Oct 6 2011
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NACCHO 2011 Budget Cuts and Job Loss Survey: Cuts Continue

bobby-prestronk Robert Pestronk, National Association of County and City Health Officials

Job losses and program cuts continue to impact local health departments according to a newly released survey from the National Association of County and City Health Officials (NACCHO). Survey results show that in the last year, more than half of all local health departments reduced or eliminated at least one program. Services for mothers and children were among the hardest hit. Other areas that faced the axe: emergency preparedness, immunizations, chronic disease screening, and personal health services.

“Fewer staff means a loss of key protections for you and me,” said Robert M. Pestronk, M.P.H., NACCHO’s executive director.

But Pestronk says that with the loss comes resourcefulness. Case in point: in response to losing millions in their budget and eliminating 20 staff positions, Coconino Public Health Services District in Arizona became its own tax district in 2010 and now has a dedicated, stable funding source that lets health officials assign funding to local priorities.

NewPublicHealth spoke with Robert Pestronk about the NACCHO 2011 survey.

NewPublicHealth: What’s new this year that you haven’t seen before in job losses at local health departments?

Robert Pestronk: I think what we’re seeing new is the impact on programs and services that local health departments have been delivering. There is more impact in more places than we’ve seen before.

NPH: Are there any bright signs ahead? New creative ideas from local health departments to help deal with the funding cuts?

Robert Pestronk: About whether local health departments are being creative as these cuts happen and whether they are thinking about different ways of conducting their business, different ways of working with partners in the community and thinking about what’s most important or most unique about the services and capacities that they have, and therefore, trying to protect those at all costs – there, in all cases, I think the answer is yes.

These are an extraordinarily dedicated, passionate and committed cadre of governmental officials. They have increasingly adopted methods and a culture of continuous quality improvement. They are moving towards a process of voluntary accreditation to benchmark themselves against the standards of and capacities of best practices, and they are constantly in a process of trying to understand how best to protect people and keep them safe both with their own resources and in collaboration with other community resources.

NPH: How much can new technologies help to mitigate some of the budget cuts?

Robert Pestronk: The work of local health departments is human being-intense and can’t be replaced entirely by technology, and that reflects itself not only in the services that they provide, but it’s the nature of the work that they do to provide the glue and provide the connective tissue for people in a community who want to protect themselves, keep themselves safe and make health easier.

I think the best example of this is in the area of preparedness. When there is an emergency, staff in local health departments will often drop what they’re doing on a day-to-day basis in order to organize themselves and help organize others in the community to respond effectively to that disaster or emergency. That kind of backup and that kind of standing up and moving over to do something else depends upon having other staff in the department to do that. As local health departments lose more and more staff, their ability to stand up and move over and back each other and other people in the community up is being eroded.

Local health department officials, particularly in preparing for emergencies and disasters, help to build successful and productive relationships and communication capacity across the community so that when disaster strikes one knows and can trust the people on the other end of the phone with whom one has to work. The erosion of staff capacity in local health departments means that those kinds of relationships and systems will be less likely to be maintained, and therefore, place our communities at unnecessary and greater risk.

Tags: NACCHO, Preparedness, Public Health Departments, Q&A