Pat Caldwell understands the war-mode could change public health matters for the worse.

"We're seeing public health funds being diverted for emergency preparedness and a lot of resources that were available are being used up. This only compounds the problem," Caldwell said.

Caldwell is a policy analyst for the Association of Minnesota Counties. She works with Margene Gunderson and other county public health nursing service and community health services directors who are reeling from unallotment cuts to state funds already made and Gov. Tim Pawlenty's budget to come.

One can't erase the massive state funding support for the state's own mandates without local governments experiencing the pain.

The AMC policy analyst was one of three experts to "star" in an AMC video that debuted locally last Tuesday.

The video is one of several being circulated by AMC to alert county governments to prepare for the state budget deficit's looming impact.

Public safety, corrections and public health were featured in the latest.

The same day the video pounded home the AMC's message, the Mower County Board of Commissioners took action to, in part, combat the spending reductions for community health services.

At the recommendation of Gunderson, county public health nursing service and community health services director, the commissioners voted to start charging for previously free teen health clinic services.

"That's one of the reactions we're seeing all over the state," Caldwell said. "Counties are charging for services they previously were able to offer the public free of charge."

"There are also staff layoffs and program cutbacks and there's going to be more of each," Caldwell said.

Because the services benefit largely people at-risk, who can't otherwise obtain those services, having counties decide "who's more vulnerable and therefore more needy" is, Caldwell said, "risky business."

"Certainly, these are people who have less flexibility than others and therefore taking these vital services away from them is risky business," Caldwell said.

Unless counties are released from the state mandates to provide the services, more people will slip through the public/community health safety net, Caldwell said.

"Counties will have to scramble for the funds to continue the programs and services or they'll have to do away with them. They can't provide the services without the funding," Caldwell said.

As March nears its end and the 2003 Minnesota Legislature struggles with the massive state budget deficit, only a few things are certain, according to the policy analyst.

"The governor's budget is on the table and the House and the Senate have to react," she said. "The governor and the House are adamant they won't raise taxes. That's about all we know for sure at this time."

With the attention higher education receives, an issue with less status such as public health may be shoved aside, Caldwell said.

The entire public/community health arena may benefit in legislators' and the public's discerning eyes by the popularity and proven success of the Women, Infants, and Children program's track record.

According to Caldwell, the WIC program is an "example of an outcome-based program that is a success."

But, the AMC policy analyst believes, "This is a really critical time for preventative health measures and health care programs for the needy."

"County officials and staff, as well as citizens, have to make it clear that public health issues from disease control to preventative measures are very important and that these programs are working," she said.