Local Health Departments Devastated By Indiana Funding Cuts

U.S. Health and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz answer reporter questions during a “Make Indiana Healthy Again” kickoff at the Indiana State Library on Tuesday, April 15. Photo by Leslie Bonilla Muñiz, Indiana Capital Chronicle.
News Release
INDIANAPOLIS — County health departments across Indiana are reeling after lawmakers slashed public health funding by 64%, a move local officials say threatens critical community programs and reverses recent progress made under the Health First Indiana initiative.
Approved in 2023, the Health First Indiana program was initially funded with a historic $225 million investment to be distributed over two years, following recommendations from former Gov. Eric Holcomb’s Public Health Commission. That investment marked a turning point for Indiana’s public health infrastructure, with funding levels increasing from $15 per resident, 49th in the nation, to a more competitive national ranking.
However, due to an unexpected $2.4 billion state budget shortfall, the Indiana General Assembly reduced the initiative’s funding to just $80 million for the next two years. Local health officials say the reduction has forced them to scale back or eliminate new programs designed to improve access to care, address chronic diseases, and combat mental health and substance abuse challenges.
“State and public health leaders were finally sleeping at night knowing that we had the resources to help our communities heal and grow,” said Marc McAleavey, CEO of the Indiana Public Health Association.
In Clark County, a $4 million allocation had funded extended clinic hours, CPR devices for rural responders, bike helmets for children, and gun safety locks. With only $1.4 million now expected, those efforts are at risk.
“This is cutting off the blood supply,” said Clark County Health Department Administrator Doug Bentfield.
In Vigo County, Health Administrator Joni Wise described the impact as “heartbreaking.” The county had used Health First dollars to hire mental health professionals for schools and jails. That initiative will be discontinued after funding was cut from $3.75 million to $660,000.
Wise explained she spent nights and weekends building the programs. “You’ve got good things that are laying the groundwork, and then it’s like a rug gets pulled out from underneath you,” she said.
Madison County Health Administrator Stephenie Mellinger echoed the sentiment, calling the cuts a betrayal after lawmakers initially promised long-term support. Mellinger also criticized a new restriction barring the use of Health First funds for tobacco cessation programs, despite Indiana’s recent increase in cigarette taxes.
“It makes no sense,” she said, noting that smoking is the leading cause of chronic disease in the nation and her county has one of the state’s highest smoking rates.
Adding to the strain, the U.S. Department of Health and Human Services canceled more than $11 billion in federal grants nationwide, with Indiana losing over $400 million. A preliminary federal injunction has temporarily halted the move, but the future of county-level grants remains uncertain.
Local governments also face an estimated $1.5 billion revenue loss over three years due to a property tax overhaul passed by the state legislature.
“We’re getting hit from all angles right now,” said Bentfield.
Public health advocates pointed to recent political developments, including federal appointments and vaccine skepticism promoted during a visit by HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz, as undermining evidence-based health practices.
“Public health decisions (are) being made by people who don’t understand public health,” said McAleavey. “That will ultimately harm our communities.”
Shandy Dearth, director of Indiana University’s Center for Public Health Practice, emphasized that sustainable improvements in public health require long-term investments.
“We can’t pull up a switch and make everyone healthy overnight,” Dearth said. “Local health departments have been chronically underfunded for 30-plus years.”