ASTHO: Who we are Survey Research at ASTHO Select findings STPHIS: Online searchable database Questions and comments

ASTHO represents the public health agencies of the 50 states, territories, and DC, as well as the 120,000 public health professionals these agencies employ.

ASTHO members, the chief health officials of these jurisdictions, are dedicated to formulating and influencing sound public health policy and to assuring excellence in state-based public health practice.

Members◦ New State Health Official visit◦ Technical Assistance

Other policymakers◦ Health reform◦ Appropriations

Public Health Systems and Services Research Community

Media General public

State and Territorial Public Health Survey◦ Similar study done externally in 2001◦ ASTHO’s first S/TPHS conducted 2007◦ 2010 survey in field◦ 2012 in planning phase◦ Every two years thereafter

Budget Cuts Survey◦ Started fall 2008◦ Every six months

Launched in 2003 Follow-up survey in 2007 Folded into 2010 S/TPHS

Environmental health survey Minority health/health equity survey H1N1 response Use of funding formulas Meaningful use in health information

technology Use of fiscal intermediaries Evaluation of the Trust for America’s Health Evaluation of America’s Health Rankings Resource allocation study

Federal49%

State34%

Other 17%

Average Proportions for State Public Health Agency Revenue (FY09)

ASTHO’s Budget Cuts Survey (November 2009)

83% of health departments suffered job losses since July

2008.

•1,564 state employees in central offices were lost

•651 state employees assigned to local/regional offices

were lost

76% of state/territorial health departments made cuts to

the FY09 budget during FY09.

Extent of Respondents’ Budget Reductions

55% reported a FY10 budget that is smaller than FY09.

A third of states with larger budgets in fiscal year 2010

compared to fiscal year 2009, indicated that this is the result

of federal stimulus and H1N1 funds and that their state

general funds actually decreased.

28% reported a FY09 budget that was smaller than FY08.

At least 23% expect further cuts in FY10.

Extent of Respondents’ Budget Reductions

Percent of State Health Agencies experiencing job losses and program reduction FY09: N= 49, FY10: N= 40, FY09 & FY10: N= 52

Cost-saving strategiesNumber of states using strategy (N=25) %

Delayed retirement 20 80%

Travel restrictions 19 76%

Hiring freeze 16 64%

Reduced training budget 13 52%

Furloughs 6 24%

Alternative work schedules 6 24%

Early retirement 4 16%

Rehiring retirees 2 8%

Pre-retirement modifications 0 0%

Nurses make up the largest professional area* Over 12,000 public health nurses working in state

health departments Public health nurses cited as top workforce

shortage concern Local health departments are experiencing

similar shortages States also cited shortages in other nursing sub-

specialties such as certified nursing assistants, advanced practice nurses, nursing aids and nurse surveyors

*largest is admin/clerical staff

Source: ASTHO 2007 Workforce Survey

Workforce◦ Number of public health nurses employed by

state health agencies◦ Salary range and benefits◦ Degree of workforce shortage◦ State-sponsored loan repayment programs to

increase supply of nurses State nursing home eligibility Nursing home regulation Quad Council competencies Professional licensure

Katie Sellers, DrPHSenior Director, Survey Research

ksellers@astho.org

surveyresearch@astho.org(571) 527-3171