Local Health Departments Engage in Outreach with Members of Congress

By Eli Briggs, Senior Government Affairs Director, NACCHO 

Last month, during the annual Congressional summer recess, NACCHO members worked to educate Members of Congress about the work their health departments are doing to keep people healthy and safe.

Below one NACCHO member provides details of her experience:

On July 31, 2019, Representative Lauren Underwood (D-IL) and Representative Joe Kennedy (D-MA) held a Mental Health Forum at the Kendall County Health Department in Yorkville, IL.  During the forum both Representatives Underwood and Kennedy expressed enthusiastic commitment to improving access to mental health care.  Representatives were met by a packed room of community members who were invited to provide narratives on both personal mental health and mental health systems challenges that they had faced.  Representatives Underwood and Kennedy both graciously received concerns and questions and provided responses to those participating in the forum and told participants that their future policy decisions would be informed by what they heard at the forum. The Kendall County Health Department was also pleased to have quality mental health best practices and treatment services posted for all to view at the forum.  We want to express our heartfelt gratitude to Representatives Underwood and Kennedy for their commitment to mental health. 

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From the Field: Strategies to Increase Hepatitis C Screening and Linkage to Care through SSPs

By Nicole Miller, MSN, RN; Lela Riherd, BSN, RN, CIC; Zac Doobovsky, BSN, RN, CIC; and Harp Cheema, BSN, RN, Whatcom County Health Department (WA)

This post originally ran in NACCHO’s Healthy People, Healthy Places Blog.

The Centers for Disease Control and Prevention (CDC) estimates nearly 2.4 million Americans are living with the hepatitis C virus (HCV), with transmission via injection drug use being the most common mode of HCV acquisition. In Washington State, there has been a 126% increase in newly acquired HCV infections between 2013 and 2017 that is linked to the opioid crisis. In 2018, Whatcom County had approximately 13 acute HCV cases and 306 chronic HCV cases, an increase from 4 acute and 241 chronic in 2017. On July 26, 2019, in response to these increasing numbers, Washington Governor Jay Inslee launched the Hep C Free Washington Plan to Eliminate Hepatitis C in Washington State by 2030, expanding upon a 2018 proclamation calling for a coordinated strategy between state and local public health agencies, tribal governments, and other partners to eliminate hepatitis C.

Expanding prevention and screening services and increasing access to treatment are critical to Washington’s efforts to eliminate hepatitis C, yet many barriers exist for people who inject drugs (PWID) when trying to access care and needed services. Opioid misuse is a complex issue that requires a multifaceted, collaborative approach across disciplines and agencies. The Whatcom County Health Department (WCHD) is working to expand its Syringe Services Program (SSP) and Adult Health Clinic services to address the hepatitis C challenges. By expanding our services, we hope to provide our clients with the resources they need to make informed decisions regarding their health and to encourage testing and treatment for people who are living with hepatitis C.

Syringe Services Program

SSPs are shown to be safe, effective, and play an important role in reducing the transmission of viral hepatitis and other infections. The WCHD SSP is a community-based prevention program that can provide a range of services, including access to clean syringes, safe disposal of syringes, testing for infectious diseases, and linkage to treatment services. Hepatitis A and B vaccines are also available.

The WCHD started its SSP to combat the disease transmission of HCV, HIV, and other infectious diseases among PWID. The number of participants served has increased fourfold since 2009, from 219 unique participants to 881 in 2018.

Participants in our SSP reported stigma as the most common reason for avoiding medical care. We work towards a no-judgment approach to help build a trusting relationship with our clients, which is crucial in the participant’s road to change and healthy outcomes.

The increasing number of unique participants has forced our SSP to change what we ask our clients, how we test, when we test, clinic flow, and how we provide follow up services and referrals. We made changes to our dialogue with clients to facilitate a more engaging conversation and achieve a positive rapport. Our clinic flow is set up to create a safe comfortable space that allows for point of care testing in all of our exchange rooms. Clients often reported time restrictions as a barrier to testing and this change has helped us to provide testing and results in a more timely manner to meet client needs.

