241331 Funding of Essential SERVICES for LOCAL PUBLIC HEALTH

Tuesday, November 1, 2011: 4:50 PM

William Livingood, PhD , Center for Health Equity & Quality Research & JPHsu COPH, Duval County Health Department & Univ of Florida & Georgia Southern Univ, Jacksonville, FL
Bonnie Sorensen, MD, MPH , Director, Volusia County Health Department, Daytona Beach, FL
Lillian Rivera, BS, MPH , Miami-Dade County health Department, Miami, FL
Michael Morris, MPH , Health Services Research, University of Florida, Gainesville, FL
Phil Street, MPH , FL Department of Health, Tallahassee, FL
Leslie Beitsch, MD, JD , College of Medicine, Florida State University, Tallahassee, FL
Susan Coughlin, MPH , Institute for Health, Policy and Evaluation Research, Duval County Health Department, Jacksonville, FL
Nancy L. Winterbauer, PhD, MS , Institute for Public Health Informatics and Research, Duval County Health Department, Jacksonville, FL
Carmen Smotherman , Center for Health Equity & Quality Research, University of Floirda College of Medicine Jacksonville, Jacksonville, FL
David L. Wood, MD, MPH , Department of Pediatrics, University of Florida, College of Medicine-Jacksonville, Jacksonville, FL
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.

Learning Areas:
Administration, management, leadership
Public health administration or related administration
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy
Public health or related research

Learning Objectives:
Describe the challenges that local health departments face in financing essential services which are increasing being used to measure agency performance. Explain broad categories of funding sources for essential services and the implications for Local Health Department performance.

Keywords: Essential Public Health Services, Financing

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was Primary Investigator on the research
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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