Category Archives: advocacy

NACCHO’s Big Cities Health Coalition Highlights Emergency Preparedness at Congressional Breakfast Briefing

By Jasmine Tinoco, NACCHO Government Affairs/Media Relations Intern

Patrice Harris, MD, Director of Health Services for Fulton County, Georgia and co-chair of Big Cities Health Coalition (BCHC) addresses Congressional audience. (Also shown (L-R): Julie Morita, MD, Commissioner of the Chicago Department of Public Health; Shelley Hearne, DrPH, Director, BCHC; Wendy Chung, MD, Chief Epidemiologist at Dallas County Department for Health and Human Services)

Patrice Harris, MD, Director of Health Services for Fulton County, Georgia and co-chair of Big Cities Health Coalition (BCHC) addresses Congressional audience. (Also shown (L-R): Julie Morita, MD, Commissioner of the Chicago Department of Public Health; Shelley Hearne, DrPH, Director, BCHC; Wendy Chung, MD, Chief Epidemiologist at Dallas County Department for Health and Human Services)

On April 28, NACCHO’s Big Cities Health Coalition (BCHC) held a Congressional briefing, “Short Term Fixes, Long Term Consequences: How Vaccines, Viruses, and Dollars Impact Emergency Preparedness in America’s Big Cities.” Representatives Tom Price (R-GA) and John Lewis (D-GA) were honorary co-hosts. The panelists at the briefing included Patrice Harris, MD, Director of Health Services for Fulton County, Georgia, and co-chair of BCHC; Julie Morita, MD, Commissioner of the Chicago Department of Public Health; Wendy Chung, MD, Chief Epidemiologist at Dallas County Department for Health and Human Services; and Jeff Gunzenhauser, MD, MPH, Interim Health Officer and Medical Director for Los Angeles County Department of Public Health.

Representative Price opened the briefing with comments about the importance of Congress coming together to support emergency preparedness. Continue reading

Bruce Pomer, Retiring Executive Director of the Health Officers Association of California, Reflects on His Long Career in Local Public Health

bruce-pomerBruce Pomer’s career in public health spans 40 years in state government and the nonprofit sector in Sacramento. He has been executive director of the Health Officers Association of California (HOAC) since 1993. From 1983 to 1993, Mr. Pomer was director of governmental affairs for HOAC. From 1971 to 1983, he held a number of executive positions at the California State Department of Health Services, including chief of external affairs and chief of the Medi-Cal Field Services Section, where he supervised a staff of over 400 employees. Bruce retired from HOAC at the end of September. He spoke with NACCHO Voice on Sept. 23.

  • Please tell us a little bit about your career path.

I imagined myself becoming a policy expert in some area and having a niche in Sacramento. I thought that I would get involved in public policy and that before I finished my career, I would make one credible run for office. After I graduated from University of California, Davis, in 1971, there weren’t many jobs available. But I got a graduate assistant position with the old state department of mental health.

A few years later I was moved to what was then the state department of health. At the time, I was staffing advisory groups to the state; within that staffing was the California Conference of Local Health Officers. They needed a staff person so they placed me, at 24 years old, in that position. As it so happens, I didn’t know anything about public health. In the beginning, the doctors (health officers) were talking to me about stuff that I didn’t understand but over time I learned.

In public health at that time, experts really controlled the action. People did not question science like they do today. My members had a lot of power because of their expertise but that expertise was starting to be questioned. I realized that I had to help the health officers strengthen their ability to present expertise within the policy development process.

In a democracy, competing values occur and legislators have to balance a lot of competing demands. It was my job to make sure that science, expertise, and professionalism were considered. I remember one of the health officers telling me, “Bruce, the key to this organization is its professionalism. That’s its strength. They can’t take that away. Ultimately, we know how to stop an epidemic, we know how to give proper advice to the public and enable them to protect themselves. People respect the physician’s medical expertise.”

I represent a group of public health physicians but I’ve never once thought I was the expert. I knew it was my job to make sure that their expertise got to the table and was part of the public discussion.

  • You’ve been in public health for more than 40 years. What’s changed for state and local health officials since you started?

There was a lot more respect for public service and a lot more respect for professional expertise. It was less political then. In other words, the complexity of interest groups involved in the discussion of issues didn’t exist like they do today. It doesn’t mean that expertise doesn’t have a role now; you just have to be smarter about how you leverage it and get it into the process.

