Spokane County commissioners voted to award $6 million in federal aid funding to the Spokane Regional Health District, covering a projected $4.9 million deficit caused by the rising costs of responding to COVID-19.

The funding, approved Tuesday, will be enough to cover contact tracing and COVID-19 costs using current budget figures needed to respond to the pandemic, but will not cover an expected surge in cases in the fall. Spokane Regional Health District Administrative Officer Amelia Clark anticipated the district would need $10.9 million or more to cover the health district’s expenses through the end of 2020 if the county sees a surge in COVID-19 cases later this year.

County commissioners voted to cover the immediate deficit and said they will wait to see if there is a surge in cases before using more more federal coronavirus relief for the health district.

Spokane County was awarded about $90 million by Congress through the Coronavirus Aid, Relief and Economic Security (CARES) Act and is the only local government in Eastern Washington large enough to receive a direct payment from the federal government.

Clark’s estimated budget numbers are best guesses, she said, and funds needed would depend on what type of response a surge in cases could necessitate.

“I am cautiously optimistic that this is where we can stay, but always know that we don’t know,” Clark said in an interview. “That’s been the hardest part with COVID, is we just don’t know, so this is our best effort.”

Clark said she would come back to the commissioners in August and give an update on where the health district is with expenses. Currently, any COVID-19 work, including work done by employees at the health district who are paid by the district, can be funded with CARES funding.

The health district’s current contact tracing budget plan is nearly $6.1 million, with federal and state funds covering $1.15 million of those costs. That leaves $4.9 million for the CARES funding to cover, if the district’s budget were to stay the same for the rest of 2020.

Staffing takes up a large amount of the budget as well as funds to potentially create an alternate care facility and isolation center, should the community need them. The health district’s projected budget also includes funds for personal protective equipment and strike teams to assist nursing homes if there are outbreaks.

Clark’s COVID-19 budget does not include funding for medical staff, which would be needed if the county were to reopen a testing site or provide care to a surge of residents with the virus. The health district does not have medical staff, Clark notes in her budget, pointing out that this would be an additional cost. Clark felt that the commissioners were supportive of “holding back a cushion” of funds in the event of a surge.

Last week, the Spokane Regional Health District board discussed a resolution requesting the county formally commit to using federal aid funding to cover the full $10 million. Commissioners declined, saying they would cover the deficit, but said other cities needed to pitch in.

County Commissioner Al French said the funds will allow the health district to continue responding to the coronavirus and gives cities time to consider chipping in.

“They will have the time they need to have that conversation and see what level they want to participate at,” he said. “If they don’t want to participate at all, it removes the uncertainty.”

He said if cities don’t use their CARES funding on the health district, the county will still cover the expenses. He said he also was willing to set aside more CARES Act funding than was in Clark’s initial budget if it’s needed.

“We’ll follow the advice of the administration of the health department,” he said. “Whatever that number is, we’ll set aside to make sure we cover the expenses.”

Spokane County has not spent the remaining CARES funding, but spent much of Tuesday morning creating a priority list of where that funding should go.

Commissioners Mary Kuney and Josh Kerns both said additional CARES funding will be set aside for a surge in cases and they’ll award it to the health district if needed.

“We are committed to making sure that the health district is funded, and they will have the money that they need to keep our community safe and keep our economy moving forward,” Kerns said.

Kuney said the funding they approved will cover expenses through July, and commissioners will again discuss the situation then. She said she hopes to reserve an additional $4 million to $5 million of CARES funding, which the county would spend if a resurgence occurs.

Kuney also said the governing structure of the health district, or whether cities contribute to it, is not what she is focusing on.

“That’s not going to be my No. 1 priority at this point in time,” she said. “My priority is to fund the health district and getting our businesses back open.”

Spokane Valley Mayor Ben Wick, health board chairman, said he appreciated the commissioner’s commitment to cover the health district’s expenses.

Wick, a proponent of last week’s resolution asking for a formal $10 million commitment from commissioners, said the intent behind that request was to alert the county to the urgency of the health district’s financial situation.

“I’m much more comfortable where we’re at right now, and I think it was very prudent for the commissioners to keep a set-aside,” he said.

Wick said the Spokane Valley City Council had not discussed how to spend its CARES funding, which is about $2.9 million, but would in the coming weeks.

He said he isn’t necessarily against using the city’s portion of the CARES money on the health board, but sees that as more of a regional and county issue that still needs to be discussed.

“We’re not saying that we couldn’t fund public health, but our public health is definitely a regional collaboration,” he said. “In my mind, the county represents the region, our citizens our citizens of the county as well.”

Spokane City Council President Breean Beggs said he wants the council to begin discussions with Mayor Nadine Woodward’s administration about how the city should use its pool of $6.6 million in CARES money, but no decisions have been made yet.

The health district’s potential deficit of $10 million was a “worst-case scenario,” Beggs said, and the $6 million authorized by county commissioners on Tuesday will more than cover what it has spent on the pandemic thus far.

Beggs expressed openness to the city contributing a “proportional” share of the its CARES money to the health district under a regional agreement with the county.

“Nobody has been talking about that, but to be fair, the city hasn’t had much of a conversation about what’s going to happen with its CARES money,” Beggs said.

As a member of the health board, Beggs said his concern last week was ensuring the health district had the funds it needed to continue its efforts. He said he was grateful county commissioners fulfilled their promise to fund the health district.

He argued the CARES money given to the county was based on its total population, which includes the city of Spokane, and that the $6.6 million in CARES money allocated to the city by Gov. Jay Inslee was essentially “a bonus,” and not the equivalent of what the county received.

Spokesman-Review reporter Adam Shanks contributed to this story.