MACo’s Legislative Director, Andrea Mansfield, recently met with the Maryland Association of County Health Officers, an affiliate organization of MACo, to discuss local health funding and the health department’s role in health care reform. These discussions are intended to frame discussions that will take place during the interim.
The Department of Legislative Services(DLS) released a report at the end of the 2012 interim titled “Survey of Local Health Departments in Maryland” which examined the funding of local health departments in the State. The report focused specifically on: (1) how local health departments (LHD) finance public health services; (2) the impact of federal health care reform on LHDs; and (3) the regionalization of public health services in the State. The findings of this study were posted in a previous blog on Conduit Street. To address the findings, DLS has recommended that additional research be performed to determine whether the current distribution of funds under the Core Funding Program is effective and whether LHDs could benefit from the regionalization of public health services.
The General Assembly also agreed to a study on local health outcomes in the 2013 Joint Chairmen’s Report, a document that accompanies the State budget and summarizes additional actions and recommendations.
Report on Local Health Outcomes and Funding for Local Public Health Services: The committees direct the Department of Health and Mental Hygiene (DHMH), in conjunction with the local health departments (LHD), to monitor and report on its efforts to address the challenges that LHDs are currently facing with regard to the significant funding reductions experienced since 2010 due to the rebasing of the targeted local health formula. Other State budget cuts to local health services should also be addressed. The report shall provide quantitative data from local jurisdictions on negative health outcomes due to State budget cuts to the seven core funding areas, with particular attention to family planning, maternal and child health services, and chronic disease prevention and treatment programs. The impact of reductions in direct care services for low-income populations that do not qualify for access to health insurance under federal health care reform should also be discussed.
These studies provide an opportunity for the LHDs to raise specific funding concerns and comment on their role in health care reform. Funding for LHDs has been cut significantly since Fiscal Year 2010. Cost containment actions of the Board of Public Works in August 2010 and further action during the 2010 General Assembly session, reduced funding from a high of almost $70 million to the base funding level to $37.3 million. In addition, a new interpretation of the statute which once provided for cumulative inflationary growth, is now being interpreted as only one year’s growth in inflation and population, permanently reducing and restructuring LHD funding.
More information on LHD funding and structure can be found in MACo’s blog series, which highlights the many budgetary challenges resulting from reductions over the past few years and describes the expanding pressures placed on these agencies through health care reform and the economic downturn.