Measure 97 Failure, Trump Presidency Hurt Prospects for Funding Oregon’s Public Health Modernization

The Public Health Advisory Board (PHAB) is preparing its road map for public health modernization for the 2017 legislature amid funding fears after Oregon voters rejected a corporate sales tax measure that had been expected to yield about $6 billion per biennium in additional revenue and worries about federal funding for public health nationwide under a Trump administration.

The odds for implementing public health modernization are looking bleak.

Oregon’s gap between current public health funding and what’s needed to fully implement a modern public health system statewide is $26.81 per person – about $100 million.

That’s on top of Oregon’s total budget gap for all state agencies in the coming biennium, estimated at nearly $1.4 billion. Gov. Kate Brown plans to release her budget Dec. 1.

“The challenges are quite large,” Lillian Shirley, director of the public health division of the Oregon Health Authority, told the PHAB but the groundwork that has been done over the past few years to define a modern public health system and assess what’s needed to bring the state up from the bottom five of 50 states in public health funding “will help us in all events.”

The PHAB continued to tinker with its tiered baseline funding model for 2017-2019, which would allocate whatever monies the state might provide to public health modernization based on not only population but also how many adults in the county are now in “fair or poor health”, the years of potential life lost before the age of 75 for county residents (called the “burden of disease” in public health lingo) and three health equity measures – the number of county residents who are nonwhite, living below the federal poverty line and have limited English proficiency.

Later, the funding model would include state matching funds to spur counties to invest in public health modernization from their own coffers and performance-based incentives after public health departments achieve their metrics.

But to avoid more unfunded mandates, local public health departments would not be held to the higher standards unless the state funds them.

On a separate matter, the PHAB voted to advise the OHA and the Public Health Policy Board to make a public statement about the direct health impacts from what Tricia Tillman called “the public discourse on the marginalization of specific communities.” Tillman, director of public health for Multnomah County, cited the uptick in suicide nationally and children experiencing bullying in schools as examples of direct health impacts.

“We should re-affirm our commitment to health equity,” said Chair Jeff Luck, an Oregon State University public health researcher. “When any community is marginalized, it’s bad for everyone’s health.”

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