Health First Indiana set to receive less funding as legislators debate its impact

Chicago Tribune

31-03-2025

The Lake County Health Department partnered with organizations to address chronic illnesses, disease prevention and gun safety. The Porter County Health Department partnered with organizations to address disease prevention, heart health and mental health for first responders.
As the state legislature discusses the future of Health First Indiana funding, Lake and Porter County health officials would like to see the state continue funding the program.
Health First Indiana was created by Senate Enrolled Act 4, which the legislature approved in 2023, 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, said Sen. Ed Charbonneau, R-Valparaiso, who authored the bill to establish the Health First Indiana program.
In the upcoming two-year budget, the program has been slated to receive $100 million in fiscal year 2026 and $100 million in fiscal year 2027. But, as the budget has been discussed in committee, some legislators have voiced concern about continuing to fund the program.
While Health First Indiana has been successful, Charbonneau said its funding, like the funding for all programs, has been closely examined this budget session as the legislature grapples with a nearly $1 billion Medicaid shortfall.
'Not everyone is 100% convinced that it's working. A part of the issue, the problem, that we're dealing with is the fact that this isn't like an economic development project where you invest $100 million … and you have an almost immediate return on your investment. This is a long-term commitment, and it's not going to provide any measurable results for many years,' Charbonneau said.
In Lake and Porter counties, health officials said the program was created as former Gov. Eric Holcomb's administration realized how far behind Indiana lagged in public health measures nationwide. The money they have received, officials said, has gone toward improving public health, the effects of which won't be seen for a few more years.
'We strongly believe that good public health and good preventative care is going to be very good in terms of overall health of the county. That will reduce the number of people who need the emergency room, it will require less hospitalization,' said Lake County Health Officer Dr. Chandana Vavilala.
Lake County – Health First Indiana
Lake County received approximately $190,500 in 2023, approximately $6 million in 2024 – of which approximately $1.2 million was split between the East Chicago and Gary health departments – and approximately $11.6 million in 2025 – of which approximately $2 million was split between the East Chicago and Gary health departments, said Lake County Health Department Administrator Sheila Paul.
The Lake County Health Department has spent its funds toward 20 partnerships, including the Indiana University School of Medicine with disease prevention education, the Purdue Extension to address chronic disease prevention, and the Food Bank of Northwest Indiana for medically tailored grocery supplies for at-risk pregnant women and those with anxiety and depression, Vavilala said.
Michelle Arnold, the Lake County Health First Indiana program director, said the Purdue Extension partnership focuses on chronic disease management, like diabetes, and its Be Heart Smart program, which focuses on food label education, nutrition and physical activity.
Through the Food Bank of Northwest Indiana partnership, the health department will receive a locker that has a refrigerated section to provide food and a separate section for hygiene products, diapers, coats and other items, Arnold said.
The Lake County Health Department has partnered with the St. John Fire Department to help people prevent falls and reduce emergency room visits, Vavilala said. The department also used the funds to purchase a mobile clinic to increase access to health services, she said.
Further, the department partnered with Methodist Hospital to support maternal and infant well-being, safe sleep and car seat education and breastfeeding instructions, Paul said.
The department has also partnered with Mental Health America for safe sleep education for at-risk parents and caregivers, and for gun safety education for families with young children, Paul said. It has also partnered with Sounds of Sarah to provide education and awareness on dangers of illicit drugs, addiction prevention and access to life-saving services, she said.
The Health First Indiana funds have helped the county increase access to preventative care and health screenings, strengthened community partnerships, expanded home visiting and case management services for vulnerable populations, among others, Paul said.
If the funding were reduced, Paul said, it would 'significantly limit our ability to provide and expand our services.' A potential reduction would result in the roll back of the mobile clinic to rural and underserved communities and home visiting programs would be scaled back, which would increase avoidable hospitalizations.
