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Budget Cuts and Cessation
– 8/30/05
Q:
One of your peers is being asked to recommend
budget cuts and would like to know, when faced with a cut,
did you cut treatment/cessation? What was the first, second,
etc. thing that you cut? What was your justification for choosing
to cut cessation?
A:
- Colorado: We have been faced with this
situation a few times. The possible choices vary depending
of what each program has in place to begin with. We did
not actually cut our cessation services but eliminated all
funding for paid media. This resulted in a decrease in utilization
of the quitline, thus saving money on both media and the
cessation service costs while maintaining the quitline as
a whole.
- Massachusetts: When MA received 90% budget
cuts, we tried to preserve core programs, and eliminated
face to face counseling but kept the Quitworks program and
support for "Clean Air Works", our statewide smokefree
initiative.
- Michigan: In Michigan during previous
budget cuts, about three or four years ago we de-funded
a Medicaid quitline along with a handful of other contracts.
Each item that was de-funded was selected because of lack
of progress on objectives, poor outcomes, lack of reports
submitted, or high cost compared to impact. The quitline
(for Medicaid clients only) that was being funded at the
time had a very high cost per person, low numbers served,
and low quit rate.
We are again faced with probable budget cuts for next year.
If we lose a percentage of our state dollars our initial
plan will be
- keep state staff because it takes too much time and
training to build back infrastructure
- reduce the amount spent on paid media, this can easily
be built back up again in good budget years
- reduce funding going toward purchasing nicotine replacement
therapy for the quitline, Providing free NRT helps drive
calls to the quitline moreso even than the media and
increases quit rates. However it is quite costly per
person
- reduce the amount of funding to our quitline and/or
require our cost-sharing partners to pick up more of
the cost of the service
- cut or decrease local or statewide contracts that
are not focused on our top priority of passing local
smoke-free ordinances, though we've already weeded many
local contracts out due to previous cuts.
How far we have to go down the list in cuts will depend
on the amount of the overall budget cut.
- Texas: In Texas we have been implementing
a comprehensive program in as large an area as our funding
will allow. When we have faced budget cuts, we have decreased
the size of the area that is receiving comprehensive funding.
Other areas without adequate funding have activities to
promote policy change. This is consistent with CDC's matrix
for how to deal with limited funding.
- West Virginia: Fortunately, in my tenure
as WV's DTP Director, we have been 'blessed' with level
annual funding of $5.85 million. We have not 'officially'
been asked to make budget cuts, but we do have a contingency
plan in place for same. If we had to make cuts: First, we
would cut funding of $200K annually to our Alcohol Beverage
Control Agency for enforcement, as we know that these enforcement
interventions are the least effective of our interventions.
Second, we would cut media funding for our quitline and
cessation services. Third, we would cut media funding for
our youth campaign / Raze efforts.These media cuts would
be about $1 million (about 20 percent) of our annual funding.
If more cuts were needed, we would propose to cut our free
NWT and/or coaching calls given by our statewide quitline.
This would cut another $250K - $300K.
Additional Resources
See pdf
containing model from Terry Pechacek, Associate Director
of Science at CDC’s Office on Smoking and Health.
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