Local Health Departments Role in Health Care
Local health departments are the governmental organizations that provide most of the direct services to the population. There are 2,800 local health departments across the United States. Although their organizational structures may differ, their basic role is to provide direct public health services to their designated areas. It is difficult to generalize as to the types of services offered by local health departments because they do vary according to geographic location, but most are involved in communicable disease control. The following are highlights of the types of direct services offered by local health departments:
■ Over 90% of local health departments provide adult and children immunizations.
■ Over 90% offer communicable/infectious disease surveillance.
■ Over 80% offer tuberculosis screening and 75% offer tuberculosis treatment.
■ Over 75% offer environmental surveillance.
■ Approximately 70% offer population nutrition services.
■ Nearly 75% provide school/day care center inspection.
■ Nearly 85% provide activities to address health disparities.
■ Approximately 75% provide food safety education ( NACCHO, 2016 ).
Local health departments receive funding from their state government and the federal government, direct funding such as from the CDC, reimbursement for services from Medicaid and Medicare, private health insurance, and fees for services. Because of population size and coverage, local health department funding varies from state to state. Local sources are the greatest contributor to funding local health departments, followed by state allocations, Medicare and Medicaid, fees, and other federal funding ( NACCHO, 2016 ). However, the ACA has strengthened the position of the local health departments by providing funding opportunities for educating the public health workforce and increasing the focus on preventive services that are traditionally performed by the local health departments (Historic Health Reform Legislation, 2013).
▶ Conclusion
The government plays an important role in the quality of the U.S. healthcare system. The federal government provides funding for state and local governmental programs. Federal healthcare regulations are implemented and enforced at the state and local levels. Funding is primarily distributed from the federal government to the state government, which then allocates funding to local health departments. Local health departments provide the majority of services for their constituents. More local health departments are working with local organizations such as schools and physicians to increase their ability to provide education and prevention services.
The DHS and FEMA now play an integral role in the management and oversight of catastrophic events, such as natural disasters, earthquakes, floods, pandemic diseases, and bioterrorism. The DHS and FEMA collaborate closely with the CDC to ensure that both the state and local health departments have a crisis management plan in place for these events. These attacks are often horrific and frightening with a tremendous loss of life, and as a result, the state and local health departments need to be more prepared to deal with catastrophic events. They are required to develop plans and be trained to deal effectively with many of these catastrophic issues. Finally, the Affordable Care Act has increased government involvement in the healthcare industry to promote access to a quality healthcare system.