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Local Health Departments Face H1N1 and Funding Cuts

November 9, 2009

NACCHO''S H1N1 blog will be the voice of local health departments as they share stories on how they have confronted the challenges during the current outbreak, offering sound inside perspective on best practices and lessons learned.

The rapid spread of H1N1—now widespread in 48 states—and the rush to vaccinate have combined to expose both the capabilities and limits of the LHDs. 

Local health officials and employees have faced the demands with impressive resourcefulness. But the lack of funding, resources, and staff support have been resounding themes in the stories received by NACCHO on the current crisis. This situation reflects the major cutbacks that LHDs have had to suffer in the last year.

Mindy Waldron, department administrator at the Fort Wayne-Allen County Department of Health in Indiana, wrote: "We are the second largest county in Indiana in terms of population—first in geographic size. When you see the national, Midwest and even Indiana averages regarding public health workers per one hundred thousand population—we are woefully understaffed. Our average is 16.5 [local health employees] per 100,000 [people]."

"I''m seriously concerned about how we''d function in a truly overwhelming crisis. We have found that the assistance we''ve needed has been during the workday. Our …volunteers are primarily those who are employed, and volunteer when there are after-hours events. In a true disaster, where we''d be functioning on 12-hour shifts and in 24-hour periods, I''m unsure how [we would] meet the demand. The overall staffing/resource issues have been brought to light in the wake of this disaster."

Diane Dierks, public health nurse at the Clay County Health Department in Indiana, echoed these concerns: "We do not have adequate staffing to serve our population. This year, Indiana State Department of Health (ISDH) decided to end funding for the Local Public Health Coordinator (LPHC) emergency preparedness positions within the local health departments, and replace them with a district team concept. Unfortunately, that meant taking away our key infrastructure personnel, and many county governments did not wish to replace this position. The federal and state government need to provide funding to local health departments to cover salaries to ensure adequate and competent staffing."

LHDs will need to be creative in the way they receive and spend funds. In a piece of good news, the Clay County Health Department recently acquired funding from the county and grants in order to hire another full-time nurse to help with emergency preparedness.

Are you a local health official currently facing the same issues? Do you have any useful solutions to share? Please email H1N1info@naccho.org or complete our online story submissions form.


Comments about this post

Ashley Bowen
Such a good point about volunteers only being able to help in non-work hours.  Sometimes we forget that volunteers are just that, and that we cant expect them to completely disrupt their lives in order to help out for 12, 14 hours at a time.

Planning ahead for volunteer contingency plans is important-- especially identifying key skills and asking those folks if they can help out at non-traditional volunteer times.

Good luck to you as you confront H1N1.