Oregon assesses where it’s at, how far to go to meet public health modernization foundational goals

Oregon is one of three states modernizing its public health system from a 50-year-old, pre-ACA model to one ready to address new emerging threats like the Zika virus, rampant population-level chronic disease and the impacts of climate change. After a long process to define needed foundational capabilities and programs, the state and counties now are assessing where they are on the scale toward meeting them.

The Oregon Health Authority and all 34 local public health departments are identifying where they are now in meeting public health goals and identify gaps.

For the first time, spending is being lumped in new foundational capabilities and program buckets. Not surprisingly for a state that ranks 46th in per capita state spending on public health and depends heavily on categorical federal funding, most spending fell into the four programs -- communicable disease control, prevention and health promotion, environmental health and access to clinical preventive services, according to Sara Beaudrault, OHA public health policy analyst.

Little money flows to capabilities -- leadership and organizational competencies, health equity and cultural responsiveness, community partnership development, assessment and epidemiology, policy and planning, communications, emergency preparedness and response.

On a 1-10 scale with 10 being the highest, more than 125 OHA employees ranked their current capacity in the 3-6 range and the 6-8 range for current expertise in meeting the modern foundational capability and program goals, according to Rebecca Pawlak, OHA policy specialist.

To meet the goals, local public health departments will have the flexibility to work with other counties to share resources or to regionalize completely. “Some counties might do the entire body of work themselves, and that’s great,” Beaudrault said

Also, public health’s role as a safety net provider for individual services is less critical with health system transformation and Medicaid expansion. “It’s time to move away from providing clinical services and shift to population-level work,” Beaudrault said.

Jan can be reached at [email protected].

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