The next session of the Indiana General Assembly is expected to lead to a huge increase in public health funding. The money is part of a plan announced by Governor Eric Holcomb as part of his next-level 2023 agenda. The plan was formed by a state commission that met last year and involves increased funding for local health departments from $7 million annually to $100 million in the budget’s first year and over $200 million the second year.
Kellie Streeter, administrator of the Daviess County Health Department, says the governor’s plan is the result of a lot of work and the realization that many Hoosiers are not healthy.
“The governor launched his public health commission about a year ago, and over the last year that commission has been scouring the state, county by county, to really figure out how we can be a healthier state,” Streeter said. “Public health funding was about 40th across the country. We are notoriously overweight. We smoke. That commission did a lot of work and brought it back to the governor to explain what the county needs and what elected officials are saying. They have made a major request to the governor through the legislature to provide stable funding to health departments across the state.
Streeter says that with only a few million committed by the state in health care funding, local departments have struggled to stay afloat in a battle for grant-based support.
“We’ve been operating on a shoestring budget for many, many years on unstable subsidies, and the only way to deliver the services critical to good health is to fund it just like they fund education, just like they fund transportation, just like economic development,” Streeter said. “The governor has recognized, and so have many of our lawmakers, that the only way to do this is to put it in the budget.”
Officials say the fact that the commission recommended a steep increase in public health funding came as no surprise. The idea that the state would go from $7 million a year to $100 million and $200 million came as a surprise.
“I’ve served on committees and been involved as this has developed over the last year. I knew this was going to happen,” Streeter said. “It’s not a shock. Investing in public health has been at the top of the governor’s priority list since the pandemic. It’s a bit of a shock that local health departments are finally being recognized as a Community resource for more than just vaccinations. But also for pregnant women and people with infectious diseases and critical health problems. Also, for child screenings and emergency preparedness. We provide more services than you think and believe we have enough people to do it”.
For the Indiana public health and public health departments, the COVID pandemic has shown what local health officials can do and what more they need to do.
“Unfortunately, what happens after most disasters is that the workers on the front lines of that disaster are recognized as critical personnel. We were faced with contact tracing, tracing. We have had to deal with all facets of the pandemic. We were the test site until most of the vaccine was delivered,” Streeter said. “It showed both what we can do and where we are missing. There is a lack of lead screening in children. We need to do more about it. We still have pregnant women who smoke. We have issues with oral health that we need to understand. The list is a mile long.”
The state could provide additional funding, but health departments have made it clear that their operations will have to be the result of local decisions.
“In these commission sessions we have loudly said to the state, ‘You can fund us as you see fit, however, the decisions about what we do have to be local.’ Each county is unique. The Daviess County Health Department does not see the same patients or services as Vanderburgh County. You cannot impose your ways on us. We are unique. We have an Amish community and some communities don’t,” Streeter said. “There are basic services, which are mostly what we already do. There are some augmented services, but those aren’t beyond the scope of what we’re able to do. or what we should be able to do. And it’s very clear in the legislative request that it will be based on local data. It won’t be a matter of the state saying do this and do that.”
Daviess County officials say their first step will be to get into the community.
“We learned that we need to be better at building relationships in our community. We have a lower middle income population in our community. We have an immigrant population in our community. We want to go out into those communities to build trust and relationships with them so we can provide them with better services,” Streeter said. “Building community awareness of our special populations, getting into schools, connecting with other partners will at the forefront of our efforts Sometimes you just have to go to people and I think over the next few years we will be working on raising community outreach so people know what services are available and where they can get them.
Streeter says the funding should help health departments make Indiana a healthier place to live.
“Public health is the foundation of everything in Indiana. The economy cannot grow if we don’t have access to healthcare and a healthy lifestyle,” she said. “I think it will mean teaching people that a healthy lifestyle and having services that create a foundation for everyone, from pregnant mothers to safe food to well inspections and septic inspections, will make Indiana better at its core.”