Dubuque County health officials wary as Iowa shifts public health funding to regional model

Dubuque County public health officials are wary of a statewide shift to regional funding for county health departments, the Dyersville Commercial reports. Iowa Health and Human Services is moving to a regional model that will change how local public health money is distributed, with the gradual change beginning Jan. 1, 2027. Rather than disbursing local public health money to all 99 counties, the state will disburse it to seven regional districts, each with a lead county health department responsible for dividing the funds among the counties in its region. Dubuque County will be grouped with 13 other counties in District 7, including Black Hawk, Linn, Johnson and Scott counties. "The move is a significant change in how public health services are organized and funded at the state level," said Allie White, executive director of Dubuque County's public health department. Kathy Dolter, chair of the Dubuque County Board of Health, said she is worried funding will not be allocated based on each district's population. "District 7 has a third of the state's population and one seventh of the budget, which makes no sense," Dolter said. "We've got five of the major public health departments all in one district, while some of the other districts have none of that expertise." Dolter said she believes the change will mean "less local control and less ability to impact outcomes at a local level." White said Dubuque County is a "fairly small health department" compared with others in District 7 and is not well situated to apply to be the lead entity, so the county will work with another county to receive its funds. The lead county will take an administrative cost from the funding it distributes, White said, and she expects Dubuque County will lose some direct funding as a result. The department received about $405,000 from the state for fiscal year 2026, according to data shared by White, funding childhood lead poisoning prevention, private well testing, immunization services and breast and cervical cancer screening, among other services. The department also shares that funding with the Dubuque Visiting Nurse Association and the City of Dubuque, which it contracts with for services. White said she hopes county residents will not notice a disruption in service, and that the department "may just need to be creative" about how it manages funds going forward.