Federal virus money slow to trickle to local public health

For example, the states, territories and 154 large cities and counties that received allotments from the USD 150 billion Coronavirus Relief Fund reported spending only 25 per cent of it through June 30, according to reports that recipients submitted to the U.S. Treasury Department. Many localities have deployed more money since that June 30 reporting deadline, and both Republican and Democratic governors say they need more to avoid layoffs and cuts to vital state services.

As the novel coronavirus began to spread through Minneapolis this spring, Health Commissioner Gretchen Musicant tore up her budget to find funds to combat the crisis. Money for test kits. Money to administer tests. Money to hire contact tracers. And yet even more money for a service that helps tracers communicate with residents in dozens of languages.

While Musicant diverted workers from violence prevention and other core programs to the COVID-19 response, state officials debated how to distribute USD 1.87 billion Minnesota received in federal aid. As she waited, the Minnesota Zoo got USD 6 million in federal money to continue operations, and a debt collection company outside Minneapolis received at least USD 5 million from the federal Paycheck Protection Program, according to federal data.

It was not until August 5 — months after Congress approved aid for the pandemic — that Musicant's department finally received USD 1.7 million, the equivalent of USD 4 per Minneapolis resident. “It's more a hope and a prayer that we'll have enough money,” Musicant said.

Since the pandemic began, Congress has set aside trillions of dollars to ease the crisis. A joint Kaiser Health News and Associated Press investigation finds that many communities with big outbreaks have spent little of that federal money on local public health departments for work such as testing and contact tracing.

Others, like in Minnesota, were slow to do so. For example, the states, territories and 154 large cities and counties that received allotments from the USD 150 billion Coronavirus Relief Fund reported spending only 25 per cent of it through June 30, according to reports that recipients submitted to the U.S. Treasury Department.

Many localities have deployed more money since that June 30 reporting deadline, and both Republican and Democratic governors say they need more to avoid layoffs and cuts to vital state services. Still, as cases in the U.S. top 5 million and deaths soar past 165,000, Republicans in Congress are pointing to the slow spending to argue against sending more money to state and local governments to help with their pandemic response.

“States and localities have only spent about a fourth of the money we already sent them in the springtime,” Senate Majority Leader Mitch McConnell said Tuesday. Congressional Democrats' efforts to get more money for states, he said, “aren't based on math.

They aren't based on the pandemic.” Negotiations over a new pandemic relief bill broke down last week, in part because Democrats and Republicans could not agree on funding for state and local governments. KHN and the AP requested detailed spending breakdowns from recipients of money from the Coronavirus Relief Fund — created in March as part of the USD 1.9 trillion CARES Act — and received responses from 23 states and 62 cities and counties.

Those entities dedicated 23 per cent of their spending from the fund through June to public health and 7 per cent to public health and safety payroll. An additional 22 per cent was transferred to local governments, some of which will eventually pass it down to health departments. The rest went to other priorities, such as distance learning.

So little money has flowed to some local health departments for many reasons: Bureaucracy has bogged things down, politics have crept into the process, and understaffed departments have struggled to take time away from critical needs to navigate the red tape required to justify asking for extra dollars. “It does not make sense to me how anyone thinks this is a way to do business,” said E. Oscar Alleyne, chief of programs and services at the National Association of County and City Health Officials.

“We are never going to get ahead of the pandemic response if we are still handicapped.” Last month, KHN and the AP detailed how state and local public health departments across the U.S. have been starved for decades. Over 38,000 public health worker jobs have been lost since 2008, and per capita spending on local health departments has been cut by 18 per cent since 2010.

That's left them underfunded and without adequate resources to confront the coronavirus pandemic. “Public health has been cut and cut and cut over the years, but we're so valuable every time you turn on the television,” said Jan Morrow, the director and 41-year veteran of Ripley County health department in rural Missouri. “We are picking up all the pieces, but the money is not there. They've cut our budget until there's nothing left.”