Connecting the Dots: Interagency & Intergovernmental Collaborations Related to Health Care

1. Connecting the Dots: Interagency & Intergovernmental Collaborations Related to Health Care Merle Cunningham, MD MPH

2. Learning Objectives At the end of this session, participants will be able to: • Better understand the key Federal players and collaboration among Federal Executive Branch agencies with respect to health care & CHCs • Better appreciate the role of key State and Local government players who relate to health care & CHCs and their collaboration with Federal agencies

3. Session Overview • Federal level: Executive Branch • Administrative agencies related to health care • State and local (county/city) level • Administrative agencies related to health care • Examples of collaboration among key players

4. Collaboration among Key Players • Childhood & Adolescent life cycles • Early childhood development -Asthma • Immunization registries -Obesity • Women’s Health life cycles • Family planning & prenatal care (reproductive health) • Screening & prevention (breast & cervical CA, HTN) • Adult life cycles • Diabetes -Obesity • Heart disease -Cancer • Depression

5. Federal Executive Branch • Key Powers related to Health Care • Agenda setting • Interact with legislative & budget process • Issue/promulgate regulations within statutes • Provide oversight and monitoring • Financing – grants, contracts, health insurance

6. Federal Executive Branch Key Health Care Players (Cabinet level) • Administrative Agencies (Direct healthcare roles) • DHHS (HRSA, CDC, SAMHSA, AHRQ, ONC, NIH, AoA, FDA, OGC, CMS) • Administrative Agencies (Indirect healthcare roles) • USDA (WIC, Food Stamps, Coop Extension Service) • Education (Health Educ Curriculum, School Health) • DVA (Veterans Health Administration) • Defense (Tri-Care: Military Health Service) Note: for underlined agencies Organizational Chart provided

7. HHS Organizational Chart

8. CDC

12. Bureau of Primary Health Care Administers Health Center programs • Policies: Policy Information Notices (PINs) and Program Assistance Letters (PALs) • Program requirements, grants management • Technical Assistance • UDS data • FTCA deeming

13. State Government • Key Health Care Players • Variable agency structure & authority related to State constitutions • Typical players in some variation or combination: • State Health Department • State Mental Health Department • State Medicaid Office • State Office: licensing & regulation of insurance companies • State Office: licensing & regulation of facilities (CON, etc) • State Education Department (staff licensing) • Complex relationship with Federal Agencies • Varying levels of federal intervention over time

14. Local Government (County or City) • Local Public Health Agencies (LPHA): • Created by referendum or legislation • Part of state network with shared responsibilities • Usually formed and managed by local government • May share oversight or directly operate health services • Typical Players/Structures • County health and or mental health departments • City health or mental health departments

15. Collaboration among Key Players • Childhood & Adolescent life cycles • Early childhood development -Asthma • Immunization registries -Obesity • Women’s Health life cycles • Family planning & prenatal care (reproductive health) • Screening & prevention (breast & cervical CA, HTN) • Adult life cycles • Diabetes -Obesity • Heart disease -Cancer • Depression

16. Questions?