Key Takeaways:
- Local health departments are taking on more direct services, like immunizations and care navigation, as funding gets tighter and demand grows.
- This shift creates new challenges, from fragmented records to missed referrals and heavier reporting burdens.
- Case management software helps by centralizing data, tracking referrals, and keeping departments audit-ready.
- PlanStreet provides this kind of integrated platform to support local health departments through this transition.
Traditionally, local health departments have been focused on prevention, inspections, and population health.
Amid funding reductions, local health departments have had to step up to ensure that community members can still receive the care that they need. For example, LA Health Services had to relocate three community health centers as of June 1, 2026, to optimize resources and maintain patient access.
This is just one specific example of the ways that local health departments are shifting priorities to meet community needs. They now have to deliver more direct services to fill the gap due to funding instability, health disparities, and growing demand for safety-net services.
Following PlanStreet's recent attendance at NACCHO360, where local health department leaders and public health professionals came together to share strategies, innovations, and best practices, this article explores how technology like case management software can support more coordinated, measurable, and person-centered public health service delivery.
Why Local Health Departments Are Expanding Direct Services
In the United States, 35.5% of insured Americans rely on public health coverage. This has led to an increase in public health departments offering nontraditional direct service, including:
- Immunizations: Vaccines that help prevent infectious diseases to protect individuals and communities.
- Communicable disease testing and treatment: Testing for diseases that spread from person to person, along with treatment when needed.
- Sexual health services: Services related to STI testing, treatment, prevention, counseling, and reproductive health support.
- Behavioral health screening and referral: Short assessments to identify mental health needs, followed by referral to appropriate care.
- Care navigation: Help connecting people to the right services and guiding them through the system.
- Community outreach and mobile clinics: Services delivered in neighborhoods, schools, or other community settings.
- Enrollment assistance for Medicaid or other coverage: Help applying for or renewing health coverage so people can access services.
Local health departments are a lifeline when residents don't have insurance, a primary care doctor, or access to regular transportation. When utilizing a local health department for all of these services, the steps in between each require more care coordination.
New Operational Challenges in Public Health Services Delivery
Direct services require more documentation than traditional public health department roles. For example, inspecting a site, giving a vaccine, or reporting on a disease trend requires studying the larger picture of what was going on in the community.
With direct services, public health providers are now shifting to tracking individuals more securely. They need to go through intake, eligibility checks for insurance, appointment scheduling, follow-ups, referrals, and robust documentation tracking to ensure a person's need is fully addressed. This may need to be done multiple times to ensure a person is properly cared for.
This level of detail becomes fraught with challenges, including:
- Fragmented records: Information is often spread across different systems, making it hard to get a full picture of a client's history or current needs.
- Referral follow-ups: Staff must confirm whether the person actually connected to the referred service, which adds another step that can easily be missed.
- Scheduling issues: Appointments may be delayed, canceled, or hard to coordinate across multiple providers and programs.
- Duplicate documentation: Staff may have to enter the same information in more than one place, which wastes time and increases the chance of errors.
- Service coordination: Different teams or partner agencies may need to work together, so communication and shared tracking become essential.
- Compliance concerns: More detailed client-level work creates greater risk if information is incomplete, mishandled, or not documented properly.
- Reporting burdens: Staff must often produce program, funding, and outcome reports, which takes time and depends on accurate data entry.
With this level of detail, relying on spreadsheets or legacy HMIS systems can lead to bloated budgets, missed follow-ups, and a lower quality of care.
How Case Management Software Helps With Service Expansion
In local health department case management, key features elevate provider's work day to help them focus on what they do best: caring for their clients. Public health software like PlanStreet helps providers stay on top of all data needs with a single source of truth to care for clients.
When looking at new software options for public health data systems, here are the tools your team will need to secure client records, create flexible workflows, and better collaborate.
1. Keep Data Secure With Role-Based Access
Every 39 seconds, a computer with internet access is hacked. Role-based access helps protect sensitive client information by limiting what each staff member can see and edit. In a local health department, not everyone needs the same level of access, so this feature helps keep records secure while still supporting care coordination.
- Intake staff can enter basic client information.
- Case managers can view and update active cases.
- Supervisors can review activity across programs.
- Outreach staff can document field visits without seeing unnecessary details.
- Administrators can manage permissions and oversight.
2. Maintain Transparency With Customizable Workflows
Each public health department follows compliance rules, but needs customization of the management of day-to-day tasks and programs. Configurable workflows let departments adapt the system to different programs instead of forcing every service into one process.
- Each program can have its own intake steps.
- Staff can assign tasks based on service type.
- Required fields can change by workflow.
- Follow-up timelines can be built into the process.
- Programs can be updated without redesigning the whole system.
3. Remove Duplicate Work With EHR and Partner Integrations
Integration helps reduce duplicate work and improves coordination across providers. When case management software can connect with EHRs, labs, or referral partners, staff spend less time re-entering information and more time helping clients.
- Data can flow between systems more efficiently.
- Staff can see a fuller picture of the client's history.
- Referral partners can stay aligned on next steps.
- Lab results and service updates can be easier to track.
- Manual errors from duplicate entries are reduced.
