title: Forecasting the Revenues of Local Public Health Departments in the Shadows of the "Great Recession".
abstract: BACKGROUND
  The ability of local health departments (LHD) to provide core public health services depends on a reliable stream of revenue from federal, state, and local governments. This study investigates the impact of the "Great Recession" on major sources of LHD revenues and develops a fiscal forecasting model to predict revenues to LHDs in one state over the period 2012 to 2014. Economic forecasting offers a new financial planning tool for LHD administrators and local government policy makers. This study represents a novel research application for these econometric methods.
  
  
  METHODS
  Detailed data on revenues by source for each LHD in Wisconsin were taken from annual surveys conducted by the Wisconsin Department of Health Services over an 8-year period (2002-2009). A forecasting strategy appropriate for each revenue source was developed resulting in "base case" estimates. An analysis of the sensitivity of these revenue forecasts to a set of alternative fiscal policies by the federal, state, and local governments was carried out.
  
  
  RESULTS
  The model forecasts total LHD revenues in 2012 of $170.5 million (in 2010 dollars). By 2014, inflation-adjusted revenues will decline by $8 million, a reduction of 4.7%. Because of population growth, per capita real revenues of LHDs are forecast to decline by 6.6% between 2012 and 2014. There is a great deal of uncertainty about the future of federal funding in support of local public health. A doubling of the reductions in federal grants scheduled under current law would result in an additional $4.4 million decline in LHD revenues in 2014.
  
  
  CONCLUSIONS
  The impact of the Great Recession continues to haunt LHDs. Multiyear revenue forecasting offers a new financial tool to help LHDs better plan for an environment of declining resources. New revenue sources are needed if sharp drops in public health service delivery are to be avoided.
authors.affiliation: Robert M. La Follette School of Public Affairs (Dr Reschovsky) and School of Nursing (Dr Zahner), University of Wisconsin-Madison.
authors.forename: Andrew
authors.initials: A
authors.lastname: Reschovsky
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Zahner
mesh_terms: D057172:Economic Recession / Q000639:trends; D005376:Financial Management / Q000379:methods*; D005544:Forecasting / Q000379:methods*; D006801:Humans; D009111:Local Government; D018803:Models, Economic; D011634:Public Health / Q000191:economics*; D014922:Wisconsin