Revenue Reporting by Illinois Local Health Departments: Observations and Recommendations

Background: The lack of a stable and adequate funding system for local health departments in the U.S. has been well documented. The lack of a comprehensive financial reporting system in public health, including a uniform chart of accounts, hampers the ability of local health departments to make a case to legislators and administrators for increased funding from local and state sources. Purpose: This study examined potential sources of revenue reporting by local health departments in Illinois to identify an accurate picture of total revenues and sources of revenues being invested. Methods: A literature review identified four sources of revenue reporting: the 2013 National Association of County and City Health Officials (NACCHO) Profile of Local Health Departments; the Public Health Uniform National Data System (PHUND$) sponsored by NACCHO; a 2015 survey by the Illinois Association of Public Health Administrators; and individual reports published by local health departments in Illinois. Researchers evaluated each source for level of participation, timeliness of reports, comparability of account categories, and access to information. Individual reports by local health departments in Illinois were compared for consistency. Results: None of the examined sources provided a complete total of revenues for all Illinois local health departments. None had total participation. The chart of accounts was different in each source. Access to information was limited. There was significant variation in categorization of revenues in the Illinois local annual financial reports. Implications: State and local health departments should work toward a uniform chart of accounts and comprehensive, timely, transparent financial reporting system consistent with national efforts