Download 2015 NCALHD Legislative Priorities Talking Points JM

NC Association of Local Health Directors
A policy priority of the NC Association of Local Health Directors is to “Increase funding
to Local Public Health to Address Rapidly Emerging Infectious Disease so preventive
measures can be implemented without delay (e.g. Ebola, Enterovirus D68, Zika Virus,
Coronavirus, Measels, Meningitis, MERS-CoV, Tuberculosis, Influenza, anti-biotic
resistant superbugs, etc.).”

Communicable disease prevention and control is an essential and distinct
cornerstone of public health work, is required by NC General Statute, and is
distinctly under the authority of state and local public health departments.

Detecting, monitoring, and addressing communicable disease saves money and lives
and safeguards our State economy.

In light of recent national and international concern around communicable disease
outbreaks, it is imperative that local health departments have a minimum set of
resources available to detect, monitor, respond to, treat, educate, prevent, and
communicate clearly about disease threats within their jurisdictions.

Support for the basic core functions of local public health departments at the federal
and state levels is waning, along with capacity funding, impacting local public
health’s ability to accomplish mandated services.

Contributions from the NC Division of Public Health to local health departments are
distributed to each county annually, yet, the local cost of delivering the services has
increased significantly. The state supports only approximately 10% of the total cost
of communicable disease work at the local level.

Additional funds are badly needed to address communicable disease – $30 million
additional funding will help but will certainly not fill the gap completely for costs
associated with the essential work performed across our 100 counties.

Communicable disease in public health includes but is not limited to: Tuberculosis
control, monitoring and treatment, rabies control, HIV testing and treatment,
foodborne illness and outbreak investigation, sexually transmitted infections, and
emerging infectious diseases that threaten the public’s health such as Ebola,
Enterovirus, Coronavirus, Meningitis, MERS-CoV, and multiple strains of influenza.
The NCALHD supports the expansion of Medicaid in North Carolina to improve access
to care, save lives, and increase funding for health care providers which in turn, saves
and adds jobs.
 The people of each state will pay for the uninsured to have access to care one way
or the other: The status quo redistributes cost to the system among individuals who
are insured privately – we see the result in increased insurance premiums. In order
to better manage the cost, the quality, and the system of care for the working poor,
expanding Medicaid gives a state much more control and funding than if we do not
expand the eligibility to 130% federal poverty level.
 By not expanding Medicaid in NC, our Federal tax dollars are going to other states
who have decided to expand eligibility to 130% federal poverty level. We are, in
effect, paying in to a system that supports other states and leaves NC out.
 Refusing to expand Medicaid is supported by the Federal system for the first three
years and then after that, states are responsible for 10% of the cost. If the number
of people in NC who currently fall in the gap between Medicaid and uninsured are
offered an opportunity to access Medicaid, that’s an increase of approximately
400,000 individuals. If, after the time limit expires to receive 100% of Medicaid
funding for that group, we have to pay in-state for 10% of the cost. Being afraid of
this 10% cost is much less worrisome to the health system than the current cost to
NC of the uninsured seeking services for which the system absorbs. It’s much more
financially advantageous, predictable, and manageable for us to expand Medicaid.
 Medicaid is a health insurance option – a cost management tool – and it is rarely if
ever misused by consumers. Expanding Medicaid doesn’t mean opening it up to
very many people – it means simply expanding eligibility from 100% federal poverty
level to 130% Federal poverty level and allows the working poor access to care.
 To not expand Medicaid in NC is a hardship on individuals as well as on hospitals,
private physician practices, health departments, urgent care centers, and safety net
programs that already take on an incredible burden of cost for the uninsured.

Restore all funding from the Women’s & Children’s Health Block Grant to local public
health in order to provide intended evidence-based programs in local communities for
women and children.

Restore Master Settlement funds for the purpose of public health improvements in
North Carolina, as originally intended.

Address local health departments’ ability to charge for well water testing in migrant
housing, childcare centers, and food and lodging facilities as part of the permitting and
inspections process. Note: Currently, N.C.G.S. 130A-39(g), states that boards of health
can only impose cost-related fees for services performed related to "Wastewater
Systems", "Public Swimming Pools", "Tattooing"; and services performed pursuant to
N.C.G.S. 87-97 “Permitting, inspection, and testing of private drinking water
wells”. (Alternatively, the state can continue to provide the water tests at no cost and
LHDs can continue to provide the staff and local resource contributions at no cost.)

Prioritize sustainability of local AID-to-County funds for local health departments.

Advocate for school nurses: regardless of a county’s status as rural or urban, school
nurses work closely with local public health to protect and promote health for children.

Oppose any bill or amendment that weakens the ability of local health departments to
protect and promote the public’s health.

Support the recommendation to raise state tax on tobacco, including electronic
cigarettes, to the national average.