NEWS
Newsletter of the Connecticut Public Health Association

Volume 10                                                                                                                                         Issue 2
Serving Connecticut's Public Health Professionals
September 2005
Editors: Maria A. Thomas, MPH, CHES & Joan Segal, MA, MS
 

Public Health at a Crossroads

A confluence of events has put Connecticut’s public health system at a crossroads; that is, at a time when critical decisions must be made.  The events in question include both the exposure of blatant weaknesses in the system and the emergence of new indications of strength.  The question is:  Will Connecticut’s leaders recognize the opportunities and make the right choices for the public’s health?  Participants in this year’s CPHA Annual Conference, which will take place on Friday, October 21, 2005 at the Rocky Hill Marriott, will be directly involved in the effort to influence policy makers’ choices and to achieve a new vision for public health in Connecticut. 

Connecticut’s encounter with anthrax and the undiminished threat of bioterrorism laid bare the deficiencies of the public health infrastructure.  While the additional federal resources for training and infrastructure development have been welcome, they have not been accompanied by the promise of sustained funding at a level equal to the task of ensuring adequate public health services for everyone in Connecticut.  The same can be said for policy.  Some important policy changes have been made to address emergency preparedness, but public policies that give full recognition to the importance of public health languish in the proposal stage.  While the improvements in public health preparedness are real, the opportunity cost has been decreased attention to on-going public health issues such as chronic disease prevention.   

The interest of policy makers in addressing the deficiencies in the public health system seems to have peaked and is now on the decline.  The challenge for public health professionals is converting the 2x4 of bioterrorism into a more thoughtful, nuanced, and sustained interest in the health of the entire public. 

Four recent events provide reason to believe that meaningful improvements in the public health system can be achieved in the foreseeable future.

·      During the last session of the General Assembly the Connecticut Association of Directors of Health (CADH) and its allies made more progress than anyone expected toward securing a legislative mandate for universal full-time public health services.  The stage is set for a fully successful effort next year.  And, even without a legislative mandate, the voluntary movement of part-time health departments into health districts has accelerated.

·      A group of over 100 UConn faculty and staff has been charged with enhancing the University’s commitment to public health education, research, and service.  At the top of group’s list of charges is completing a feasibility study for a UConn School of Public Health, which, if built, will be devoted to the public health needs of the State of Connecticut. 

·      While the Department of Public (DPH) has often seemed to be in a state of constant re-organization, the most recent iteration appears to have cut deeper into issues that have compromised the Department’s effectiveness.  The Department remains under-resourced, but it is much better positioned to capitalize on the talents of its existing staff.

·      After several years of waiting, the Yale Center for Public Health Preparedness has finally been funded by the Centers for Disease Control.  The Center promises to bring significant new resources to Connecticut’s public health system.

These events constitute new strengths on which a much stronger public health system can be built.  But, this will not happen automatically.  If the State of Connecticut is to give public health its due, members of the public health profession must recognize their collective assets and advocate for the resources and policies needed to bring them to fruition.   

This year’s CPHA Annual Conference is designed to jump start the process.  Participants will have an opportunity to contribute directly to a new vision for public health in Connecticut – the first step in realizing full-time, full-service public health for the entire state.  Following brief presentations from a panel of representatives from CADH, DPH, UConn, and Yale, conference participants will be divided into small discussion groups and charged with reflecting on the presentations and offering their own visions for the future of public health in Connecticut.  The small group discussions will be facilitated, and a scribe will record the salient points of each.  Conference proceedings will combine the results of the small group discussions and then be widely circulated among public health professionals and policy makers.  The CPHA Conference is the opportunity to demonstrate the considerable strengths within the public health system and to build on those strengths in creating a public health system in which we can all take pride.

 Further information on the CPHA Annual Conference can be obtained at the CPHA website, www.cpha.info.

CPHA and the CPHA Advocacy Committee were busy working to further Connecticut’s public health agenda during the recently concluded legislative session.  Some of the significant public health initiatives supported by CPHA during the 2005 legislative session included: 

HUSKY Part A:
Due to legislation that passed in 2003, HUSKY A adults between 100-150% of the federal poverty level (FPL) were scheduled to lose their coverage as of April 30 of this year.  CPHA supported the extension of HUSKY A benefits through June 30, 2005.  The legislation passed and the Governor signed the extension into law.  CPHA continued to support insurance coverage for this population in the new biennial budget and we are happy to report that HUSKY A parents have been included in the budget.  There will, however, be a $1 co-pay for office visits and the second year will require $25 monthly premiums.

Public Health Infrastructure:
Moving in the direction of full-time public health departments and districts is an important public health initiative long supported by CPHA.  Advocacy for this issue began early in the session with mailings to the entire CPHA membership, requesting support in communicating with their legislators.  More targeted lobbying of the Public Health Committee membership via the Grassroots Initiatives Advocacy Network (“GAIN”) followed.  Written testimony on behalf of CPHA was presented during the public hearing phase of debate.  During the final week of the session, the entire General Assembly received personal letters from the President of CPHA, requesting the elimination of part-time health departments and districts.  Despite the efforts of CPHA and several other public health organizations, the full-time health district legislation, while making great strides, did not pass during 2005.  There is much hope and momentum for the 2006 legislative session.

