Originally published under the title "What's NACCHO got to do with Oregon's vaccine exemption fight?"

NACCHO? It sounds like a bad acronym from an Austin Powers movie. But it is actually one of the most powerful anti-vaccine choice front groups in the country, whose primary funder appears to be the CDC.

NACCHO?

It sounds like a bad acronym from an Austin Powers movie.

What/who the heck is NACCHO?

NACCHO is The National Association of County and City Health Officials. If you briefly perused their website, you might be confused into thinking that they were a federal agency of sorts. First off, there's the name. Many people associate "National Association" with something sort of official. The next thing that might throw you off is the way NACCHO describes themselves:

NACCHO's members are the 2700 local health departments across the United States. NACCHO's vision is health, equity, and security for all people in their communities through public health policies and services. NACCHO's mission is to be a leader, partner, catalyst, and voice for local health departments in order to ensure the conditions that promote health and equity, combat disease, and improve the quality and length of all lives.

For the uninitiated, reading NACCHO's self-description might cause you to reach the following conclusions:

NACCHO is a federal organization

Its members are all the local health departments

Somehow, this is a way for all the local health departments to all be connected together, probably there is a rule somewhere that says they should all coordinate themselves on a national basis (and there isn't, the health of citizens is a state-level job, according to the U.S. Constitution)

As you're probably getting used to by now with these articles, NACCHO could not be farther from any of that in reality, so let's look at the details:

1. NACCHO's "membership" revenue numbers don't add up at all

Referring to the conclusions one might draw from the above, it appears that NACCHO is a collective of local health departments. According to NACCHO, there are "over 2700" of them and most people would probably presume these local health departments pay a membership fee to be a part of NACCHO, which they do.

NACCHO has a membership form for local health departments, you can see it right here. If you look at the form, you'll see that local health departments (NACCHO's claim is that they are just a group of local health departments) can join NACCHO, and that their annual membership fees is pro-rated based on how large a population they serve. The most an annual membership could cost any health department would be $4,150 per year, as you can see right here:

Just for fun, we ran the math. 2,700 local health departments. To be conservative, let's say EVERY health department had 3 million or more people in it (which would be impossible because with more than 2,700 health departments as NACCHO members that would mean the U.S. had 8.1 billion people) but let's just see how much money NACCHO could pull in annually from membership dues if that were true:

"Membership Fee of $4,150 x 2,700 local health departments= $11,200,000"

Here's the problem. NACCHO breaks out their revenue from membership dues on their 990 form. Are you ready for this? Here's what NACCHO actually made in membership revenues in 2013:

$595,881

If you are saying, at this point, "so what"? You're right. We haven't proven anything. In fact, the only thing you know about NACCHO so far is that:

They claim to be a collective of 2,700 local health departments. (In fact, it's fair to say this is the primary way they define themselves.)

From their members they receive just over a half million dollars a year in membership dues, according to their 2013 990 form filed with the IRS.

Here's the problem NACCHO makes $25 MILLION a year in revenues:

$25 million a year? That means membership dues—which NACCHO implies defines who they are—are responsible for approximately 2% of their annual revenues.

2. NACCHO makes all their money from government and private grants

With membership dues of roughly $500,000 and revenues of $25 million, the story on NACCHO is $24.5 million short of an explanation. Luckily, their 990 has to break out sources of revenue one step further, which is how we learn the following:

NACCHO is making the majority of their annual revenue from two sources: government grants ($19.3 million) and other grants ($3.6 million).

Government grants? What kind of government grants? Who, aside from a local health department, wants to contribute to an organization that represents local health departments? Remember, NACCHO's mission is very clear:

"NACCHO's mission is to be a leader, partner, catalyst, and voice for local health departments"

Government grants

Unfortunately, NACCHO's Form 990 doesn't break out exactly where their Government grants come from, but this document gives you a pretty good idea:

Wait a minute. 7 of the 11 funding priorities from NACCHO come from the Centers for Disease Control? Not only that, but CDC is really all over NACCHO's website, like here, here, and here.

NACCHO spells out who their partners (funders) are on their website right here. CDC is listed. So is the Immunization Action Coalition. And, a myriad of other "private nonprofts" that focus on public health.

Can we draw any conclusions from this information? Sure we can:

NACCHO gets most of their money from government grants. CDC appears to be a primary funding source.