Jul 9 2012
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Robert Pestronk Offers a Sneak Preview of NACCHO 2012

Bobby Pestronk Robert Pestronk, NACCHO Executive Director

Local health officials will be meeting in Los Angeles later this week at the NACCHO Annual 2012, the annual meeting of the National Association of County and City Health Officials. Key conference topics this year include:

  • Affordable Care Act and its impact on local health departments and service delivery
  • Chronic Disease Prevention and Control
  • Transforming and Supporting the Local Public Health Workforce
  • Building a Disaster Resilient Community
  • Public Health Research

NewPublicHealth will be on the ground conducting speaker and attendee interviews, featuring session coverage and capturing the stories of public health departments across the country. Follow our coverage here.

In advance of the meeting, NewPublicHealth spoke with Robert Pestronk, MPH, executive director of NACCHO.

NewPublicHealth: How difficult is it to cull to the final session list for the meeting this week?

Robert Pestronk: The conference committee has once again done their wonderful job of selecting from among hundreds of potential sessions. I think the tracks selected are in areas that speak to the issues local health departments are confronting. They’re looking at transition into chronic disease prevention and control. They’re looking into and acting in many areas on the policy, system and environment and organizational change spectrum. There are big questions about the local public health department workforce and how that needs to change in light of both the reductions in funding and the increasing emphasis on new areas of work. And certainly, the need to have a resilient community and to have the health department play an important role in planning for disasters. The departments also need to do the best job that can be done to communicate to policymakers, to community members, to governing boards, the case for local health departments. These are timely, essential issues, and those attending the conference will hear from local health department officials and others who are grappling with these issues and coming up with ways to address them successfully.

NPH: Recent public health meetings have addressed the importance of both quantitative and qualitative research to improve public health. Are you seeing that at NACCHO as well?

Robert Pestronk: Both quantitative and qualitative research are becoming increasingly important. On the research side, I think that perhaps not just in the field of public health but in the human services or social services field generally the qualitative research has been seen as a poor step child to the quantitative that has been done at the medical or the research bench, and I think part of what’s happening is we’re coming to understand the importance of both styles and types of research. Researchers are coming to grips with the need for both types and also becoming more sophisticated in terms of the methodologies that they’re using. I think this convergence is a good thing, and I think that the recognition of the importance of both types of research by people and researchers in both areas is a very important development.

NPH: How important will the topic of Affordable Care Act be, now that the Supreme Court has ruled, at this year’s NACCHO meeting?

Robert Pestronk: We do have a couple of sessions on the Affordable Care Act, and I think that there’s going to be a lot of conversation among participants at the meeting about how the Supreme Court’s decision will play out in their state and play out across the country. Certainly, the changes in IRS rules for non-profit hospitals has opened up lines of conversation both at the member organization level as well as in local communities, either opened it up or enhanced that conversation, and I think that Medicaid and the way in which states either adjust or not adjust their programs to limit coverage are going to be conversations because those decisions have implications for the kinds of services that local health departments may need to continue to provide or not.

I think that other areas that will get discussed are the evidence that’s been generated from the funding that has been out there already. It’s going to be necessary to bring those stories forward to communicate why these changes are important for the health of their communities.

NPH: How does the Affordable Care Act help local health departments?

Robert Pestronk: It continues the nation down a road of assuring that people in communities have insurance coverage and have access to healthcare services regardless of whether their place of employment provides that as a benefit. So it will continue the conversation in local health departments across the country about the role that they should or shouldn’t and can or can’t play with respect to clinical care. I think that what we’ve learned is that some health departments will, because of the nature of the clinical resources available in their communities, need to continue to provide these services. I think that local health departments will hope that the expansion in dollars that are available through the Public Health and Prevention Fund continues over the next couple of years and that expansion will result in more opportunities for local health departments to become more active in the policy system in environmental and organizational change area. I think that the resources that are available through the Fund present opportunities for enhanced relationship-building within communities.

