Revenue Sources for Essential Services in Florida

Findings and Implications for Organizing and Funding Public Health

Most county health departments (CHDs) rely on general revenue funding to provide essential services (ESs).

To understand the relationship between self-assessed performance on ESs and sources of funding, the Florida Public Health Practice-Based Research Network conducted a study of Florida county health departments (CHDs).

Ten ESs provide the basic organizing structure for the National Public Health Performance Standards and play a role in the measurement of public health functions. This study used primary and secondary data analysis to examine the relationship between ESs and revenue sources, including categorical funding, fees for services and programs, noncategorical general revenue, and other sources. Using an online survey tool, 50 of Florida’s 64 CHDs self-assessed their current ES performance.

Key Findings:

  • For ES 2, Investigating, 98 percent of respondents assessed their performance as complete or almost complete.
  • Only 30 percent reported complete or almost complete performance on ES 10, Evidence/Research.
  • Most CHDs relied on general revenue funding to provide ESs.
  • Medicaid revenue and fees were positively correlated with some ESs, including ES 7, Improve Access; ES 8, Maintain Workforce; ES 9, Evaluation and Quality Improvement; and ES 10, Evidence/Research.

Overall, self-assessment varied greatly over the CHDs, yet these findings also demonstrate that the capacity of CHDs to provide ESs is dependent on funding for those services. In lean budget times, funding sources should be considered for ESs.