Recent national threats of bioterrorism have exposed severe deficiencies in an already overburdened and underfunded health care system, and with further budget cuts looming, local and national health officials are sounding the alarm.

“I think the people should know that in Island County and in Washington state right now, we do not have the capacity to respond to a real bioterrorism threat,” said Island County Health Director Tim McDonald on Thursday.

“What we’ve done for years is not fund adequately the whole broad area of communicable disease prevention,” McDonald added. “A small part of that broad area is bioterrorism, and bioterrorism allows us to understand our weakness in communicable disease.”

Human and Health Services Secretary Tommy Thompson announced on Friday that Washington state would receive over $20 million in federal money to improve response to bioterrorism and other health emergencies. It has yet to be determined whether or how the money will break down into local dollars, McDonald said.

“I’ve been in this game long enough not to get overly optimistic about finds coming in,” McDonald said, adding that he is waiting to see what strings are attached to the package and how it will assist local health departments, if at all.

“I’m looking forward to hearing more specific information about how this new funding will assist our own community,” McDonald said. He is especially concerned with his department’s capacity to monitor and respond to communicable diseases.

McDonald called communicable disease surveillance and bioterrorism preparedness a “good fit” because, though bioterrorist attacks so far are quite rare, the health department can ready itself for them through its routine monitoring of disease outbreaks.

McDonald said even though no anthrax was found in the state during the national scare that followed the Sept. 11 attacks, the Island County Health Department was nevertheless maxed out in responding to the numerous so-called credible threats.

“It was a relatively small event,” McDonald said of the anthrax scare. “It taxed our system completely.”

McDonald’s comments were inspired by a press release from the Washington State Association of Local Public Heath Officials titled, “Local public health in critical condition: poor funding & political games risk lives.” The release outlines in broad and alarming language the financial and structural obstacles government agencies currently face in responding to potential health-related emergencies.

This Friday in Olympia, health officials from around the state testified before the House Health Care Committee that “budget cuts could cost lives,” according to the report.

Perhaps the most disturbing piece of the release are comments made by Snohomish health officer and M. Ward Hinds, who stated that “if a significant outbreak of smallpox were to occur in Everett, we quickly would be overwhelmed — the 600,000 lives in my county and three million lives along the I-5 corridor would be in jeopardy.”

McDonald described these comments as “very accurate,” adding that, in general, health agencies are “underfunded in our county, in this state and in this specific community.”

Because the Board of Island County Commissioners opted to utilize a large portion of the county’s reserve fund to balance this year’s budget — rather than enacting massive cuts to departments across-the-board — the health department was spared anything but minor cuts to its own budget. However, without significant reserves to protect the county from certain budget difficulties in years to come, the future of funding to health programs looks pretty bleak.

About 20 percent of health department funding comes from tax dollars, McDonald said. Early indications from the state legislature now in session are that all “backfill” funding, which makes up a portion of the revenue counties lost when the Motor Vehicle Excise Tax was eliminated in 2000, will be discontinued.

The loss of backfill funds would entail a double-blow to Island County’s health department. Not only would the department lose about $100,000 in direct funding; they could also see cuts as the county covers its own loss of approximately $400,000 in backfill money.

Most health department funding comes in the way of grants and fees. McDonald said this money is also threatened in the current climate of slice-and-dice budget balancing.

“I think the state legislature will probably cut down the amount of money we receive in grants,” McDonald said, adding that he is most concerned about funding beyond this year.

“The handwriting is on the wall,” McDonald said. “I have to be realistic that we will probably have cuts over the next 2 or 3 or 4 years in our budget.”

McDonald said few people are aware of the range of services provided by local health departments, whose duties include monitoring water quality, food quality in restaurants, providing immunization services for children, as well as monitoring, responding to and investigating outbreaks of communicable diseases.

In the instance of communicable diseases, it is the health department’s job, along with investigation and prevention, to “practice early intervention, and scramble out and make sure everyone who needs medicine gets medicine,” Mcdonald said.

“When you get specific to bioterrorism,” he added, “you have to do a lot more things, because there’s a crime being committed, too.”

Considering that the mere threat of anthrax pushed Island County’s response capacity to its limits, it would appear too soon to sit back and breathe a sigh of relief over what has or hasn’t happened yet — and this despite reassurances that everything is under control.

“I was frustrated when I heard some national politicians reassuring the public,” McDonald said. “Most certainly, our system right now is not in a state where we can respond.”

McDonald said that it has been the health department’s practice, when responding to a crisis, to pull public health nurses and professionals away from other jobs for help. Unfortunately, McDonald added, “all those other jobs are being cut, too, along with the rest of the government infrastructure that’s being cut.

“I would say the thing I fear most is for our health department to be cut so much in certain areas that we’ve simply lost the capacity to provide a service,” he said.