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Health Reform: Is Colorado Ready?

Health Reform: Is Colorado Ready?. Dennis Lenaway, PhD, MPH Office of the Chief of Public Health Practice U.S. Centers for Disease Control and Prevention June 9, 2009. Health Care Crisis + Public Health Crisis. Aging Population Re-emerging Diseases

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Health Reform: Is Colorado Ready?

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  1. Health Reform: Is Colorado Ready? Dennis Lenaway, PhD, MPH Office of the Chief of Public Health Practice U.S. Centers for Disease Control and Prevention June 9, 2009

  2. Health Care Crisis + Public Health Crisis Aging Population Re-emerging Diseases Emerging Diseases Obesity Health Disparities Access to Quality Health Care Health Insurance Costs Uninsured and Underinsured

  3. Japan Cuba Switzerland United States SierraLeone Life expectancy vs. health care spending 90 80 70 Life Expectancy 60 50 40 30 0 500 1000 1500 2000 2500 3000 3500 4000 4500 5000 Per Capita Health Care Spending in International Dollars

  4. 2006 U.S. National Health Expenditures

  5. Health Reform and Public Health “Simply put, in the absence of a radical shift towards prevention and public health, we will not be successful in containing medical costs or improving the health of the American people” President Barak Obama

  6. Health Reform and Public Health “Public health is also essential to health reform. As the nation’s lead prevention agency, CDC will play a role to establish a health care system that is more accessible, more cost-effective, and more accountable” Dr. Thomas Frieden CDC Director

  7. Question: Can Public Health fully deliver on the “Promise of Prevention”? “The public health infrastructure has suffered from neglect…” Institute of Medicine 2003 “Currently, serious gaps exist in the nation’s ability to safeguard health…The country does not devote the resources needed to adequately help prevent disease and protect the health of Americans” TFAH “Shortchanging America’s Health” 2008 “Public health is chronically underfunded in the US. There is currently a shortfall of $20 billion per year in spending on public health” TFAH “Blueprint for a Healthier America” 2008

  8. Health Reform and CDC’s Strategies • Setting Agency Standards • Public Health Accreditation Board • Setting System Standards • National Public Health Performance Standards Program • Engaging with Communities • MAPP • Managing our Resource Portfolio • Senior Management Officials • Strategic Management Agreements • Workforce Development

  9. Public Health Agency (PHAB) Comprehensive Infrastructure for State and Local Public Health Agencies Workforce Development Public Health System (NPHPSP) Resource Management (SMO & SMA) Community Engagement (MAPP)

  10. Why Accreditation? “The establishment of a voluntary national accreditation program is desirable for many salient reasons. Chief among them is the opportunity to advance the quality, accountability and credibility of governmental public health departments” Exploring Accreditation Project Steering Committee (2007) “If you’re not keeping score, you’re just practicing"

  11. Strong Recommendations from the Institute of Medicine (2003) • “Accreditation mechanisms may help to ensure the robustness and efficiency of the governmental public health infrastructure, assure the quality of public health services, and transparently provide information to the public about the quality of the services delivered.” • “The performance standards (NPHPSP) effort is seen as one way to help move the state and local components of the nation’s public health system closer to the system envisioned in the Future of Public Health IOM report (1988).”

  12. And Strong Recommendations fromthe Trust For America’s Health (2008) “Today our public health system is not held as accountable as it should be for health outcomes, or for how taxpayers’ public health dollars are spent.” “CDC should develop incentives and provide support for states and localities to pursue accreditation.” “CDC would require a significant increase in resources both to manage its federal leadership role on accreditation and to fund PHAB and health department activities directly related to achieving accreditation…A special infrastructure grant…would require its own dedicated resources.”

  13. American Recovery and Reinvestment Act of 2009Public Law 111-5 Prevention and Wellness Provisions • Section 317 immunization program - $300 million to CDC • Healthcare-associated infections - $50 million to HHS • Evidence-based clinical and community-based prevention and wellness strategies that deliver specific, measurable health outcomes that address chronic disease - $650 million to HHS

  14. Is Colorado Prepared for Health Reform? • New 2008 Public Health Act • Calls for standards and improvements • New Public Health Alliance of Colorado • Collaborative of 10 public health organizations • New Colorado School of Public Health • Combining the resources of CU, CSU, UNC • New CDPHE Office of Planning and Partnerships • Actively engaged in statewide planning with partners

  15. Health in all policies Population/Community-based disease prevention and health promotion Health care service and delivery improvement Comprehensive Health Reform

  16. “OK Fellas, we shoot first…. then Q and A”

  17. Building Public Health Infrastructure for a Healthier America

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