Online Program

Consolidating Local Health Departments in Ohio: Impacts on Externally Generated Revenues

Tuesday, November 3, 2015 : 9:18 a.m. - 9:30 a.m.

John Hoornbeek, PhD, MPA, Center for Public Policy and Health, Department of Health Policy and Management, Kent State University, Kent, OH
Michael Morris, PhD, MPH, Health Policy and Management/Fay Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR
Matthew Stefanak, MPH, Health Commissioner (Retired), Mahoning County District Board of Health, Pulaski, PA
Josh Filla, MPA, Center for Public Policy and Health, College of Public Health, Kent State University, Kent, OH
In recent years, practitioners and scholars have been discussing ways to improve our nation’s public health infrastructure (Institute of Medicine, 2011). The majority of Local Health Departments (LHDs) serve fewer than 50,000 persons (NACCHO, 2014) and it has been argued that the minimum efficient scale for local health departments involves service to about 100,000 persons (Santerre, 2009). Recent studies have also suggested that consolidating LHDs may yield expenditure reductions and cost savings (Morris et al, 2013; Hoornbeek et al., 2012), as well as potential service improvements (Mays et al, 2006).       

However, relatively little attention has been paid to the impacts of consolidation on the ability of LHDs to attract external revenue to support their operations.  Some may argue that consolidation is likely to have positive impacts on external revenues due to likely expansions of LHD capacities and geographic areas covered, while others may argue that there is little reason to believe that consolidation will have these kinds of effects. 

This presentation will share the results of a mixed method study to assess the impact of LHD consolidation on external revenues.  We use data submitted to the State of Ohio between 2001 and 2011, as well as interviews with local health officials to evaluate the impacts of consolidation on non-local revenues.  We find that consolidating LHDs may experience reductions in non-local revenues in the short term and that this effect may disappear after about two years.  We also discuss the implications of our findings for efforts to consolidate LHDs in the future.

Learning Areas:

Administration, management, leadership
Public health administration or related administration
Public health or related public policy
Public health or related research

Learning Objectives:
Describe the likely financial advantages and disadvantages of consolidating Local Health Departments (LHDs). Explain how LHD consolidations in Ohio have affected externally generated revenues. Discuss the implications of potential short term external revenue loss for consolidating LHDs.

Keyword(s): Local Public Health Agencies, Practice-Based Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have served as principal or co-principal investigator on multiple federal and externally funded grants on issues relating to administration and public health. In recent years, my research has focused on issues associated with collaboration and consolidation of public entities, and -- as a part of these efforts -- I have focused particular attention on local health departments. I also served as Academic PI on the grant yielding the research presentation being proposed here.
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.