Indiana, Johnson County officials talk public health funds at special meeting

Johnson County officials gathered Monday for a conversation on public health funding.

Local officials met with officials from the Indiana Department of Health during a special meeting of the Johnson County Board of Commissioners to reconsider opting into Health First Indiana funding. After turning down the funding last year, county commissioners are reevaluating the potential benefits and concerns regarding opting into the funds.

Johnson County was one of six counties in the state to turn down funding from the Health First Indiana initiative enacted in Senate Enrolled Act 4 of 2023. The law added $75 million in funding for local health departments for 2024, followed by $150 million in 2025.

If the commissioners chose to opt in this year, the county would receive approximately $3.1 million in new public health money from the state, said Dr. Lindsay Weaver, Indiana health commissioner.

Commissioner Ron West moderated the discussion on Monday. He said the roundtable’s purpose was to provide clarity on the benefits of Health First Indiana funding while also allowing county officials to voice their concerns. Among the key contention points raised was the funding’s sustainability and the potential need for additional health personnel.

Those in attendance included all three commissioners, three county council members, county health department leaders and other local public health stakeholders.

SEA 4 provides a list of “core public health services” to be provided by local health departments, including communicable disease prevention, sanitary inspections, tobacco prevention programs, access to immunizations, testing for STDs and STIs, child fatality reviews, partnerships with schools, different health screenings and more. The main reason the money was turned down initially is that local officials feel the Johnson County Health Department already provides these services adequately and other counties need this money to prop up their public health services more than Johnson County.

West expressed apprehension about the per capita funding model applied by the state, noting that healthier counties received significantly more funding compared to those with greater health challenges.

“It was my feeling that the funds should go to the counties that were most in need,” West said.

On average, the five worst counties in the state for health received just under $600,000 from Health First Indiana while the top five healthiest counties received an average of about $3.7 million. Johnson County ranked sixth in Indiana when it comes to health-related topics, West said.

“I struggled with that,” he said. “My thinking in opting out was that hopefully, the state would take over our funds and not redistribute them on a per capita basis, but maybe make them available to those counties that are direly in need.”

Betsy Swearingen, Johnson County health department director, said the health department does not have any immediate staffing concerns and that collaboration with existing county entities was being pursued to address current health gaps.

“We don’t believe at this point that we are understaffed in any way,” Swearingen said. “I think our biggest goal would be to reach out to JMH and other entities within the county that already have staffs that we could work together with them to grow our programs.”

Despite the concerns, Weaver said that the health department is really “excited” about the Health First Indiana funds and the ability to tackle some of the state’s most pressing health-related issues.

Currently, Indiana ranks poorly on most health metrics including infant mortality, obesity, smoking, diabetes and hypertension, Weaver said.

“If you accept the funding, it will provide more public health services to your community,” she said. The funds can help address preventative public health measures such as maternal and infant health, tobacco prevention, trauma injury prevention and help people who are suffering from substance use disorders, she said.

If Johnson County opts into the funds, at least 60% would need to be put toward preventative health services and no more than 10% could be spent on capital. Other than that, Johnson County officials would have some flexibility on how they would use this funding, Weaver said.

Hearing that the money could be put toward mental health caught West’s interest, he said.

“Having heard what Dr. Weaver said, I am now under the assumption that if we took this funding, we would be able to direct it more into those areas,” West said. “If we are capable of using the funding in areas that I am concerned with, that would be important. There was a lot of speculation in relation to this funding of losing our independence and our local control of our health department.”

Commissioner Brian Baird said the roundtable discussion was worthwhile and the meeting brought forth “some real positives.” He also cautioned meeting attendees that if the commissioners were to opt in, they would need to tactfully monitor what the funds were used for as they would be held accountable for those initiatives.

Johnson County Council member Ron Deer asked for specifications on the funding’s usage, asking if the Health First Indiana funds could be used for projects like expanding the county’s EMS services, supporting food panties or building community ramps for ADA residents.

Weaver said that as long as the county follows the state’s preventative health stipulations, the funds’ usage would be up to local officials.

“The creativity and the things that are happening across the state is so inspiring that we have had several states from across the nation come to speak to us and talk to us,” Weaver said. “This works because there is local control. Nobody knows what is needed more in Johnson County than the people sitting around this table.”

Weaver also argued that opting in would be an investment into the local economy, saying that they know of at least one county that has lost out on bringing a business into their community after they had shared their local health metrics.

No decision was reached at the meeting and county officials will continue to discuss the funding internally. The commissioners have until June 1 to decide whether to opt in this year.

Editor’s note: This story previously contained outdated information regarding the number of counties that opted out.