Funding of Essential SERVICES for LOCAL PUBLIC HEALTH

The Florida Public Health PBRN conducted the study of county health department leaderships' perceptions of funding sources for Essential Services (ESs) to assess how ESs are funded. We used secondary data sets from the state of Florida budget system and primary data from an on-line survey tool based on PHAB standards for ESs. In addition to descriptive statistics, we use regression analysis to assess the impact of variations in funding on the LHDs' delivery of ESs. The response rate for all CHDs in Florida was 74%. Self assessed CHD's performance for each of the ESs varied extensively among the CHDs and across the 10 ESs, ranging from a high of 98% CHDs completely or almost completely meeting the standards for ES 2 (investigating problems and hazards) to a low of 32% completely or almost completely meeting standards for ES 10 (Research and evidence). Adequate and very thorough documentation similarly varied extensively from 100% to 48%. Per capita revenue support varied extensively among the CHDs with most (72%) of CHDs reporting decreased revenue support for ESs. This study also found that financial support for ESs is heavily reliant on non-categorical (discretionary) revenue in comparison to categorical (program specific) revenue or revenue from fees for services. Funders and LHDs may need to collaborate on more innovative approaches to support ESs through fees and categorical funding streams that are ostensibly dedicated to other more traditional programs and services.