ALIGNING THE KANSAS STATUTES AND REGULATIONS TO THE FOUNDATIONAL - - PowerPoint PPT Presentation

ALIGNING THE KANSAS STATUTES AND REGULATIONS TO THE FOUNDATIONAL PUBLIC HEALTH SERVICES

Christi Nance, BS April 4, 2016

BACKGROUND

History of LawAtlas3

• Developed through Robert Wood Johnson Foundation
• Provides platform for the systematic collection, measurement and display of

state-level laws

• Managed by the Policy Surveillance Program housed at Temple University
• Allows researchers, practitioners, policy-makers, and the public to conduct policy

surveillance

Foundational Public Health Services5

• New framework to establish the minimum package of public health services

each health department should be providing

• Stepping stone toward PHAB accreditation
• Three parts:
• Foundational Capabilities
• Foundational Areas
• Additional Important Services
• April 2012 - Institute of Medicine’s recommendation
• April 2013 - Public Health Leadership Forum
• March 2014 - First Version Released

FPHS - Since Release

• Adopted in:
• Washington
• Ohio
• Oregon
• WA Legislative Action:6
• Adopt the FPHS framework and definitions
• Incorporate FPHS into state public health statutes
• Establish a dedicated account for FPHS funds
• Begin to statutorily dedicate funding to the FPHS account.
• Fully fund FPHS with statutorily-directed funds

Funding of PH in Kansas

• Ranked 46th for State Public Health Funding per Capita7
• Slowly been on the decline since at least 2009 (38 → 46)
• 2009: $52 Million
• 2015: $36 Million
• 30% decline
• State Aid for local health funding decreased by 12% since the recession8

Health Outcomes in Kansas

• Ranked 38th in Occupational Fatalities and Obesity9
• Ranked 46th in Immunizations - Adolescents9
• 2015 Outbreaks
• Measles outbreak in Kansas City10: 13 cases
• Pertussis outbreak in Reno County11: nearly 50 cases
• # of newly diagnosed chlamydia cases (per 100,000 population) 9:
• National - 287.7 versus State - 381.6
• # of reported violent crime offenses (per 100,000 population) 9:
• National - 199 versus State - 360

STUDY PURPOSE & OBEJECTIVES

Study Purpose

• Determine the gaps in current Kansas statutes and regulations to fulfill the

Foundational Public Health Services

• Answer the question: Does Kansas have the legal capacity to implement the

Foundational Public Health Services?

Assessment/Performance Management - KHI Legal - KPHA Policy - KALHD Fiscal - KUSOM-Wichita Review current statutes and regulations in Kansas that describe the currently required public health services and how they are delivered in the state. Review enacted or proposed statutes in states that have embraced or explored the FPHS model, as well as model public health statutes developed by public health law centers. Develop a possible legislative model suitable for Kansas

Study Objectives

• Objective 1: Develop a website to organize public health statutes and provide

easy access for Local Health Departments and County Government

• Objective 2: Gain understanding of public health statutes in Kansas and how

they align with the Foundational Public Health Services

• Objective 3: Identify gaps in our current statutes or rules and regulations and

thereby provide recommendations to enable Local Health Departments to provide the minimum package of public health services

METHODS

KS Statutes and Regulations Book

• Development: May 2015 - September 2015
• Resource to KPHA Members and Local Health Department Employees
• Contained all statutes and regulations pertaining to public health
• End Result: ~ 625 pages

Literature Review

• Researched:
• Foundational Public Health Services
• FPHS in other communities
• Current state of public health in Kansas

RESULTS

53% of Foundational Capabilities and Foundational Areas were answered by statutes or regulations

Foundational Capabilities

• Assessment
• All Hazards
• Policy Development
• Communications
• Community Partnership
• Organizational

Competencies Foundational Areas

• Communicable Disease
• Chronic Disease &

Injury Prevention

• Environmental Health
• Maternal, Child, Family

Health

• Access to Clinical Care

30% 82% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Foundational Capabilities Foundational Areas

Percent of Capabilities or Areas Answered in Statutes

DISCUSSION

Things to Consider

• Outdated laws
• Statutes that aren’t enforced/Making statutes that have the capacity

to be enforced

• Changes in PH over the last 50 or more years both in Kansas and

the United States

Policy Next Steps

• Publish LawAtlas website?
• Develop a legislative model suitable for Kansas
• Focus on Foundational Capabilities
• Adoption of FPHS framework and definitions
• Statutes or regulations for identified funding gaps

FPHS Next Steps

• 1. Assess current services provided

by local health departments

• 1. Begin conversation with local

health departments regarding FPHS

Policy Fiscal Assessment

• 1. Review policies from other states

that have adopted FPHS

• 1. Develop cost-estimation model

for delivering/implementing FPHS in Kansas

• 1. Provide funding options for

implementation of FPHS Educate and seek buy-in from county commissioners/Board of Health Develop tailored minimum package of public health services for Kansas

Limitations/Conclusion

• Definitions of Foundational Capabilities and Foundational Areas
• Possibility of missing statutes or regulations pertaining to questions
• Examined state laws versus local laws

References

1. Section 7. Ten Essential Public Health Services. (n.d.). Retrieved April 04, 2016, from http://ctb.ku.edu/en/table-of- contents/overview/models-for-community-health-and-development/ten-essential-public-health-services/main 2. Accreditation Background. (n.d.). Retrieved March 04, 2016, from http://www.phaboard.org/about-phab/public-health-accreditation- background/ 3. About LawAtlas. (n.d.). Retrieved March 16, 2016, from http://www.lawatlas.org/about 4. Kansas Public Health Association. (n.d.). Retrieved March 20, 2016, from http://archie.kumc.edu/handle/2271/550 5. Foundational Public Health Services. (2014, March). Retreived March 20, 2016, from http://www.resolv.org/site- healthleadershipforum/files/2014/03/Articulation-of-Foundational-Capabilities-and-Foundational-Areas-v1.pdf 6. Foundational Public Health Services Preliminary Cost Estimation Model. (2013, September). Retrieved March 15, 2016, from http://www.doh.wa.gov/Portals/1/Documents/1200/FPHSt-Report2013.pdf 7. Key Health Data About Kansas. (n.d.). Retrieved March 21, 2016, from http://healthyamericans.org/states/?stateid=KS#section=3,year=2015,code=undefined 8. Who Pays? The Cost of Kansas’ Tax Cuts for Local Communities. (n.d.) Retreived March 28, 2016 from http://realprosperityks.com/wp- content/uploads/2013/12/KS-Center-for-Economic-Growth-Local-Impacts-Report.pdf 9. Health Rankings. (n.d.). Retrieved March 04, 2016, from http://www.countyhealthrankings.org/app/kansas/2016/overview

• 10. 13 cases of measles now confirmed in Kansas City area. (n.d.). Retrieved March 30, 2016, from http://www.kctv5.com/story/25738130/13-

cases-of-measles-now-confirmed-in-kansas-city-area 11. Whooping Cough Spreads In Reno County, Kansas. (n.d.). Retrieved March 30, 2016, from http://kcur.org/post/whooping-cough-spreads- reno-county-kansas#stream/0

QUESTIONS?