Budget Cuts, Fall 2009

Impact of Budget Shortfalls on Environmental Health Programs Survey of NEHA Members Oct 2 –Oct 9, 2009

Purpose of the Survey
Most city, county and state agencies are experiencing significant cuts due to budget shortfalls and reduced fee-based services.
In keeping with our mission, "to advance the environmental health and protection professional for the purpose of providing a healthful environment for all", NEHA was interested in researching the effect of the economic downturn on Environmental Health programs and the communities they serve.

We asked NEHA members
“ Is the loss of staff and funding affecting your ability to provide environmental health services?”
Examples could be cuts in restaurant and food production facility inspections, monitoring and surveillance of potential disease vectors, enforcement of air quality standards or many other of the varied responsibilities of environmental health professionals.
Our goal was to document that the loss of capacity in local programs is detrimental to members of our communities.

Survey Results
Over 100 members responded
Additional comments were posted on the NEHA blog at http://ehbudgetcuts.blogspot.com/

Format of this report
Responses for each question were grouped into categories
The number in parentheses indicate the number of responses in that category.
Also provided are examples of participant comments
Please note: Question 3 and 7 were duplicates.
Responses are shown on Question 7

Question 1
This survey is confidential. However, we would appreciate knowing which communities have been most impacted by environmental health program cuts. If you are comfortable doing so, please enter the city or county and state where you are employed.
Respondents represented city, county and other agencies from 37 states and Saudi Arabia
AL AZ CA CO CT FL
GA HI IA ID IL IN
KS KY MA MD ME MI
MN MO MT NC ND NH
NJ NM NV OH OK OR
PA RI SA SC TX VA
WA WY

Question 2
While it can be difficult to correlate health problems with reduced services, please describe any anecdotal examples of individuals or groups in your community that have been impacted by budget cuts in environmental health programs

Question 2: Impact on Public
Programs for Children and Young Adults (4 similar responses)
The greatest impact in our area is with children under the age of five that go to daycares. We eliminated our daycare licensure program and the nurses used to monitor daycares. This occurred in July, and we now have an increase in shigella at daycares
Pregnancy rate (especially among teenagers)increase due to lack of education, free condoms/birth control

Communication with the public has suffered (7)
Lack of funding for community outreach programs has stunted the time spent on spending the quality "face time" with community members. This results in less education and lessens the trust factor because they don't see us anymore.
We have maintained mandated services such as inspections and response to complaints in a timely fashion. But with less staff the community has a more difficult time reaching a health environmentalist to make service requests or ask questions. We have had to cut office hours and the environmental county offices are often un-manned during the work day.

Fewer Inspections or Slower Response to Complaints (14)
We get daily complaints of environmental health hazards within the city limits such as unsanitary conditions, rats, roaches, refuge, hazardous waste, waste water, unsanitary keeping of animals, swimming pools, no heat, no water, improper storage of salvable materials, etc. In 2008 it took us an average of 9 days to resolve a complaint, now it is taking us an average of 20 days to resolve a complaint.
It is hard to quantify any increase in illness and environmental degradation as a result of the budget problems in my jurisdiction. All types of complaints are up and compliance is down in the facilities we license.
Residents have asked if we are inspecting restaurants because they do not see a current inspection on our web page

Question 2: Impacts on Public
Public Health and Low Income Groups (7)
Community Health, immunizations
More & more patients at the local tribally owned & operated hospital and clinics, where tribal members receive free services.
Physicians have left city due to lack of business.

