The Impact of Health Care Reform on Public Health & Prevention

by Jean C. Chabut, Chief Administrative Officer, Public Health Administration, Michigan Department of Community Health (as published in the Michigan Primary Care Association newsletter, News & Notes, Spring 2010 issue)

The Patient Protection and Affordable Care Act will do many things that will transform the entire health system in the United States today.  There are many features that will enhance both the focus on prevention in the medical care system as well as provide significant resources to support official federal, state, and local public health and other community-based services.  

I want to provide a brief description of what some of the more important ones will be.   

Our mission in Public Health in Michigan is to, “Promote health and safety, prevent disease, and assure treatment and management working through community/population based strategies and using evidence-based approaches.”  

The “essential services” that are part of Public Health include things like:

  • Surveillance to monitor health status and identify community health problems
  • Diagnosing and investigating community health issues, risks, and hazards
  • Mobilizing community partnerships to identify and solve health problems
  • Educating and empowering people to understand and take action on health issues
  • Linking people to the services they need and sometimes providing it if necessary
  • Working to assure a healthy and safe environment for people to live, work, and play 

There are a number of new or expanded programs that will provide support for these activities at the federal, state, and local levels.

  • A National Prevention, Health Promotion and Public Health Council is created within the Department of Health and Human Services (HHS) to provide coordination and leadership at the federal level among federal agencies related to prevention and health promotion practices in the Public Health system. The Surgeon General will chair the Council, which is tasked with developing a National Prevention and Health Policy Strategy.
  • A Prevention and Public Health Fund is established and administered through the HHS Secretary’s Office. It will provide an expanded and sustained national support for public health and prevention programs authorized by the Public Health Service Act and also includes support for a Community Transformation grant program directed toward activities to prevent and control chronic diseases. It will also support a national public-private partnership for a public prevention outreach and awareness campaign. It will be funded at $500 million in 2010, increasing annually to $2 billion in 2015 and thereafter.
  • The law directs the HHS Secretary to establish an oral health public health education campaign and demonstration grants for school-based sealant programs, oral health infrastructure, and surveillance.
  • Healthy Aging, Living Well Community-Based Prevention Programs will support Centers for Disease Control and Prevent (CDC) competitive grants to health departments and Indian tribes for Public Health community prevention programs for 55-64 year olds.
  • The states are authorized to purchase adult vaccines at prices negotiated by the Secretary and there will be a demonstration program to improve immunization coverage as well.
  • Other initiatives directed toward specific chronic diseases including diabetes, depression, congenital heart disease, and young women breast cancer awareness and support are also included, as is support for various public health and prevention workforce planning and development.
  • Many other very important prevention initiatives are included in the Act as well, and will be discussed by others.
  • Prevention services without co-pays or deductibles will be required for Medicare, Medicaid, and privately insured citizens.
  • There is significantly expanded support for Community Health Centers, School-based Health Centers, home visiting services, and improved data collection and analysis to better understand health disparities. 

Many of the initiatives and services in the Health Care Reform Act are generally described and without detail regarding how, when, and sometimes if they will be implemented.  This is especially true for prevention services.  Some have specific funding appropriations in the law, while others are authorized but will require appropriations later.   The next several years will be an exciting time for Public Health and prevention to help mold and support the many opportunities that will unfold as the law is implemented.  We must be ready, willing, and able to act quickly if we are to be able to maximize the benefits for Michigan citizens.  We look forward to the challenge.

The Patient Protection and Affordable Care Act will do many things that will transform the entire health system in the United States today.  There are many features that will enhance both the focus on prevention in the medical care system as well as provide significant resources to support official federal, state, and local public health and other community-based services.   I want to provide a brief description of what some of the more important ones will be.    Our mission in Public Health in Michigan is to, “Promote health and safety, prevent disease, and assure treatment and management working through community/population based strategies and using evidence-based approaches.”   The “essential services” that are part of Public Health include things like:

  • Surveillance to monitor health status and identify community health problems
  • Diagnosing and investigating community health issues, risks, and hazards
  • Mobilizing community partnerships to identify and solve health problems
  • Educating and empowering people to understand and take action on health issues
  • Linking people to the services they need and sometimes providing it if necessary
  • Working to assure a healthy and safe environment for people to live, work, and play 

There are a number of new or expanded programs that will provide support for these activities at the federal, state, and local levels.

  • A National Prevention, Health Promotion and Public Health Council is created within the Department of Health and Human Services (HHS) to provide coordination and leadership at the federal level among federal agencies related to prevention and health promotion practices in the Public Health system. The Surgeon General will chair the Council, which is tasked with developing a National Prevention and Health Policy Strategy.
  • A Prevention and Public Health Fund is established and administered through the HHS Secretary’s Office. It will provide an expanded and sustained national support for public health and prevention programs authorized by the Public Health Service Act and also includes support for a Community Transformation grant program directed toward activities to prevent and control chronic diseases. It will also support a national public-private partnership for a public prevention outreach and awareness campaign. It will be funded at $500 million in 2010, increasing annually to $2 billion in 2015 and thereafter.
  • The law directs the HHS Secretary to establish an oral health public health education campaign and demonstration grants for school-based sealant programs, oral health infrastructure, and surveillance.
  • Healthy Aging, Living Well Community-Based Prevention Programs will support Centers for Disease Control and Prevent (CDC) competitive grants to health departments and Indian tribes for Public Health community prevention programs for 55-64 year olds.
  • The states are authorized to purchase adult vaccines at prices negotiated by the Secretary and there will be a demonstration program to improve immunization coverage as well.
  • Other initiatives directed toward specific chronic diseases including diabetes, depression, congenital heart disease, and young women breast cancer awareness and support are also included, as is support for various public health and prevention workforce planning and development.
  • Many other very important prevention initiatives are included in the Act as well, and will be discussed by others.
  • Prevention services without co-pays or deductibles will be required for Medicare, Medicaid, and privately insured citizens.
  • There is significantly expanded support for Community Health Centers, School-based Health Centers, home visiting services, and improved data collection and analysis to better understand health disparities. 

Many of the initiatives and services in the Health Care Reform Act are generally described and without detail regarding how, when, and sometimes if they will be implemented.  This is especially true for prevention services.  Some have specific funding appropriations in the law, while others are authorized but will require appropriations later.   The next several years will be an exciting time for Public Health and prevention to help mold and support the many opportunities that will unfold as the law is implemented.  We must be ready, willing, and able to act quickly if we are to be able to maximize the benefits for Michigan citizens.  We look forward to the challenge.  

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