The Capacity of Local Health Departments Diminished by State Budget Crisis
July 28, 2015 with an update September 8, 2015
We are continuing to see a dismantling of local public health capacity as a result of the budget impasse, the reductions in state funding, and slow payments. These three factors are having such a significant impact because they come after seven years of similar issues which has significantly reduced local health department resiliency to withstand fiscal problems. Local Health Departments rely on three primary sources of funds to provide services to their communities: state and federal grants, property taxes, and fees. Most of the state grants that local health departments receive require additional local funding to pay for the services provided. This reliance on local funding has increased over time and is now unsustainable. The funding structure for local health departments is a house of cards in the best of years, and this year one side is not available, causing for increased instability.
Over the last few years most, if not all, local health departments in the state have reduced staff (mostly through attrition), reduced services and reduced discretionary spending. For example, Vermilion County Health Department had 34 nurses when they responded to the Flu Pandemic in 2009; today they employ 5 nurses, two of whom are part-time.
With the current budget impasse and potential additional cuts in state funding, the number of health departments taking drastic steps continues to grow. The level of steps required to keep some services being delivered to our communities is increasing as the budget impasse continues and as local agencies scramble to meet payroll and pay for services. Each of the steps being taken further dismantles the capacity of local health departments to protect the health of their communities and decreases public health’s ability to respond to outbreaks and other public health emergencies.
As of July 28, 2015:
- 18% have laid off any staff or reduced staff time since June 1, 2015
- 12% have reduced service hours since July 1, 2015
- 15% have suspended or discontinued programs since July 1, 2015
- Eastside Health District laid off 65% of their staff in mid-July. They serve a population of 65,000 which now have drastically reduced services.
- Franklin Williamson Bi-County Health Department has laid off 17% of their staff since March 1st of this year.
- Starting August 3rd Effingham County Health Department will reduce their hours of service from 37 hours/week to 30 hours/week.
- Cumberland County Health Department is now open only 4 days a week and their staff have taken a pay cut.
As cash reserves continue to dwindle and in some cases are no longer existent, additional steps have been taken since this original report the end of July. Over a million Illinois residents live in communities with a local health department which has taken action to reduce staff, hours, or service.
As of September 8, 2015:
- Brown County Health Department has reduced hours of operation by one day, thereby cutting employees’ hours to a maximum of 30 per week; the administrator’s position has been changed to part-time. The board intends to look at discontinuing services if the situation doesn’t improve.
- Clinton County Health Department has 1.5 full-time equivalent (FTE) nursing positions that will not be filled. Nursing staff had already been reduced in recent years. They are also limiting travel and reducing expenses where possible.
- Coles County Health Department eliminated 2 positions as of August 14th.
- Crawford County Health Department has a hiring freeze, cut spending, and non-essential travel.
- Cumberland County Health Department has reduced the hours of part-time staff, sold equipment, eliminated a contract for building maintenance, and staff now perform janitorial responsibilities as a part of their jobs.
- Jackson County Health Department will be closed for business on Fridays.
- Jefferson County Health Department is planning to reduce hours to 30 per week and to be open 4 days a week.
- Kendall County Health Department has seen a 20% reduction in state grant support and has reduced staffing.
- Lee County Health Department is cutting two Family Planning Staff from full time to 80% time and reducing clinic services to 4 days per week. They are not going to replace a nurse who resigned recently.
- Effective September 1st, full-time staff at Pike County Health Department will be required to take a furlough day every Friday. Part-time staff will be required to take 7.5 hours of furlough each month. WIC clinic hours are being reduced from 4 days to 3 days (2 half days and 2 full days) per week.
- Rock Island County Health Department has laid off 1 full time clerical position from its Family Planning and Breast and Cervical Cancer Programs have not filled 2 nursing and 3 case manager positions.
- Effective September 14, Southern Seven Health Department (which serves Alexander, Hardin, Johnson, Pope, Pulaski, Massac, and Union counties at the southern tip of the state) has reduced program directors and managers to a 4-day work week and all other staff will be placed on laid-off status and will work only one day a week. The hours for satellite clinics have been reduced to one day per week.
- The Schuyler County Health Department is currently working with very little staff due to the state budget crisis. A receptionist took another job in July, so that position has remained unfilled until a budget is passed. We have cut staff over the last few years from 6 people down to 3 full time and one part time contractual person employee. It is very difficult to meet the community’s needs on such a reduced staff level. Staff as they are trying to complete workloads that were in the past done by more people.
- Tazewell County Health Department has eliminated three part time positions, has given notice of layoff to three other staff and reduced case management by a full time nursing position.
- Beginning on September 7, 2015, Wayne County Health Department has reduced staff hours from 40 to 32 hours per week and is closed for business on Fridays. Travel and spending restrictions have been implemented.