Save Florida Healthy Start Program

Author: Bob Yelverton, MD

This week the Florida Legislature will begin a joint budget conference to resolve differences in the House and Senate budget for the coming year. While I understand this has been a tough year for a Legislature charged with difficult decisions, in order to reduce the budget, some decisions may carry negative consequences far exceeding those realized by many legislators. A most obvious example is the decision by the House Health Care Appropriations Committee that Healthy Start Coalitions, in existence since 1991, are expendable. As a result, the House of Representatives budget eliminates the $4 million currently provided to the coalitions. The appropriation will be transferred to general funding for county health departments, thus dismantling a system that ensures identification of risk pregnancies and provides patient access to vital medical care and services through a network of prenatal care providers and hospital obstetrical services. Since the Senate version of the budget wisely maintains the coalitions, the joint budget conference committee will decide the ultimate fate.

While shifting budget expenditures from one organization to another may appear on the surface to be a relatively minor item, the unrealized negative impact of eliminating the Healthy Start Coalitions may result from a lack of knowledge or understanding as to how these organizations are actually funded and how they function. Nineteen years ago the Florida Legislature made a bold decision to form the Healthy Start Coalitions as community based, private, non-profit organizations focused on improving the health and well being of pregnant women, their children and families through a private and public cooperative. While some state funding is still obtained annually, the bulk of the services provided by the coalitions are funded by individual grants applied for and obtained by the local coalitions. In addition to the $4 million budgeted by the state last year, the 31 coalitions leveraged another $32 million dollars from children services councils, United Ways, foundations, private donors and other sources. In 2008, the Hillsborough County Healthy Start Coalition alone leveraged $4.1 million dollars in grants from the Children's Board of Hillsborough County, the Ounce of Prevention Fund of Florida, Allegany Franciscan Ministries, the March of Dimes and others. County health departments, many of which do not even provide maternity services, as a public entity will not be able to apply for these grants, thereby losing millions of dollars of non-public funding so desperately needed to provide services for those at risk for pregnancy and newborn related complications, and often unable to provide totally for themselves or their children.

As an obstetrician and chief medical officer of a large medical group providing obstetrical services to women in six Florida counties and as the Chairman of the Hillsborough County Fetal and Infant Mortality Review Committee, sponsored by Healthy Start, I daily observe the benefits gained by preserving a system that has played such a vital role in the 20% reduction in the Florida infant mortality rate during the last decade. Florida currently leads all other southern states in this reduction. Hopefully, the budget conference will adopt the Senate's wise recommendation to continue these vital services by preserving the Florida Healthy Start Coalitions.

Last Revision: April 22, 2010