(The Center Square) – Spokane Regional Health District officials outlined a $57 million budget proposal on Thursday with $1.37 million in the red that the Board of Health expects Spokane County to pick up.
The budget proposal comes as the Board of County Commissioners grapples with a $20 million deficit of its own. SHRD receives some of its funding from Spokane County, so the commissioners had asked all of their outside agencies and partners to budget flat for next year to avoid having to raise taxes.
Finance Director Kim Kramarz said everything is going to plan so far this year, with SHRD having spent only $35 million, or 60.8% of the 2025 budget. The Board of Health passed a balanced budget last fall with $57.5 million in spending, but it required an additional $2 million from the county to achieve this.
The 2026 proposal spends $57.77 million, but SHRD is only requesting $1.37 million from the county.
“This is down $675,000 from 2025,” Kramarz told the SRHD Board of Health on Thursday. “Spokane County had met with us early on to ask us to see what we could do with a reduction to our budget.”
Kramarz said the budget team began preparing for next year in June. Personnel and benefits make up 55% of the 2026 proposal, with employee headcount increasing by six to 282.25 full-time equivalents.
State and federal grants make up most of SHRD funding, at nearly $30 million, with Medicare/Medicaid fees and public health fees/permits providing another $15.3 million. Local grants, donations, existing fund balances and other revenues account for the roughly $12.4 million in remaining funding for 2026.
The board also discussed its proposed fee schedule for next year, but it’s largely unchanged compared to 2025. County Commissioner Amber Waldref noted that only the four elected officials on the Board of Health would be able to vote on that in the coming weeks, and not the three appointed members.
Kramarz said the state published an accountability audit and a financial and federal audit into SRHD on Thursday, neither of which resulted in any negative findings. Those reports dig into last year’s finances after SRHD failed to verify the eligibility of a vendor that received $618,712 in federal funding in 2023.
Whenever an audit reveals findings like that, it increases the likelihood of further probes in the future.
“This year we had a clean audit, no findings,” Kramarz said. “And so the following year, one more year, [if] we have another clean audit, we will drop back down to the low risk.”