NPH: Collaboration is becoming a very important part of improving public health services delivery. Are we seeing both more in terms of recognizing how vital these partnerships can be as well as the actual collaborations at the local health department level?

Robert Pestronk:I think that in most cases local health departments have always been in a collaborative mode. They’ve always known that the resources that they have aren’t big enough and large enough in most communities to make a difference all by themselves. Those who are practicing in local health departments understand that to move the needle; to make a change to create the conditions in which people can be healthy requires collaborations around individual projects and programs as well as collaboration on the vision for healthier communities.

NPH: Shared services is also a topic of current important for local health departments—can you talk about its importance for local health departments?

Robert Pestronk: We have some sessions on that topic. I think that people will be interested in it. In some parts of the country, local health department districts or regions or two or more counties or communities have long been joined despite a law which might allow all individual counties or communities to have a local health department. And it’s not just shared services between local health departments; I think the conversations are underway about whether health departments are helped by collaboration or shared service arrangements with other service providers in communities as well. It’s the recognition that shared services among the public and private and non-profit sectors within a community are aimed at common goals. That includes between the media and local health departments, between the clergy and the local health departments, between businesses and local health departments—the notion of everybody on the same team rowing in the same direction, having the same vision for the community and sharing aspects of their resources with one another because some members or organizations in a community have expertise that others don’t. By combining those different assets with one another, health is more likely.

NPH: What’s your hope this year for some of the hallway conversations among meeting attendees?

Robert Pestronk: One of the major outcomes that we seek from the Annual Meeting each year is to have presented an opportunity where people around the country who face similar challenges can talk with one another about the work that they are doing and to gain enthusiasm and support and recognize the importance of persistence around difficult issues, and to recognize the importance of partnerships. It’s to give people opportunities to see what others are doing and to see how their success or what they’ve learned from failure can be adapted within their own communities. I think at a 10,000 foot level people may be grappling with the same kinds of issues. Here they can attend sessions that are of practical interest to them that will open up their eyes to the ways in which their peers are addressing an issue or have confronted an issue which they themselves may confront.

That was always as a local health department practitioner why I valued the NACCHO Annual Meeting so much was because it was a source of stimulation for me, it introduced me to my peers around the country. I always discovered that there was somebody doing something better than I or who had attempted to do something that I was interested in doing and the conference provided an opportunity for me to learn from them both there and then to establish a personal relationship with them so that if later I called them on the phone they would have a face to attach to the person on the other end of the line.

NPH: The intersection of public health and health care is at a critical juncture. What’s ahead at NACCHO on this issue?

Robert Pestronk: I think that one of the things that we’re going to be focusing on at NACCHO over the next year is what does the health department of the future look like? And clearly, again, based upon the resources that individual communities have this intersection between the clinical domain and the governmental public health practice domain is going to be an important conversation. I think that it’s going to play out differently in different communities because the resources that are available are different in different communities. I don’t think there’s going to be a one size fits all. I don’t think we’re close to having a national system in which these two separate domains are appropriately and proportionately resourced and appropriately and genuinely linked together in the ways that they might be. I think that we’re going to be on a long road in that direction over time.

NPH: Any sessions in particular you’d like to note?

Robert Pestronk: That’s like picking a favorite child! I’d say look carefully at the program ahead of time, pick sessions that are in areas that are familiar and pick sessions that are in areas that one knows nothing about because that’s a way of both discovering what’s immediately useful in terms of one’s own work in the community and it’s also useful in the long term because it often is the case that although one isn’t confronting a particular challenge at this time, one very well may be confronting it soon after. And also take time to have informal conversation with others because it’s often in that space where very interesting observations and relationships are made and joined, and those are ones that can last a lifetime.

>>Follow NewPublicHealth coverage of NACCHO Annual 2012.

Tags: Access to Health Care, Community Benefit, NACCHO, Public Health Departments