Category Archives: ASTHO

Sep 24 2013
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Public Health and Medicaid Partner in States to Improve Health Outcomes

ASTHO 2013's "Medicaid and Public Health: Improving Partnerships" Panel

GUEST POST by Virgie Townsend, JD, associate editor at the Association of State and Territorial Health Officials (ASTHO)

About 40 percent of the health care dollars spent in New York State come from Medicaid. Realizing that the rate was climbing far too fast, the state brought together health care advocates, physician representatives, elected officials, management and unions to solve the growing financial issue by addressing the social determinants.

And they were effective. Last year the state saved $4 billion while adding approximately 154,000 people to its Medicaid program.

One of the key figures behind the public health improvements was New York State Health Commissioner Nirav R. Shah, MD, MPH, who last week moderated the panel discussion “Medicaid and Public Health: Improving Partnerships” at the Association of State and Territorial Health Officials’ (ASTHO) 2013 Annual Meeting.

>>Read more in a NewPublicHealth Q&A with Shah.

>>Read more on New York State’s Health Improvement Plan.

>>Follow continued ASTHO Annual Meeting coverage on NewPublicHealth.org.

In addition to Shah, the panel included Vermont Department of Health Commissioner Harry Chen, MD; Executive Director of the National Association of Medicaid Directors Matt Salo; and Chief Medical Officer for Center for Medicaid and CHIP Services Stephen Cha, MD, MHS. Shah and Chen discussed how their states are improving population health through greater integration with Medicaid, while Cha and Salo presented their views from the Medicaid perspective.

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Sep 23 2013
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Leading the Workplace Wellness Movement: Public Health Departments' Role

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GUEST POST by John Skendall, Manager, Web and New Media at the Association of State and Territorial Health Officials (ASTHO).

“How much are we really doing in the area of worksite wellness? Are we walking the talk and serving our employees the way we should?” This question was posed by Paul Jarris, executive director of the Association of State and Territorial Health Officials (ASTHO), in a session on workplace wellness at the organization’s annual meeting last Friday in Orlando.

Jarris said that health departments can do more to foster wellness among employees in the states and territories. “We in public health are not leading in this area,” he said. “We are the laggards.”

>>Follow continued ASTHO Annual Meeting coverage on NewPublicHealth.org.

Terry Dwelle, state health official for the North Dakota Department of Health and moderator of the session, agreed. “Health departments must have a worksite wellness program. We need to practice what we preach,” said Dwelle. He also said that the business case for worksite wellness needs to be made to convince employers of the value of investing in wellness.

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Sep 20 2013
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CDC Director Tom Frieden Offers Encouragement, Challenges to State and Territorial Health Officials

GUEST POST by Lisa Junker, CAE, Director of Communications at the Association of State and Territorial Health Officials (ASTHO).

The United States is facing a “perfect storm of vulnerability,” said U.S. Centers for Disease Control and Prevention (CDC) Director Tom Frieden, MD, MPH, yesterday at the 2013 Annual Meeting of the Association of State and Territorial Health Officials (ASTHO)—and state and local public health officials are on the front line of defense.

Frieden began his remarks by encouraging his listeners to “go back to first principles” and keep in mind the first priority of government, which is to keep people safe.

“If the government can’t keep people safe, whether it’s the police or us in public health, we are failing at our number-one responsibility to the public,” Frieden said.

And to keep the U.S. population safe today, public health officials have to keep their eyes open for threats arriving from outside our borders. Infectious diseases, drug resistance, new pathogens, intentional engineering of microbes, and globalization of travel, food and medicines: “If there’s a blind spot anywhere, we’re at risk everywhere,” Frieden emphasized.

He also focused on CDC’s partnership with state and local public health, even during the current tight fiscal atmosphere.

“Overall, our approach has been to double down on support for the front lines [state and local health agencies],” he said. “We all are in this together…We have lots of problems and lots of opportunities, and the more effectively we are connected, the more effectively we can address these opportunities.”

