San Juan County health director warns of 24% cut to foundational public health services, about $346,000 hit

Mark Tompkins, director of Health and Community Services for San Juan County, told the Board of Health on May 20 that the county will face a 24% reduction in its Foundational Public Health Services (FPHS) grant allocation for state fiscal year 2027.

The reduction stems from a $21 million statewide shortfall related to changes in the state's vaping-tax definition and subsequent budget adjustments. "What came out of the state legislature this year is we received a $21,000,000 reduction to the FPHS account," Tompkins said, explaining the steering committee made roughly $10 million in system-level cuts and assigned about $9.2 million of sector reductions to local health jurisdictions.

Tompkins said San Juan County's share of those cuts equates to about $346,000, effective July 1. He described the $346,000 as the combination of approximately $77,000 from system reductions and roughly $269,000 from sector-specific reductions. "San Juan County, we are gonna get a 24% reduction," he said.

Why it matters: FPHS funds pay for core public-health staff and programs that counties use to meet state-defined foundational services. Tompkins stressed that many FPHS dollars support staffing and program capacity that would be difficult to replace with local revenues.

Board members asked how the reductions were calculated and whether the distribution formula was fair. Tompkins said the administrators used a new base-plus-population formula to allocate the sector reductions and that some jurisdictions voluntarily forewent increases to reduce the severity of cuts for others. He did not have the exact per-jurisdiction base amount available at the meeting and said he would return with precise figures.

On staffing, Tompkins warned the board the department must comply with union rules and legal notice requirements while planning reductions. "We have a process we have to work through with our HR department, following the union contract," he said. He said the county is obligated to provide staff with statutory notice (about 10 working days) and preferred to give more time.

Tompkins also highlighted program-level impacts identified so far: system reductions include cuts to REDCap (a disease-data system used for case investigation), emergency preparedness and response allocations, and some foodborne-illness tracking functions. He said some REDCap-related reductions are delayed until the end of September to allow transition planning.

Board members stressed the compounded effect of prior cuts: the department had earlier consolidated a management position and made other midyear reductions. The county's general fund position also matters: Tompkins and council members said the failed levy lid lift has left the county facing a multi-million-dollar shortfall in the 2027 current-expense budget, meaning further trade-offs across county services.

Next steps: Tompkins said staff will continue internal review to identify where grant-contract reductions will come from and will collaborate with human resources and county leadership to finalize plans. He told the board he expects to present updated, itemized impacts at the next board meeting in mid-June.

Outcome: No formal board action was taken on the FPHS cuts at this meeting; the presentation was informational and the board directed staff to return with more numbers and options.