A standing order was approved to draw confirmatory HCV RNA testing for any of our clients that are reactive for the point of care HCV antibody test or who have received a reactive test with us in the past with no additional follow up or linkage to care. By providing confirmatory testing we can help clients document chronic HCV and initiate treatment sooner. Clients are more likely to be compliant with care if services can be provided in one centralized location.

SSPs are a tool that can help reduce transmission of viral hepatitis and other infections as well as serve as a bridge to other healthcare or treatment services. Program participants have reported that our services decrease needle reuse and sharing. This in turn helps to reduce disease transmission in our community.

Linkage to Care

Follow-up testing and linkage to care is essential for clients with a new diagnosis, but understanding the next steps for follow-up can be challenging. Our SSP program staff met with a local community health clinic about the potential to expedite referrals that screen reactive to HCV at our SSP. We worked on creating a process that ensured the appropriate testing and linkage to care happened in a timely manner. The community health clinic created a flow sheet, standing orders for HCV testing, and signed a Memorandum of Understanding (MOU) for this process. This MOU allows expedited referrals for better client outcomes.

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NACCHO Honors Anthony L-T Chen as its 2019 Advocate of the Year

The National Association of County and City Health Officials (NACCHO) named Anthony L-T Chen, MD, MPH, Director of Health of Tacoma-Pierce County Health Department, its Advocate of the Year. This award recognizes outstanding accomplishments related to advocacy and outreach to members of Congress to create better health policy outcomes. Dr. Chen received the award the organization’s 2019 Annual Conference in Orlando. Continue reading

NACCHO Statement on Gun Violence in Texas and Ohio

By Lori Tremmel Freeman, NACCCHO CEO

“Gun violence is a profound public health crisis in America. The horrific loss of life and injury in Texas and Ohio once again fill us with sadness, anger, and frustration at yet another senseless act of violence.  These tragedies have reached epidemic proportions and as with other epidemics, we must act to protect our communities’ public safety and well-being. Continue reading

Transformational Leaders Inspire Communities at the Local Level to Improve Population Health

By George T. Roberts, Jr., MHA, FACHE, NACCHO President and Chief Executive Officer of the Northeast Texas Public Health District

I’m thrilled and honored to have the opportunity to serve as President of the National Association of County and City Health Officials (NACCHO) this year. For 25 years, NACCHO has served as the voice of local public health and NACCHO stands ready to help local public health professionals and their partners serve their communities. I see public health professionals as important transformational leaders as we unite our communities, address critical health issues, and work to improve population health. Continue reading

NACCHO Vector Control Collaborative: A Cinderella Story

By Bob Lamkin. Environmental Health Manager, Brazos County Health District (TX)

Brazos County, Texas, is home to Texas A&M University and a population of nearly 230,000. We have hot temperatures, high humidity and lots of mosquitoes.  Our Health District is small and our resources for a vector program have been limited.  However, we knew we wanted to help protect the citizens in our county from arboviruses. Continue reading

CHOICES Learning Collaborative Partnership Announces New Opportunity to Develop Effective Strategies to Prevent Childhood Obesity

The CHOICES Project at the Prevention Research Center on Nutrition and Physical Activity at the Harvard T.H. Chan School of Public Health will be accepting applications beginning on August 1 for state and local health agencies to apply to participate in the CHOICES Learning Collaborative Partnership (LCP).

Over the past four years, the CHOICES team has fostered Learning Collaborative Partnerships with 15 state and local health agencies throughout the United States, with Philadelphia, Denver, San Antonio, Salt Lake County, Allegheny County, Detroit, and Houston taking part. The CHOICES LCP presents an opportunity for health agencies representing populations of 500,000 or more to receive funding, training, technical assistance, and locally tailored data to help decision-makers understand and use data on health and cost impact to identify best value for money strategies to prevent childhood obesity. Continue reading