When it comes to healthcare services, Indiana is ranked in the bottom 10 of the 50 U.S. states.
In order to help change that, the 2023 Indiana General Assembly passed Senate Enrolled Act 4, which provides Health First Indiana funding - starting this year - so counties can determine the health needs of their citizens and also implement evidence-based programs focused on prevention, according to the state’s website at www.in.gov/healthfirstindiana.
“They decided, during and after Covid, that there was a need for more county-based initiatives for healthcare,” said Elizabeth McCullough, Health First Kosciusko (HFK) assistant, in an interview Monday.
Local health departments must report metrics on 15 core health services, which include tobacco prevention and cessation, chronic disease prevention, trauma and injury prevention, maternal and child health, school health liaison, lead case management, access to and linkage to clinical care, tuberculosis prevention and case management, health-related areas during emergencies/disasters, infectious disease surveillance and prevention, vital records, food protection, environmental public health, fatality review and immunizations.
“They did data trackers under each of those, and they have different KPIs (key performance indicators) that they’re asking each of the 92 county health departments (to track and report on),” McCullough said. “And at first, I think we were 41st out of 50 healthcarewise, so we do need a little bit of work here in Kosciusko County to get a little bit better, so that’s why we find this very important and the state is providing that funding under the Health First Indiana program. We actually renamed it Health First Kosciusko because they’re wanting it to be more county-based.”
For 2024, Kosciusko County received $968,263.83 in Health First Indiana funds, with the county’s match being the average of county tax levy-related funds distributed to the local health department in the preceding three years. In 2025, Kosciusko County will receive $1,871,327.38 in Health First Indiana funds, with the county’s match being a minimum of $391,170.
The Health First Indiana grant funding is set up for two years, 2024 and 2025. After that, the state will review the program. Information on each county can be found online at in.gov/healthfirstindiana/your-community-info
Of the 15 core services, McCullough said the Kosciusko County Health Department “has done a wonderful job. They’re pretty robust in what they offer. Some of the core services here, we already had.” As an example, she said the KCHD has a “wonderful” vital records system so they were able to mark that as completed. The core service on tuberculosis also was able to be marked as completed, as was health-related areas during emergencies/disasters.
“There’s quite a few here that we were already doing, but there’s some that we needed to touch on. So, for example, tobacco prevention and cessation,” she said.
A KPI question for tobacco prevention and cessation asks, “Does your local health department participate in a local tobacco control coalition?” When Health First Kosciusko Coordinator Kurt Carlson started as coordinator this year, McCullough said the health department did not. “There was some of these that we found out we don’t have that county level, so these are some of the things we need to address and see if we can.”
For tobacco prevention and cessation, she said they partnered with the Live Well Breathe Well coalition.
Currently, McCullough said they’re gathering data to see where the gaps are in the 15 core services. The KPIs are due to the state on June 15 and Dec. 15 annually, with the core service data due by June 30 and Dec. 31.
“Now that we have that data, we’re going to look into it and see where in our community and our county do we need to address some of the health concerns? Where does the funding need to be placed? We’re doing the research now,” she stated.
With the state funding, McCullough said the local health department can either develop new roles for itself to meet the core services, or it can have partners. “They don’t want us - and it makes sense - not to create something that’s already being done. So if we can just partner with somebody who is already doing that, and just kind help of them, and then they can help us by providing the data that we need and then we know what our county needs,” she said.
Another partnership Health First Kosciusko formed is with the Chronic Disease, Obesity and Cancer Coalition, which is out of Live Well Kosciusko as well.
The state wants the county’s information so it can compare it to the Indiana rates and see what it’s doing, what other counties are doing and how they are meeting the KPIs.
McCullough said they have at least started working on all 15 of the core services.
They are working on the school health liaison, which they hope to have completed in 2025. Currently, Carlson is also serving in for that role until the position can be filled.
“And that’s just a nurse going into the schools and working with those nurses and seeing what the kids need,” she said. “... Are the schools doing vision screenings? Hearing screenings? Health screenings? Just different things like that, because then the school health liaison is going from the school and reporting back to the health department on if the needs are being met for these kids and what can we do to help with that.”
There is an advisory committee for Health First Kosciusko. Carlson and McCullough report to the committee, which reports to the Kosciusko County Board of Health. There is a committee meeting at 6 p.m. Wednesday, July 24 in the old courtroom of the Kosciusko County Courthouse, which is open to the public. The Board of Health meets quarterly.