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ate food waste in schools and recom- mend ways TDA can reduce it. Dr. Avila Edwards encourages physi- cians to get involved with state and lo- cal groups that have the power to shape public health policy.


“Physicians have expertise in individ- ual health and behaviors and can lend their unique viewpoints to influence the overall health of Texas communities,” she said.


Transforming public health PHFPC, upon which Drs. Guidry and Riggins serve, helped DSHS change the way it funds local health departments. The committee evaluated DSHS con- tracts with local departments and helped them improve operations. DSHS funds local health departments in two ways: noncompetitive contracts renewed an- nually and competitive grants for which local health departments and other enti- ties, such as community health centers, apply.


According to Dr. Guidry, DSHS had many noncompetitive contracts for services with local health departments that posed administrative burdens. The committee recommended — and DSHS agreed — that noncompetitive contracts be bundled. Now, instead of 25 separate contracts for services, for example, lo- cal health departments receive one that bundles all services together. Dr. Guidry says this makes the process more man- ageable for local health departments. Dr. Riggins says the committee’s op- erational recommendations to DSHS


“will result in improved flexibility and predictability of public health contracts and hopefully improved stability for lo- cal health departments to focus on the health of their communities.” The legislature directed PHFPC to define the core public health services a local entity should provide to establish a common standard for what should be funded. The committee also evaluates the state’s public health system related to those services and identifies areas for improvement. PHFPC identifies all fund- ing sources available to local health en- tities to perform the core public health services, and committee members estab- lish public health policy priorities.


Each year, the committee presents 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.


The committee’s 2013 annual report, available at www.dshs.state.tx.us/phf pcommittee/default.aspx, details the group’s efforts to accomplish its goals. Additionally, PHFPC surveyed local health authorities and found that many feel the position is underutilized and its responsibilities too vaguely defined. Drs. Riggins and Guidry say the results of the survey suggest a need for more training for local health authorities. “I think as we redefine public health agencies, we need to look at a more modern role for local health authorities as the formal bridges to the health care community and as leaders in community preparedness, health improvement, and


the provision of culturally appropriate services. I think we should ask if the current role, with its emphasis on regu- latory programs, police powers in emer- gencies and outbreaks, and approval for transport of deceased bodies, is the best use of our time and talents as trusted leaders,” Dr. Riggins said.


TMA takes a stand As a member of the TMA Council on Sci- ence and Public Health, Dr. Riggins has the opportunity to report back and seek input from the association on policy is- sues PHFPC is considering. This collabo- ration resulted in the recent revision of TMA policies on public health infrastruc- ture. The TMA House of Delegates at TexMed 2013 adopted a policy that lists these 10 essential public health services:


1. Monitor health status to identify com- munity health problems.


2. Diagnose and investigate health prob-


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