California's population is growing and aging, but the public health and aging infrastructure is not keeping up. While demand increased, two-thirds of California's Local Health Departments (LHDs) and Area Agencies on Aging (AAAs) experienced budget cuts in the 2010-2011 fiscal year, while nearly 40 percent faced staffing reductions. Budgetary and personnel reductions compromised the ability of local health departments to serve seniors in a number of critical areas, including the investigation of health and environmental hazards, the enforcement of public health laws, the implementation of health promotion programs and quality improvement activities.
With no end in sight to California's budget crisis, the authors recommend that local public health system stakeholders reexamine the distribution of responsibilities, eliminate redundancy in overlapping areas and pinpoint gaps in services. LHDs may also benefit from streamlining and coordinating service delivery with system partners through written formal agreements with AAAs, and cross-agency sharing of provider and consumer electronic information systems. This policy note is based on a survey of senior managers within LHDs and AAAs.