Oregon Health Authority Public Health Division Presented to Joint - - PowerPoint PPT Presentation

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Oregon Health Authority Public Health Division Presented to Joint - - PowerPoint PPT Presentation

Jul 15, 2023 333 likes •875 views

Oregon Health Authority Public Health Division Presented to Joint Committee on Ways and Means Subcommittee on Human Services March 20, 2019 Patrick Allen, Director Lillian Shirley, B.S.N., M.P.H., M.P.A., Public Health Director Why PHD

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Oregon Health Authority Public Health Division

Presented to Joint Committee on Ways and Means Subcommittee on Human Services March 20, 2019 Patrick Allen, Director Lillian Shirley, B.S.N., M.P.H., M.P.A., Public Health Director

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OREGON HEALTH AUTHORITY Public Health Division

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Why PHD

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The Triple Aim for Health Care

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OREGON HEALTH AUTHORITY Public Health Division

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The Role of Social Determinants of Health

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OREGON HEALTH AUTHORITY Public Health Division

Impact of different factors on risk of premature death

SOURCE: Schroeder, SA. (2007). We Can Do Better — Improving the Health of the American People. NEJM. 357:1221-8.

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OREGON HEALTH AUTHORITY Public Health Division

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What PHD Does

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Vision, Mission and Goals

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OREGON HEALTH AUTHORITY Public Health Division

Vision: Lifelong health for all people in Oregon Mission: Promoting health and preventing the leading causes of death, disease and injury in Oregon Goals: A modern public health system that serves every person in Oregon by:

  • Protecting people from communicable diseases
  • Preparing for and responding to emergencies
  • Limiting environmental risks to public health
  • Promoting health and countering the harmful impact of

chronic disease and injuries

  • Ensuring equitable access to quality health care
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Public Health Achievements: 20th Century

  • Vaccination
  • Motor-vehicle safety
  • Safer workplaces
  • Control of infectious diseases
  • Decline in deaths from coronary

heart disease and stroke

  • Safer and healthier foods
  • Healthier mothers and babies
  • Family planning
  • Fluoridation of drinking water
  • Recognition of tobacco use as a

health hazard

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OREGON HEALTH AUTHORITY Public Health Division

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Public Health Achievements: 21th Century

  • Eradication of Vaccine-Preventable Diseases
  • Prevention and Control of Infectious

Diseases

  • Tobacco Control
  • Maternal and Infant Health
  • Motor Vehicle Safety
  • Cardiovascular Disease Prevention
  • Occupational Safety
  • Cancer Prevention
  • Childhood Lead Poisoning Prevention
  • Public Health Preparedness and

Response

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OREGON HEALTH AUTHORITY Public Health Division

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OREGON HEALTH AUTHORITY Public Health Division

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Tribes

Oregon’s Public Health System

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Federal Agencies Oregon Health Authority Local Public Health Authorities

OREGON HEALTH AUTHORITY Public Health Division

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OREGON HEALTH AUTHORITY Public Health Division

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Public Health Division Organization

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335

homeless persons living with HIV provided supportive housing services

85,000

specimens tested for over 98 identified

  • utbreaks

1,844

people trained and certified on lead-safe work practices

979

Health care facilities and providers licensed

500

Grocery stores increased availability of healthy foods

364

Outbreak investigations conducted

13,425

Prescription Drug Monitoring Program new users registered

1,508

State- coordinated tobacco retail inspections (Jan- Sept 2018) Screened

59,978

students and provided dental sealants to

25,434

students

2,862

Volunteers in the State Emergency Registry of Volunteers in Oregon (SERV-OR)

20,363

Food, lodging and pool inspections conducted in 2015

560

Public water systems inspected

115,350

Vital records registered

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OREGON HEALTH AUTHORITY Public Health Division

Public Health Activities

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Public Health Partnerships

OREGON HEALTH AUTHORITY Public Health Division

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PHD Supports 57 Advisory Committees

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OREGON HEALTH AUTHORITY Public Health Division

Public Health Division

Public Health Division

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Strategies and Successes

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Strategies: 2017-19 State Health Improvement Plan Priorities

  • Prevent and reduce tobacco use
  • Slow the increase of obesity
  • Improve oral health
  • Reduce harms associated with

substance use

  • Prevent deaths from suicide
  • Improve immunization rates
  • Protect the population from

communicable diseases

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OREGON HEALTH AUTHORITY Public Health Division

