Hi, Atlanta!

This week I sat in on a state legislative committee as members grappled with how to address public health funding from the federal government, local staffing shortages, and how to better coordinate services. 

“We have huge issues, especially when it comes to nursing,” Dr. Zachary Taylor, director of the state’s North health district and interim director of the Gwinnett, Newton, Rockdale district, said at a meeting Wednesday. Health departments face competition from the private sector and hospitals to fill nursing and other positions, he said. 

Chris Rustin, interim director of the Fulton health district, said restaurant inspectors are often trained by health departments but then head to the private sector, where they can make more money. 

“It's cheaper to retain them in the long term, plus you end up with a more stable workforce that knows the job and hopefully is more community oriented for our services,” Rustin said of the public health workforce. 

Coordination and duplication of services is also a challenge across the 159 county health departments and 18 health districts. All but one district has electronic medical record systems, but each district has its own contract, making collecting data in a unified way difficult, Rustin said. 

The state has contracted with Patagonia Health to establish an EMR for the entire system, but it will take about two years to get it up and running. 

Meanwhile, concerns about federal funding loomed. 

“We are all waiting to see what Congress does,” said committee chairwoman Rep. Darlene Taylor, a Thomasville Republican. About half of the state’s $922 million public health budget comes from federal sources. 

“Obviously, we can help some, but I don't think we can make up all of those dollars,” said Rep. Butch Parrish, a Swainsboro Republican.

Still, public health leaders highlighted some positive developments for lawmakers. 

Many rural health departments are able to use telehealth to provide services they wouldn’t otherwise have. Families in 120 counties can access providers for children and youth with special needs across specialties ranging from genetics to pulmonology. Some departments also use telemedicine for HIV services, managing complex tuberculosis cases, pediatric audiology, and dentistry. 

On the staffing front, the Emory University School of Public Health established the Rollins Epidemiology Fellowship Program in 2020 to encourage early career epidemiologists from across the country to serve in Georgia health departments. So far, 74 epidemiologists have been placed through the program, and of the 44 who have graduated, over half have remained in state and local public health, said Allison Chamberlain, the Emory professor who founded the program. 

And the state Department of Public Health is expanding its maternal and child home visiting program to 75 counties. The home visitors screen pregnant women and new mothers and their babies for common but serious problems, like diabetes or mental health issues. 

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