August 27, 2008

Colorado Welcomes Historic Public Health Reform

By Johnson, Teddi Dineley

New legislation brings comprehensive services to entire state PUBLIC health in Colorado took a huge leap toward the future in May with the passage of landmark legislation that will restructure and revitalize the state's public health infrastructure.

The Colorado Public Health Reauthorization Act, signed into law June 3 by Colorado Gov. Bill Ritter, assures that core public health services will be available with a consistent standard of quality to everyone in Colorado. The law replaces a patchwork public health system that lacked coordination, organization and adequate funding, Colorado public health leaders say.

Under the new law, each county in Colorado must establish - or be part of - a local public health agency organized under a local board of health with a public health director and other staff necessary to provide public health services. In addition, the state of Colorado and each local public health agency must, by Dec. 31, 2009, have a comprehensive public health plan in place that outlines how services will be provided. The Caring for Colorado Foundation will sponsor a summit in November to begin developing the statewide public health plan.

The new law calls on public officials, including the State Board of Health, Colorado Department of Public Health and Environment, county commissioners, local public health directors and local boards of health, to work together to develop a statewide pub lic health improvement plan that will become the model for local public health improvement plans.

Hailed as historic legislation by Colorado public health leaders, the new law recognizes that public health has evolved over time to deal with more than just the diseases that sickened Coloradoans a century ago, such as cow pox and cholera. The new law broadens public health's focus to encompass today's pressing public health issues, such as environmental health, obesity and new diseases such as West Nile virus.

In recent years, efforts by various public health groups to revise the public health laws in Colorado have not met with success. This year, however, the political climate was more favorable, said Jennifer Miles, MSW, a lobbyist for the Colorado Public Health Association. Last November, Colorado state Sen. Bob Hagedorn, chair of the Colorado Senate's Health and Human Services Committee, contacted Miles to say he was interested in having a major public health bill as part of his last term.

"It was something (Hagedorn) believed strongly in," Miles told The Nation's Health. "It was his last term in the Colorado Senate and it was a legacy he wanted to leave."

The Public Health Alliance of Colorado moved swiftly to bring stakeholders together to draft the legislation. Formed in 2007, the alliance is a state collaborative of 10 public health groups in Colorado.

"We were the conveners," said alliance manager Sharon Stevenson, MA, who is an APHA member. "We didn't own the bill in any way. There was a lot of give and take, a lot of meetings of core people coming together and drafting legislation and making concessions and hearing feedback from all the groups."

Some of the language in the 47-page bill is based on the Model State Public Health Act developed by Turning Point's Public Health Statute Modernization Collaborative, said Colorado Public Health Association President Steve Holloway, who is an APHA member. The Model State Public Health Act, released in September 2003, was created to help update current state, local and tribal public health laws, many of which are outdated and insufficient to handle modern public health threats.

"Various public health groups in the past in Colorado had attempted changes to the legislation, so we used some of their work as a template as well," Holloway said.

Public health services have been inconsistent around the state, said APHA member Lee Thielen, MPA, executive director of the Public Health Alliance of Colorado and executive director of the Colorado Association of Local Public Health Officials.

"This legislation should lead to greater consistency and the availability of more comprehensive services, regardless of where one lives, works or travels in Colorado," Thielen said.

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- Teddi Dineley Johnson

"This legislation should lead to greater consistency and the availability of more comprehensive services, regardless of where one lives, works or travels in Colorado."

- Lee Thielen

Colorado public health leaders look on as state Gov. Bill Ritter signs the Colorado Public Health Reauthorization Act in June. The new law will revitalize Colorado's public health system.

Copyright American Public Health Association Aug 2008

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