The other thing is the “fiscalization” of policy. I saw the tail end of the great era, the 25 years after World War II when California was building highways, the university system, and the hospital system. But as we got into the 1970s, as we had some of these recessions, policy became more about dollars and less about substance. When I started, a director of a department had power. A director could go to the legislature and directly lobby for something. Now everything is controlled by the department of finance. Directors run the departments but they don’t have the influence.

  • How have you raised the visibility of local health departments with policymakers?

Once you introduce people to who you are, you have to have ownership, you have to have a program that you’re pushing in the Capitol. If you don’t have your own legislation, if you don’t have your own specific budget item that everybody knows you’re sponsoring, you can’t take it to the next level.

About 20 years ago, I realized that was the single thing I needed to do with HOAC. Up to that time, we reviewed legislation, we provided testimony and expertise, and we talked to people about what local health departments did. We even sought amendments to things when we thought things wouldn’t work. But we didn’t proactively sponsor bills. It wasn’t until we proactively sponsored our own bills that we became real players in the system.

You have to develop relationships. You have to think long-term. If you’re not going to be in this battle for a long time, you’re not going to get anything done. A great political consultant that I know in Sacramento said this to me: “There are no winners or losers—just short-term and long-term players.” The people who play for the long haul eventually win. Case in point: we lost our department of public health in 1973. When I took the job with the health officers, the primary thing on our mind was to recreate that separate department of public health. You know how long it took us? Until 2006. We never lost sight and we always kept our eye on the ball.

  • What has been the most challenging issue you’ve faced at HOAC?

I’d say the most challenging issue I’ve faced was keeping the role of the physician health officer alive. When I first took the job, I remember a lobbyist saying to me “Physician health officers are dinosaurs. In a couple of years, they aren’t even going to be around.” People didn’t necessarily like physicians in positions of power because their allegiance isn’t to a bureaucracy; it’s to a professional set of ideals. The worst of the battle was between the late 1980s up to 9/11. There were actually attempts to take the physician requirement out of the statute. I remember getting into a pitched battle with the counties about it and them threatening to cut off our dues. It was really a difficult time.

  • What are you most proud of in your career?

Our succession plan to replace me as executive director is the thing that I’m most proud of. About 10 years ago we were awarded a grant that enabled us to hire Kat DeBurgh.  She was 26 when we hired her. It became pretty clear after a few years that she was someone special and that’s why we decided to finance her master’s of public health, which she received from the University of North Carolina at Chapel Hill with honors. She is smart, she has leadership capability, and she knows how to take charge of a situation.

About three years ago, I went to my membership and I said “I think it’s time for me to look at where the end is going to be.” It was a very difficult decision for me to make, to give up the love of my life, the way of my life, the passion that it turned out to be. But I told them we needed to do a final three-year contract and a succession plan and that I thought Kat is up to leading the organization.

This year Kat got two bills on the governor’s desk, which will probably get two signatures. She’s done great work around the Capitol; people are raving about her. Her staff are motivated because she knows how to frame a goal and leave them alone. What I’m most proud of is that when I leave the organization on Sept. 30, my group isn’t going to miss a beat.

  • What advice would you give to young professionals just starting their careers in local public health?

I’d say, like anything, loyalty and persistence are the most important qualities. If you really want to be successful, you have to commit to it. Don’t let people tell you you’re a fool because you’re hanging in there, that you should jump around and be ambitious to get up the ladder. The bottom line is that if you believe in something and have passion for it, you’re going to be successful.

Pick your team and stick with it. You have to be smart about seeing opportunity. You have to be flexible. In the long run, you’re going to win some things you don’t deserve to win and you’re going to lose some things that you don’t deserve to lose. You can’t get too high when you win and too low when you lose. Sometimes, the deck is going to be stacked against you and sometimes you’ll be incredibly lucky. But you have to stay in the game. You can’t win if you don’t stay in the game.


Interview by Lindsay Tiffany, Communications Specialist, NACCHO

OMB Visit Highlights Minnesota Health Departments

By Britta Orr, Executive Director, Local Public Health Association of Minnesota

OMB-MN

From left to right: Jane Braun, Minnesota Department of Health; Gina Adasiewicz, Dakota County Department of Health; Bonnie Brueshoff, Dakota County Department of Health; Tricia Schmitt, Office of Management and Budget; Denise Dunn, Minnesota Department of Health; Britta Orr, Local Public Health Association of Minnesota (author); and Elizabeth Parilla, Minnesota Department of Health.