Reducing public health funding won't benefit the county or the state in the long run, Vavilala said. Funding public health improves people's lives, reduces hospitalizations and has economic impacts as businesses prefer to establish themselves in healthy communities, she said.
'If we don't spend enough on public health, or the preventative care, in the beginning, we will be paying a much higher price in the long run anyways. Spending the money towards the preventative health care is much better than spending the money on the negative effects that we can have in the long run by not investing adequately into public health,' Vavilala said.
Porter County – Health First Indiana
Porter County received $135,768.41 in 2023, approximately $1.8 million in 2024 and approximately $3.4 million in 2025 in Health First Indiana funds, said Porter County Health Department Administrator Carrie Gschwind.
In Porter County, funds have gone toward a health fair, which allowed community health organizations to gather to offer free health screenings and services from vision to heart health and provide IHSA sports physicals, among other services, Gschwind said.
The Porter County Health Department partnered with the Portage YMCA, Purdue Extension and Powers Health to work toward chronic disease prevention, which included blood pressure and diabetes screenings, and connecting people with resources they may have needed, she said.
Further, Porter County also worked with food pantries to provide diapers and baby wipes to those who need them, Gschwind said. The department has also partnered with area school districts and Northwest Indiana No Child Hungry to address food insecurity in children, she said.
The funding also went toward reviewing trauma and fatalities, offering harm reduction kits – with items ranging from seasonal wound care to hygiene products – throughout the county, and working toward becoming a Heart Safe county, which includes CPR training, installing AEDs in county buildings and a certain number of Heart Safe community sites, Gschwind said.
The Porter County Health Department also hired a psychoanalyst to work with the Porter County Sheriff's Department to offer mental health support to county first responders, Gschwind said.
The 2024 funds went toward other programs as well, including a mobile health clinic, Gschwind said. In 2025, the funds will go toward the programs established in 2024 as well as addressing four areas of need for the county, she said.
For 2025, the Health First Indiana funds will go toward reducing adult obesity over the next 10 years, reducing emergency room visits for asthma attacks by 2027, reducing the suicide rate by 2027, and increasing the number of required immunizations in children by 2027, Gschwind said.
The Health First Indiana program has let county health officials work with community partners to identify the health needs within the community, Gschwind said. Losing funding, she said, would be 'devastating to the work' the department has begun.
'Without the funding, we wouldn't be able to offer these expanded services, this type of outreach. We wouldn't be able to further these programs that we've started to be able to see that needle move,' Gschwind said. 'This was an amazon state investment in public health. We just ask that we're able to continue and expand upon even more this great work.'
Legislative debate
As the Senate Appropriations Committee holds hearings about the budget, the Health First Indiana funding has been placed under a microscope.
During a committee meeting earlier this month, Committee Chair Sen. Ryan Mishler, R-Mishawaka, said he and other legislators received pressure from constituents to cut or eliminate the program because they question how the money has been spent.
In the same meeting, Sen. Liz Brown, R-Fort Wayne, questioned allocating more funds to the program because the state hasn't seen 'significant results' in the last two years.
Charbonneau, a member of the Senate Appropriations Committee, said in an interview with the Post-Tribune that he's concerned about funding the program amid the Medicaid shortfall. But Charbonneau pointed to the irony of facing a Medicaid shortfall and its rising costs while discussing funding for preventative care.
'The problem is going to continue to grow unless we stop the front end, unless we stop people from getting sick,' Charbonneau said. 'What this is doing is focusing on the front end and addressing issues before they become serious problems.'
Charbonneau said he's hopeful that the program will retain its allocation of $200 million over the next two years.
'We may, at a minimum, put some guardrails on it as to how the money can be spent. I can live with some guardrails, as long as they are reasonable, if that's what it takes to continue the funding,' Charbonneau said.
Specific guardrails haven't been discussed, Charbonneau said. The Health First Indiana program is a paradigm shift for the state, he said, and should receive funding.
'The return on investment will be incredible, but it's going to take time,' Charbonneau said.
Vavilala agreed, saying the program will have lasting benefits into the future.
'We are investing not just for now,' Vavilala said. 'We are investing this money for generations to come.'