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THE PROBLEMS RELATED TO ADEQUATE PERSONNEL AND BUDGETS TO PREVENT AND MITIGATE FOODBORNE DISEASE

Federal funding is essential for the maintenance of many state and local public health and environmental health programs. The budget for the CDC has decreased from $7.07 billion in fiscal year 2005 to $5.98 billion in fiscal year 2013 and may be lowered further for 2016-2017. This has not only resulted in severe cuts at the CDC in programs and preparedness as well as the loss of highly skilled people with huge amounts of practical experience, but also severe cuts in federal/state and local programs resulting in once again losses of highly skilled individuals with excellent knowledge and long-term experience. Forty-eight states, three territories, and Washington, DC, have reported budget cuts and serious job losses. Instead of practicing prevention as the most effective and common sense approach to reduce potential disease and injury, the various departments have to resort to putting out the fire after the problem has occurred. Some 75% of the CDC budget is distributed to states, local agencies, and other public and private partners and is used to support services and programs. (See endnote 50.)

In addition, the state and local public health workforce is declining at a substantial rate each year. According to the Association of State and Territorial Health Officials, approximately 20% of the various health agencies workforces are eligible to retire within the next 3 years and there do not appear to be sufficient specially trained new people to fill their positions. Much of this is due to the relatively low salaries paid to people in the environmental health and public health fields although the qualifications for the positions and the necessary credentials or licensure are very strict. In all cases, appropriate continuing education is required to maintain the credentials or licensure.

Prevention appears to be a nasty word until we have an outbreak of an exotic disease such as Ebola and then everyone demands to know why public health officials cannot solve the problem immediately and prevent the spread of disease. It is the easiest budget to cut because it is rather difficult to prove in many instances that prevention has saved lives and money.

Because of restricted budgets, local units of government have furloughed huge numbers of public health staffers, including environmental health professionals. Others have been forced to accept unpaid furlough days, pay reductions, and across-the-board program eliminations and reductions.

Environmental health professionals especially have a serious public relations problem. When the newspapers refer to them as inspectors, the work that these individuals do is demeaned. It reinforces the idea that in a budget crisis, the first place to cut is in public health, especially environmental health.

At budget cutting time, the last to go are the police and firemen, because of the potential for disasters involving the public. The same should also be true of the environmental health practitioner, who helps prevent disasters involving food, water, air, hazardous chemicals, hazardous wastes, housing, terrorist acts, serious outbreaks of disease, etc.

Best Practices for Personnel and Budgets (Also see Best Practices in Avoiding Problems in

Politics below)

  • • Develop and utilize a comprehensive fee-for-service program to obtain appropriate funding for a comprehensive environmental health services program including adequate and properly educated and trained credentialed environmental health practitioners receiving appropriate salaries and using state-of-the-art equipment. Fees should be charged for virtually all services including those related to: camps and campsites; water supplies of all types; all types of food service establishments; mobile home parks; subdivision plan reviews; individual sewage disposal systems; sanitary surveys; all forms of swimming pools, spas, and bathing beaches; tanning facilities; tattoo and body piercing facilities; hotels, motels, and boarding houses; all forms of solid and hazardous waste disposal; hospitals, rehabilitation centers, nursing homes, retirement homes, etc.; all forms of pet businesses where there is necessary disposal of wastes; plumbing and gas piping fees; food establishment plan reviews; school plan reviews; temporary foods and special events; food manager training programs; mobile homes or RV parks; child care facilities of all types; etc. It is then essential that adequate funds are provided for response to different types of environmental health and public nuisance complaints, fires, and other emergencies or disasters, as well as outbreaks of disease. It is necessary to convince the political entities that all of these funds which go into a general fund be allocated solely for the operation of the various environmental health programs in the community.
  • • Determine the actual costs of each of the services provided above and add a percentage for administrative fees to cover all of the other services which should be provided free to the public in the event of special problems, emergencies, or disasters.
  • • Develop a concerted united effort using all forms of communication including all types of internet platforms, by all agencies and all professional associations such as the National Environmental Health Association to teach the public the serious potential for disease, injury, and environmental disasters that are occurring currently and may accelerate in the future, and the extreme value of the highly trained professional environmental health specialist to help prevent, control, and mitigate the effects of these occurrences.
  • • Develop and distribute professionally prepared materials to various media including the various internet platforms and also to all portions of the public and political groups, brief descriptions of the qualifications of the applied scientists called “environmental health specialists” and also describe the nature of his/her work including prevention, mitigation and control of factors leading to disease and injury and the protection and sustainability of the natural environment.
  • • Using Ebola as an example, develop a concerted effort to discuss with all national, state, and local legislators the great significance of expanding budgetary and other resources for environmental and public health to prevent the potential effects of other outbreaks of exotic diseases as well as those which are occurring regularly now to prevent future disasters from occurring. Prevention is far cheaper than treatment or control at a later date.
  • • The United Nations has to empower and fund the World Health Organization at such levels that when there is just the hint of an outbreak of a highly infectious disease, adequate numbers of highly trained individuals utilizing the latest equipment and resources will move into the area and help the particular country stop the outbreak before it becomes an epidemic or a pandemic, thereby affecting other countries.
  • • Discuss with your colleagues of similar size communities what techniques you used to help persuade legislative bodies to provide funding for necessary programming.
  • • Establish a special group of senior environmental health administrators and retirees who can give guidance to individual communities on how best to get appropriate budgetary support and best utilize the funds to achieve appropriate goals.
 
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