Analysis of the Proposed Implementation of a Public Health District in Maricopa County
A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. === Background: Since the number and variety of services that a public health department is able to provide is related to its financial reso...
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| Language: | en_US |
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The University of Arizona.
2016
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| Online Access: | http://hdl.handle.net/10150/603651 http://arizona.openrepository.com/arizona/handle/10150/603651 |
| Summary: | A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. === Background: Since the number and variety of services that a public health department is able to
provide is related to its financial resources, it is important that each department have secure
funding. The Public Health District model, in which the public health department is mostly
funded by a dedicated public tax, rather than as a dependent on the county’s overall budget,
has been proposed as an option for the Maricopa County Department of Public Health
(MCDPH). This model was implemented in neighboring Pinal County in 2007 and is funded by a
0.1% sales tax.
Specific aims: Our study aims are: (1) analyze the current MCDPH funding structure in
comparison to other similarly sized county-managed public health departments, as well as
review the development and structure of the Pinal County Public Health Services District as a
local reference; (2) project the likely financial effects of the implementation of a tax-based
Public Health District in Maricopa County; and (3) assess the potential effects on MCDPH
management and public health outcomes in Maricopa County. We hypothesize that the
implementation of a Public Health District in Maricopa County will secure a source of stable and
increased funding and allow for improved public health services.
Methods: Specific Aim 1: Budget data for FY 2011-2012 was analyzed for revenue types and
percent contribution for each county department in the comparison. Budget data for FY 2003-
2014 for Pinal and Maricopa counties was analyzed in a similar manner. Phone interview with
Pinal County Director, Mr. Thomas Schryer, was completed regarding the development of the
Public Health District model in Pinal County; Specific Aim 2: Revenue data from the Maricopa
County Jail Excise Tax was reviewed and utilized as a proxy to estimate potential income
generated by a 0.1% sales tax; Specific Aim 3: The 2012 Maricopa County Community Health
Assessment was evaluated to identify areas of need.
Results: Specific Aim 1: Funding structures varied greatly between county public health
departments, though heavy reliance on government funds was a common theme. Pinal County
demonstrated increased funding stability with an increase in overall revenue budget upon
implementation of Public Health District model. Specific Aim 2: Estimated revenue from a 0.1%
sales tax was calculated to be $70 million in FY 2014-2015, with potential average revenue of
$92 million over the next ten years. Specific Aim 3: Top areas for health improvement in
Maricopa County include obesity, diabetes, lung cancer, cardiovascular disease and access to
care.
Conclusion: The current funding structure of the MCDPH follows the trend of other similarly
sized county-managed public health departments with a heavy reliance on government funds.
The potential revenue generated from a 0.1% sales tax in Maricopa County would be sufficient
to significantly decrease the department’s dependence on general county funds and
government grants. The result is increased overall funding and financial stability, thus helping
the department to better target area needs and improve public health outcomes. |
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