Multiple federal and state public health cuts are coming, and local officials are working out how to deal with the losses.
The Johnson County Health Department was given roughly $3.2 million for this year’s Health First Indiana cycle, but it will only receive approximately $845,000 for next year, said Betsy Swearingen, Johnson County health department director.
There has also been a slash in COVID-19 funding that has affected a collaboration with ASSIST Indiana, the sexual abuse and domestic violence nonprofit. The Centers for Disease Control and Prevention made an $11.4 billion cut that includes an about $40 million loss in Indiana, according to a March story from the Indiana Capital Chronicle. About $425,000 of that was previously allocated to Johnson County, Swearingen said.
Health First Indiana
Health First Indiana was authorized by the state legislature for two years initially, with Johnson County opting out in 2024 and opting into the funding this year. Based on an earlier draft of the state budget, local officials initially thought they would receive about 70% of the 2025 HFI grant, but state budget cuts in response to the projected shortfall ultimately eliminated approximately that much, Swearingen said.
In 2025, Indiana’s 92 counties got a piece of $150 million allocated to HFI grants. However, for 2026 and 2027, counties will share $40 million, a drastic decline, WFYI reports.
With the knowledge that these cuts are coming, Swearingen said the health department faces the reality that new projects and partnerships created with Health First funding may be fleeting.
“If we go ahead and fund some projects and form some partnerships now, are they going to be sustainable in 2026?” Swearingen said. “So it’s already kind of rearing its ugly head that way at us now because it really just impacts even what we’re doing this year.”
Swearingen anticipates that community preparedness grants, community health grants, and community aid to other local health departments would be taken out of the spending plan for future rounds of funding. She also said tobacco cessation will not be funded anymore since it was removed as a core service under the grant.
Two new positions were created with HFI funds, but Swearingen said the health department will prioritize continuing those before all else. Since one of the positions is a school liaison, the department would be able to use another grant to fund that, she said.
The health department can also use leftover money from this year’s cycle to add to next year’s funding. Right now, there is $600,000 in unspent funding, Swearingen said.
However, Johnson County Commissioner Brian Baird has asked to use the $600,000 for the county’s behavioral health center.
“To me, those funds going to that would be more productive for our citizens and Johnson County than some of the other things that we may be looking at to spend those other funds on,” Baird said at the May 27 commissioners meeting.
Swearingen also hopes to find a “pragmatic and creative” way to keep the health department’s new partnerships with Upstream Prevention, Johnson County WIC, Empower Johnson County, and Drug Free Johnson County, and to continue them next year, she said.
Despite the cuts, she is confident the health department will still meet the community’s needs.
“It’s a consensus on spending the money and in prioritizing what are the most important needs in the community,” Swearingen said. “And I believe that those needs will still be addressed, and I still hope to tighten or to remain consistent in our support for our first responders, whether EMS or police.”
Though people questioned the decision, the commissioners opting out of HFI funds in the first year means the county is less reliant on the grant.
“I think we’re seeing now, thank goodness, that we were kind of thoughtful in that decision because we are now not relying on these funds for stuff that we will not be able to sustain in the future,” Swearingen said.
Federal cuts
With federal funding, the Johnson County Health Department didn’t take as big of a hit as anticipated, but was set back in forming a partnership with ASSIST. The health department was using the grant to put on weekend and after-hours vaccine clinics, but also had allocated $125,000 to ASSIST.
The nonprofit was planning to use the money to take over the child advocacy center and offer a SANE, or Sexual Assault Nurse Examiner, program. These specially trained nurses offer forensic examinations for victims of sexual assaults and domestic violence, said Jenny Lee, ASSIST’s founder and executive director.
These professionals are in short supply, and crime victims often have to travel out of the county to be examined by one, Swearingen said. Time is of the essence, and SANE professionals must see victims in person to collect physical evidence that can be used in court.
ASSIST has been trying to find the resources to establish a SANE program for the past 10 years. The organization was ready to start offering exams, but had to cease operations because of the funding cuts. ASSIST had to turn away four victims when the funding was abruptly pulled.
“It really set us back, as well as the victims of Johnson County,” Lee said. “It poses a significant concern, and these services are very critical [to help with] the sexual violence of adults and children.”
The $125,000 allocated to ASSIST would have funded the program for about 18 months. ASSIST was partnering with the Johnson County Health Department to utilize their offices for after-hours and during exam hours, with care to not mix clientele.
Right now, ASSIST is projecting that the program will cost $89,000 annually. The organization already has the equipment, but needs to have a sustainable funding source before trying again, Lee said.
ASSIST’s state funding expires in September, but Lee is unsure at what rate it will be renewed, she said.
The nonprofit is also funded with federal grants, but there have been cuts to VOCA, or the Victims of Crime Act, funding over the years. The organization also has a small Department of Child Services grant and is looking to partner with the health department to acquire HFI funding.
These various cuts have required ASSIST to go “down to just a skeleton crew” with the minimum required to operate in the community efficiently and safely, Lee said.
Despite the uncertain path for the program, both Lee and Swearingen want to make sure it will be available someday, somewhere in Johnson County. The location is what is questionable right now, Lee said.
Right now, ASSIST is in discussions with Johnson Memorial Hospital, the health department, and county officials. Lee said the program could also be brought in-house if that’s what’s better for the community.
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