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Health departments are struggling to spend Covid funds

A year later, with the covid killing 1 million people in the United States since the start of the pandemic and hospitalizing millions more, little money has been used, according to KHN’s requests for information of a dozen grants from state and county agencies. Although some states and localities have allocated large portions of CDC money to projects, they have still spent only a small proportion.

The Missouri Department of Health has not spent any of its $35.6 million. Wisconsin, Illinois and Idaho, the state departments of which each received $27 million to $31 million, have used less than 5% of the grant money.

The Pennsylvania Department of Health has used about 6% of its nearly $27.7 million grant.

The California Department of Health has spent just over 10% of its $32.5 million funding.

Public health agencies give a litany of reasons for this: they need time to hire people. They blame the lengthy budget process on their state. They say it takes time to work with nonprofits to create programs or use the money. They are already taking advantage of other federal dollars to combat covid disparities.

The accumulation of unspent covid relief dollars is one of the key reasons why Republicans in Congress oppose Democrats’ efforts to appropriate billions more federal dollars to manage the pandemic. legislative funding cycle. “These are investments that will overwhelm a system that has been starving for so long,” said Dr. Usama Bilal, an assistant professor of epidemiology and biostatistics at Drexel University in Philadelphia. Kirsten Bibbins-Domingo, a health equity expert and editor-in-chief of JAMA, added that it is difficult for public health systems to lack resources and fight a pandemic by establishing links with local non-profit organizations so quickly.

“The pandemic shed light on these major health disparities, but they also shed light on the fact that [public health systems] they don’t have the structures to partner directly with communities, ”he said.

The funding aims to reduce the disproportionate effect of the pandemic on minorities. By adjusting for age differences between racial and ethnic groups, black, Hispanic, and Native American communities experienced higher rates of hospitalizations and covid deaths compared to white people. These adjustments are necessary, the researchers say, as communities of color tend to be younger.

Despite the need to address these issues, the Riverside County Department of Health in California has spent about $700,000 of its $23.4 million grant, which is independent of state Department of Health funding.

“Historically, public health has been underfunded, and all of a sudden it’s a lot more money than we ever get,” said Wendy Hetherington, head of the agency’s public health program. “It’s great that we’ve got this funding because it’s needed, but we’re struggling to try to spend it.”

Part of the problem was that county health officials had to wait six months for local government approval to spend it. At the time, he said, he was facing delays in negotiating contracts with nonprofits in the area.

Stan Veuger, a senior member of the Conservative American Enterprise Institute, echoed concerns from Republican lawmakers, saying the slow deployment of these grants shows that Congress sent more pandemic relief than needed by state and local governments. that their tax revenue recovered much faster than many expected.

“It raises questions about why this separate grant program was created,” he said.

Rachel Greszler, a senior researcher at the Heritage Foundation who has argued against funding the new covid relief in Congress, said slow spending also shows how states need time to absorb revenue and develop programs, especially when governments face labor and supply shortages. chain problems.

The CDC said the money could be used to help prevent the spread of the covid virus, improve data collection, expand covid-related health services, and address social and economic issues that have prevented many minority communities from receiving covid. adequate care during the pandemic. . He initially said the grant was to be spent in May 2023, but earlier this year he told states they could apply to extend that time.

CDC officials are working with groups on the implementation of the grant, said spokeswoman Jade Fulce.

Because the term “health inequalities” encompasses the challenges facing all population groups, money can be applied to almost anything that affects health.

The Illinois Department of Public Health received $28.9 million and has spent $138,000, according to spokesman Mike Claffey. The state plans to spend more money on translating American Sign Language for covid materials, outreach to people in prison, mobile health units for rural areas, and hiring community health workers.

“The goal was to design programs that would build health infrastructure and address these historical inequalities in a meaningful and meaningful way,” Claffey said.

The Florida Department of Health plans to use $236,000 of its nearly $35 million grant in newborn hearing tests after covid-related closures led to a decrease in timely checks, said spokesman Jeremy Redfern.

The Miami-Dade County Department of Health has spent $4 million of its 28 million CDC grants. Money is being given to local non-profit groups to address food insecurity and language barriers. Like other jurisdictions, the county noted that it has provided funds that groups have not yet spent, including $100,000 to improve the literacy of its large Haitian community. Saradjine Batrony said he hopes to help between 60 and 100 people from May with this grant.

“The language barrier is what kept people from getting vaccinated,” said Batrony, who was a researcher at the University of Miami before starting her own business last year focused on translating health documents into Creole. Haitian.

Nearly $4.6 million of the Pennsylvania CDC grant went to the State Office of Rural Health, which was scheduled to donate money to 20 counties last fall. Until May 5, he had not funded any.

“Over the past two months, we’ve had problems with county leaders losing momentum and interest in covid-19’s work,” said Rachel Foster, the agency’s covid-19 rural program manager. Penn State University. “In rural Pennsylvania, cases are low, interest in vaccines has waned, and rural residents largely feel the pandemic is over.”

Some counties and states say they were addressing health inequality issues before the CDC disparity money.

The $8.3 million grant from Philadelphia came after several CDC awards that also addressed issues affecting neglected communities, spokesman Matthew Rankin said. Philadelphia has spent about $147,000 on the disparities grant.

The University of Florida health care system in Jacksonville received $1.25 million last July from Duval County to expand services to communities disproportionately affected by covid. But by early May, the university had not yet received the money, spokesman Dan Leveton said. “We don’t care because we have other covid funding that we are using at the moment and we will use CDC funding when it arrives,” he said.

Mississippi received $48.4 million, the largest award to any state health agency grant. So far, the agency has spent $8.2 million, spokeswoman Liz Sharlot said, although it has already used other federal relief dollars to address the covid’s health disparities.

As states figure out how to spend the money, health experts are concerned about the political consequences and the communities that need help.

“Money is very much needed, but we have to keep in mind that these health departments have long been overburdened and don’t really have enough people to handle it,” Bilal de Drexel said.

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