On Aug. 18–19, the Local Public Health Association of Minnesota (LPHA) hosted Tricia Schmitt, who is responsible for Centers for Disease Control and Prevention (CDC) programs at the Office of Management and Budget (OMB). The staff at OMB are the budget experts within the White House and write the President’s annual budget proposal to Congress, in collaboration with various federal agencies. Ms. Schmitt toured and met with staff from the Minnesota Department of Health, Washington County Department of Health, Minneapolis Health Department, and Dakota County Department of Health.

This visit was jointly planned by NACCHO and the Association of State and Territorial Health Officials to showcase the work of local and state health departments and how federal investment supports their efforts to protect the public.

During the visit, local health officials discussed a variety of issues, including accreditation and foundational capabilities for health departments, emergency preparedness grant requirements, and changes to local health department activities in the wake of the Affordable Care Act.

At the Washington County Department of Public Health and Environment, Ms. Schmitt saw a hazardous waste disposal site that doubles as a local distribution network in the event of an emergency. Staff emphasized the federal support that has allowed them to train to be ready when they are called upon in an emergency.

In Minneapolis, Ms. Schmitt visited the public housing authority where Community Transformation Grant dollars have been leveraged alongside Statewide Health Improvement Program funding to improve nutrition, physical activity, and smoking policies for low-income residents. She also met a staff member in the Minneapolis Health Department who is funded through CDC’s Public Health Associate Program, which trains entry-level public health professionals through serving in federal, local, state, tribal or territorial health roles.

Ms. Schmitt also visited an immunization clinic at Dakota County Health Department that demonstrated the use of emergency preparedness structure and processes. This gave her a feel for the on-the-ground service delivery, patient flow, and incident command structures for emergency response.

After the visit, Ms. Schmitt said, the site visit “reinforced the critical role state and local health departments serve in transforming our healthcare system.” This experience was a true highlight of the past year at LPHA, and a great example of the value of NACCHO membership. We learned a lot about the federal budget process and landscape, and Ms. Schmitt got to see Minnesota governmental public health in action. We all hope and plan that the relationship will continue into the future.

While not all local health departments may have the opportunity to talk with staff who work for the President, there are many other opportunities to educate policymakers. All local health departments should make sure that Members of Congress and others who make decisions that affect the health of our communities understand the work you do.

NACCHO has resources that can help you, including sample meeting request letters, template factsheets, guidance videos and more. Go to NACCHO’s website to learn more or contact Eli Briggs, NACCHO Government Affairs Director.

An LHD of the Year Award Winner Explains How to Implement a Tobacco-Free Policy

Interview by Ian Goldstein, Web and New Media Specialist, NACCHO

NACCHO honored the exceptional achievements of local health departments (LHDs) and local health officials at the 2014 NACCHO Annual Conference, held July 8–10 in Atlanta. NACCHO’s LHD of the Year Award recognizes and honors outstanding accomplishment of LHDs across the country for their innovation, creativity, and impact on communities. The following winners were categorized by size of jurisdiction and recognized for accomplishments in outstanding internal and external policy: Small Jurisdiction: Macon County Public Health Center (Franklin, NC); Medium Jurisdiction: Whatcom County Health Department (Bellingham, WA); and Large Jurisdiction: Chicago Department of Public Health (Chicago, IL).

The following is an excerpt from a recent NACCHO podcast featuring an interview with Macon County Public Health Center Health Director Jim Bruckner, who spoke about his health department’s winning tobacco control policy.

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NACCHO: What made you decide to apply for this award?

Bruckner: Macon County has long advocated for strong tobacco control policies for our community. In partnership with our community partners—local youth groups—we set a goal in 2008 to try and get a tobacco-free parks and recreation policy established in the community. We met a bit of resistance at the time. Our county commissioners didn’t feel that they had the ability to set forth such a policy. Things changed for us in 2012 when the North Carolina legislature passed the Smoke-Free Restaurants and Bars law. Although that focused on exposure to second-hand smoke, it also gave authority to local governments to regulate smoking in public places.

NACCHO: How has this policy been implemented in Macon County?

Bruckner: Our timeline for the project was nine months initially and the process began with some legislative and policy research. We utilized folks from the state division of public health’s tobacco control branch and their online toolbox for implementation policies. They also had a model policy that was great to have available; it sped up the process in getting the policy through our county attorney and into the board of commissioners. We then transitioned into building public support and securing some necessary grant funding. Once we verified that we had public support, we set about building evidence-based feasibility and support from community leaders and elected officials. In this phase, we basically went to a lot of meetings.

