A half-decade of budget cuts has left Massachusetts’ public health department so understaffed that it cannot keep pace with a massive backlog of safety inspections for public facilities and investigations into Americans’ complaints about medical mismanagement and malpractice. State public health officials are now begging lawmakers for more funding in order to prevent another public health disaster like last year’s deadly meningitis outbreak, which stemmed from unclean conditions at an uninspected Massachusetts pharmaceutical mixing plant.

The Boston Globe reports that the budget cuts are so steep that there is now a five-month waiting period for investigating consumer complaints at Massachusetts nursing homes, clinics, and hospitals — including for sexual abuse and medical malpractice complaints. Other facilities such as summer camps, biotechnology firms, and food plants are simply bypassing routine inspections due to the dearth of state inspectors.

Funds were appropriated for surprise inspections of pharmaceutical facilities like the one at the root of last December’s meningitis outbreak — but only temporarily. That has public health officials and Gov. Deval Patrick’s (D) administration worried that the Commonwealth is unprepared for another outbreak barring more funds, since the surprise inspections found rust and mold at many such facilities. The state legislature has only appropriated a portion of the funds so far:

“The department has done a herculean task at doing the best it absolutely can with the resources that have understandably been short over the past half decade,” Dr. Lauren Smith said in an interview last week, her last as interim public health commissioner.

Over the past four years, the bureau responsible for health care safety has seen its budget reduced by about $4.7 million, a 26 percent cut when adjusted for inflation, according to an analysis by the Massachusetts Budget and Policy Center.

Smith said the department needs to make the case for more funding “before there is any adverse outcome for any particular patient.” [...]

The House included the pharmacy money in its budget, but not money for the additional inspectors the administration sought.

But even if funds for additional pharmaceutical inspectors are restored in the legislature’s budget, they still won’t be enough to address the logjam of medical complaints. That’s a major problem, since the existing backlog “means that inspectors performing routine reviews often are unaware of the pending issues,” and cannot incorporate them into their investigations.

Seeing as Patrick has been governor since 2007, he had to have signed off — and even advocated — every budget that cut funding for the public health department and led to the current resource shortage. That underscores the unfortunate reality that, while conservatives are often scrutinized for undermining health initiatives, Democratic leaders are also tempted to balance their budgets at the expense of important public health programs.

California Gov. Jerry Brown (D) has paired his support of Obamacare’s Medicaid expansion with big cuts to local counties’ funding that critics say could cripple important community medical resources. In Massachusetts, Patrick himself has fought to shutter state mental health hospitals, arguing that there are already “too many hospital beds” in the state and that patients can simply pack up and go to other mental care facilities — even though such hospitals tend to be dispersed across long distances.

Jeff Bauman, center, promoting the Boston Marathon

In the aftermath of the Boston Marathon bombings on Monday, Jeff Bauman’s image was seared into the American consciousness. An extremely graphic photo of Bauman being escorted in a wheelchair with most of his legs blown off quickly went viral. Public admiration for Bauman rose even further after reports surfaced that he had looked into the eyes of one of the bombing suspects minutes before the explosion, and that the moment he awoke from emergency care, he gave law enforcement critical information that substantially narrowed their field of suspects. But while police continue to scour the streets for at-large suspect Dzhokhar Tsarnaev, the 27-year-old Bauman is scouring the internet for donations to help pay for his outsized medical bills.

Bauman’s friends created the page “Bucks For Bauman!” on the gofundme.com crowdfunding service. The money raised through donations to the site are meant to help Jeff and his family pay the exorbitant costs of his surgeries, ongoing medical care, and physical therapy. Since Tuesday, when the site was launched, Americans from across the country have poured in $158,294 in donations — over half of the overall $300,000 goal.

Bauman has been fortunate enough to receive an impressive number of donations to help him pay his bills, and his uncle plans to buy him his first pair of prosthetic legs. But many other victims in the Boston bombings may not be as fortunate. The cost of treating the bombing survivors’ injuries is expected to exceed $9 million. The out-of-pocket costs associated with that treatment could bury many of the victims financially, even if they do have insurance — unless hospitals, insurers, and charitable foundations swoop in to help, as they did after the mass shooting in Aurora, Colorado.

You can donate to Jeff Bauman’s recovery fund here.

On Wednesday, Cape Cod Online reported on Gov. Deval Patrick’s (D-MA) push to shutter Taunton State Hospital — a Cape-area psychiatric facility that provides long-term care to severely mentally ill patients. Patients’ families are outraged at the effort, arguing that it will eliminate access to essential mental health services. The closest hospitals that provide any sort of comparable mental treatments are over 100 miles away from the Southeastern Massachusetts region.

Patrick and his state’s Department of Mental Health Commissioner, Marcia Fowler, argue that the hospital has “too many beds,” and that patients can receive adequate treatment at other facilities. Shuttering the hospital would save Massachusetts an estimated $12.5 million out of Patrick’s $34.8 billion budget. But the effort highlights the fact that state officials — including those in progressive states — are woefully out of touch when it comes to effective mental health care, often using funding as a conduit for budget savings at the expense of public health. Here are three reasons that Patrick’s decision is the wrong one for sick Americans:

1. It will disrupt effective treatment regimens for the long-term mentally ill.

Treating severely and long-term mentally ill patients isn’t the same thing as treating the flu — patients can’t just pack up their bags, go to a clinic, and expect to receive the same level of care they were getting before. Medical regiments for the long-term mentally ill often involve a combination of social motivation, personal engagement programs, and complex drug cocktails. “You’re not just talking about beds,” said Karen Curtis, whose son is a long-term Taunton patient. “You are talking about a whole program that is unique to Taunton and its campus. They have a transition program (in) four or five cottages right on the grounds. Those cottages are always filled. They have work programs.”

Americans with severe mental illness are particularly vulnerable to disruptions in in their established care regimens. Even short-term changes can have negative effects — especially if patients stop receiving their medication. In an international survey of caregivers for people with severe mental illnesses such as schizophrenia and bipolar disorder, Keep Care Complete found that even doctor-authorized changes to a medication regimen led to a 56 percent relapse rate. That number shoots up to 91 percent for patients who disrupt their established treatments against doctors’ orders.

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