01-03-2025
Public health funding cuts in new state budget would undo some HFI gains
GOSHEN — State lawmakers are undermining efforts to improve Hoosiers' health by proposing 33 percent cuts to public funding, local health officials warn.
House Bill 1001, the two-year budget bill that advanced to the Senate last week, cuts local public health spending from $150 million annually to $100 million. That would largely reverse dramatic funding increases made under the Health First Indiana initiative just two years ago.
'Speaking from the board of health and personally, that HFI funding potential decrease is just really tragic for our state,' Elkhart County Board of Health Chair Paul Shetler Fast said Thursday.
The $225 million total directed toward local health departments in the last budget cycle was meant to help Indiana catch up to the rest of the nation. The boost was based on the recommendations of the Governor's Public Health Commission, though the amount was less than half of what the commission said was needed.
'We had been under-funding public health for years. That was recognized,' Shetler Fast said. 'We brought it up to kind of an average level of funding. And now it's going to drop, if this goes through, well below that again.'
The commission's findings highlight the fact that Indiana is one of the unhealthiest states with nearly rock-bottom health funding. Indiana residents die two years earlier than the national average, a life expectancy that has been declining since 2010.
Indiana ranks below most other states when it comes to health issues like infant mortality, obesity, smoking and mental health. The state's overall public health ranking fell from 26th to 41st within a generation.
One of the commission's goals was to increase per-person public health funding to reach the national average of around $91. Indiana's average was $55 per capita, with individual counties ranging from $1.25 to $83.
'A reminder of why that was passed, is there's this huge disparity also in our state, with the rural areas, poor areas, tending to get less health services,' Shetler Fast said. 'Rural communities around the state tend to be some of the worst impacted if that gets cut.'
'We can't do it on our own'
Elkhart County spent less than $20 per person before it opted in to the new funding formula, according to Elkhart County Health Officer Melanie Sizemore. HFI requires a 20 percent local match, which in the second year of the program every county committed to providing in order to receive a share of the $150 million allotted for 2025.
Elkhart County received just under $2.5 million for 2024 and around $5 million for 2025. It's money that factored into the department's planning, Sizemore said Friday.
'We've always had a Plan B in the back of our mind, but thinking that we were going to get this particular set amount helped us understand how we can make Elkhart County healthier without growing our staffing and that sort of thing,' she said. 'That is a concern by county council, that we stay about the size that we are. So granting out these funds is what needs to happen in order for the work to get done.'
The extra funding comes with the obligation that health departments provide pass-through grants for other local organizations that provide health services. Last year, Elkhart County directed $300,000 in one-year grants to programs that met priority needs in the county in the areas of maternal and infant health, mental health and sexually transmitted infections.
This year, the department gave $1.1 million to 12 programs.
Sizemore said the 33 percent cut in state funding would hurt the health department's ability to fund programs that seek to improve the health of Elkhart County residents.
'That would affect our ability to grant dollars out into the community at the level that we do,' she told the board. 'That is a deep concern because we cannot do the work alone.'
She added Friday that mental health, in particular, is an area where the department relies on community partners to provide services. Grant recipients have included Clubhouse programs for adults with mental illness, a mobile integrated health team who responds to mental health crises and Oaklawn Psychiatric Center.
'A lot of that work, we can't do on our own, particularly the mental health area,' Sizemore said. 'We do not specialize in mental health, so we have to give money to help make that happen for Elkhart County. And if that money goes away, that means there are that many fewer services available if needed. It's concerning.'