Once the ordinance was successfully adopted by the commissioners, we transitioned to the implementation phase. This phase was about 90 days long. We did facilities surveys, which looked at where they needed signage and what other needs facilities had. That’s what we were trying to secure the grant funding for. We purchased signage for all the recreation facilities and all of the parks; we purchased rugs for the entryways of the buildings; we did a widespread media campaign with press releases; and we did signs at the movie theaters. We clarified with our parks and rec staff and our sheriff’s department what the enforcement procedures would be and helped them develop talking points and handouts that they could give to folks who had questions or if they met with any violations. The ordinance actually went into effect July 9, 2012. One of the good things about the fact that it’s an ordinance on the enforcement side is that it established penalties if you are caught smoking in a parks and rec area.

NACCHO: For those who don’t know, what is the population of Macon County and where in North Carolina are you located?

Bruckner: We are in far western North Carolina and have a population of about 34,000. We’re a small rural county; about 50 percent of the county is national forest.

NACCHO: North Carolina was traditionally part of tobacco country. Is that part of Macon County?

Bruckner: Not necessarily Macon County but it is part of the state.

NACCHO: What was the biggest challenge, from a governmental standpoint, when implementing this ordinance?

Bruckner: We had three challenges upon which our success was largely dependent. This first was the ability to develop and demonstrate strong community support for the cause. The second was the argument of tobacco-free versus smoke-free. The third was the cost of implementation to the county.

NACCHO: Tell us more about the issue of tobacco-free versus smoke-free.

Bruckner: What we had to do in the beginning was squelch the argument of tobacco-free versus smoke-free. We built support for the tobacco-free argument by showing photos at presentations showing kids running around at the park or under bleachers at the ball field and we made sure to highlight the fact that there were cigarette butts on the ground and tobacco pouches and tobacco plugs where the children were playing. Also, the youth who were involved in advocating for this did cigarette butt pick-ups in parks and actually presented those in 20-gallon trash bags in front of the board of commissioners as an example of what they picked up in just a few hours at the park.

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Listen to the rest of the interview with Jim Bruckner about his community’s response to the ordinance and his advice to other LHDs that are looking to implement similar policies (start at the 5:30 mark) at http://bit.ly/1Ah1d8e.

Interested in listening to more of NACCHO’s podcasts? NACCHO’s podcast series is now available for subscription on iTunes. If you have iTunes or an iPhone, download the podcast app and search “NACCHO.” Once you subscribe, the latest NACCHO Podcasts will automatically download to your phone. You can also subscribe with the following link: http://bit.ly/1zd6xrI.

NACCHO Members Carry their Message to Capitol Hill

surviveandthrivehill

Florida NACCHO members outside the office of Senator Bill Nelson (D-FL)

By Eli Briggs, Director of Government Affairs, NACCHO

On Dec. 12, 2013, a record number of local health officials went to Capitol Hill to meet with Congressional staff and Members of Congress as an optional part of NACCHO’s Survive and Thrive program for new and aspiring health officials. NACCHO members met with nearly 100 Congressional offices representing 30 states.

This year, it is important that as many NACCHO members as possible educate Congressional staff and Members of Congress about how local health departments improve health and safety with the support of federal programs. While Congress has taken action to reduce expected federal budget cuts for this year, spending levels for non-defense programs still remain at historically low levels; both the FY 2014 and FY 2015 funding levels are well below the FY 2010 funding level, even without adjusting for inflation. In FY 2013, the Centers for Disease Control and Prevention’s budget was reduced to the lowest level since FY 2003, while health threats and challenges have increased since then.

To get involved, sign up for NACCHO’s Congressional Action Network. You can also learn about the issues NACCHO is currently involved in at the Legislative Action Center.

