[{"_1":2,"_88":-5,"_89":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6501327,"mediaKeyId","5607350-e440c053d890ae9c19a587f7223b86c4","parentId",5607350,"title","Committee hears how Georgia public health is organized and funded — districts, grants, EMR rollout and budget pressures","audioSeconds",6475,"startMs",3524000,"endMs",9999000,"viewUrl","/Search/View?dp=1&key=5607350-e440c053d890ae9c19a587f7223b86c4&start=3524&end=9999","thumbnailUrl","https://assets.pipeline.soar.com/5607350-e440c053d890ae9c19a587f7223b86c4/thumbnail_3524000.jpg","articleUrl","/articles/6501327/Georgia/Committee-hears-how-Georgia-public-health-is-organized-and-funded-districts-grants-EMR-rollout-and-budget-pressures","mediaUrl","https://secure.pipeline.soar.com/6501327-f00246867357b7e216e081586cee367c/orig.mp4?Expires=1770655983&Signature=bYQThM3JiM0tBXhZIXugjHm6IjfCE82sNgW7YNj8Cwvz-9Or5D~c67lEQk5A~BebJvJVcBIvErq~CyCUjjjBkm2SwBMEqoHU2pwUZhJ6pAOSc8IovT44uggp4F72gjkFbHxlucU9mv9q3VIS7mIRmsUlxv~mEhp6SmeJWMYOmgp97M2djCJc~x8FYdOa904xP0Io33qIjfAuNgErMcEfsLk0UxIP7nOEdIZBg~UqCfRYbasTCLWRfUInxmDKdI1tF0iWZA7jZV86bA~-Yo65sZ7ANcQpZzxw-9193MghufgBJ1ceT9N77kMH9nEHtQyASMFmS9JQxzuPBbih9RAGJQ__&Key-Pair-Id=KUT5TJCACFTXG","author","State of Georgia ","date","2025-08-20T18:05:24.417Z","article","State and local public‑health officials briefed a Georgia House study committee on how county health departments are organized and how DPH allocates state and federal funds, and they described operational differences between urban and rural counties.

Chris Ruston, interim district health director for Fulton County, and Will Bell, chief financial officer for the Georgia Department of Public Health, gave detailed descriptions of districts, staffing and DPH’s FY26 appropriation and county grant flows.

Structure and service delivery

Georgia’s public‑health system is a hybrid: oversight and technical assistance come from the state Department of Public Health while a county board of health in each of the state’s 159 counties sets local policy and approves local budgets. The state is organized into 18 public‑health districts; some districts are a single populous county (for example, Fulton) while others cover many rural counties.

District directors serve as the operational link between state and local boards: they are appointed by the DPH commissioner, vetted by county boards of health and act as chief executive for district governance. Local county health departments provide direct services — immunizations, WIC, family planning, STD/HIV testing and treatment, environmental health inspections, newborn and children’s screening programs — but the mix and frequency of services varies by county size and staff availability.

“District staff provide economies of scale — IT, HR and finance functions — so a 1‑county health department isn’t required to staff all of those functions,” Ruston said, summarizing how districts support smaller counties.

Funding flows and grant types

CFO Will Bell told the committee DPH’s FY26 appropriation totals approximately $922,500,000 across funding sources. Federal funds account for roughly half of that total ($464,800,000), with WIC alone representing about $250,000,000 of federal funding. Bell said the FY26 state general fund appropriation for DPH is about $402,700,000 and that roughly half of that state funding is distributed to county health departments as general grant‑in‑aid.

Bell explained two major categories of grant aid to counties:

- General grant and aid: state funds to support local public‑health infrastructure (personnel, basic operations). DPH allocates these funds annually via a formula last updated in 2011 that weights county population (40%), county population under poverty (40%) and county poverty rate (20%). The county “local match” requirement stems from the master agreement between DPH and county boards of health; the required base match across all counties was approximately $12,200,000 in FY24 though counties collectively provided more than that ($48,500,000 total county funding in FY24). Bell said three counties missed the match last year.

- Programmatic grant and aid: funds directed to specific programs (for example, HIV/Ryan White, maternal and child health, emergency preparedness). Bell said about 75% of programmatic grant aid originates with federal agencies.

Bell provided FY25 headcount figures showing roughly 4,245 staff working at county health departments statewide and about 1,079 employees at DPH’s state office. He also presented district‑level grant and aid spreads: general grant aid a median of roughly $11,000,000 per district and programmatic grant aid median about $11,000,000 per district (district totals vary widely by population and program).

