85: Public Health on Capitol Hill

ROBERT JOHNSON:

This is Public Health Review Morning Edition for Wednesday, December 15th, 2021. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.

Congress is in the home stretch, racing to finish its work before heading home for the holidays. Two items impacting public health are on the agenda, but it could be next year before any decisions are made. The first is the Build Back Better act.

Carolyn Mullen is ASTHO's senior vice president of government affairs and public relations.

CAROLYN MULLEN:

Build Back Better has a number of provisions that would dramatically change public health.

Number one, it fixes Medicaid for the territories permanently so Medicaid funding for the territories would be fixed forever, which is a huge accomplishment.

Number two, it would establish a public health infrastructure fund; this fund would be mandatory, it would be disease-agnostic, and it would be guaranteed for five years to help state and local health departments build core capabilities with their staff—hiring staff—and other needs that they may have at the state and local level.

So, those two provisions are things that we are really excited about that are in the bill; but it may change as it goes through the legislative process in the Senate.

JOHNSON:

Waiting for lawmakers in the new year could be another continuing resolution. The current stop gap funding measure expires February 18th.

MULLEN:

I think the odds of another continuing resolution are extremely high. Congress started this year with a riot on Capitol Hill on January 6th, and they have been unable to recover since then. There are a lot of hurt feelings and emotions, and fear for safety of congressional staff. A lot of trust was eroded after that event on January 6th. So, it's going to be really difficult to reach a bipartisan agreement on appropriations bills.

I do want to caveat that, however. If the situation with Russia and Ukraine starts heating up more, there may be an impetus for Congress to pass a defense appropriations bill; and with that, they could pass some appropriations bills with that Department of Defense annual funding. So, a lot still to be determined.

I think the odds of them passing another short-term continuing resolution are high, but we can't rule out the unlikelihood that they may reach an agreement in February, depending on what happens in the world.

JOHNSON:

Rhode Island has a lot of experience with health equity zones, issuing its first call for proposed projects in 2015. Today, the state has 15 health equity zones.

Dr. Nicole Alexander-Scott is director of the state's health department. She says these community-focused projects turn traditional public health models upside down.

1. NICOLE ALEXANDER-SCOTT:

We need to move away from the historic government or academic approach of swooping into a community, declaring what they're doing wrong and telling them they have a way to fix it, maybe helping to fix it, and then swooping out.

JOHNSON:

Katie Lamansky manages two health equity zones in Idaho—both of them launched during the pandemic. She says the state's partners appreciate the opportunity to try something new.

KATIE LAMANSKY:

So, what we have heard from our first funding community is truly gratitude, really focusing on the importance of this funding lasting more than a single year. So, we're with them for four years; that's allowed our community collaborative to build that trust, to know that we're not just here to assess, we're not just here to hopefully get what we need from the community to satisfy grant deliverables or grant objectives. We're really here to build that community power and trust, and help it be sustaining over the long term.

JOHNSON:

Lamansky and Dr. Alexander-Scott explore the value of health equity zones in a new episode of the Public Health Review podcast, available soon everywhere you stream audio.

Finally this morning, ASTHO is hiring. Among the positions available: a coordinator supporting leadership and organizational performance; a senior analyst for program evaluation; a director of data linkages and information exchange; and an advisor of state and community engagement.

Get more information using the link in the show notes.

That'll do it for today's report.

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Be sure to join us again tomorrow morning for more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great day.