Local Health Department Financing: Findings from the 2005 National Profile

of Local Health Departments Study

National Profile of Local Health Departments

Collaboration with CDC to collect data on local health department infrastructure

Four National Profiles conducted to date• Studies conducted in 1989, 1992-3, 1996-7, 2005

Census design – includes all LHDs in U.S.

Topics in 2005 Profile Core

Governance Population served Finances Characteristics of top

executive Workforce

Activities and services provided

Community health assessment & improvement

Information technology

Topics in Profile Modules

Detailed information on: Finances Workforce Community health

assessment & improvement

Information technology

Additional Topics: Performance improvement Emergency preparedness Partnerships Policy-making and

advocacy Addressing health

inequities

Financial Information in 2005 Profile

Core questionnaire Total annual expenditures (2 years) Revenues sources (percentages of total) CDC & HRSA emergency preparedness fundingModule questionnaire Changes in sources of revenue

LHDs Included in the 2005 National Profile Study (by State and Type of Governance)

LHD Jurisdictions (by Size of Population Served)

Activities and Services Most Frequently Provided by LHDs

Total Annual LHD Expenditures

Total Annual LHD Expenditures – by Pop’n

Population Served MedianInterquartile

Range

<25,000 $340,000 $450,000

25,000 - 49,999 $890,000 $1,200,000

50,000 - 99,999 $2,000,000 $2,400,000

100,000 - 249,999 $5,100,000 $5,300,000

250,000 - 499,999 $11,000,000 $10,000,000

500,000 - 999,999 $23,000,000 $27,000,000

1,000,000+ $57,000,000 $65,000,000

Median Annual Per Capita LHD Expenditures (by LHD Characteristics)

All RevenuesNon-clinical

Revenues

Size of population served

<50,000 $28 $22

50,000 - 499,999 $31 $24

500,000+ $34 $31

Degree of urbanization

Urban $24 $21

Small city/large town $31 $24

Rural $35 $25

Median Annual Per Capita LHD Expenditures (by State)

Change in Total Annual LHD Expenditures

Total LHD Revenues from Various Sources

Mean Percentage of LHD Revenues from Selected Sources (by Type of Governance)

Predominant LHD Funding Source: Local

Predominant LHD Funding Source: State Direct

Predominant LHD Funding Source: Federal pass through

Predominant LHD Funding Source: Medicaid & Medicare

Balanced LHD Funding Sources

Predominant LHD Funding Source: Combined

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

Regulatory fees

Private foundations

County

Medicaid

Patient personal fees

Medicare

Federal pass-through

Private insurance

City/Town

State direct

Federal direct

IncreaseDecrease

Change in LHD Revenue from Selected Sources

For information on 2005 Profile study:

Carolyn Leep, Senior AnalystNational Association of County & City Health Officials

cleep@naccho.org

http://www.naccho.org/topics/infrastructure/2005Profile.cfm