EMR roll‑out, telehealth and lab capacity

Committee members pressed officials on data systems and billing. Ruston said the state selected an electronic medical record (EMR) vendor, Patagonia, and plans a phased rollout over roughly 24 months with rural and urban pilots; the stated goal is to move districts from disparate systems to a single platform to improve data flow, reporting and program oversight. DPH officials said the federal infrastructure grant will initially pay implementation costs, and the state will evaluate long‑term maintenance and possible cost‑sharing after stabilization.

Officials described telehealth and teledentistry pilots, expanded HIV telemedicine and regional specialty clinics that use telemedicine for pediatric genetics, neurology, and other services. Ruston described the Georgia Public Health Laboratory’s scope — a Decatur headquarters and a smaller Waycross facility — with more than 150 lab staff, about 115 assays available and nearly 360,000 newborn screening specimens processed in FY24 (more than 8 million tests and hundreds of thousands of QC runs across the lab’s work in FY24).

Questions from lawmakers focused on workforce, billing and local funding. Panelists said nursing, environmental health specialists and nutritionists are the hardest positions to recruit and retain; competition from private hospitals, remote‑work options and variable county funding levels all contribute to turnover. The committee heard that county pay and career ladders vary and that DPH and districts have increased targeted salary funding in recent years to help retention.

What lawmakers asked and next steps

Members asked whether the EMR could enable statewide billing agreements and collective contracting with insurers. Officials noted structural limits because local clinical staff are county board employees rather than state employees; any broad contracting approach would need statutory or governance changes to implement statewide billing or contracting arrangements.

Bell and Ruston told members they will provide county‑level breakout data on general grant aid and local match amounts on request. Committee members said follow‑up questions will focus on the master agreement, county contributions, EMR cost‑sharing and workforce career ladders.

Ending

Officials urged legislators to consider how state investments can shore up the core workforce and infrastructure as federal funding shifts. The committee will hold additional hearings and compile recommendations and a final report on funding and organizational options for Georgia public health.","mediaType","Video","parentTitle","Evaluating Funding for Public Health 08.20.25","oneSentenceSummary","Department and district leaders told the House study committee that Georgia’s hybrid public‑health structure (state oversight and county boards) creates local responsiveness but uneven capacity. Lawmakers were briefed on grant types, local match, an EMR rollout, telehealth expansions and FY26 budget breakdowns.","taxTitle","Appropriations, HOUSE OF REPRESENTATIVES, Committees, Legislative, Georgia","taxId",16937,"location","Georgia","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6501331,"Georgia public health officials tell lawmakers prevention, lab and home‑visiting programs are central to keeping communities well",1476,1221000,2697000,"/Search/View?dp=1&key=5607350-e440c053d890ae9c19a587f7223b86c4&start=1221&end=2697","https://assets.pipeline.soar.com/5607350-e440c053d890ae9c19a587f7223b86c4/thumbnail_1221000.jpg","/articles/6501331/Georgia/Georgia-public-health-officials-tell-lawmakers-prevention-lab-and-homevisiting-programs-are-central-to-keeping-communities-well","https://secure.pipeline.soar.com/6501331-5477032b2b709a2a0faf243251210cac/orig.mp4?Expires=1770655983&Signature=NeUKJ6wJWgmlVrq0Q0B5HZajQI2qT1XbeZBdH03p3qQvVb8PPgGf3d7PFwtG2Jnft4O-YYiBDj7vNOeQubxaOwNaOxvGR-2MvdLTJK8QCPRUyLDQhE~zg8vNAqz-0Ptm1AK0Ns3nIZJgME~LI8ErUtXgWq6Zek9r~CY7vPC7FHfTeJnU-1X4qyxLPaxa0ZoTXEMR0hHNPZ62zeMfv3ahpLSkgLIylH0m8HZ~cSIaNqZOBVAjLIP9OlpUBKmlXHs9f8QwYyqnPsTiovxBb9BUTVoh7FErnQLqGLErXo7VbMqBUrUvFQhEt5J7-FHh5CNdnZdauqLX54fODj0Gy88hZQ__&Key-Pair-Id=KUT5TJCACFTXG","Dr. Becky Toomey, a long‑time public health leader with the Georgia Department of Public Health, told a Georgia House study committee that public health’s chief mission is to prevent disease, protect communities and promote health at the population level.

