Capacity of Local Health Departments at the Breaking Point

More than 5.5 million people – two of every five Illinoisans – are served by local health departments that are struggling to serve their communities due to the budget impasse.


Illinoisans are served by 97 local health departments.  These agencies lead their communities in improving health through prevention.  They also inspect restaurants, regulate private water and sewage disposal systems; investigate disease outbreaks; immunize children and adults; help pregnant women, infants and young children access health and human services; prevent child abuse and teen pregnancy; find children affected by lead poisoning; help people quit smoking, lose weight, exercise, and manage chronic diseases like diabetes; and identify women with breast cancer and people with HIV.


Nearly half of local health departments report decreased capacity caused by the budget impasse, including lay-offs, cuts to the length of the work week, reduced hours of operation, or reduced, suspended or terminated services:

  • More than one-third of local health departments have laid-off staff; the most severe lay-offs have been seen in rural health departments like Southern Seven Health Department (many staff reduced to one day per week) and East Side Health District, the health department that serves four townships in St. Clair County, including East St. Louis (half of its staff).  Registered Nurses are more likely to be laid-off.
  • More than one in six local health departments have reduced the length of the work week, often by one hour per day, one-half day per week, or one day per week.
  • More than one in six local health departments have reduced their hours of operation, often by one day per week.


The lack of a budget for General Revenue Funds has led to service cuts: reduced clinic hours for immunization, substance abuse prevention, Teen REACH, school health, WIC, Family Case Management, emergency preparedness, breast and cervical cancer case management, genetic screening and counseling, smoking cessation, and other services. 


The State of Illinois has under-funded its public health system for years.  Exacerbated this year through staff cuts and the exhaustion of cash reserves and lines of credit, the capacity of local health departments to respond to public health emergencies, like outbreaks of Legionnaire’s Disease, Ebola, or natural disasters like the recent floods downstate is at the breaking point.  More lay-offs and service cuts are expected each passing month without a budget.


Failing to pay for prevention now means the problems get worse and cost more to treat.


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