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Department of Health warns of staffing shortfalls, immunization declines and rising surveillance needs; requests funding for data, lab and behavioral health
Summary
Department of Health Director Fink told the Finance Committee that DOH faces a roughly 30% vacancy rate in some units and flagged declining childhood immunization coverage, increased behavioral‑health demand, wastewater and avian‑influenza surveillance needs, and PFAS testing as priorities for FY2026–27 funding and planning.
The Department of Health told the House Finance Committee that staffing shortfalls and rising workload are constraining public‑health functions and that the department is seeking targeted funding for data modernization, laboratory work, behavioral‑health capacity and environmental monitoring.
Lede and context: Director Fink (addressed in testimony as “Director Fink”) told lawmakers DOH’s mission is to protect and promote public and environmental health and to execute the CDC 10 Essential Public Health Services. The presentation highlighted a roughly 30% vacancy rate in parts of the department and staff‑survey results showing employees have high purpose but high workloads; many reported intentions to seek other jobs.
Major priorities described: - Workforce and vacancies: DOH presented survey findings (conducted by the Office of Wellness and Resilience) showing staff reported meaningful work but said insufficient staffing and workload pressure were the top drivers of stress and intent to look for new employment. Director Fink said the department must address vacancies to maintain service continuity. - Vaccination and outbreak risk: DOH reported declining kindergarten vaccination coverage and an increase in nonmedical (religious) exemptions, noting the state is below the commonly cited 95% threshold for measles herd immunity. Director Fink said this trend increases the risk of measles and other vaccine‑preventable outbreaks and asked for legislative attention to vaccination policy and provider access to vaccines. - Emerging infectious diseases and surveillance: DOH described wastewater surveillance and early detection work for influenza A and the H5 avian influenza strain; the state lab first detected H5 in wastewater, a leading signal that the virus reached Hawaii. DOH said it is testing raw milk at a local dairy and coordinating with clinical labs to subtype influenza A samples. - Behavioral health and State Hospital: DOH reported behavioral‑health surge work supported by a SAMHSA emergency grant and said the newly opened behavioral health crisis center on Oahu is connecting people to care. The State Hospital census often exceeds licensed bed counts, creating capacity and discharge challenges; DOH said most in‑hospital patients are clinically stable but awaiting placement or forensic resolution. - Environmental monitoring and PFAS: DOH described efforts on PFAS sampling in wastewater and landfill leachate and highlighted upcoming EPA maximum contaminant rulemaking for several PFAS compounds; the department flagged the potential fiscal ramifications of future standards.
Specific budget requests and system needs: - Data and analytics modernization (enterprise data warehouse and business intelligence tools), upgrades to vital records and a Kronos/HIP time‑and‑leave integration, and support for grants and contracts fiscal modules. - Staffing and position requests in environmental health, vector control and a public‑health veterinarian to strengthen zoonotic disease response and emerging‑disease readiness. - Behavioral health items including psychologist positions funded by prior appropriations and pilot proposals for mobile intensive outreach and community behavioral health center expansions.
Questions and follow‑up: Representatives asked about PFAS source identification, cesspool conversion costs and how the behavioral health crisis center receives referrals. DOH staff said they are developing prioritization tools for cesspool closures and working with counties on sewer and wastewater planning. For PFAS, DOH said further work is needed to identify specific inputs into wastewater and groundwater and suggested potential legislative follow‑up to establish testing requirements.
Ending: DOH urged the committee to consider investments in laboratory capacity, data modernization and behavioral health as time‑sensitive and important to public safety and environmental protection.