Toomey, a longtime state epidemiologist and public‑health clinician, outlined routine and emergency public‑health work, from newborn screening to outbreak investigations, and described how those functions operate differently than clinical care. “What public health focuses on is prevention, protecting and improving health of communities,” she said, adding that population‑level interventions “will clearly improve the health of all the individuals in the community.”

Public health’s value, witnesses told the committee, is often invisible until a local outbreak or a system stressor occurs. Toomey described two investigations that led to policy changes beyond the immediate outbreak: a norovirus cluster tied to decorated cakes that reinforced glove requirements in food service, and a 2006 E. coli O157:H7 outbreak linked to a Cobb County water park that prompted changes in pool design and chlorine‑monitoring rules after several children were infected. “It was such an — to me, it was so interesting,” she said of the cake investigation, and of the water‑park case she recalled roughly 26 infections, seven hospitalizations and one child death.

She also emphasized infrastructure that rarely reaches headlines: the state public‑health laboratory, newborn screening and the epidemiology unit. Toomey said Georgia’s lab performs tests “that no other laboratory, no commercial lab is going to do,” including newborn screening (screening more than 126 disorders for newborns) and testing used in outbreak response, and that the state’s epidemiology capacity is one of the department’s strongest assets.

Program examples: home visiting and contraception access

Toomey highlighted the department’s home‑visiting program for pregnant and postpartum women as a model of prevention that helps identify risk early and connect families to care. She said a short pilot rapidly showed measurable improvements in maternal and infant outcomes and helped identify life‑threatening conditions for newborns during routine postpartum checks. That program, combined with perinatal telehealth expansions lawmakers recently funded, is intended to reduce access gaps in counties that have lost labor‑and‑delivery services.

Toomey and district leaders also described how DPH reduced barriers to long‑acting reversible contraception (LARC) by allowing nurses to insert devices under protocol and through industry partnerships and targeted funding. The department used a mix of private support and legislative backing to expand Nexplanon insertion in counties that previously had limited access to clinic‑based advanced practice clinicians.

Structure, history and federal ties

Testifying to the committee, Toomey traced public health’s work in Georgia from early federal sanitary efforts and malaria control through the evolution of county health departments. She noted the state’s hybrid structure — county boards of health alongside state oversight — creates both local responsiveness and uneven capacity across 159 counties. “If you’ve seen one health department, you’ve seen one health department,” she said, describing wide variation in services by county.

Federal funding and shifting federal priorities were a recurrent theme. Toomey said many core programs have substantial federal funding but warned about the uncertainty created by recent federal grant changes. She urged lawmakers to consider the state’s role in sustaining core services as federal resources shift.

What public health does daily

Witnesses described a wide set of routine tasks health departments perform at the county level: immunizations for children and adults, provision of vital records (birth and death certificates), maternal and child services including WIC, family planning, tuberculosis and STD diagnosis and treatment, environmental health inspections (restaurants, pools, septic systems), newborn screening and, in some counties, dental and mosquito control services. Toomey said transportation is a frequent barrier to care in many communities and that outreach — mobile clinics, home visits and telehealth — can help close gaps.

Where lawmakers asked for clarity, Toomey and district directors described limits of local authority and how services differ by county size. For example, some rural counties rely on a single environmental health specialist; larger counties may field teams that inspect dozens of facilities. She urged the committee to consider regional solutions for specialized services where local staffing and volume make full local coverage difficult.

Quotations and sources

Direct quotations in this article come from Dr. Becky Toomey during her committee presentation. Examples and program details were provided by Toomey and were repeated by district directors during the session.

Ending

Committee members said they will use the session as an early step in a broader study of Georgia’s public health funding and structure. Witnesses asked lawmakers to prioritize investments in laboratory capacity, epidemiology and community‑level prevention programs — services, they said, that keep people out of hospitals and reduce longer‑term health costs.","State and local public health leaders told a Georgia House study committee that the core work of disease prevention, epidemiology and laboratory testing — plus targeted programs such as home visiting and long‑acting contraception access — underpin the state’s ability to prevent outbreaks and improve maternal and child health.","actionData","errors"]

Article not found

Committee hears how Georgia public health is organized and funded — districts, grants, EMR rollout and budget pressures

Georgia public health officials tell lawmakers prevention, lab and home‑visiting programs are central to keeping communities well