Tobacco:
Once again, efforts to undermine Connecticut’s smoking ban were alive and well in the halls of the Legislative Office Building.  Advocacy efforts were required early in the session to remind legislators of the legitimate public health concerns that originally prompted passage of the statewide smoking ban.  Still, efforts by some eastern Connecticut legislators sought to designate smoking areas within certain public facilities.  Response from CPHA included an alert to its entire membership to communicate with their representatives, a targeted response by GAIN toward key Public Health Committee members, as well as presentation of written testimony in favor of maintaining the comprehensive ban.  The bill died in the Public Health Committee. 

Efforts by the pro-tobacco contingent continued into the 11^th hour, with an unsuccessful last minute push for “designated smoking areas” hidden within a mercury abatement bill. 

During the special session in June, lawmakers tried again to put a hole in the ban by attempting to allow smoking in certain off-track betting facilities.  Fortunately, several legislators made a lot of noise so that the provision was removed from the bill.

Anti-tobacco efforts also centered on SB 1225, which sought to allocate funds to cover smoking cessation services for HUSKY recipients, as well as a smoking cessation telephone hotline.  Despite early support for this initiative, no action was taken by the General Assembly during this session.   

Childhood Obesity:
CPHA’s advocacy efforts were instrumental in passage of Public Act 05-117, An Act Concerning School Nutrition.  The bill required a minimum amount of physical exercise for students in full day kindergarten through grade five and permitted the establishment of school wellness committees.  Additionally, the bill limited the beverages that could be offered in schools and required boards of education to implement and enforce a State Department of Education (SDE)-published list of recommended foods that may be offered to students at schools.

Senator Don Williams, President Pro tempore, championed this bill through the Senate.  However, the going got tougher in the House where the debate lasted over eight hours.  This was one of the most hotly contested bills of the session due to the opposition of the soft drink industry, food and other beverage groups and, in many cases, local Boards of Education. Although the House also passed the bill, the Governor vetoed it because she felt childhood nutrition in schools was better left up to the local Boards of Education.
 

APHA PHACT CAMPAIGN

During the August 2005 Congressional Recess, APHA has been mobilizing support for local initiatives to educate legislators about evidenced-based policy making relating to public health issues. This advocacy effort focuses on APHA’s 3 policy priorities: Increasing access to care; Eliminating health disparities, and Rebuilding the public health infrastructure.

The goals of the PHACT Campaign are to:

      1.   Increase Congress’ recognition of the public health profession as a vital source of science-based information on
            health issues.
      2.   Impact current public policy that supports the mission of the public health profession in promoting and protecting the
            health and safety of our communities.
      3.   Offer leadership development opportunities and policy exposure to public health professionals. 

The campaign addresses the following priorities before the 109^th Congress include:

   1.   Funding Public Health: During the FY06 appropriations process, APHA seeks increased funding for critical public health activities,     
   including funding for CDC, HRSA, and other vital community-based public health programs;

2.   Supporting Trained Public Health Professionals: The Public Health Preparedness Workforce Development Act (S. 506) has been introduced in the Senate by Senators Hagel (R-NE) and Durbin (D-IL).  There are 8 co-sponsors in the Senate but more are needed to move the bill; moreover, a primary co-sponsor in the House has to be recruited. 

   3.   Providing Health Care for All Children: Kids First Act (S. 114/HR 1668) has been introduced in the Senate by Kerry (MA) and in the House by Waxman (CA).  There are 8 co-sponsors in the Senate and 38 in the House but the ACT needs additional co-sponsors in both chambers to help this bill move.

      4.   Preserving Medicaid: Public health professionals must convey the potential harm associated with cutting $10
   billion from Medicaid to the House Ways and Means and Senate Finance Committees, which will be
   considering Medicaid reform legislation in the fall.

 
Letters addressing these important issues, and signed by President Charles Huntington, were submitted to Senators Lieberman and Dodd on behalf of CPHA.  For further information on this initiative see www.apha.org/legislative.

If you are interested in joining the CPHA Advocacy Committee or GAIN please contact CPHA Advocacy Committee Co-Chairs: David Mack at 860.275.8392 or david.mack@cpha.info  or Tracey Scraba at 860.275.8302 or tracey.scraba@cpha.info

The CPHA Annual Meeting, “A Vision of Public Health in Connecticut,” will take place on Friday, October 21 at the Marriott in Rocky Hill.  The opening session will feature a panel discussion led by J. Robert Galvin, MD, MPH, Commissioner, Department of Public Health; Eileen Storey, MD, MPH, Co-director, UConn Center for Public Health and Health Policy; Baker Salsbury, MPH, MSW, MHSA, President, Connecticut Association of Directors of Health; and Linda Degutis, DrPH, MSN, Director, Yale Center for Public Health Preparedness.  Following this, participants will break into small groups to reflect on the discussion and contribute to the building of a vision for public health in our state.  After a luncheon address by Dr. Degutis, a brief business meeting, and an awards ceremony, three break-out sessions will include “Going from Part-time to Full-time” (local public health); “Realizing the Vision through Advocacy;” and Student Posters.  The program will end with a wrap-up and social hour.  The program for the annual meeting will be posted on the CPHA website shortly.  Please register early and save on registration fees:  $80 for members, $45 for student members; $120 for non-members; and $60 for student non-members if registered by October 7.  The program is approved for up to five continuing education credit hours (CECH) for Certified Health Education Specialists (CHES).  Registration fees increase by $10 if paid after October 7 or on-site.

Registration brochure will be posted soon at: http://www.cpha.info/annual_meeting2005.htm