Public health commission hopes report translates to laws

Indiana Gov. Eric Holcomb’s Public Health Commission on Thursday released its long-awaited final report examining the state’s public health infrastructure and outcomes, which commission leaders hope translate into legislation come January.

“Our goal is to build on the advantages that we currently know that we have here in the state and adjust the gaps that we have identified so that every Hoosier has the same opportunity to achieve their best health,” State Health Commissioner Dr. Kris Box said at a news conference Thursday afternoon. “We look forward to sharing these recommendations with our legislators and to working hand-in-hand with them to make Indiana a leader in public health.”

A December 2020 report from the IU Richard M. Fairbanks School of Public Health at IUPUI and Fort Wayne analyzed the state’s public health system, calling it “chronically underfunded and undervalued.”

As part of its roadmap to better public health, the commission recommended developing a health care workforce plan to allay shortages, boosting access to state data for local health departments, establishing a state strategic equipment stockpile, and more. The 107-page report‘s recommendations spanned governance, infrastructure, workforce, data, emergency preparedness, child health — and, of course, funding.

Indiana ranks 48th in the nation for public health funding, spending approximately $55 per Hoosier on public health initiatives or $36 less than the nationwide average of $91 per capita. The commission suggested closing that gap by precisely $36 a Hoosier annually — to the tune of nearly $243 million a year — to provide local health departments with “stable, recurring and accessible” funding.

“I kept multiplying that number out myself a number of times trying to make it be smaller,” quipped commission co-chair Luke Kenley, a former chair of the state Senate’s Appropriations Committee.

“Remember, right now, almost all of the funding of your local health department comes from the county budget. And so it’s very poorly funded because of that situation,” Kenley added, emphasizing less-populated counties’ smaller tax bases and competing budgetary needs.

From report to action

But how to sell a price tag that large to his fellow Republicans still serving at the Statehouse? The commission may have already laid the groundwork for it.

Kenley said the commission made transparency and education part of its process, describing how the commission went through all of the public comments it received online or at its meetings, held seven listening sessions and conducted outreach with key groups.

Now, he said, “We have a plan set up, and we know we need to execute. We need to convince people that this is the best thing they need to do.”

Box recounted how Kenley and Micha Burkert, the commission’s director of legislative and policy affairs, sent reports to legislators and others after each of the commission’s meetings, and met with many of them.

State Sen. Ed Charbonneau, the Republican chair of the Health and Provider Services Committee, said Kenley’s make-the-case approach was “the right thing to do.”

“[The commission] is coming now with a lot of information that we need to share with my counterparts to make sure that they fully understand the need, and that is going to come from the data and education,” Charbonneau said after the news conference.

“It’s a heavy lift. $242.6 million is a lot of money. And, you know, Sen. Kenley is right. If he was on the other side, he’d be asking a lot of questions too,” Charbonneau added. “We need to be able to overcome the skepticism and get people to understand, I believe, that we need this.”