Effect on Programs (21)
Some legislation now increases our workload with no financial compensation (smoke-free air act)
No new programs implemented. Existing inspections programs were cut back due to increased stress levels whether personal or job-related. No job cuts or freezes inside LHD. However, no increases in services or personnel. More red tape internally regarding office supplies and inter-office spending. Community continues to grow, however at a reduced rate, but LHD doesn't. That will have more of an impact as time goes on.
Food establishments are inspected only one time each year. In the past we inspected them at least 2 times a year

Question 2: Impact on EH
Continuing Education and Professional Development (7)
EH staff are no longer approved to travel out of county (or state) to attend any training or continuing education.
In the environmental federal sector if you want to go to training you pay.
Fewer conferences attended but still trying to maintain our CEU's

Question 2: Impact on EH
Personnel Issues (15)
Budget shortfall and union/management bickering is resulting in unwarranted scrutiny of federally funded programs, thus jeopardizing their success.
With the increase in food product recalls, BT preparedness, and special events, we do not have enough food inspectors to do the normal routine inspections. Cuts in food inspection staff have not saved us any money, but has resulted in increased overtime cost and reduction in routine inspections.
The cut has not yet happened, but nearly the entire Vector Control Branch has been slated for termination.

Question 4
How long have you worked in the
environmental health field?
Possible responses:
Less than 2 years
2-5 years
5-10 years
10-15 years
More than 15 years

Question 4: How long have you worked in the environmental health field?

Question 5: What is your job title?
(2) Director
(2) Health Officer
(2) Registered Environmental Health Specialist
(3) EH Supervisor
(3) Environmental Specialist
(3) Environmental Health Specialist 2
(3) Program Managers
(4) Directors of Environmental Health
(4) Registered Sanitarians
(8) Sanitarians
(8) Environmental Health Specialists

Question 5: Variety of job titles and responsibilities
CEO
Chief of Environmental Health
Consultant
Deputy Director, EH
Director of Code Enforcement
Director of Health Protection Services
Director of Vector Control
Director, EH Division
District Sanitarian
Division Director
Division Manager
EH Director
EH Manager
Environmental Administrator
Environmental Health Administrator
Environmental Health Director
Environmental Health Manager
Environmental Health Officer
Environmental Health Practitioner
Environmental Health Services Administrator
Environmental health specialist III
Environmental Protection Manager
Environmental Scientist
Environmental Services Director
Environmental Specialist II
Environmental Supervisor
Environmental Supervisor II
Environmentalist

Question 5: More titles
Food Hygiene Coordinator/ES III
Food Inspector/FT-Sanitarian/ PT
Food Safety Manager
Food Safety Specialist
Food Safety Unit Chief
Health Director / Forensic Sanitarian
Health Inspector
Lab Specialist
Manager, Bureau of EH Services
Manager, Radiation Protection & Dosimetry
Plan Review Engineer
Planning Specialist
Public Health Advisor
Public Health Specialist
Quality assurance manager
Region Food Program Supervisor
Region Supervisor
Regional Lead Coordinator
Research Associate
Sanitarian IV
Sanitary Inspector (old Job)
Senior Environmental Health Specialist
Senior sanitarian

Question 6: Are you employed by
Possible responses were:
City Agency
County Agency
State Agency
Federal Agency
Private Company or Consulting Firm
Not-for-Profit Organization
University or College
Military or Uniformed Services
Other

Are you employed by

Question 3 & 7: Please describe the impact of budget or staff reductions on services provided
Possible Responses:
More emphasis placed on fee-based services
Fewer inspections
Programs eliminated (please identify)
Unrealistic workload expectations
Outsourcing of programs
Supply and equipment budget reduced
Cuts in technology support
Changes of specific programs

3 & 7. Please describe the impact of budget or staff reductions on services provided

Question 3 & 7: Changes to specific programs
Training/prof. dev. Cut
Fee collection stressed
No mobile home park inspections now
On-site; user fees increased
Fewer remediations provided
Loss of Cell Phones
Reduction in overtime to inspect after hours
cut or eliminate all non-mandated programs
Meals on Wheels, immunizations
Child Care Health eliminated, well inspections cut
Food manufacturing plant inspection (now by Ag)
My staff cut 50% in hours
Working in other program areas
No after hours inspections
Layoff/cut back on part-time LEHP-office staff
Less training, cut to office supplies, animal control
Cut prevention priorities
Unable to fill positions when workers leave
EH plan review shifted to Building Codes
Daycare licensure program eliminated
Bed bugs

