At the MACo Summer Conference, a panel of public health experts discussed a pressing challenge facing counties today: how to protect and promote community health while working within limited budgets.
Dr. Elizabeth Kromm, Interim Deputy Secretary for Public Health Services at the Maryland Department of Health, opened with a focus on workforce and harm reduction. She underscored that both state and local governments have a long list of responsibilities, from fiscal planning and health delivery to immunizations and infectious disease control. Ensuring access to treatment, especially in areas with historic underinvestment, remains a top priority. Dr. Kromm highlighted the importance of reducing health disparities and keeping the public health infrastructure strong, even as resources tighten.
Matt Levy, Deputy Health Officer for Carroll County, emphasized that local health departments (LHDs) are the heart and soul of public health. But with federal pandemic relief dollars drying up, many counties are now carrying more financial responsibility. Levy noted the tension between state-set priorities and community-level needs, urging greater alignment between the two. Counties are on the front lines delivering essential services even when resources don’t always match local realities.
From a rural perspective, Gena Spear, Health Officer for Allegany County, shared the challenges of serving a declining population while trying to maintain critical services. Transportation and access to care remain major barriers, alongside the difficulty of sustaining a strong health workforce. Spear explained that nearly one-third of her department’s budget goes toward core services, yet longstanding funding formulas have not been updated in 30 years. This means counties are being asked to do more without the structural resources to match.
Dr. Larry Polsky, Medical Director of Calvert County, brought the conversation back to investment. Public health, he argued, is not just a cost; it’s a smart investment in community well-being. He shared that access to mental health services for inmates has reduced re-arrest rates in his county, an example of how targeted investments can produce measurable outcomes. Dr. Polsky asked a pointed question: Why do we wait until people are incarcerated to connect them with care? Preventive strategies, he urged, must take center stage.
Together, the panel painted a clear picture of both the challenges and opportunities for local health departments. Modernizing Maryland’s outdated funding formula emerged as a critical step for long-term stability. At the same time, partnerships, innovation, and prioritizing high-impact services remain essential tools for county leaders navigating today’s fiscal and workforce limits.
As temporary federal supports recede and state budgets shift, the message from this session was clear: strong local health departments are vital to healthy and resilient communities.
Title: Leading Through Limits: Protecting Public Health
Speakers:
- Elizabeth Kromm, Acting Deputy Secretary for Public Health Services, Maryland Department of Health
- Matthew Levy, Deputy Health Officer, Carroll County
- Gena Spear, Health Officer, Allegany County
- Laurence Polsky, Medical Director, Calvert County
Moderator: The Honorable Emily Shetty, MD House of Delegates
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