After years of flat funding, Connecticut got a healthy spike in aid to a nutritional program for mothers and children in the federal fiscal year that ends today. Yet state health officials on Monday will merge oversight of five offices into five others, cutting staff to reduce administrative costs.
That's because there are no financial guarantees, the officials say. Program funding is not firm until well into the operating year, supplemental funds are not parceled out until about midway, and most of the 10.9 percent increase in 2007 was eaten up by huge milk price increases in the Northeast.
"We continue to feed those folks. There's no saying no," John Frassinelli, co-director of the Women, Infants and Children program at the state Department of Public Health, said Friday.
The department oversees the $41 million federally financed WIC program, which serves 53,000 people in Connecticut. WIC provides food, counseling and medical referrals for pregnant women, infants and children under 5 who qualify. Half the infants in the country are enrolled in the program.
State officials could not pinpoint the total savings or staffing impact of the mergers, but local program operators spoke of layoffs, job reassignments and pay cuts.
A Vernon program coordinator, whose office will be overseen by the East Hartford WIC, will become a full-time nutritionist. In April, another part-time position will be cut and dieticians' hours will be reduced from 40 to 35, East Hartford's health and social services director, Jim Cordier, said.
The departure of the Middletown WIC coordinator will save about $100,000 as that program merges into the Meriden office, said Meriden's health and human services director, Beth Vumbaco. A clerk position will be removed from Meriden, and the remaining three Middletown staff members will receive pay cuts of about $2,500 each.
Vumbaco called the impact on experienced people tragic, but said, "The staff that's there will continue to provide first-class service. They're pros that way."
The cost of a gallon of milk in the Northeast rose from $3.14 in April to $3.74 in August, according to the Consumer Price Index. In about the same time frame, Frassinelli said, gasoline prices skyrocketed and the competition for corn to make ethanol increased the cost of corn-based cereals WIC participants get.
Although $30.5 million of the $41 million sent to Connecticut was for food, officials still had to take $491,000 from about $10.7 million in administrative, outreach and counseling funds to pay food costs, which rose about 12 percent.
"The food supplement cannot be cut in any way shape or form," said Renee Coleman-Mitchell, section chief of the DPH branch that encompasses WIC.
An 8.5 percent increase in administrative funds went to contractual obligations such as rental space, salaries and equipment, Frassinelli said.
Supplemental funds are often available later in the year, but the state cannot bank on them. "You can give folks a raise, then you'd have to take it away Oct. 1. We don't do that," Frassinelli said.
On Aug. 2, the U.S. House of Representatives passed a $5.62 billion WIC appropriation for fiscal 2008, and the Senate will consider a similar $5.72 billion bill, representing 9.9 percent more than was spent in fiscal 2007. The increase would be more than double the increase proposed by the president.
DPH officials, however, are projecting a conservative administrative budget close to their actual total two years ago. They say the funding isn't firm until the award letter comes in February or later. With an estimated 10,000 qualified people not signed up, the caseload could also rise.
And if both the number of participants and the cost of food goes up, as it did this year, "then it's a double whammy," Frassinelli said.
That's why WIC supporters are pushing for the state to share some of the cost, as the Bush administration has encouraged.
"It's taken this kind of crisis of reorganizing for everyone to recognize that we've got to do our share in the state," said state Sen. Mary Ann Handley, D-Manchester, co-chairwoman of the public health committee and a sponsor of bills for state funding of WIC.
New York augments its program funding by $20 million and Massachusetts by $12 million. Connecticut doesn't even come close.
For the first time, a small amount of money for outreach - $125,000 - made it into the Connecticut budget outside the formal process, but, in the last two sessions, bills setting aside $500,000 for WIC failed to pass.
Still, Handley thinks the prognosis for significant state help is good.
"Once people understand, it's not going to be a hard sell," she said. State improvement in outreach would increase WIC's share of federal funds, she said, and a WIC advisory committee is being formed.
U.S. Rep. Rosa DeLauro, D-3rd District, chairwoman of the House agricultural appropriations subcommittee, is proud of the growth in federal WIC funding. "It is now up to each state to focus on outreach and education campaigns to ensure that we are reaching all of those who may be eligible," she said in an e-mail.
WIC is touted as a public health success story that saves about $2 to $4 in Medicaid costs for every $1 spent. Health studies credit WIC for reducing low birth weight, fetal mortality, anemia and obesity, and for enhancing nutrition, breastfeeding efforts, cognitive development and school readiness.
One 2000 records analysis found that WIC prevented more than 300 Connecticut babies from weighing fewer than 5.5 pounds at birth, saving an estimated $11.8 million in medical costs.
In August, participants visiting the Vernon office were greeted by notices saying the site would be closed by Nov. 30, hours at satellites in smaller towns would be curtailed and appointments would be made through the East Hartford office. Fliers urged them to contact their state legislators to lobby for more state money.
The notices were removed about a week later. The Vernon office, run by the Eastern Connecticut Health Network, has been negotiating to stay open, subcontracting with the East Hartford health department, which will head the merged program.
Private health agencies and municipalities contract with the state health department to provide WIC services in the 17 regions, which will be reduced to 12. Along with the East Hartford-Vernon and Meriden-Middletown mergers, the ACCESS Agency of Windham will take over the Day Kimball Hospital region in Putnam; the Waterbury Health Department will oversee the region now run by the Naugatuck Valley Health District in Seymour; and the Stamford Health Department will oversee the Norwalk region, now run by that city's health department.
Raeanne Raiche goes to the Vernon office to get nutrition advice for her 3-year-old daughter, Niesha, and uses vouchers for milk, cheese, eggs, peanut butter, juice and cereal. She also gets parental counseling to equip her for handling her active 10-year-old, Dominic. She was particularly concerned about the possibility that the Vernon office would close.
"Here I feel free to ask anything. They don't try to make you feel stupid or inadequate," she said, before dashing off to get to her part-time job at a law firm.
The local connection with mothers and children is why Cordier and Vumbaco say they hope the state will step up to the plate. Cordier, who worked with the program for 27 years, said WIC serves as a hub to refer people to other health services.
"A whole chain reaction of good can occur," he said.
Reprinted with permission of the Hartford Courant.
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