The Dane County Sheriff's Office was able to reduce manual re-entry of data into reentry workflows when converting to PlanStreet. The software integrated with Spillman Flex, allowing them to automatically synchronize jail records, allowing case managers to always have the most up-to-date information when case planning for reentry.
4. Help Clients See Specialists With Referral Tracking Features
On average, only about 35% of referrals from a primary care doctor to a specialist are completed. There are many points where a client can slip through the cracks — the referrer may think the provider is tracking the appointment and vice versa.
Referral tracking software takes the guesswork out of public health referral management. You can track referrals in real time, with visual timelines and status indicators to immediately understand where each referral is in the process without a time-consuming phone call.
5. Track Social Determinants With Dashboards to Piece Together Connecting Issues
Tracking social determinants of health helps staff understand the non-clinical barriers that affect care. Many clients need help with transportation, housing, food, or insurance before they can fully benefit from health services.
With outcome tracking software, social services case management providers can create digital SDOH screeners and then track all of the information in an easy-to-read dashboard. This helps them assess needs and make referrals to the right services faster.
6. See The Whole Picture With Analytics
It can be difficult when in the weeds of service delivery to see how the entire machine of your public health department is running. Customizable analytics in outcomes tracking software allow your team to create data visualizations with a few simple clicks. You can look at a single case or at an entire program at a glance to track KPIs and spot any inefficiencies before they become problems.
7. Stay Accountable With Automated Audit Trails
CMS continues to stay abreast of Medicaid audits, with 22 audits performed on MCPs in 5 states. Any provider that accepts government funding must remain audit-ready at all times. Case management software like PlanStreet provides a detailed audit trail for grants, referrals, billing, and more, so that if your local health department undergoes an audit, it won't derail your work.
8. Close the Gap Between Service and Billing With StreetRCM
Public health departments often have to undergo complex billing workflows, working with Medicaid, Medicare, CHIP, and others. StreetRCM tracks every step of the process, offering an end-to-end revenue cycle management service. This ensures that eligibility is covered and that your department receives payments with minimal denials.
StreetRCM helps your team:
- Verify eligibility and benefits faster before services are delivered.
- Track and manage prior authorizations to avoid claim denials.
- Automate claim submission, tracking, and payer workflows.
- Streamline payment posting and reconciliation so that the amounts are always accurate.
Pinnacle Services utilizes PlanStreet to streamline eligibility verification for their Home and Community Based Services (HCBS). They were overwhelmed with manual eligibility checks and service authorization tracking. By using PlanStreet's integrated case management software to verify participant eligibility directly within the system, they reduced claim denials.
Improve Direct Service Delivery With PlanStreet
As local health departments take on more direct service delivery, they can't rely on the same tools that supported inspections and population-level reporting. Case coordination, referral tracking, eligibility verification, and audit-ready documentation now sit at the center of daily operations. Disconnected systems or spreadsheets simply can't keep pace with that level of detail.
PlanStreet's Community-Based Care Platform was built to help local health departments manage exactly this kind of complexity, giving your team one connected system to coordinate care, track referrals, and stay audit-ready without adding administrative burden.
If your department is expanding direct services and outgrowing your current systems, schedule a free demo to see how PlanStreet can support your team.
Frequently Asked Questions
Case management software for local health departments is a digital platform that centralizes client intake, eligibility verification, referral tracking, service documentation, and outcomes reporting into one system. It replaces spreadsheets or legacy HMIS tools that were originally designed for population-level tracking rather than individual client case coordination.
Local health departments are expanding into direct services, such as immunizations, behavioral health screening, sexual health services, and care navigation, due to funding instability, growing health disparities, and rising demand for safety-net services as other providers scale back or become inaccessible to uninsured or underinsured residents.
Case management software creates automated audit trails that log grant activity, referrals, billing actions, and service documentation as they happen. This gives departments a defensible, time-stamped record for CMS or state Medicaid audits without requiring staff to reconstruct activity manually after the fact.
Yes. Case management platforms like PlanStreet can integrate with EHRs, lab systems, and external referral partners so that client data flows between systems automatically. This reduces duplicate data entry, lowers the risk of manual errors, and gives staff a more complete view of a client's history.
Referral tracking software provides real-time status indicators and visual timelines so staff can see exactly where a client is in the referral process without follow-up phone calls. This addresses a common gap in care coordination, since on average only about 35% of specialist referrals are completed.
Role-based access controls what each staff member can view or edit within a case management system. For example, intake staff may only enter basic information, while supervisors can review activity across programs. This protects sensitive client data while still allowing appropriate visibility for public health care coordination across intake, outreach, and supervisory roles.
Departments can use digital SDOH screeners built into case management software to capture non-clinical barriers like housing instability, transportation access, food insecurity, or lack of insurance. That data feeds into dashboards so staff can identify patterns and route clients to appropriate referrals faster than manual screening allows.
StreetRCM is PlanStreet's revenue cycle management service, built to help public health departments manage billing across Medicaid, Medicare, and CHIP. It verifies eligibility and benefits before services are delivered, tracks prior authorizations, automates claim submission, and reconciles payments to reduce claim denials.