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Sep 19 2013
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Healthy Babies: Tracking Progress Across the Nation

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Every baby should have a chance to celebrate a healthy, happy first birthday. Unfortunately, that is not always the case. And that risk disproportionately affects people with lower income and people of color. This Infant Mortality Awareness Month, we can celebrate some progress in helping more babies reach that first milestone, according to health officials who shared successes at the Association of State and Territorial Health Officials (ASTHO) Annual Meeting in Orlando, Fla., this week.

>>Follow our ASTHO Annual Meeting coverage throughout the week.

David Lakey, MD, Commissioner of the Texas Department of State Health Services

“We are collectively moving forward in improving birth outcomes across the nation,” said David Lakey, MD, Commissioner of the Texas Department of State Health Services and former ASTHO president, who took on healthier babies as his President’s Challenge during his tenure. Lakey set out a goal of an 8 percent reduction in premature births by 2014.

“There is a high human cost of prematurity,” said Lakey, and that cost includes low birth weight, increased morbidity and mortality, and an impact on standardized test scores and other outcomes later in life for those who do survive. “Those who are born early have a much lower chance of having a healthy, happy first birthday.”

There is also an economic and societal cost of premature birth, the cost of which is largely paid for by Medicaid. Lakey said that 57 percent of all Texas births are paid for by Medicaid. Extreme preterm birth costs an average of $71,000—while a full-term birth costs an average of $420.

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Sep 19 2013
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ASTHO Annual Meeting: A Conversation about Public Health Department Accreditation

John Wiesman, DrPH, MPH, Secretary of Health for the state of Washington

Public health department accreditation is a key topic on the Association of State and Territorial Health Officials (ASTHO) annual meeting agenda this year. John Wiesman, DrPH, MPH, Secretary of Health for the state of Washington, will participate in a discussion on the issue during the meeting. He speaks with authority, as Washington, along with Oklahoma, is one of only two states recently accredited by the Public Health Accreditation Board.

>>Follow our ASTHO Annual Meeting coverage throughout the week.

In advance of the meeting, NewPublicHealth spoke with Wiesman about the benefits of accreditation to public health departments and the communities they serve.

NewPublicHealth: What are benefits of public health accreditation to share with directors of state health departments who have not yet applied for the credential?

John Wiesman: Honestly, I think accreditation gives you bragging rights in the sense that you’re saying “our organization values quality and outcomes.” For example, you can add that to a grant for a question that asks about quality processes. That states your commitment and that a national organization found that to be true. And it gives you bragging rights with fellow cabinet officers and the governor. To be able to say you are an accredited health department means something and you can value that.

Another critical thing is that for the local public health agencies in your state, the process of going through accreditation and developing a state health improvement plan gives you an opportunity to talk about how you want to improve health in your state and get everyone on the same page. So it’s a way to build relationships with health departments in the state and showcase priorities you want to work on together. In that sense, the process of applying for accreditation goes a very long way.

NPH: What benefit has the state health department accreditation brought to local health departments in your state who are considering applying for the credential?

Wiesman: We have learning collaborative in the state as well as some grants that allow us to work with local health departments on quality improvement to become accreditation-ready. And by having gone through the accreditation process ourselves as a state health department, we bring added credibility to the table and can answer many of their questions, and our firsthand experience gives things more meaning. I think it’s absolutely important for state health departments to become accredited if you want others to do that as well.

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Sep 18 2013
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ASTHO Annual Meeting: NewPublicHealth Q&A with Terry Cline, PHD, Health Commissioner of Oklahoma

Terry Cline, PhD

For the last several years, each incoming president of the Association of State and Territorial Health Officials (ASTHO) has introduced a President’s Challenge for the year of their presidency to focus attention on a critical national health issue. Previous challenges have included injury prevention, health equity and reducing the number of preterm births. This year, incoming ASTHO president Terry Cline, PhD, will focus his President’s Challenge on prescription drug abuse, a national public health crisis that results in tens of thousands of deaths each year.

