Revenue generation as budget strategy: Predictors of per capita LHD non-tax revenue

One strategy used by local health departments (LHDs) faced with declining local tax support is to increase revenues from sources other than local taxes. This analysis of LHD expenditure and revenue data aims to identify organizational and jurisdictional characteristics associated with higher revenues from sources other than local taxes. Secondary data analysis using descriptive and multivariate regression methods was conducted on annual Wisconsin LHD financial data from 2002 to 2008. Mean per capita LHD expenditures rose from $25.78 in 2002 to $27.79 in 2007, then declined to 2002 levels in 2008 ($25.92). Mean per capita LHD revenue rose from 2002 ($12.50) to 2005 ($13.81), but subsequently fell to $12.87 in 2008. Overall mean per capita expenditures varied considerably between counties ($8.06 to $58.05) as did mean per capita revenues ($2.92 to $47.26). Organizational characteristics are associated with mean per capita revenue levels. LHDs structured as independent agencies had revenues ($13.84) compared to those structured as part of a human services department ($12.29) (p<.05). Mean per capita revenue was also higher for LHD serving a county ($14.92) compared to a city or smaller jurisdiction ($9.12) (p<.01). A fixed-effects regression model using panel data at the jurisdictional level shows that greater levels of jurisdiction wealth (as measured by property values) over time were associated with higher mean per capita revenue raised over time. There is considerable regional variation in mean per capita revenue across the state (range=$8.13 to $20.51). Additional analyses examining the influence of differences in demand for services and LHD personnel characteristics will be presented. As economic challenges to publically funded services continue, identifying factors associated with capacity to generate higher revenues from sources other than local taxes has implications for LHDs across the country, particularly for those in jurisdictions with smaller local tax bases.