Lake, Porter counties navigate Health First Indiana budget cuts
Health First Indiana was created by Senate Enrolled Act 4, which was legislation that passed in the 2023 legislative session, to address public health in Indiana. The program establishes a public health infrastructure through a state and local partnership where each county, after choosing to opt in, can determine which health services to invest in based on community needs.
The state funded the program $75 million in fiscal year 2024 and $150 million in fiscal year 2025. For fiscal years 2026 and 2027, Health First Indiana will be funded $40 million per year, $80 million total, said Porter County Health Department Administrator Carrie Gschwind.
Porter County received approximately $3.39 million in Health First Indiana funds in 2025, and has been notified it will receive approximately $906,000 in 2026, Gschwind said.
'We will have to cut some programming with the 73% reduction and are currently working with our team and partners to determine the most strategic course of action to make the most impact on the health outcomes of the residents of Porter County, keeping in mind those county-level key performance indicators, in light of the reduced funding,' Gschwind said.
Lake County Health Department Administrator Sheila Paul told the Lake County Council Tuesday the department will take a 'big gut punch' after learning it would receive $2.5 million in Health First Indiana funding in 2026 compared to the $9 million received in 2025.
'Lake County deserves a public health infrastructure that is proactive, not reactive. Continued investment is key to making that vision a reality,' said Lake County Health Officer Dr. Chandana Vavilala.
As part of the Health First Indiana program, Lake County established a goal to decrease the rate of mothers not receiving early prenatal care from 33.7% in 2022 to 28% in 2027. Another goal under the same umbrella is to decrease the count of congenital syphilis cases in Lake County from 4 in 2023 to zero in 2027.
Initially, the Lake County Health Department had planned to hire six people to meet its key performance indicator for maternal and child health, Paul told the council. But with the decrease in funding, that program was scrapped, she said.
Vavilala told the Post-Tribune the plan was to open two maternal health clinics – in the northern and southern portions of the county – staffed with a dedicated team of nurse practitioners, social workers and clerical staff.
The clinics and staff would provide comprehensive support to expectant mothers, including prenatal care access, social support and child safety education, Vavilala said.
'Our vision was to take a holistic approach to maternal and infant health, targeting the systemic factors that contribute to poor outcomes,' Vavilala said. 'Disappointingly, with the potential reduction in Health First Indiana funding, we will not have the resources to staff or equip these clinics.'
But Vavilala said Lake County is committed to improving prenatal care access. Department officials will continue to work closely with community partners and enhance internal education and outreach to support maternal and child health throughout the county, she said.
'Establishing two fully staffed clinics would require significant investment overall,' Vavilala said. 'While we continue to believe in the importance of these services, the financial realities make this model unsustainable under the revised funding.'
Beyond this programming, Vavilala said the Lake County Health Department is still evaluating how else the reduced funds may impact programming.
'Our goal is to maximize impact with the resources we have and to minimize disruption to essential services. At this time, no final decisions have been made, and we are actively engaging with internal teams and local stakeholders to determine the best path forward,' Vavilala said.
Health First Indiana was established to help local health departments address health challenges and make health care equitable to all, Vavilala said. So a reduction in the program will impact the county's ability to expand essential services that address pressing public health issues, she said.
'With fewer resources, we may have to scale back or delay programs that directly address health disparities, connect residents to care, and support long-term prevention. This not only limits the reach of our work but also slows progress toward measurable improvements in community health outcomes,' Vavilala said.
akukulka@post-trib.com
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