Over the past decade, local health departments have seen dramatic fluctuations in funding levels, impeding their ability to respond to emergency events like infectious disease outbreaks or severe weather events.
Too often, federal funds are provided on a case-by-case basis after disaster has struck, leaving health departments to play catch up once federal emergency dollars flow. Sustained, consistent funding that allows communities to prevent and prepare would save money and – more importantly – save lives.
Most local health departments are at a unique funding disadvantage, as well. With the exception of Chicago, Los Angeles County, New York City, and Washington, DC, emergency preparedness funding for city and county health departments is at the discretion of state agencies, which disperse the majority of federal funds. The state agencies are not required to report how much of their federal funding is distributed to local health departments, nor are they required to provide justification for those decisions.
THE COALITION'S STANCE
The BCHC is urging federal policymakers to maintain FY 2010 spending levels for emergency preparedness as well as to enhance accountability and transparency in funding to big city health departments.
Cities are on the front lines of addressing public health emergencies, from the introduction of Ebola to the United States in 2014 to the measles outbreak in recent months, but they are last in line to receive emergency funding or be informed of crucial developments.
The BCHC urges lawmakers to:
- Restore funding for the Public Health Emergency Preparedness (PHEP) program and the Hospital Preparedness Program (HPP) to FY 2010 levels.
- Require federal and state health agencies to publicly report how much money reaches local health departments.
PHEP and HPP are critical elements in the United States’ emergency preparedness system. Cuts to these programs translate to an underprepared public health workforce and gaps in equipment and digital resources. The nation’s recent brushes with Ebola and measles represent the new normal: international travel and business will constantly reintroduce viruses from abroad, and our public health system needs to be at full capacity to identify, contain, and prevent threats.
Additionally, the BCHC is concerned that the proposed cut in funding to the Immunization Grant Program (Section 317) will lead to gaps in vaccination coverage, making the United States more vulnerable to acute infectious disease outbreaks. The BCHC urges policymakers not to cut Section 317 funding in the next fiscal year.
CAPITOL HILL BRIEFING: “Short Term Fixes, Long Term Consequences: How Vaccines, Viruses, and Dollars Impact Emergency Preparedness in America's Big Cities"
On April 28, 2015, the Big Cities Health Coalition (BCHC) held a Capitol Hill briefing hosted by U.S. Representative Tom Price (R-GA) and U.S. Representative John Lewis (D-GA): Short Term Fixes, Long Term Consequences: How Vaccines, Viruses, and Dollars Impact Emergency Preparedness in America’s Big Cities.
Representatives from four major metropolitan health departments that have tackled measles, Ebola, and other public health emergencies shared their experiences and highlighted what needs to be done at the federal level to adequately prepare for current and future crises:
- Patrice A. Harris, MD
Director of Health Services, Fulton County (GA) Department of Health and Wellness
Chair, Big Cities Health Coalition
- Wendy Chung, MD
Chief Epidemiologist, Dallas County (TX) Health and Human Services
- Julie Morita, MD
Commissioner, Chicago Department of Public Health
- Jeffrey D. Gunzenhauser, MD, MPH
Interim Health Officer and Medical Director, Los Angeles County Department of Public Health
Read more here.