Who establishes the budget for a public health authority, and where does the money come from?

A public health authority establishes and is responsible for its own budget. Funding for all types of local public health agencies comes from several sources, including federal funds (which are often “categorical”—that is, designated for particular services), state funds, and local appropriations from the county or counties served by the public health agency. To receive local appropriations, a public health authority board submits a budget request to the board or boards of commissioners within the authority’s jurisdiction.  The request could take various forms, including specific funding requests for programs or staff or a contribution based on population (per capita).

Many local public health agencies receive grant or contract funding from public or private sources. Local agencies may also generate revenue from fees for services. Fees for clinical services may be paid by third-party payers, including Medicaid, NC Health Choice, or other public or private insurers. In some cases clients themselves may be charged a fee for clinical services, but charges to a client may be prohibited or limited by law. The public health authority board may impose fees for other local services, such as on-site wastewater or private drinking water well permits, subject to limits imposed in state law.