House committee urged to update public‑health funding formula; rural leaders cite 50‑year gap

Members of the House Study Committee on Evaluating Funding for Public Health were told Friday that Georgia’s method for allocating county public‑health dollars needs overhaul if the state is to equitably serve rural communities.

"Our funding formulary really needs some work and attention," said Dr. Chris Scoggins, board member of the Georgia Rural Health Association, adding that the county contribution formula "has not been updated since the '70s" and that the current system is "crude" because it relies mainly on population and poverty measures. Scoggins urged a new formula that would draw on more nuanced measures such as the Social Vulnerability Index and state epidemiologic data.

Why it matters: Committee members from largely rural districts described practical consequences when funding and district lines do not align — including transportation barriers, duplicated services, higher per‑unit costs and difficulty recruiting and paying staff at market rates. Scoggins said rural districts "do not enjoy those economies of scale" and that fixed costs make rural public‑health delivery more expensive per capita.

State public‑health officials confirmed there are two separate formulas to understand. "The funding formula that determines the allocations that the state gives to DPH and then in turn we give down to the counties is the general grant and aid formula that was actually developed in 2011," Megan Andrews, Department of Public Health deputy, told the committee, but she clarified that the county contribution formula based on population and tax digest data dates back to the 1970s.

Local providers described operational practices that rely on better data and partnerships. Shelly Spires, CEO of Albany Area Primary Health Care, said FQHCs use EMR analytics and the state’s public OASIS data to run PDSA cycles and target services, and she credited collaborative programs — like a breast and cervical cancer effort that exceeded 582 visits — with improving access.

What lawmakers asked for: Representatives requested follow‑up data and said they would welcome formal dialogue between the Georgia Rural Health Association and DPH about formula changes. Representative Dexter Sharper pressed whether the association had engaged the health department; Scoggins said they had not engaged formally but would welcome the conversation. Chair Darlene Taylor and others asked DPH and the Department of Community Health to provide precise counts, fiscal impact analyses and illustrative PMPM numbers so the committee could consider options.

Next steps: Committee members signaled interest in ordering data runs and a statewide audit of county health‑department facilities and partnerships, including co‑location and space‑sharing, to identify where investments or statutory adjustments might improve efficiency. The committee requested follow‑up materials from DPH and DCH and said it would consider options that separate county contribution obligations from the state allocation formula.

At the close of the session Chair Taylor said the committee would collect presenters’ materials and that members hoped to see specific recommendations in the next meeting.