Public Health Funding and Emergency Preparedness


The backbone of public health departments

Christian Sandrock, MD, MPH, Yolo County Health Officer
June 9, 2011

Over the past 15 years, emergency preparedness has been a public health priority. Funding for emergency preparedness skyrocketed after September 11, 2001 and the subsequent anthrax attacks with significant funding directed at public health departments, hospitals, community groups, emergency medical services and law enforcement. As a result, programs were developed for conventional, biological and chemical terrorist attacks, as well as natural disasters. As the threat of pandemic influenza become apparent, and in the wake of Hurricane Katrina, preparedness grants began to encompass an all-hazards approach. With this broad all-hazards approach and events over the past decade, funding remained strong and thus became an essential component of local, state and federal health departments.

In the midst of strengthened emergency preparedness funding, federal funding for general public health has declined by 27% over the past five years. In the past two years, the State of California has decreased its public health budget by 8.5%. Fifty-three percent of local health departments nationally have reported cuts over the past three years with Yolo County experiencing reductions upwards of 13% during this same time period.

Despite these broad cuts in public health, funding for emergency preparedness has remained strong, providing financial support for emergency services, communicable disease, hazardous materials response (HAZMAT) and epidemiology. Funding, however, is beginning to decrease, leaving a void in the backbone of essential public health services. Since 2008, Yolo County’s state and federal emergency preparedness funding has declined by only 2%. Regrettably though, a decrease of nearly 13% is anticipated in next year’s funding which threatens over a decade of growth and partnership.

Emergency preparedness programs provide a number of essential functions that the community and Yolo County rely on daily. Rapid diagnostic testing and information exchange between public health and medical providers has been solely supported by this funding. Countywide communication systems, from radio to hospital-based redundant systems, are used daily. Response training for emergency medical services (EMS), HAZMAT, physician and nurses are used daily in medical care delivery. The rapid ability to provide mask FIT testing and infection control practices in the H1N1 influenza pandemic were directly related to years of training and preparation. Finally, the development of county and regional emergency preparedness relationships and mutual aid systems has provided intangible benefits.

During the last decade, emergency preparedness funding has provided a platform for county and community providers to develop relationships. Doctors, nurses, EMS providers, law enforcement, fire services, homeland security and public health officials have met to implement these emergency preparedness grants, forming invaluable relationships that have supported day to day activities. In any given moment, these relationships can support a new communicable disease outbreak, mass casualty incident or training exercise. With reductions in funding, these workgroups and relationships are likely to decline with immeasurable impacts.

With the decline in emergency preparedness funding, Yolo County public health will need to be creative in maintaining services. Statewide, public health laboratory support has declined and training and communication systems have been cut. Without these grants as a platform, medical and public health leaders will need to continue regular communication and meetings, perhaps using another avenue than that which was naturally created with the emergency preparedness funding and programs.