>>Follow our ASTHO Annual Meeting coverage throughout the week.

Just before the ASTHO annual meeting began, NewPublicHealth spoke with Cline about the scope of the issue and steps Cline will introduce to help health officers collectively focus their attention on reducing this public health crisis.

NPH: Why have you chosen prescription drug abuse as your President’s Challenge?

Terry Cline: If you look at the trend lines in the United States, we’ve seen a very rapid increase in the number of deaths from the misuse of prescription drugs. We’ve also seen a huge increase in the number of children born with neonatal abstinence syndrome, which has actually tripled in the last decade. Prescription drug abuse has created an incredible burden on the health of people in the United States. Deaths are just one indicator; others include lost productivity, absenteeism and health care costs. Just using neonatal abstinence syndrome as an example, in 2000 the total hospital charges were about $190 million and in 2009, which is the last year we have that data, it was $720 million. Because in many states Medicaid pays for a large percentage of the births, in 2000 that amount was about $130 million out of the $190 million, and in 2009 it was $560 million of the $720 million. So that is becoming a larger and larger financial burden on states as well, and that does not include the long-term effects on babies.

The President’s Challenge will be looking at the absolute number—bringing down the number of deaths, which stand at more than 16,000 deaths per year. We’ve seen opioid deaths increase and continue every year over the last decade. And in most states now, the number of deaths from prescription drugs is actually greater than the number of deaths from automobile accidents, which has steadily gone down over the last decade. So, one is an example of a public health success; the decrease in motor vehicle deaths stems from a comprehensive approach and work with multiple sectors to bring that death rate down. The other, prescription drug deaths, is an alarming increase. My hope is that with the President’s Challenge, we can really increase awareness and leverage public health agencies across the country to mobilize around this issue.

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Sep 18 2013
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ASTHO Annual Meeting: A NewPublicHealth Q&A with José Montero

José Montero, MD

For the last several years there’s been a bit of a tradition at the annual meeting of the Association of State and Territorial Health Officials (ASTHO), with the incoming president introducing a year-long “President's Challenge” to focus the attention of state health officers on a critical national public health issue.

José Montero, MD, outgoing president of ASTHO and director of the New Hampshire Department of Health and Human Services, chose the reintegration of public health and health care. The starting point for the challenge was a report by the Institute of Medicine, Primary Care and Public Health: Exploring Integration to Improve Population Health. In his announcement, Montero emphasized the need to take a systems approach to health care transformation in order to achieve lasting improvements in population health.

Throughout the past year, both state health departments and other public health organizations have added their integration projects to a project list maintained by ASTHO. This includes the State of New Hampshire Department of Public Health, which has collaborated with a community health center network and others to use electronic health records to link providers and tobacco quitline services, with the goal of cutting smoking rates.

>>Follow our ASTHO Annual Meeting coverage throughout the week.

Just ahead of the 2013 ASTHO annual meeting, NewPublicHealth spoke with Montero about the importance of the challenge he put forward for his fellow state health officers and next steps.

NewPublicHealth: What participation have you seen by the state health departments in your President's Challenge on reintegration of public health and health care?

José Montero: The specific metric that I used was to have states and the District of Columbia send stories that illustrate levels of partnership and integration. During the past year, the visibility of the topic has grown dramatically. In addition, ASTHO has an ongoing partnership that has brought together more than 50 different organizations for the same purpose. We meet regularly, working together on how to advance the agenda of better coordination and integration, and every day we identify new people who want to participate, and I think that has been an amazing result. I don’t want to claim that all of this is because of the ASTHO initiative. There were a lot of things that were out there already. But this was a timely call, and all of those who were working on it are joining efforts to make it happen.

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Sep 17 2013
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ASTHO Annual Meeting: NewPublicHealth Q&A with Paul Jarris

Paul Jarris, MD, ASTHO Executive Director

The annual meeting of the Association of State and Territorial Health Officials (ASTHO) begins tomorrow in Orlando, Florida. Attendees at the ASTHO annual meeting head to the same sessions and listen to the same speakers over three days, which helps create a common fluency with critical public health issues. It also creates cohesion among state health officers, who often work with each other during public health crises and learn from each others’ successful approaches to dilemmas such as budget cuts and entrenched chronic disease.

