Aschenbrener Believes Public Health Deserves a Strong Voice

September 29, 2011 -- The role of public health departments in coordinated care organizations (CCOs), how to manage budget cuts and how to influence public perceptions of public health concepts were major points of discussion as the Public Health Advisory Board last week.

The board was unable to vote on any issues because it met without quorum. Among those missing from the meeting was its chair, Tom Eversole.

However, Thomas Aschenbrener, president of Northwest Health Foundation, reported on the progress of health system transformation work groups, saying he was reasonably optimistic despite certain concerns: namely, that some groups looking to become CCOs are largely interested in doing so to profit financially, and that some groups have no interest in providing basic women's reproductive health services, such as family planning and cancer screening.

Right now, he added, there’s no language in the healthcare transformation legislation that addresses the role of public health departments.

“I will certainly be keeping the reminder in there that you can't have a coordinated system without public health,” Aschenbrener said.

Dr. Mel Kohn, the state’s public health director, is optimistic about the transformation process and said in his own conversations with the Oregon Health Authority and the governor's office, he stressed that regulations for CCOs must be flexible.

“There should be as few requirements as possible, so that local innovation and ownership are really driving this,” Kohn said.

The state’s public health department does anticipate major budget cuts, said Kohn, who stressed the need to work closely with partners in county public health departments to ensure programs continue to run.

There’s also good news on the funding front, as the department has received major grant funding to support children’s health, including $4.7 million to support home visits for new parents, and a Healthy Start program for young children from low-income families.

“I think it's a tremendous gift,” Kohn said. “We wouldn't have the funding for any of this without the federal partnership.”

“I have to comment on the unintended consequences” of reduced funding, said Betty Bode, the board’s vice chair, when Kohn finished speaking. “The unintended consequences that happen are going to be much longer. We're telling the next generation, ‘You really don't have to go study public health, because that job could go away any time.’ We've done that with education. If you're a teacher at one to five years, your job is on the chopping block. As a result, people don't want to go into those professions.”

When Kohn raised the issue of accreditation for local public health departments and officials, discussion became heated, with board members agreeing that the public is unclear on precisely what public health departments do and that the way they’re run from one jurisdiction to another isn’t standardized – but the conversation didn't reach any conclusions.

“In order to do accreditation process right, it requires people who are on the front lines saying, 'This is what it's going to take to make those changes,'” Aschenbrener said.

During the legislative report, Katy King, government relations manager, noted some major victories for public health: increased funding to screen and treat maternal mental health issues, as well as funding for breast and cervical cancer screenings for low-income women.