The U.S. Department of Health and Human Services (HHS), the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), plays an important role in supporting state and local public health infrastructure. HHS provides national surveillance of infectious disease, applied research to develop new or improved diagnoses, disease prevention and control strategies, and helps strengthen states’ capacity to respond to outbreaks of new or reemerging disease. Federal support through grants and cooperative agreements, research and technical assistance is key to the stabilization and effective operation of the nation’s public health system and provides critical support for the state and local public health infrastructure.
NCSL urges the administration and Congress to continue to support: (1) grants and cooperative agreements to state and local governments for a broad range of public health activities; and (2) research and technical assistance, which assists states in the development and implementation of effective programs. In addition, NCSL supports efforts to foster the development of public and private sector partnerships to increase community accessibility to public health information and public health programs.
HHS and its offices, institutes, and centers, should work with NCSL and state policymakers to reduce and eliminate health disparities by: (1) identifying social determinants which lead to health disparities; and (2) helping to create and enhance standards for the collection and reporting of data on:
- race, ethnicity, sex, primary language, disability status;
- those living in rural, underserved metropolitan and frontier areas; and
- other characteristics identified by the Secretary of HHS by federally-funded health and health care programs in order to analyze and monitor health disparity trends and develop promising practices and programs to eliminate disparities, based on the data collected.
NCSL believes reporting requirements are important, but should be limited to requirements where there is a reasonable expectation that the data will be used to: (1) analyze trends; (2) improve patient outcomes; (3) improve programs; and (4) eliminate health disparities. In addition, efforts must be made to impose data collection and reporting requirements in the least burdensome way possible.
NCSL urges the President and Congress to maintain funding to HHS, including the CDC, OMH, and NIH, to:
- support the continued efforts of the HHS Office of Minority Health’s National Partnership for Action to End Health Disparities (NPA)’s efforts to mobilize a nationwide, comprehensive, community-driven, and sustained approach to combating health disparities, and;
- continue support for the Regional Blueprints for Action, which aligns with the National Stakeholder Strategy to help guide action at the local, state, and regional levels;
- augment outreach and other efforts targeting populations, including racial and ethnic minorities, at higher risk of chronic diseases and illnesses;
- provide quality and efficient care;
- improve health outcomes;
- increase cost-effectiveness;
- meet legislative, organizational, and accreditation standards; and
- develop additional evidence-based prevention and interventions targeting ethnic and racial minorities.
Clinical Trials and Research
NCSL urges the federal government to make every effort to include more women and minorities in clinical trials and other research initiatives to improve health care strategies and programs and to eliminate disparities.
Health Promotion and Disease Prevention
NCSL urges the administration and Congress to continue to support public health education initiatives that are culturally sensitive, language accessible, and age appropriate,. It is imperative that these public health education initiatives integrate (1) healthy lifestyle choices and (2) disease prevention messages and (3) strategies targeted for all communities and ages as well as other specifically identified populations within the community who have special healthcare concerns, needs and risks.
Healthy and Responsible Lifestyle Choices
NCSL supports programs that promote voluntary healthy lifestyle choices and reduce high-risk behaviors through education, counseling and, treatment, and encourages federal government to provide adequate funding for these programs.
Preventive Health and Health Services Block Grant
NCSL urges Congress to continue to support this program. Under this program, states are given maximum flexibility to design and implement programs that meet the needs of their citizens.
Preventive Health Screenings and Check-Ups
NCSL urges Congress to increase support for initiatives to promote regular preventive health screenings and check-ups. NCSL is particularly supportive of efforts that provide information about and promote screening for cardiovascular disease, dental disease, obesity, asthma, diabetes, and cancer. NCSL also supports efforts to ensure that children receive age-appropriate check-ups and screenings that include recommended childhood immunizations, comprehensive dental, vision and hearing screenings, and recommended follow-up treatment.
Chronic Disease Management
NCSL urges Congress to continue to support initiatives that promote affordable access to care and the management of chronic conditions such as obesity, cardiovascular disease, dental disease, diabetes, asthma, kidney disease, mental health disorders, and a wide range of autoimmune diseases. NCSL is supportive of initiatives that provide case management services to children with one or more chronic conditions.
NCSL supports federal initiatives that promote oral health by encouraging individuals to have regular check-ups and to practice good oral hygiene. These initiatives should include educational activities that emphasize the importance of good dental care to overall good health. NCSL supports efforts to increase access to quality, affordable dental care, including initiatives to improve public and private sector coverage of dental services, and improve oral health literacy within the public. NCSL also urges HHS to provide states flexibility to develop innovative Medicaid dental programs to increase access to and the utilization of oral health care services.