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Success: Youth Tobacco Use

Percentage of teens who currently smoke cigarettes

8th Graders 12% 3% 20% 8% 2001 2011 2017 11th Graders

OREGON HEALTH AUTHORITY Public Health Division

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Concern: Youth Vaping

Percentage of teens who currently smoke cigarettes and/or use e-cigarettes

7% 8% 12% 16% 2001 2011 2017 11th Graders 8th Graders

OREGON HEALTH AUTHORITY Public Health Division

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Concern: Youth Obesity

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10% 14% 10% 2009 2011 2013 2015 2017 2020

Obesity prevalence among 11th graders

11th Graders Healthy People 2020 Target

OREGON HEALTH AUTHORITY Public Health Division

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Success: Oral Health

12% 8% 14% 2002 2007 2012 2017 2020

3rd Graders with cavities in permanent teeth

Healthy People 2020 Target 3rd Graders

OREGON HEALTH AUTHORITY Public Health Division

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Success/Concern: Opioid Deaths

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OREGON HEALTH AUTHORITY Public Health Division

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0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Median = 94%

Percent of Students Fully Vaccinated K-12 Schools, from Highest to Lowest Vaccination Rate (1,670 Schools)

Concern: Immunization Rates

OREGON HEALTH AUTHORITY Public Health Division

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Public Health Modernization

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OREGON HEALTH AUTHORITY Public Health Division

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LPHA Partnership Communicable Disease Focus Areas

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OREGON HEALTH AUTHORITY Public Health Division

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Strategy: Communicable Disease Control

Ensure everyone in Oregon is protected from communicable disease threats

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OREGON HEALTH AUTHORITY Public Health Division

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Goal: Improve Outbreak Prevention, Surveillance and Response in Central Oregon One strategy: Employ a regional infection prevention nurse to work directly with long- term care facilities Results (to date):

  • 78% of long-term care facilities in the

region have received infection prevention training

  • After-action analysis reports have been

completed for 100% of outbreaks

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OREGON HEALTH AUTHORITY Public Health Division

Success: Central Oregon Public Health Partnership

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Goal: Implement evidence-based vaccination improvement program One strategy: Team up with PeaceHealth to create a pneumococcal vaccination program for older adults and high-risk individuals Results (to date):

  • More than 250 pneumococcal vaccines

have been administered

  • Leveraged modernization funding to

acquire $48,000 in Community Benefit Funds and from OHA to purchase pneumococcal vaccines

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OREGON HEALTH AUTHORITY Public Health Division

Success: Coast-to-Valley Regional Partnership

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Strategy: Prevention and Health Promotion

The public health system prevents and reduces harms from chronic diseases and injuries through policy change, enhanced community systems and improved health equity to support the health and development of people in Oregon across the lifespan

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Success: Wildfire Response

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OREGON HEALTH AUTHORITY Public Health Division

  • Coordinate with state agency partners
  • Share health protection information with

communities

  • Monitor ED reports of illnesses

associated with smoke exposure

  • Work with ODF, DEQ to implement

rules protecting air quality during controlled forest burns

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Strategy: Environmental Health

Environmental health works to prevent disease and injury, eliminate the disparate impact of environmental health risks and threats on population subgroups, and create health-supportive environments where everyone in Oregon can thrive

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Success: Response and Mitigation

  • Salem water crisis response
  • HealthSpace database
  • School lead mapping tool
  • Radon mapping

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OREGON HEALTH AUTHORITY Public Health Division

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Strategy: Access to Clinical Preventive Services

Ensure people in Oregon receive recommended clinical preventive services that are cost-effective

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OREGON HEALTH AUTHORITY Public Health Division

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Success: Innovations in Service Delivery

  • Reproductive Health Equity Act

implementation, support of reproductive health services

  • Behavioral health integration into

school-based health centers

  • Dental pilot projects

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OREGON HEALTH AUTHORITY Public Health Division

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PHD Major Program Changes 2017-19

Additions

  • Reproductive Health Equity Act (HB 3391)
  • One-time funding to expand WIC Farm Direct Nutrition Programs
  • Restoration of General Fund for core public health programs
  • Public Health Modernization investment

Reductions

  • Reduction of Tobacco Master Settlement Act (TMSA) funding to public health
  • Medical marijuana changes as a result of legalization (SB 1057)

New Responsibilities

  • Extended Stay Centers (HB 4020)
  • Mandatory registration requirement in Prescription Drug Monitoring Program (HB 4143)
  • EMS patient encounter data reporting (SB 52)
  • Wallowa County transfer local public health
  • Implementation of non-binary designation on birth certificates (HB 2673)
  • Cyanotoxin monitoring in drinking water

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OREGON HEALTH AUTHORITY Public Health Division

