services at the local level, has not kept pace in this rapidly changing health care environment,” he said. Next, the committee will evaluate the state’s public health system in relation to those services and identify areas for improvement. The committee also will identify all funding sources available for use by local health entities to perform the core public health services. Finally, committee members must establish pub- lic health policy priorities. Each year, the committee will present
a report on its activities to the legislature that includes recommendations on the use and allocation of funds, ways to im- prove the overall health of Texans, and the contracting process for local public health services while sustaining a collab- orative relationship between DSHS and local public health departments. “When funding comes to DSHS, we have to take into consideration a lot of competing interests. For instance, the committee will help us determine how to allocate funding in rural and urban ar- eas. In the past, we haven’t had any uni- form way of looking at allocating fund- ing across the state,” Dr. Morgan said. He adds that committee members
represent communities of varying sizes throughout Texas. (See “DSHS Public Health Funding and Policy Committee Members,” page 44.) Stakeholders and the public will have semiannual opportunities to provide in- put to the committee. For updates on committee meetings open to the public, visit
www.dshs.state.tx.us. Mark Guidry, MD, MPH, health au- thority for Galveston County & Cities and chief executive officer of Galveston County Health District (GCHD), is a member of the committee. He describes Texas’ public health infrastructure as “fragmented and diverse.” “In many ways, it’s broken. Because
there is no clear, current scope of ser- vices defining what a health department should do, public health infrastructure is vulnerable to any changes in policy and funding,” he said.
Public health on alert WCCHD receives about 25 percent of its total budget (excluding the Women, In-
fants and Children [WIC] program) from state and federal sources and about 75 percent from Williamson County and cit- ies’ general funds, as well as from fees. The district collects fees primarily for environmental health services, such as restaurant permits, septic system licen- sure, and copayments for services such as immunizations. Dr. Riggins says WCCHD’s state and federal contracts amount to about $1 million per fiscal year, represent- ing reductions in the neighborhood of $150,000 for FY 2012. “We also have seen the last of the Pub- lic Health Emergency Response funding
that we’ve had for several years,” Dr. Riggins said. For fiscal years 2009, 2010, and 2011, WCCHD received federal Public Health Emergency Response (PHER) funds to- taling $1.2 million. In response to the 2009 H1N1 influenza pandemic, CDC administered funding through the PHER grant to upgrade state and local pre- paredness and response capacity during the pandemic. Dr. Riggins says that the district used the funding to enhance hardware and software for disease surveillance, im- prove pandemic plans and training curri- cula, and hire temporary staff to support
10 essential public health services
Texas state law establishes the essential public health services to be conducted by a local public health system. This system must:
1. Monitor health status to identify and solve community health problems.
2. Diagnose and investigate health problems and health haz- ards in the community.
3. Inform, educate, and empower people about health issues. 4. Mobilize community partnerships and action to identify and solve health problems.
5. Develop policies and plans that support individual and com- munity health efforts.
6. Enforce laws and regulations that protect health and ensure safety.
7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
8. Assure a competent public and personal health care work- force.
9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
10.Research new insights and innovative solutions to health problems.
February 2012 TEXAS MEDICINE 43
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