Question 8: How has your department budget changed in the last 12 months?
Possible responses
Salary reductions
Salary freeze
Furloughs
Layoffs
Hiring freeze--retirees or vacant positions not filled
Staff transferred to other programs or departments
No new positions
Reduced training budget or fewer professional development opportunities
Restricted travel
Travel budget for training eliminated
Programs reduced or eliminated
Unable to support new initiatives or mandates
Reduced ability to provide mandated services
Increased reliance on revenue from fee-based services
Loss of grant funding
Other, please specify

How has your department budget changed in the last 12 months? Please check all that apply.
Top 5 changes:
No new positions
Hiring freeze
Salary reductions
Salary freeze
Reduced training budget or fewer professional development opportunities

Question 8: Comments on change to department budgets in the last 12 months
No /reducing after hours inspections.
obsolete technology kept
Increase in user fees and new fees (on-site prog.)
furlough - reduces work time
My bacteriological testing program is compromised.
Radon and PCBs are addressed less
cut or eliminate non-mandated programs in EH
We must look for grant opportunities for funding.
(3) Unable to fill positions as become vacated
(2) No Training budget dollars for 2010
EH plan review shifted to Building Codes
daycare licensure program eliminated
Vector Control
Bed bugs inspections stopped.
travel to needed job related educational training
Prevention priorities
Food manufacturing plant inspection (now under Ag)
Small Public Drinking Water Program
All health education programs cut
TB, STD, Early child care, Food Program,
drinking water
Only delay or freeze some construction projects.
Reduction in clerical support staff-lay offs
Loss of state money for EH programs
Septic system program directed to our bldg inspect
My staff on half-time -- during the peak West Nile
(2) EH professional now working in other programs
No more free water tests

Question 9:
Aside from funding, what do you see as the greatest challenge for environmental health practitioners in the future?

Question 9: Challenges
Program concerns (20)
Ever changing highly susceptible population and new hazards in foods
The hyper sterilization of the public. That perception will swing to the far end of the spectrum, from not knowing about sanitation to immune systems becoming weak from sanitizing every aspect of life.
Supporting the very important non-mandated Environmental Health programs, in particular, community based initiatives. weak from sanitizing every aspect of life.
Addressing community quality of life issues (junk cars, trass, behavior issues)

Recognition (16)
History of Public Health is forgotten. We will have Public Health Issues return to the forefront. Read history. We All thought TB was done. Ha!! it has returned. Food--Who heard of E. coli before 1993. A few of us.
Until there is a pandemic, communities don't recognize their need for environmental health professionals.
Being recognized as giving a valuable service that prevents disease or important component of increasing wellness in a community
Unless people are getting sick, people will continue to question our regulatory work (too much regulation). And if they do get sick it will be because we are not doing enough.

Education and Professional Development (12)
We need the latest training to be at the top of our game. Without the latest training we cannot be very effective!
Training. Here in Hawaii the training options are very limited. Trainers cannot afford to travel to Hawaii and the government cannot afford to send us to the Mainland for training
Due to budget restraints, the ability to send employees to enough conferences to receive enough CEU's for the LEHP. I would like to see more web based conferences.

Staffing Issues (15)
Competency of the work force, quality starts with qualified competent people. Licensing of our profession should be a federal mandate...
Transitioning from Baby Boomers managing EH programs to a new generation
Attracting new graduates to the field, and attracting more students to the EH fields of study

Attitude and Morale (4)
Changing mind-set from an ineffective, reactive, establishment inspection orientation to a more effective, efficient, establishment auditing mode.
The focus is on quantity and not quality. Getting staff hired with experience in environmental health. We are like the training ground for employees who then move to the private sector for employment
Low staff morale
The discouraging future of EH as we will not likely see any future salary increases, not even marginal ones that don’t keep up with cost-of-living or health care increases, and are expected to keep up with increasing work loads and customer demands.

Question 10: When the current economic crisis eases, do you expect your department funding and operations to pre-recession levels?

Question 11
What do you find most frustrating about the recent budget changes in your department?