>>Follow our ASTHO Annual Meeting coverage throughout the week.

Ahead of the meeting, NewPublicHealth spoke with ASTHO’s long-time executive director, Paul Jarris, MD, about the key issues participants will engage in during the 2013 ASTHO meeting.

NewPublicHealth: What are key themes at this year’s annual meeting?

Dr. Paul Jarris: There are a number of major health issues on the agenda for the conference, including an update on Healthy Babies are Worth the Wait, last year’s ASTHO presidential challenge. Together with the Health Resource Services Administration (HRSA) there’s an intention to roll out Healthy Babies learning collaboratives across the country, and we’ll be sharing successes of the initiative from the past year.

Another major area we’ll be talking about will be the reintegration of public health and health care. A lot of this work has been outgoing ASTHO president Dr. Jose Montero’s presidential challenge for the last year, and there’s been a lot of work going on, including the development of a national collaborative between public health and primary care that ASTHO is supporting. The collaborative involves more than 50 different health care and public health organizations, brought together for the purposes of improving the population’s health.

Incoming president Terry Cline will launch his Presidential Challenge, a major initiative on prescription drug abuse and misuse and overdose. There are more people who die from prescription drug overdose than from motor vehicle accidents in this country—and there’s much that can be done about it. We’ll also have the leadership from the Office of National Drug Control Policy speaking on this critical issue.

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Sep 13 2013
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State Health Officers Convene Next Week: NewPublicHealth is On the Ground

The annual meeting of the Association of State and Territorial Health Officials (ASTHO) begins next week in Orlando, Fla., bringing together state health officials and other leaders to talk about the latest critical issues around public health in the United States. NewPublicHealth will be on the ground throughout the meeting covering workshops, sessions and keynote speeches, as well as speaking with program speakers and conference attendees.

Discussions will highlight ways to integrate and coordinate health care and public health, including new opportunities under the Affordable Care Act. We will also explore the new ASTHO President's Challenge around preventing prescription drug abuse, check in on efforts around healthy babies and more. Coverage will also include interviews with thought leaders including Paul Jarris, Terry Cline, José Montero and John Wiesman.

>>Follow NewPublicHealth coverage of the ASTHO meeting here.
>>Follow the coverage on Twitter @RWJF_PubHealth, and join the conversation using the hashtag #ASTHO13.

Oct 5 2012
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Dr. Lawrence Deyton of the FDA Center for Tobacco Products: NewPublicHealth Q&A

Dr. Lawrence Deyton, FDA Center for Tobacco Products

Last month at the Association of State and Territorial Health Officials Annual Meeting (ASTHO), attendees focused during one session on the progress made in reducing tobacco death and disease—and the significant room for improvement, as tobacco remains the leading cause of preventable death in the United States.

We caught up with Lawrence Deyton, MSPH, MD, director of the Food and Drug Administration’s (FDA) Center for Tobacco Products at the ASTHO meeting to get his take on the value of tobacco control as a prevention strategy, as well as the role of state and local public health officials.

NewPublicHealth: What did you go to ASTHO to learn, and what did you share? 

Dr. Deyton: State health officers are on the front lines of tobacco control. They see the impact in their communities. I went to the ASTHO meeting to both hear from them, and to explain where we are in tobacco regulation at the FDA and to invite the public health community to get more involved in the regulatory process by commenting.

The depth and breadth of my respect for the work state health officers do—and the budgets they have to do it with—is great. We’ll want to see comments from all stakeholders, including folks from ASTHO, on our proposed regulations, because public health officials all have a very important view we’ll want to hear about. They may have the data that could be important to support their recommendations.

NPH: What is the FDA Center for Tobacco Products doing to help prevent tobacco-related death in the U.S., and what do you want public health leaders to know about this work? 

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