Revive Local Health Funding Today for a Better Tomorrow

LHD InitiativeOne of MACo’s priorities this session is advocating to re-prioritize public health in the face of the opioid epidemic and crises to come by reviving local health department funding.

SB 645 / HB 1082 achieves those goals by restoring local health funding to historic levels and updating the formula to recognize the growing costs of medical care these departments provide.

Want to know more? The following is a primer on Core Funding and how SB 645 / HB 1082 helps.

What is Core Funding?
Local Health Departments are funded through a combination of federal, state, and county funds as well as fee collection. The state “Core Funding” is determined through a statutory formula that sets a minimum funding level with subsequent increases based on inflation and population growth.

What is the Problem?
Core Funding is still historically significantly lower than it once was due to state fiscal constraints, cost containment measures, and new interpretations of inflationary increases. Funding reached a high of $67 million in FY 2008. It is only $51 million in FY 19. That is 23% below where it was 10 years ago. Funding has remained relatively stagnant while costs continue to increase.

How Does SB 645 / HB 1082 Help?

SB 645 / HB 1082 re-bases the Core Funding formula to around $80 million in FY 2021 — approximate amount of what Core funding should be in today’s dollars had it not been cut in the recession. It then ensures that the total amount of funding never falls below that new base. The bill would also change the inflationary index within the statutory Core Funding formula from a general cost-of-living adjustment (based on the generic Consumer Price Index) to a more relevant measure for medical costs.

What Programs Does Core Funding Support?
Dozens of essential public health services and programs can be supported through Core Funding. County health officers can use Core Funding to target local needs and fill gaps in services. It is flexible enough to be applied where other funding sources are limited or unable to be used.

Examples of Programs:

  • Providing mental health and substance use disorder treatment, crisis services, case management and care support, prevention, education and recovery services.
  • Investigation, treatment, and monitoring of infectious disease outbreaks such as Ebola and Zika
  • Administering vaccinations to children and adults
  • Offering testing and treatment for sexually transmitted infections
  • Conducting reproductive health exams, cervical cancer screenings, and family planning services
  • Cancer screenings and referrals
  • Tobacco cessation classes and treatment services
  • Conducting inspection of retail establishments for tobacco sales to minors
  • Conducting case management of children with lead exposure
  • Providing case management and advocacy services for persons with disabilities.
  • Monitoring and health inspections for beaches, public pools, campgrounds, mobile parks, daycares, foster and adoption placement
  • Reviewing and approving permits and collecting well samples
  • Conducting soil evaluation and well water perc testing
  • Conducting food service facility licensing and inspections for restaurants, farmers’ markets, mobile food trucks and temporary food vendors and events
  • Investigations of potential food-borne outbreaks
  • Providing school-based health services such as flu vaccinations, hearing and vision screenings, and behavioral health services.

Who Can I Contact for More Information?
Natasha Mehu, Legislative Director, MACo: 410.269.0043 or

Related coverage from Conduit Street – Archived Blog Series on Local Health Department Funding:

Blog Series: Local Health Departments – Part 1

Blog Series: Local Health Departments – Part 2: Services, Structure and Staffing, and Funding

Blog Series: Local Health Departments – Part 3: History of Local Health Services and Core Funding

Blog Series: Local Health Departments – Part 4: Core Funding Formula and Recent Challenges

Blog Series: Local Health Departments – Part 5: Core Funding Formula and its Shortcomings

Blog Series: Local Health Departments Part 6: Conclusions and Recommendations