Mickal Lewis, associate director of the Center of Excellence on Dementia Risk Reduction with the Alzheimer's Association, shares how community health workers play an essential role supporting a continuum of care for community members with dementia, and how public health leaders can help advance progress; Jeffrey Ekoma, senior director of government affairs at ASTHO, provides an update on the current government shutdown and explains how federal health agencies are impacted in this week’s View from Washington, D.C. report,...
Mickal Lewis, associate director of the Center of Excellence on Dementia Risk Reduction with the Alzheimer's Association, shares how community health workers play an essential role supporting a continuum of care for community members with dementia, and how public health leaders can help advance progress; Jeffrey Ekoma, senior director of government affairs at ASTHO, provides an update on the current government shutdown and explains how federal health agencies are impacted in this week’s View from Washington, D.C. report; a new ASTHO report provides key resources that can help state and territorial health departments break down silos and collaborate with their partners in Medicaid agencies to improve health outcomes in their communities; and Dr. Susan Kansagra, chief medical officer at ASTHO, was recently quoted in a story for STAT Health about low-income children’s lack of access to the COVID-19 vaccine.
ASTHO Legislative Alert: Federal Government Shutdown Update: Contingency Plans Released
ASTHO Report: Leveraging Public Health Assets in Medicaid Managed Care
STAT Health: Low-income children lack access to Covid vaccines because of approval delay
JANSON SILVERS:
This is the award-winning Public Health Review Morning Edition for Friday, October 3, 2025. I'm Janson Silvers. Now, today's news from the Association of State and Territorial Health Officials.
MICKAL LEWIS:
Whether that's supporting risk reduction, early detection, or caregiving, community health workers have the potential to make a big impact, and public health leaders have an opportunity to help make that happen.
SILVERS:
In 2018, Congress passed the BOLD Infrastructure for Alzheimer's Act, establishing the first-ever national public health strategy dedicated to addressing dementia. One promising approach: community health worker programs. Mickal Lewis, with the Alzheimer's Association, explains why CHWs are ideally positioned to support a continuum of care for those with dementia.
LEWIS:
During home visits, they might observe and report signs of cognitive decline, connect individuals to brain health resources, and health caregivers with dementia-friendly home modifications or access to community programs.
SILVERS:
Through research and conversations with CHWs, they found there's a real need for national guidance on how community health workers can be involved in dementia efforts.
LEWIS:
Oh, there are some great opportunities for public health leaders that can really help move the needle by advancing certification standards in developing national dementia-specific trainings for community health workers.
SILVERS:
Lewis says that this kind of formal recognition of community health worker roles is essential for long-term viability, and public health leaders are needed to guide the development of standards that can be adapted in different states.
LEWIS:
That means taking stock of existing curricula and bridging together leading organizations to define a core set of competencies and a clear scope of practice for community health workers working in dementia care.
SILVERS:
To learn more about the role community health workers play in dementia care and how public health leaders can help pave the way for progress. Check out the research article Lewis co-authored using the link in the show notes.
On Wednesday, October 1, the federal government entered a shutdown. ASTHO senior director of government affairs, Jeffrey Ekoma, has been monitoring the situation and joins us to provide an update in this week's View from Washington, D.C. report.
Happy Friday, Jeffrey. How are you this morning?
JEFFREY EKOMA:
I'm doing well. Good morning.
SILVERS:
I know that a lot has happened this week, including a federal government shutdown officially on Wednesday. Can you tell me what that really means for state and territorial health departments?
EKOMA:
Yes, we are officially in the government shutdown. We released a Legislative Alert earlier in the week on the release of contingency staffing and operation plans for various federal health agencies. Overall, HHS will seize all non-exempt and non-accepted activities, which include oversight of extramural research contracts and grants. They also will not be able to process any FOIA requests or public inquiries, collect data, or validate and analyze data. However, the Payment Management System, in addition to other financial service-related activities, will be operational and retain necessary staffing. Now, for CDC, they will be able to continue to respond to urgent disease outbreaks as well as continue their efforts for programs like the Vaccines for Children's program, but they will be unable to guide state and local health departments, among other things. Now, for FDA, much of their activities are funded through carryover user fee funding and other unexpired funding will continue. This includes FDA activities related to the regulation of tobacco products, amongst a host of other things. However, though FDA will also reduce food safety efforts within the FDA's Human Foods Program. Moving on to HRSA, they will continue to oversee activities that are funded through mandatory funding or advanced appropriations, or even prior carryover funds and user fees for various programs. Shifting to SAMHSA, they will continue substance use and mental health programs that are vital to the safety and protection of all Americans. We're track- we're also tracking developments related to staffing at agencies that are outside of the expected furloughs of staff that typically occur during a shutdown. And lastly, we're also actively tracking state-level impacts of the shutdown on public health-related programs and services, and we really do urge our members to continue to let us know things that are happening on the ground.
SILVERS:
Sounds like you and your team are busy, for sure, it's a good thing you got that Legislative Alert out to keep all of your members informed. Are there any developments, though, that you're hearing on the Hill for discussions that might end this shutdown? Are we trending toward that? Where do we stand?
EKOMA:
Yeah, it's a little bit of a mixed bag. I mean, I think the Senate, you know, they've indicated that they will continue to vote on the House-passed measure that seeks to extend funding for the government through November 21, and also a separate bill proposed by minority leadership in the House and Senate that would extend funding through October 31. There are also ongoing discussions on whether the Senate will continue to vote on these bills through the weekend. However, it does seem like concerns related to enhanced ACA premium tax credits will continue to impact discussions, and there really is an expectation that discussions will continue, like I said, through the weekend, but things are moving fast, but also moving slow at the same time, but as always, we will continue to track and update members as things develop.
SILVERS:
We always appreciate the work to keep everyone informed, and I know that will continue. So, thank you for joining us.
EKOMA:
Thank you so much, and hope everyone has a great weekend.
SILVERS:
Partnering with Medicaid agencies is essential for state and territorial health departments that want to improve health outcomes for their constituents enrolled in the program, but the different tools, terminology, and services of the separate agencies can make collaboration difficult. To help public health officials break down those barriers, ASTHO authored a new report that provides key resources and information to facilitate partnerships with Medicaid. Click the link in the show notes to access the report.
Finally, ASTHO's chief medical officer, Dr. Susan Kansagra, was recently quoted in a story for STAT Health about low-income children's lack of access to the COVID-19 vaccine. Kansagra said, quote, "The delay in adopting COVID-19 vaccine recommendations puts their health at risk, reduces access and choice for families, and puts a strain on providers who want to deliver the best care for their youngest patients." You can read the full article on STAT's website now. We'll have a link in the show notes.
That'll do it for today. We're back on Monday morning with more ASTHO news and information. I'm Janson Silvers. You're listening to the award-winning Public Health Review Morning Edition. Have a great weekend.
Mickal Lewis MPH CHW
Associate Director, Center of Excellence on Dementia Risk Reduction, Alzheimer's Association