Public health — working for everyone, everywhere

April 1–7 is Public Health Week

by John Wiesman, Secretary of Health

Each year, Public Health Week gives us the opportunity to acknowledge and celebrate the great work of public health being done across our state.

I passionately believe that the people of Washington, wherever they live, deserve to be protected by the state’s governmental public health system. This system is made up of the State Department of Health, the State Board of Health, Local Health Jurisdictions and Tribal Nations.

Over the past several years, we have been working to define the services that need to be available to everyone, everywhere, for example communicable disease control and prevention, and environmental public health. We refer to these as our “foundational public health services,” or FPHS. These services also include the core capabilities needed to effectively deliver these basic programs, like assessment.

In 2017 we secured one-time funding of $12 million for the biennium (2-year period). These dollars were designated to address gaps in communicable disease control and prevention. Part of this money was used to assess the system, and was conducted with input from our agency, the State Board of Health, and local health jurisdictions. The assessment revealed many gaps and an estimated shortfall of $450 million per biennium in the system’s ability to deliver the core services necessary to keep our communities healthy and safe.

We knew that the $12 million was not enough to address all gaps, but it helped us strengthen some of our public health infrastructure and allowed us to catch up on case investigation backlogs and improve immunization rates. We were also able to dedicate $1 million to explore new ways of delivering services more effectively and efficiently as a system. You can read more about this in the Report to the Legislature.

Again this legislative session, FPHS has been a top priority. This is the first time the decision package for FPHS has included all four components of the governmental public health system. It also outlines the necessary activities to strengthen our work in basic services and core capabilities. At $296 million per biennium, I know this is a large and ambitious decision package, but I felt it was important for us to use our FPHS assessment data to ask for what we truly need. We’ve also asked for ongoing funding that is securely built into our agency’s budget instead of one-time funding that we can’t count on. It is very difficult to build a system when there is uncertainty from biennium to biennium about available resources.

In addition to the decision package, our agency also put forward 2SHB1497, setting the context for FPHS. It defines the components of the governmental public health system, the programs and capabilities that comprise FPHS, and the state’s responsibility to provide these services. It also describes a process for the four governmental public health entities to work together and make decisions about how to define and resource FPHS.

Strong bi-partisan support ensured that 2SHB 1497 passed both the House and Senate and moved forward to the Governor. DOH thanks the partners who testified in support of the bill including the prime sponsor, Representative June Robinson and: Stephanie Wright, Snohomish County Council and Chair of Snohomish Board of Health; John Wiesman, Secretary, Washington State Department of Health; Steve Kutz, Cowlitz Tribal Council; Cowlitz Tribe Health & Human Services Director and Chair of the American Indian Health Commission; Theresa Adkinson, Director, Grant County Health District; Michelle Davis, Executive Director, State Board of Health

I’m very pleased with the strong bi-partisan support that helped the bill pass both the House and Senate, and move forward to the Governor. I think one reason it has been successful is that we have come together as a system to advocate for it. In addition, the measles outbreak has been a good example of why we need both basic programs such as communicable disease control and prevention, and core capabilities like community partnership, communications, and emergency preparedness and response. Hearing about the costs of responding to the outbreak, including diverting staff from other important public health activities, has made an impact on legislators.

I am proud of the work we are doing on FPHS, and Washington is leading the way in public health system transformation. National partners are looking for ways to resource foundational services and our state is contributing to these conversations. You can read more about this in the Public Health Leadership Forum Report.

I am proud of the work we are doing on FPHS, and Washington is leading the way in public health system transformation. National partners are looking for ways to resource foundational services and our state is contributing to these conversations. You can read more about this in the Public Health Leadership Forum Report.

John Wiesman, DrPH, MPH, is the Washington State Secretary of Health.

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