New health funds get 1st OK

Health First Indiana funding will not immediately improve Wayne County residents’ health.

Instead, accepting more state money will signal the beginning of ramped-up efforts to make Wayne County healthier and help residents live longer. The county ranks 90th of Indiana’s 92 counties in life expectancy.

Wayne County Council members Aug. 16 unanimously approved the Wayne County Health Department’s proposed budget for more than $773,000 in additional 2024 funding. That leaves the county’s commissioners to officially opt in to the Health First Indiana program, a vote that’s seemingly a formality.

Commissioners did not vote Aug. 16 because Mary Anne Butters could not attend the evening workshop. A supporter of the Health First Indiana program, she asked that she be included in the final vote, which is planned for Aug. 23. Commissioners Brad Dwenger and Jeff Plasterer indicated after the council’s vote that they are comfortable with the health department’s plan as presented to the council. 

The primary question had been how the health department would acquire contract workers that would provide additional services without expanding health department staffing. Reid Health has agreed to partner with the health department to contract for workers and assist toward the overall goals when possible.

The county would receive at least $773,678.63 for 2024 and at least $1,547,357.25 for 2025 from the state legislature’s two-year, $275 million allocation to Health First Indiana. The county’s totals could rise if other counties decide not to accept the additional funding by the Sept. 1 deadline, but as of Aug. 18, 73 counties had already officially opted to receive the funds, according to an online Indiana Department of Health map.

Should Wayne County not accept the additional funding, it would receive $79,259.81 in state public-health funding for 2024. Commissioners have heard from citizens advocating the county turn down the extra funds, saying it amounted to a “bribe” that would enable the state or federal agencies to dictate local policy.

State Rep. Brad Barrett addressed that issue during the workshop, saying the legislative intent was for counties to maintain local control.

“Providing funds with no strings attached is important,” Barrett said, later saying the program “empowers local government in every way, shape and form.”

Senate Enrolled Act 4, which establishes Health First Indiana, specifically states: “A county that accepts additional funding to provide core public health services does not transfer any authority under statute in operating the local health department to the state department in return for the additional funding.”

Barrett said Health First Indiana addresses the “absolutely horrible public-health indicators in the state and an absolute lack of funding.” Wayne County has spent $11 per resident on public health, much less than the $55-per-person state average.

“What we’re doing is we’re treating disease in a reactive fashion, not a proactive fashion,” said Barrett, who used diabetes as an example, “and as we learned over the years, there are advantages to preventive measures and education.”

Dr. David Jetmore, the county’s health officer, presented the council with a budget for the minimum extra funding. He called the funding “incredibly exciting” and agreed with Barrett about disease prevention.

“I’ve spent my life in surgery, and Brad’s right, it’s so much better to prevent these diseases than to cut something out or cut something off,” Jetmore said.

The budget includes money for an environmental health officer, who would be a county employee. Jetmore said that’s necessary because the position includes regulatory power. It also includes $140,000 to partner with Richmond Fire Department for a countywide expansion of its paramedicine program and $37,000 for a vehicle.

Because accepting the funds represents a beginning, the final plan to provide required core services and any budget impacts are not finalized. The intent is to, when possible, partner with local providers already offering services and with surrounding counties to improve citizen health.