budget cuts, fall 2009

Impact of Budget Shortfalls on Environmental Health Programs

Survey of NEHA MembersOct 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 respondedAdditional 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 AssociationsSome associations have joint conferences with other

agencies to help with costsSome associations are hosting on-line programs instead of

conferencesSome 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