1. P UBLIC H EALTH R EVITALIZATION Law

2. SB 194 W AS S IGNED I NTO L AW Gov. Bill Ritter Jr. Signed the bill on June 3, 2008. A number of public health professionals were present for this historic moment.

3. S UPPORT F OR P UBLIC H EALTH R EVITALIZATION SB 194 Endorsers Colorado Academy of Family Physicians Colorado Assoc. of Local Public Health Officials Colorado Community Health Network Colorado Counties, Inc. Colorado Directors of Environmental Health Colorado Environmental Health Association Colorado Medical Society Colorado Public Health Administrative Directors Colorado Public Health Association Colorado Society for Public Health Education Healthcare Reform for a Stronger Colorado Health District of Northern Larimer County Oral Health Awareness Colorado Public Health Directors of Colorado Public Health Nurses Association of Colorado Pueblo Board of Health

4. C URRENT S TRUCTURE IN C OLORADO Codified in Current Public Health Law Part 5 County & District Health Departments Part 6 Public Health Nursing Services Part 7 Regional Health Departments The law has different requirements, powers, and duties for these agencies.

5. L OCAL P UBLIC H EALTH A GENCIES Colors: Organized Health Departments White: Nursing Services

6. N EW S TRUCTURE IN C OLORADO Part 5 County & District Health Departments Part 6 Public Health Nursing Services Part 7 Regional Health Departments Local Public Health Agency The new law creates one type of local public health agency that fits with the needs and resources of the community it serves.

7. P UBLIC H EALTH R EVITALIZATION L AW Requires the State Board of Health to establish public health standards for Colorado. Each local public health agency will develop a local public health plan based on the state plan. Local plans will be approved by the local and state boards of health. A statewide public health plan will be approved by the State Board of Health.

8. P RINCIPLES OF I MPLEMENTATION Assuring the Provision of Basic Services State and Local Collaboration Financial Feasibility Functional Regionalization

9. G OVERNANCE & A DMINISTRATION County Commissioners appoint Board of Health. Public Health Administrator or Director may or may not be an MD. Health officer may be director, advisor. Former Organized Health Departments

10. G OVERNANCE & A DMINISTRATION Former Nursing Services County Commissioners ARE board of health. Health officer may be medical advisor, nurse manager, or local citizen. Some Changes in the new law: Nurse Manager/Director is Public Health Director Board of Health and Public Health Director are designated

11. P ROGRAM A CTIVITIES Conduct programs according to the size and need of the community. Implement population based services. Collaborate with other PH entities. Participate in health planning. Local Public Health Agencies

12. D EFINING P UBLIC H EALTH Core Public Health shall be defined by the State Board of Health and shall include, but need not be limited to, the assessment of health status and health risks, development of policies to protect and promote health, and assurance of the provision of the essential public health services. 10 Essential Services of Public Health are included in the law. Public Health Revitalization Law

13. D EFINING P UBLIC H EALTH Public Health Agency means an organization operated by a federal, state or local government or its designees that acts principally to protect or preserve the public’s health. Public Health Revitalization Law

14. Public Health Director means the administrative and executive head of each county or district public health agency. D EFINING P UBLIC H EALTH Public Health Revitalization Law

15. I MMEDIATE A CTION County designates Local Public Health Agency by July 2009. County designates Local Board of Health 90 days later. County appoints Public Health Director.

16. W HAT ’ S N EXT ? Participate in Public Health Summit work groups in Fall 2008 CDPHE creates Statewide Public Health Plan “on or before December 31, 2009…and…every 5 years thereafter. LHA’s create local plans “as soon as practicable after the approval of…statewide…plan.” State Board of Health develops minimum quality standards for public health services. State Board of Health establishes minimum qualifications for local health directors and medical officers.

17. T IMELINE

18. S TATE B OARD OF H EALTH D UTIES Establish core public health services that each county and district public health agency must provide or arrange for the provision of said services. Establish minimum quality standards for public health services. Establish minimum qualifications for county and district public health directors and medical officers. Ensure the development and implementation of a comprehensive, statewide public health improvement plan. Review all county and district public health agency public health plans.

19. L OCAL P UBLIC H EALTH A GENCY D UTIES Provide or arrange for services to carry out the public health laws and rules of the state board of health and commissions according to the specific needs and resources available within the community. Complete a community health assessment and create the local public health plan every five years and submit to the local and state boards of health for review. Advise the local board of health on public policy issues necessary to protect public health and the environment. Provide or arrange for the provision of quality, core public health services deemed essential by the state board and the comprehensive, statewide public health improvement plan. If there are insufficient funds to provide the above services, the local board of health shall set priorities for providing services and include the list in the local plan.

20. S TATEWIDE P UBLIC H EALTH I MPROVEMENT P LAN Set public health priorities Guide the public health system in targeting core public health services and functions through program development implementation and evaluation. Identify areas needing greater resource allocation to provide essential public health services Consider available resources, including but not limited to state and local funding, and be subject to modification based on actual subsequent allocations Address core public health services and standards for local public health agencies Recommends legislative or regulatory action Provide a strategy for coordinating services delivery within the public health system Provide measurable indicators of effectiveness and successes

21. “Florence Sabin would be proud.” - Dr. Mark Johnson, Executive Director, Jefferson County Department of Health and Environment