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OREGON HEALTH AUTHORITY Public Health Division

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Challenges

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Challenge: Climate and Health

  • Wildfires and smoke

– People with asthma, CRD – Infants, children – Older adults – Pregnant women – People with CVD – Smokers

  • Harmful algal blooms

(cyanotoxins)

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OREGON HEALTH AUTHORITY Public Health Division

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Challenge: Climate and Health

  • Vector-borne diseases

– Zika – Chikungunya – West Nile virus – Dengue Fever – Colorado Tick Fever – Lyme Disease

  • Extreme weather

– Heat – Cold – Flooding

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OREGON HEALTH AUTHORITY Public Health Division

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Challenge: Youth E-cigarette, Youth Marijuana Use

  • E-cigarettes and other

“inhalant delivery systems”

  • Youth marijuana

exposure, attitudes, consumption

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OREGON HEALTH AUTHORITY Public Health Division

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Challenge: Sexually Transmitted Infections

  • Gonorrhea
  • Syphilis
  • Chlamydia
  • HIV
  • Hepatitis B
  • HPV

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Challenge: Vaccine-Preventable Diseases

  • Measles
  • Mumps
  • Whooping cough
  • Meningococcal

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2017-19 Major Budget Drivers and Risks

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Budget drivers

  • Categorical Federal funding
  • Health care system changes
  • Population changes
  • Climate change

Risks

  • Uncertainty of Federal funds
  • Decreasing local participation in public health
  • Declining medical marijuana revenue
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OREGON HEALTH AUTHORITY Public Health Division

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Proposed Budget

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764 pos. / 751.11 FTE

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2019-21 Governor’s Budget by Fund

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OREGON HEALTH AUTHORITY Public Health Division

2019-21 Governor’s Budget by Activity

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Local Pass- Through

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OREGON HEALTH AUTHORITY Public Health Division

2019-21 Governor’s Budget, Pass-Through

State Portion WIC Vouchers Federal Funds General Fund Other Funds

$103 M $116 M $162 M $170 M $52 M $40 M $33 M $50 M

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POP 405: Public Health Modernization

  • Build on 2017-19 investment
  • Improve health equity
  • Modernize data collection and reporting
  • Fill disease investigation gap
  • Increase immunization rates
  • Reduce STIs
  • Reduce tobacco use and improve public health by raising the price
  • f tobacco (HB 2270)

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OREGON HEALTH AUTHORITY Public Health Division

General Fund Total Funds Positions

POP 405

  • $13.9 Million

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POP 401: Universal Family Linkages and Home Visiting

  • 100% voluntary
  • 1-3 home visits by postnatal nurse
  • Improves:

– Breastfeeding rates – Postpartum depression screening – School readiness

  • Removes stigma
  • Promotes health equity

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OREGON HEALTH AUTHORITY Public Health Division

General Fund Total Funds Positions

POP 401 $4.1 Million $8.7 Million 4

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POP 417: State Support for Local Public Health

  • Communicable disease control by Local Public Health Authorities
  • Previously General Fund, then OMMP revenues
  • Continues OHA funding for Local Public Health Authorities

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OREGON HEALTH AUTHORITY Public Health Division

General Fund Total Funds Positions

POP 417 $5.48 Million $5.48 Million

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Fees: How They’re Established

ORS enabling legislation authorizes how fees are set (either in statute

  • r by administrative rule process), who will pay fee, and what are

intended uses for the revenue generated. Fee changes are made by: Statute

  • Requires legislative concept

Oregon Administrative Rule (OAR)

  • If prospective changes are anticipated, approval from Legislature is
  • btained during budget hearings, or
  • An Interim SB 333 process requires DAS approval, then
  • Legislative approval to continue fee beyond current biennium

OREGON HEALTH AUTHORITY Public Health Division

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POPS 418, 419, 420: Other Fund Fee Increases

  • Drinking Water (SB 27)
  • Food, Pool and Lodging (SB 28)
  • Toxic Free Kids Act

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OREGON HEALTH AUTHORITY Public Health Division

General Fund Total Funds Positions

POPS 418, 419, 420

  • $2 Million
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  • SB 253 – Transfer of Local Public Health Authority
  • SB 27 – Drinking Water Fees
  • SB 28 – Food, Pool, and Lodging Fees
  • SB 29 – Public Health Housekeeping
  • HB 5526 – Oregon Health Authority fee ratification
  • Extended Stay Centers

OHA Public Health 2019 Bills

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OREGON HEALTH AUTHORITY Public Health Division

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Thank You