Legislation Would Help Ensure Public Health Workers Have Capacity to Meet Demands of Current and Future Public Health Emergencies

WASHINGTON, [1.14.22] – Last night, U.S. Senators Tina Smith (D-Minnesota), Susan Collins (R-Maine), Cory Booker (D-New Jersey), and Lisa Murkowski (R-Alaska) introduced bipartisan legislation to reinforce and expand our public health workforce amidst significant shortages.

Their legislation, the Strengthening the Public Health Workforce Act, would help restore the public health workforce at the state, local, and Tribal level to support the COVID-19 response effort. These measures are particularly urgent given the current state of our public health sector; according to CDC Director Dr. Rochelle Walensky, there is a nationwide shortage of 80,000 public health professionals.

This bill is endorsed by the National Association of County and City Officials (NACCHO), the Minnesota Local Public Health Association, and the Association of Minnesota Counties.

“Improving the health of our nation and our economy depends on a robust public health workforce,” said Sen. Smith. “The pandemic has stretched public health departments thin in Minnesota and across the country, leaving us less prepared to address the COVID-19 pandemic and future public health emergencies. This bipartisan legislation would help rebuild our public health capacity, mitigate the spread of COVID-19 and future pandemics, and provide much needed relief to health care workers who have shouldered the burden of understaffing throughout the pandemic.”

“Our nation’s public health workers are the true heroes of the COVID-19 pandemic, but the severe shortage of these skilled professionals has taken a toll,” said Sen. Collins. “As we continue to respond to this persistent pandemic, it is imperative that we take steps to alleviate the many burdens on our public health infrastructure and support the development and expansion of this workforce so that we are better prepared for the next crisis. Reauthorizing and strengthening the bipartisan Public Health Workforce Loan Repayment program would help attract more young people to the field, support our state and local health departments, and preserve access to critical activities like testing and contact tracing.”

“As we seek to build a more resilient health care infrastructure and continue our response to the COVID-19 pandemic, we must address the public health workforce shortage occurring across America,” said Sen. Booker. “Local and state health departments have lost nearly a quarter of their workforce since 2008 and many more public health workers are set to retire in the coming years. To address this shortage, I am proud to introduce this bipartisan bill that would fund an education loan repayment program to attract and retain more of these essential workers, which in turn, will help improve the health and safety of our communities.”

“As we continue to see COVID-19 cases surge, a robust public health workforce is as important as ever,” said Sen. Murkowski. “Unfortunately, states across the country are facing real challenges in hiring and retaining healthcare workers—an issue that we must work to address. Ensuring that we have the healthcare workers we need in all areas of Alaska—urban and rural—remains my priority. I’m proud to join Senators Collins and Smith in introducing this legislation to create better incentives for Americans to join the public health workforce. By opening up doors for loan repayment assistance, expanding eligibility requirements, and ensuring greater equity among geographic regions, we can help ensure all Americans have greater access to the care they need and deserve.”

“COVID-19 has underscored the critical role public health workers play throughout our state and nation,” said Tarryl Clark, Association of Minnesota Counties Health and Human Services Chair and Stearns County Commissioner. “From assisting with quarantine measures to delivering vaccines and serving as the intake for many of our community questions, public health workers have proven themselves to be an invaluable and dependable resource during the most trying times. The Association of Minnesota Counties thanks Senator Smith for her leadership in introducing legislation that will provide critical support for local health departments and ensure that we can rely on a future public health workforce. ”

“As a result of the COVID-19 pandemic, our public health staff have worked around the clock to ensure the health and wellbeing of our communities,” said Sarah Grosshuesch, Local Public Health Association of Minnesota Chair and Wright County Public Health Director. “Providing loan forgiveness for public health workers will ensure we have a robust public health workforce to provide these critical public health prevention services into the future. The Local Public Health Association of Minnesota is proud to support this legislation and appreciates the leadership of Senator Smith.”

“The COVID-19 pandemic has highlighted the vital role local health departments play in keeping their communities safe and healthy.” said Lori Tremmel Freeman, MBA, CEO, National Association of County and City Health Officials. “But a decade of disinvestment and the multi-year pandemic response has stretched health departments thin. The public health workforce needs attention now – not only to get us through the pandemic, but to address other critical public health challenges in our communities. That is why we are so grateful to Senators Smith, Collins, Booker, and Murkowski for reintroducing this legislation. A federal Public Health Workforce Loan Repayment program would be a vital incentive to help recruit and retain talented professionals to work in local, state, and tribal health departments, and represents an important investment in strengthening health department capacity in the years to come,”

Since 2008, local and state health departments have lost nearly a quarter (23 percent) of their workforce, representing over 50,000 jobs across the country.  Public health departments also face a looming retirement crisis, with almost a quarter of health department staff currently eligible for retirement and 55 percent of local public health professionals already over age 45.  It is projected that nearly half of the public health workforce is considering leaving their organization in the next five years.  Furthermore, COVID-19 may exacerbate workforce shortages, as over half of public health workers surveyed reported experiencing poor mental health due to the demands of responding to the pandemic.

Recognizing these challenges, the Affordable Care Act (ACA) established the Public Health Workforce Loan Repayment Program to help bolster public health capacity and reduce workforce shortages.  The program provides education loan repayment assistance to eligible individuals in exchange for work in a public health department.  While the Public Health Workforce Loan Repayment Program was authorized from 2010 to 2015, it has never been funded or implemented.  As a result, public health departments have not been able to benefit from this targeted loan repayment incentive, and they continue to face workforce shortages.

Senators Smith, Collins, Booker, and Murkowski’s bipartisan Strengthening the Public Health Workforce Act would reauthorize and improve the Public Health Workforce Loan Repayment Program to help expand the public health workforce at the state, local, and Tribal level and support the COVID-19 response effort. 

Specifically, the Strengthening the Public Health Workforce Act:

  • Reauthorizes the Public Health Workforce Loan Repayment Program to provide education loan repayment assistance to eligible individuals who work in a state, local, or Tribal public health department.  Under the program, an individual could receive up to $35,000 in repayment assistance for each year of service;
  • Authorizes the program for the next 3 fiscal years;
  • Shortens the obligated service time period from three years to two years;
  • Expands eligibility requirements to include individuals with degrees in public health, epidemiology, data systems, data science, data analytics, informatics, or statistics;
  • Ensures that program contracts are equitably distributed between geographic areas, local, state and Tribal health departments, and rural and urban health departments; and
  • Directs the Comptroller General to conduct an evaluation of the public health workforce in the United States during the COVID-19 pandemic.
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