Some first-time participants in NACCHO Capitol Hill visits reflect on their experiences below:

“I have never had the opportunity to visit any of the elected officials in Kansas or Washington, DC, so this was a brand new experience for me. I worked hard to be prepared prior to arriving in Washington, DC, but I was still very nervous about the meetings. Through the webinars provided by NACCHO prior to the visits, the development of fact sheets and coaching from NACCHO staff, I feel like I learned more than expected.” —Allison Alejos, Director, Local Health Department, Shawnee County

“Working with colleagues from my state to coordinate our public health message to our Senator and meeting one-on-one with Representatives from our respective areas of the state is an experience not all health officers, particularly new health officers, get the opportunity to experience. NACCHO not only coordinated the visits on our behalf but prepared participants throughout the year to boost our confidence and ability to craft and communicate our message. It was an opportunity my colleagues and I will not soon forget and [for which we] are thankful. I hope more health officials will take the opportunity to meet with Members of Congress and their staff at home or in Washington, DC, and tell them about how local health departments are protecting health every day.” —Erin Hess, County Health Officer, Florida Department of Health, Hardee and Okeechobee County

“Working with NACCHO to help coordinate the Capitol Hill visits was a great experience. Supporting the members of CADH [Connecticut Association of Directors of Health] by being with them as they delivered the message of the impact of what they do in the communities that matter to their congressional representatives was very powerful. We even incorporated some intense physical activity by hustling between offices across the Capitol to make sure we delivered a timely message prior to the House members voting to approve the budget resolution.” —Charles Brown, Executive Director, Connecticut Association of Directors of Health

Please e-mail me at ebriggs@naccho.org with any questions or for more information about NACCHO’s advocacy activities.

Local Health Departments Build Relationships with Congressional Staff and Showcase Public Health Programs

capitolBy Eli Briggs, Director of Government Affairs, NACCHO

In this era of shrinking federal budgets when programs that support local health department (LHD) activities are being cut, education and outreach to Congressional staff is particularly important. During the summer recess, Congressional staff visited LHDs to learn how they keep people healthy and safe.

In August, Health Director Claudia Blackburn and her staff from the Sedgwick County Health Department in Wichita, KS, met with Mike Zamrzla, Deputy State Director with Senator Jerry Moran (R-KS). Moran is a powerful leader in the Senate, newly-serving as Ranking Member on the Labor, Health and Human Services (HHS), and Education Appropriations Subcommittee. This subcommittee, along with its House counterpart, determines the funding for the Centers for Disease Control and Prevention, Health Resources and Services Administration, and other agencies within HHS.

In preparation for meeting with Sen. Moran’s staff, Blackburn and her staff compiled a one page fact sheet that showed the sources of funding for the health department and how they had been impacted by budget cuts at the federal and state level. (Fact sheets from other LHDs are available here.)

According to Blackburn, “The meeting was an important step in establishing relationships and educating Sen. Moran’s staff on the role of Sedgwick County Health Department and our revenue streams. We found Mr. Zamrzla to be approachable, interested, and willing to share our concerns with Senator Moran.”

In September, Executive Director Amaal Tokars, MD, of the Kendall County Health Department in Illinois (about 50 miles outside of Chicago) met with Robert Johnson, Outreach Coordinator with Senator Mark Kirk (R-IL). Senator Kirk is a member of the Labor, HHS, and Education Appropriations Subcommittee and the Health, Education, Labor, and Pensions Committee, which authorizes public health programs.

In the meeting, Tokars described some of services that the health department provides as a safety net resource for the community, such as behavioral health. As the director of a small health department, she was able to educate Johnson about how their department differs from a metropolitan department like Chicago.

Dr. Tokars reflected on the meeting: “I found Mr. Johnson to be to be genuinely interested in understanding our federal funding concerns and the impact of the Affordable Care Act on the work of local health departments. I also discovered through the course of our meeting that Senator Kirk’s office was very interested in the diversity of programs and services offered by our health department. The meeting quite exceeded my expectations.”

In addition, Dr. Tokars acknowledged assistance from NACCHO Government Affairs staff: “The NACCHO staff helped me at every step along the way and were available to answer any questions I had.”

NACCHO encourages all members to develop relationships with Members of Congress and their staff to highlight the work LHDs do to improve and protect the health of every member in their community.

NACCHO has the following resources to help you plan and engage Members of Congress and their staff:

Join the Congressional Action Network
At-Home Advocacy Webpage

  • Sample meeting request letter
  • Fact sheets
  • Talking points

Online Advocacy Guide

  • Who and how to engage with Congress
  • Advocacy vs. lobbying
  • Key committees with oversight of public health

Federal Budget Webpage

  • Current status of funding bills
  • Funding charts
  • Appropriations committee report language

Legislative Action Center

  • Alerts on hot topics
  • Members of Congress committee assignments and contact information