Compare and contrast public health funding (and resulting impacts on service and program delivery) in your area. How does funding impact the quality of public health?

Response one -PHM-03

In healthcare we depend on the physicians to heal us from any type of illness that we may have, and we also depend on our state and local public health departments to be our ambassadors when it comes to preventing diseases and injuries by keeping us healthy and safe. For that to happen we need public health programs which are financed through a variety of state, federal, and local appropriations.

On the local level side, the funds come from local taxes, fees, and Medicaid and Medicare reimbursements for services (Salinsky, 2010). This helps to fund California's local government programs including education, police/fire protection, welfare, transportation, and healthcare. On the other hand, California's state government programs are funded through federal appropriations including healthcare license inspections to fund healthcare, education, pensions, family health, Alcohol and drugs, and air pollution (Salinsky, 2010).

The current standards that are in place for the way public health service are funded needs to be revamped considering how so many people are losing their job because of underfunding. This is evident as public health budgets have been decreasing in recent years that local health departments have been struggling to keep people on board.

To meet the needs of the public you have be able to promote quality while making sound organizational improvements but if you are not able to have enough staff then how you can be able to offer services that will not last due to funding. Another reason they need to revamp the system is because whenever there is a shortage in money the effect is devastating to those in low-income or impoverished areas since they seem to need the programs the most but are always the first to get them cut. It is understandable that money needs to be spread out through out the local and states, but better financial decisions need to be made so this doesn't happen.

Response two PHM-03

There are many public health services that are funded at the state level. New York State has funding for different programs, including: the Assisted Living Program, the Preventive Health/Health Services Block Grant, the New York State Child/Adult Care Food Program, the Infertility Demonstration Program, the Drinking Water State Revolving Fund, and the Sexual Assault Forensic Examiner (SAFE) Program (New York State Department of Health [NYSDOH], 2018).

For the Preventive Health and Health Services (PHHS) Block Grant, it provides funding for programs in prevention that have a need that is demonstrated, that is relevant to the objectives within the state department of health's Prevention Agenda, and that is also relevant to the objectives required for Healthy People 2020 as pointed out by the U.S. Department of Health and Human Services (NYSDOH, 2017). The state department of health also, on an annual basis, receives funding from the federal government (specifically the U.S. Department of Agriculture [USDA]) to enhance and support the Child and Adult Care Food Program (NYSDOH, 2017).

As a matter of fact, the state received around 272 million dollars in federal USDA funds for this particular program in 2016 (NYSDOH, 2017). Child care centers, community-based adult day care centers, after school programs, homeless shelters, and home-based family/group child care are participants in this program (NYSDOH, 2017). As far as the Infertility Demonstration Program (IDP) is concerned, the health department invited selected infertility providers throughout the state to participate in that particular program (NYSDOH, 2017).

The respective providers that agreed to participate are highly responsible for billing the state for IVF (in vitro fertilization) and GIFT (gamete intra-fallopian tube transfer) costs, after insurance reimbursement/patient co-pays are all taken into account (NYSDOH, 2017). Based on the services that are offered by the provider, the IDP program also includes a subsidy for testicular sperm extraction (TESE) (NYSDOH, 2017). There is a five-year contract term for the program, which began in October of last year, and lasts until September of 2022; however, the program's continuation all depends on the availability of funds (NYSDOH, 2017). The Drinking Water State Revolving Fund (DWSRF) provides a financial incentive for drinking water systems that are owned privately and municipally in order to finance improvements that are needed in the infrastructure of drinking water (NYSDOH, 2011).

These improvements include distribution mains, storage facilities, and treatment plants (NYSDOH, 2011). There is a subsidized low interest rate financing for eligible water system construction projects (NYSDOH, 2011). Money is made available for new financings as the financings are repaid (NYSDOH, 2011). Interest rates can be reduced to a percentage of zero for communities that are facing hardships financially (NYSDOH, 2011). Additionally, Financial Assistance (grants) may be available in the event that hardships become more severe (NYSDOH, 2011).

During the 2011 fiscal year period (from October 1, 2010 to September 30, 2011), a grand total of $26,828,100 was available to provide grants to eligible communities that were disadvantaged (NYSDOH, 2011). Within the local level, public health services are also funded. In Westchester County, for the 2014 fiscal year, there had been new grants that have been funded within the areas of HIV/AIDS outreach, health insurance (for individuals and small businesses), disaster relief/preparedness, and HPV/meningococcal vaccine distribution for the college-aged group population (Westchester County Department of Health, 2013).

I believe that the way public health services are funded promotes quality and overall organizational improvement because they are distributed to various population groups who are in dire need.

These services are also of great benefit to the surrounding communities because some of them lack the basic necessities/resources as well as the access to affordable health care.

Children, adolescents, adults, seniors, and the homeless all suffer from hunger, so the example of the child/adult care food program would particularly cater to these groups. There are some communities that do not have access to pure water that is drinkable; so in this case, the example of the Drinking Water State Revolving Fund would greatly help these communities to get water that is safe, affordable, and clean.

If everything is distributed fairly/equally and everyone is accounted for, then the local/state health departments will, in turn, become more productive/effective organizations. Everyone within the organizations must work together in an unselfish manner to allocate the funds to the respective groups. Helping others is a very important part of being an efficient steward in the public health field.