Elkhart County Health Department outlines core services, faces Health First Indiana cuts and proposes limited staffing trims

Melanie Sizemore, a deputy or senior official with the Elkhart County Health Department, briefed commissioners on the department’s program mix, grant funding and budgetary pressures during the Sept. 11 special meeting.

Sizemore summarized regulated public-health functions — immunizations, communicable disease reporting, environmental-health inspections, WIC (Women, Infants and Children), pediatric dental, lead case management and emergency preparedness — and identified which programs are grant-funded or reportable to the Indiana Department of Health (IDOH).

Key points

- Health First Indiana (HFI) grant change: Sizemore said the county’s HFI allocation had fallen from roughly $5 million in earlier years to about $1.3 million after a funding formula change, describing that as a roughly 74% reduction. “The 1.3 just gets us by by the skin of our teeth,” she said.

- WIC: Sizemore said WIC remains the department’s largest program, employing roughly 22–25 staff and serving about 6,500 participants every three months. She said program activity results in roughly $4 million in grocery spending in the county each year (through WIC benefits), while the local program’s operating budget is roughly $1.5 million.

- Dental clinic: The county’s pediatric dental program is largely Medicaid-funded (about 80%), with a reported clinical revenue shortfall relative to budget; Sizemore said the program budgeted about $831,000 and typically brings in roughly $600,000 in receipts and that the department maintains roughly half a million dollars in savings to manage variability.

- Staffing and proposed trims: To close projected shortfalls, Sizemore proposed modest, specific options: reduce the county medical officer’s on-call hours from 15 to 10 per week (estimated savings about $38,000), defer one open RN position (approx. $76,000) and a clinic assistant (approx. $43,000). She said those choices would keep the department functional while the grants picture stabilizes. Commissioners asked for additional detail before any formal personnel decision.

- One-time investments and internal grants: Sizemore reported internal county investments funded by HFI in 2024–25, including about $200,000 for parks workout equipment, $50,000 in AEDs for the sheriff’s fleet and other smaller grants to internal departments.

Why it matters

The Health Department is a major county service provider; cuts in HFI and other grant changes force tougher prioritization on services that affect low-income families, infant health and preventative care. Commissioners expressed concern about program outcomes and asked for measurable results and tracking data; Sizemore said many measurable outcomes are reported to HFI and IDOH and offered to provide publicly available performance links and additional outcome metrics.

What’s next

Commissioners asked staff to return with the detailed cost-savings analysis for the suggested staffing adjustments and to provide outcome data for the department’s major programs (WIC outcomes, infant-mortality work, tobacco prevention and dental revenue/expense projections). No formal personnel reductions were approved on Sept. 11.