Question 11: Frustrations
Staff Morale (19)
Some of the impacts of the decisions made today will not appear until over time. By then too many lives will have been impacted. Those who determine where the funds are allocated do not seem to care about prevention and what may happen in the future; they only care about what is happening during the time they are in office.
The psychological impact of the economy and the strains it causes on the workforce. The budget changes have caused a ripple effect from the professional lives to the personal lives of everyone in the office.
The not knowing when or if the other shoe will drop.

Question 11 Frustrations:
Compensation and Staffing (18)
No raises and increased amount taken from us for insurance, therefore, a pay cut
People at the very top are continuing to get salary increases. EH is taking a back seat to PH clinics
Cuts are of whichever positions are vacant, not which ones should go first based on our strategic plan.
Loss of staff and potential reduced response times for certain events

Workload (11):
The workload has not diminished and the regulations have not diminished although personnel who do the work are reduced.
The new blood the future of Public Health was laid off. It will take years to regain the loss.
Having to cut the hours of good people, and putting the residents at risk of disease
Inability to perform all necessary functions in a timely basis

Education and training (9)
Unable to travel and/or train as needed to perform work as professionally as we'd like
Unable to keep up with NEHA continuing ed requirements unless I pay out-of-pocket for classes and travel
Funding issues (10)
Billions are being wasted on projects that make representatives look good in the news media but they make cuts to public health funding which provides essential services to the public.
State elected officials increase the mandates on local health without an increase in funding.

Note: Members who have been in the field the longest (more than 15 years) tend to feel that funding will continue to be a concern

NEHA Annual Focus Group
From the 2009 President Affiliate Group meeting of Regions 7,8, 9 and 10.
How specifically is the economy impacting environmental health in your area of the country?
Furloughs have been given to employees from one week to 20 days. One university was required to take an additional week off for the holidays, with 1 week with pay and the second week without pay.
Some multiple site Health Departments have been closed to one site
Some states have eliminated jobs, but employees can re-apply at lower positions
Some Health Departments are focusing only on ten essentail services of Environmental Health.

NEHA Annual Focus Group (Con’t)
How are the EH programs with which you familiar responding to these economic challenges?
Some states have implemented Recovery Cost Programs to recover the cost of the program and not the inspection. It was found that it changes the relationship of the business and HD. The business feels they should have more input.
Regionalization has been the major program implemented by most states. It has had both a positive effect in some areas and negative in other; one state suggested forming a council on regionalization.
Press announcements have been released on Health

NEHA Annual Focus Group (Con’t)
Affects on Associations
Some associations have joint conferences with other agencies to help with costs
Some associations are hosting on-line programs instead of conferences
Some associations have moved from having three day conferences to one day conferences
What are the long term projections?
The projected effects are thought to be both psychological and physiological where environmentalists will change to other fields
Thank you to Lonnie Pressley, Alabama Environmental Health Association for sharing this information

In 2009, NCHESA asked their members to complete a survey on the current economic situation in their counties. The questions that were asked are shown on the following page. Results are posted at Economic survey or http://www.ncehsa.org/downloads/survey/2009july--economic%20survey--master.pdf

Questions from the NCEH Supervisor’s Association Survey
How many staff did you have in BY 08-09? Staff for BY 09-10? Net loss
if you have lost staff, what EH group were these former staff from?
List: wells and septic, food and lodging, animal control, other
Is your county giving raises in BY 09-10?
Is your county furloughing staff in BY 09-10?
Describe the length of furloughs
Has your county reduced staff pay in BY 08-09? Reduced staff pay in BY 09-10?
Have any of your full time positions been changed to part time?
Have you shifted staff from one program area to the other? if yes, please list
Has your county reduced any benefits in 08-09 or 09-10?
i.e. health, 401k match, etc…
What other money saving measures have you taken (either voluntarily or coerced)? pls list
What is your turnaround time for a:
well permit: soil evaluation foodservice plan review customer return call back
Have your turnaround times improved/ worsen since this time last year

Your feedback is important .
Thank you to members who have provided information on the impact of the current budget situation on environmental health professionals and the communities they serve

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Budget Cuts, Fall 2009

by NEHA on Apr 15, 2010

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