The following was written by Miriam Link-Mullison, administrator of the Jackson County Health Department in Murphysboro, Illinois.
The State of Illinois' budget impasse is eroding the capacity of local health departments to protect the health of its citizens. Local health departments are taking appropriate - yet drastic - action in response to this crisis: they are laying-off staff, reducing the work week, and reducing the hours that they're open for business. Rural health departments are particularly hard hit because their populations are older, incomes are lower, property values are less, and there are fewer local tax revenues for the health department, cash reserves are smaller and the demand for public health services is greater. Sixteen of Illinois' 97 local health departments, serving nearly a million people, have already reduced staff, hours, and services. More health departments will be forced to take similar action if no state funding is received for the services that have been delivered but not paid for since July 1. It is only a matter of time until there is a disease outbreak that leaves many people sick and may even cost some their lives - an outbreak of a disease that could have been prevented by public health.
In Illinois, front-line public health services are provided by local health departments. They are units of local government. They are supported by local tax revenues, fees, and grants from the state and federal governments. There are 97 of them; they serve 100 of Illinois' 102 counties and more than 99 percent of the state's population.
Essential public health services provided by local health departments-- like restaurant inspection, regulation of private sewage systems, investigation of disease outbreaks and immunization against communicable diseases -- are in jeopardy because of the budget impasse. In addition, due to the loss of staff, the local public health system is losing its capacity to protect the public and respond adequately to public health emergencies, like the cases of measles in northern Illinois, outbreaks of mumps downstate, and the outbreak of Legionnaires' disease in Adams County.
The case of Vermilion County Health Department illustrates the impact of both the short-term crisis and the long-term trend of diminished state and federal support for local public health services. In response to the state fiscal crisis in 2010, the health department discontinued 14 programs and laid-off two-thirds of their staff (from 74 to 27 employees). They were able to respond effectively to the 2009 Influenza Pandemic because they had 34 nurses on staff; today they have five nurses, two of which are part-time. If a pandemic or another public health emergency would occur today they would have very few resources with which to respond.
The Governor and the General Assembly can take action now to avoid further erosion of Illinois' public health system. The Illinois Public Health Association, which represents more than 7,000 public health professionals in local health departments, hospitals, clinics, academia and other settings, calls on the Illinois General Assembly to pass, and the Governor to sign, Senate Bill 2178, which appropriates $17.1 million for the Local Health Protection Grant. This is the funding level that the Governor requested for the current fiscal year. These funds are distributed to all 97 certified local health departments in Illinois, and they support the provision of essential public health services statewide - in every House and Senate district, for every citizen in Illinois.
Many in Springfield are saying that this year's budget may not be passed until next March. Local health department administrators are already stretching every dollar they have to the breaking point. Some - especially in rural Illinois - simply won't be able to last that long. If your readers have benefited from the services provided by local health departments - if they are glad they eat in restaurants that have been inspected to ensure that food is handled safely, if they are glad they were helped through a difficult pregnancy, helped to stop smoking, or had a place to have their children immunized, if they are glad that they drink clean water from their own wells, if they are glad someone is making sure that sewage is disposed of safely -- I urge them to call their state Representatives and Senators now. Pass this bill to pay for the services that protect the public's health.
Miriam Link-Mullison, M.S.
President, Illinois Public Health Association
Miriam Link-Mullison is the Administrator of the Jackson County Health Department in Murphysboro, Illinois.