EbolaFunding cuts hamper health agencies’ ability to prepare for, respond to Ebola
Federal and state funds for local health agencies have been cut over the past few years, so when hospitals and municipal health agencies are asked proactively to respond to possible threats of Ebola, many question how they will fund such activities. Since 2008, at least 51,000 state and local public health jobs (roughly 20 percent) have been lost due to cuts in federal funding.
Federal and state funds for local health agencies have been cut over the past few years, so when hospitals and municipal health agencies are asked proactively to respond to possible threats of Ebola, many question how they will fund such activities. Since 2008, at least 51,000 state and local public health jobs (roughly 20 percent), have been lost due to cuts in federal funding, according to a new survey by the Association of State and Territorial Health Officials (ASTHO). Next week, the Senate Committee on Appropriations will hold a hearing to consider additional funding to prepare for an Ebola outbreak.
“It’s critically important to have a sustainable infrastructure, tools and the necessary resources to effectively address all potential health threats to the public, not just Ebola,” said James Blumenstock, emergency preparedness officer for ASTHO. “Public health threats don’t come one at a time, especially this time of year.”
Last month, the Centers for Disease Control and Prevention (CDC) issued new guidelines requiring public health officials to monitor travelers coming from Liberia, Sierra Leone, and Guinea for twenty-one days. Some states including California, Connecticut, Georgia, Illinois, Maryland, New Hampshire, New Jersey, New York, and Virginia ordered mandatory at-home quarantine measures for at-risk travelers. “We’re not in a panic now, but we’re starting to get tired,” said David Trump, deputy commissioner for public health and preparedness in Virginia’s health department. The state is monitoring the roughly fifty passengers who arrive daily to Dulles International Airport from Liberia, Sierra Leone, or Guinea. Most are returning U.S. residents and are boarding connecting flights to a final destination outside of Virginia. Trump expects the number to rise up to 300 in the next couple of months. On how to fund the monitoring efforts for another year or two, Trump said that most public health staff are putting in overtime, and it is unclear whether funding for hiring additional staff will be available. “We’re also looking at redirecting funds from other state agencies and waiting to see whether there will be federal funds,” Trump said.
The Pew Charitable Trusts reports that the primary source for funding such efforts, the CDC’s Public Health Emergency Preparedness cooperative agreement, initiated after the 9/11 attacks to improve the nation’s public health system in emergency situations, has dropped from more than $1 billion in funding in 2006 to $585 million last year. The Hospital Preparedness Program administered by the U.S. Department of Health and Human Services, also funds similar initiatives to prepare health care workers for emergencies, but it too has faced funding shortages from $515 million in 2004 to $225 million this year.
Health officials anticipate that funding for emergency readiness programs will remain relatively low in the coming years, but they still demand that the nation’s public health system maintain a minimum standard of preparedness. “There is no uniformity among public health systems across the country,” said Jack Hermann, chief program officer of the National Association of City and County Health Officials. He pointed out that smaller jurisdictions may be more challenged because they have fewer resources, but they also have the advantage of a close community. “Sometimes, the fire chief and the top health official are the same person,” Hermann said. Last year, the CDC, state health agencies, and research groups launched the National Health Security Preparedness Index, to rate the public health readiness of health agencies. The index takes into account the ability of each agency to activate first responders, schools, volunteer groups, and other state agencies to respond to emergencies. On a readiness scale of one to ten, with ten being the best, the national average in 2013 was 7.2. Massachusetts, Rhode Island, Virginia, North Dakota, New York, Maryland, Connecticut, and Vermont received top marks, while Nevada, Louisiana, Idaho, Montana, Arkansas, Georgia, Kansas, and Mississippi were considered least prepared.
