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Lynne Saxton Speaks Out on Public Health

The administrator of the Oregon Health Authority spoke to public health officials about modernization efforts.
June 15, 2015

Sustaining coordinated care organizations financially “dovetails with public health modernization,” according to Lynne Saxton, director of the Oregon Health Authority. “Modernization is the single greatest opportunity to integrate into the CCOs. The way to do that is the way it’s always done -- with optimism, collegiality and data.”

Saxton’s appearance before the Public Health Advisory Board came one day after the Legislature passed a $528.7 million public health budget for 2015-2017, nearly half of which comes from federal funds often earmarked for programs such as WIC.

“Public health is engaging in the conversation at the wrong level due to categorical funding,” said Loreen Nichols, director of community health services for Multnomah County. “We hope for additional funding” from the state to be able to try more upstream public health innovations.

Patrick Luedtke, who described himself as working half time for Lane County public health and half time at the Eugene area’s five federally qualified health clinics, said his CCO is discussing how to “cut out a couple joint replacements” to save money instead of asking a public health question such as “what’s behind all the joint replacements – obesity.”

If you cut out two joint replacements this year, it won’t help next year’s budget. “We’re getting older and fatter,” Luedtke said. “Public health needs a seat at the table” on CCO boards.

Modernization of public health seeks to improve quality of life and increase years of healthy life; promote and protect safe, healthy and resilient environments; strengthen public health capacity; and integrate with healthcare transformation.

Its five-year 2015-2020 improvement plan focuses on tobacco, substance use, obesity, oral health, suicide, vaccines and communicable diseases.

“It’s the moment for prevention,” said Rosa Klein, legislative coordinator for OHA’s public health division.

Two positive things for public health happened in the Legislature in a single day -- the public health modernization bill moved full Ways and Means and another bill, intended to require retailers selling tobacco and e-cigarettes to be licensed by OLCC, died in committee.

“It’s better to have no bill at all than to have a bad licensing bill,” Klein said, adding that she “made peace with no retail licensing bill [this session] and something solid to bring forward next session.”

Klein also described as “wonderful for the state of Oregon” a bill signed into law last month prohibiting the sale and use of e-cigarettes by minors and restricting their use where the Indoor Clean Air Act applies.

“The face of Oregon is changing,” said Patricia Lewis, deputy public health director for OHA, who hopes modernization can help her agency respond to increasing diversity and the fastest aging population in the nation, particularly in rural communities.

Block grant funds could be used to help counties modernize, said Jan Kaplan, OHA’s community liaison manager, such as creating assessment tools and participation in assessing foundational capabilities.

“We’re becoming part of an integrated health system,” said Alejandro Queral, PHAB chair and director of systems planning and performance for United Way of the Columbia-Willamette. “Prevention strategies work in favor of CCOs.”

Jan can be reached at [email protected].

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