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Public Health Policy Platform January 2013 Local Health Districts in Ohio have the primary responsibility to prevent illness, promote wellness, and protect against the spread of disease in their communities. The Association of Ohio Health Commissioners (AOHC) is committed to providing leadership and advocacy to assist local health districts in fulfilling their responsibilities. AOHC has determined the following areas to be of critical importance in securing public health and safety in all Ohio communities. Financing of Local Public Health Operations Local health districts are funded through a variety of means, including fees-for-service and grants for specific programs. There are, however, a number of critically important public health responsibilities and mandates, such as the control of communicable diseases, which are poorly and inadequately funded by the state of Ohio. These core public health functions benefit the entire state and should be funded through the state general fund. Ohio’s current direct support to local health districts through the Ohio Department of Health’s operating budget provides approximately $0.17 per capita in direct funding to local health districts, while requiring local health districts to spend at least $3.00 per capita of local funds to qualify for this funding. Ohio ranks 43rd in state support for public health. AOHC supports a greater commitment by Ohio to fund local health districts for these important protections that benefit all Ohioans. Elimination of unfunded mandates – e.g., school inspections – through identification of funding resources and requiring all new mandatory services to have funding sources identified before implementation Acquisition of state funding consistent with current requirements to address core public health functions and state-mandated programs implemented at the local level - add PH futures ideas for funding plus community benefit, hospital franchise fees, corporation tax benefit. Don’t call it subsidy Adequate state funding levels for the local government fund Permissive authority for local health districts to assume fiscal authority Ability for local health districts to contract for mandated services and to participate in shared services agreements and other efficiency measures Public Health Preparedness and Security Local health districts continue to strengthen capacity to respond to bioterrorism, outbreaks of infectious disease and other public health threats and emergencies. All response is local. In collaboration with other state and local systems, local public health must be assured the resources to maintain critical services such as preparedness planning and readiness assessment; surveillance and epidemiologic response; access to essential laboratory services; reliable electronic information and communication; risk communication and health information dissemination; and ongoing education and training of the public health workforce. Readiness initiatives should not diminish core public health capacity. Development increased and implementation of strategies and technologies to prevent human illness from chemical, biological, radiological agents, and naturally occurring health threats Sharing of information from and with health care providers regarding threats to the public’s health in a timely fashion Collaboration between state and local agencies for planning and funding allocation decisions Stability of core preparedness funding to local health districts must be assured over a 3-5 year planning cycle Current Priorities Indicated in Purple Public Health Administration Effective and efficient management of public health programs requires a clear delineation of legal authority, accountability and liability of local boards of health. AOHC supports the provisions of the Affordable Care Act that support local public health capacity, especially the Prevention and Wellness Fund. Adequate human resources for public health practice through targeted workforce development and leadership succession planning Adequate state financial support for performance standards and public health accreditation for local health districts to assure minimum public health capacity, with a commitment to continuous quality improvement Strong and clear authority of local boards of health to adopt regulations to protect public health Consistent educational qualifications for all health commissioners Robust systems of health information technology, including health information exchange, electronic health records, and electronic commerce authority and capacity Access to Quality Health Care Services AOHC supports access to quality universal health care services, especially for vulnerable populations, such as children, the disadvantaged and the aged. Targeted Public Health Services AOHC supports adequate funding for episodic direct patient health services, catastrophic healthcare to deal with long-term chronic health conditions and disease prevention programs which target high risk groups. AOHC supports adequate funding for initiatives that will improve the health and well-being of all Ohio residents. Prioritization and strengthening of preventive health services across the lifespan, with particular focus on decreasing chronic disease in Ohio through provisions in the Affordable Care Act Oral health care, mental health and pharmaceutical access Immunizations Assessment, evaluation and development of community health care delivery system based on sound evidence-based principles Women Infant Children (WIC) Expansion of and better collaboration with community health centers with emphasis on screening, prevention and wellness Mental Health and Behavioral Health Services Services for the medically handicapped maintained and strengthened Children and Family Health Services (CFHS) Environmental Health The promotion and protection of a healthy environment is a key component of a successful public health system. AOHC supports environmental health professional practices that assure safe drinking water and proper waste water disposal, environmentally sound solid waste management, strong food safety programs, effective animal vector/pest control and other appropriate programs that assure a healthy and safe environment. Assessment, evaluation and development of environmental health programs based on sound evidence based principles Leadership for public health interests in land-use planning Efforts to minimize disproportionate exposures to environmental risk by different cultural or geographically disadvantaged communities Collaboration with local solid waste districts and other local entities to identify funding source for solid waste enforcement activities Standardization of and consistent oversight and enforcement programs for food safety by one agency EH program compliance and public access to data monitored electronically through IT technology supported by ODH Authority of animal control officers broadened for all pets and develop mechanism to recoup costs of animal control and rabies abatement activities Assurance of West Nile Virus and other vector borne disease prevention, response and education activities Implementation of comprehensive indoor air quality management programs including lead risk assessment and remediation, advocating for adequate resources to assist low income property owner Financial assistance program – revolving fund - for onsite home sewage system repairs Help Me Grow (HMG) TB and communicable disease Children with Medical Handicaps (BCMH) Long-term care (end of life issues, traumatic injuries, etc) Chronic disease management (renal dialysis, diabetes, genetic syndromes, etc.) Priority programs (obesity, cardiovascular, women’s health, preventive health, etc.) Early childhood intervention programs aimed at obesity prevention Catastrophic health care – reorganize multiple independent funding sources into a comprehensive, effective and efficient system Child Fatality Review Tobacco, Alcohol and Drug Prevention Programs There is clear documented evidence that the use of tobacco and drugs, such as cocaine and methamphetamine, are harmful to the user’s health. Improper use of alcohol also has adverse health effects. AOHC supports all efforts to reduce the incidence and consequences of drug and alcohol abuse. Effective enforcement efforts for Clean Indoor Air Act that includes adequate funding for timely investigations of complaints Comprehensive tobacco use cessation and reduction programs including reduced sales to minors Tobacco tax increases targeted to support tobacco use prevention and enforcement programs Fetal Alcohol Syndrome screening Expanded education regarding public health implications of drug and alcohol use including its detriment to childhood development Environmental tracking and clean up of methamphetamine labs with standards based on sound scientific evidence Comprehensive coordinated effort to stem prescription drug abuse Current Priorities Indicated in Purple