this point — and a barely rational one as well — that requires systemic reformation.”

Kathleen Haley is a staff reporter for The Sacramento Press.