Counties, like others, are seeing significant impact related to the COVID-19 pandemic.
As the local public health authority, counties are faced with the large task of delivering direct, on the ground response to the pandemic, in addition to the everyday services they provide. Local public health is charged with tracking down every case of COVID-19 in a community and conducting an investigation, supporting that individual and working with employers and facilities. In addition, contacts of COVID-19 cases also need daily monitoring, and support including quarantine and isolation, and wrap-around services. While some federal resources have been delivered to counties, a broad need for resources across critical service areas remains.
COVID-19 has put a spotlight on Oregon’s public health response further illuminating the historic underfunding of the public health system. In September, the Association of Oregon Counties (AOC) published a 2020 County COVID-19 Needs Report that was submitted to legislative leadership and the governor with a letter clarifying its purpose, the partnership of counties in COVID-19 response, and a call for additional support. The report, among other areas of need, identified a conservative need of $45 million dollars to sufficiently support appropriate county public health efforts from September through December of 2020. This funding need will continue into 2021.
In addition to the case investigation, contact tracing, and supports like isolation, quarantine, and food, public health authorities will help facilitate the process of distributing and strategically delivering new vaccines to Oregonians while addressing the flu season simultaneously. While 2020 provided an almost insurmountable challenge, the need for the federal and state governments to support local health departments will be further amplified in the coming year.
In the initial stages of the pandemic, federal aid totaling over $80 million was distributed to counties. The funding was specifically tied to supporting local public health needs through the end of the year to supplement their on the ground response efforts covering case investigation, contact tracing, public education, and other mitigation efforts. This funding for six months almost matched the State’s 19-21 biennium investments in public health, highlighting the magnitude of the pandemic’s effects in Oregon. While significant, this amount left a large gap in budgets due to the duration of the virus and its infectious nature illustrated in recent community spread and sporadic cases.
Historically, State funding has not matched Oregon’s local public health system needs. In the 2019-21 biennium, public health requested $47.7 million to meet the goals of a statutory program to increase public health services in Oregon, known as Public Health Modernization, which included emergency response planning, and preventing the spread of communicable diseases. In the 2019 Legislative Session, the Legislature invested $15 million in Public Health Modernization to expand communicable disease prevention, support health equity, increase emergency planning, and help develop modernization plans.
With the uncertainty of the timing and no guarantee of additional resources from federal or state governments and the continued response needed for the COVID-19 pandemic, public health faces short-term and long-term funding dilemmas. As cases rise across the state, it is unclear how public health will continue to support their increased workloads, maintain staff, and provide appropriate services to meet every county’s needs, even through the end of 2020.
AOC and partners are continuing to advocate for funding to support public health and other critical services counties provide during the pandemic and into future fiscal years.
Contributed by: Lizzy Atwood Wills | Legislative Affairs Manager