For the past week, Maricopa County public health officials have been figuring out how to return federal money they've already spent on vaccines.
The federal Centers for Disease Control cut the department's immunization funding for this year by 25 percent earlier this month, said Dr. Bob English, the county's public health director. Nearly all that cash has already been spent.
Immunization money is just the beginning, as public health and all other county departments prepare to eliminate up to 20 percent of their budgets. The county is in a $58 million budget deficit this fiscal year, and finance officials project that next fiscal year, which begins July 1, will have a $98 million deficit.
Already, the county cut $115 million in June to prepare for shrinking tax revenue - whittled down by slumps in homebuilding, retail and other key industries.
County departments laid off 54 employees then and eliminated many vacant positions.
County Manager David Smith has asked each department to draft a "cut list" of programs or operations - listed from least important to most - that account for 20 percent of their expenses.
"What departments feel are the easiest things to give up, compared to other things that are the hardcore services," Smith said.
After months of cuts, English said the public health department has only hardcore services to knife.
"I don't see any way we're going to be able to make the possible levels of cuts that are still pending without it severely interrupting services that are already at a minimal level," English said. Programs that provide immunization and work to reduce the spread of communicable diseases are suffering from federal, state and county cuts.
Maricopa County Superior Court might increase its own cash flow to cover a share of whatever budget reductions come.
Marcus Reinkensmeyer, the judicial court administrator, said the courts provide free packets of legal forms and instructions on how to begin hundreds of legal proceedings, like child custody filings. Those packets might soon cost a few dollars.
And convicts serving probation could face higher fees to cover more of the expense of their supervision.
"They pay $50 a month and we're looking at increasing that amount," Reinkensmeyer said. "That might help to save some of our probation officer positions."
Conversely, to eliminate positions, Reinkensmeyer said the courts could reduce their number of entrances and exits into the courthouses and thereby reduce the number of security guards it needs.
For past budget cuts, the county spared departments headed by elected officials, such as the sheriff's and assessor's offices, from the largest percentage cuts. Those departments won't be considered separately this time, Smith said.
Instead, he and the county's budget officials are meeting with each department to negotiate spending reductions.
Operations in which residents directly interact with county departments, such as filing property documents at the Recorder's Office, are safe.
"I don't expect those kinds of things to be closing up," Smith said.