Health Education for Health Care Professionals
NCSL supports efforts to encourage institutions that train health professionals to include in their curriculum a greater emphasis on culturally competent health promotion and disease prevention information.
Access to Health Screenings and Disease Treatment
NCSL supports efforts to encourage insurers and other third-party payers, including Medicare and Medicaid, to cover cancer screening tests. NCSL supports federal initiatives to improve coverage of cancer screenings, tests, and treatments that have been shown based on evidence-based evaluation to be beneficial for the population served.
Technical Assistance to States to Improve the Quality, Capacity, and Access of Mental Health Services
NCSL urges HHS to provide technical assistance to states to monitor and improve the provision of mental health services to adults and children and to work with the medical community to develop guidance regarding behavior therapies that may replace or be used in concert with medications to reduce the dependence
of on psychotropic medications as the primary or sole treatment.
Mental Health Treatment of Children
NCSL encourages the federal government to support efforts to:
- develop treatment protocols to be used before advancing to pharmacotherapies;
- offer guidance to the primary care community on the alternatives to pharmacotherapies for mental illness in children; and
- increase the pediatric mental health workforce.
Vaccines and Immunizations
NCSL supports efforts designed to increase the overall number of children immunized and the use of alternative sites such as schools, community health centers, or other community settings to deliver vaccines to children when appropriate, cost effective, and convenient. NCSL urges the federal government to increase public education initiatives designed to provide parents with the most up-to-date information regarding recommended immunizations for children and supports continued research to improve the safety and efficacy of childhood immunizations. NCSL urges Congress and the Administration to work with states to ensure every child receives the recommended childhood immunizations and to improve immunization delivery, education, funding and other policies to help meet that goal over the long term. Finally, NCSL asks Congress to continue to allow states to set child vaccine coverage policy.
NCSL urges Congress to continue efforts to increase the number of adults who receive recommended immunizations and encourages continued special efforts to ensure high-risk adults, young adults, and older adults receive all recommended immunizations.
NCSL urges the administration and Congress to provide or appropriate sufficient funds to maintain a reasonable stockpile of pediatric immunizations and vaccine, seasonal influenza vaccine and vaccines that may be used during a pandemic so that everyone who needs an immunization can be served.
Workplace Safety and Health Care Workers
Occupational Hazards/Workplace Safety
NCSL urges the federal government to increase awareness of occupational hazards and ways to avoid accidents in the workplace. Information must be provided to employers and employees and should be included in the national effort to emphasize health promotion and disease prevention.
Pandemic and All-Hazards Preparedness
State and local governments are the first line of defense against acts of bioterrorism and other public health emergencies. State legislators are committed to enhancing the ability of their states to prepare for and respond to these events. A strong partnership between states, the federal government, and other public and private non-profit entities is the best way to accomplish this goal. NCSL urges to the administration and Congress to:
- provide states, territories, and the District of Columbia with direct, sufficient and stable funding to enable them to continue to build and maintain an infrastructure to support ongoing efforts to respond to bioterrorism and other public health emergencies;
- pass federal funds through the states for distribution to local governments, hospitals and other entities, permitting state officials to take the lead in planning on a regional and statewide basis and utilize federal funds in the most efficient and effective way;
- require grantees to collaborate with their respective states and coordinate all of their activities with the state plan;
- provide states the flexibility necessary to meet their diverse needs and priorities;
- build upon existing national and state efforts;
- ensure that regulations and requirements imposed on states are accompanied by sufficient funding and deadlines to support implementation, both immediately and in the long term; and
- authorize the appropriate federal official to temporarily waive or modify the application of federal laws that may impede implementation of state plans during a bioterrorist attack or other public health emergency.
Public Health and the Environment
NCSL supports federal efforts to prevent and detect lead poisoning in children. and the environment NCSL urges the federal government to continue to assist state and local health officials in addressing this serious health care problem.
NCSL supports the efforts of the CDC to abate vector-borne illness, including-Chikungunya, Eastern equine encephalitis virus (EEEV), Lyme-Disease, Malaria, Rocky Mountain spotted fever, and West Nile Virus, and Zika virus–by:
- providing training and assistance to front-line disease surveillance and response staff;
- offering clinical education programs;
- collaborating with state and local health departments; and
- providing funding to states to support epidemiology and response activities addressing vector-borne disease.
Maternal and Child Health
Maternal and Child Health (MCH) Block Grant
The MCH block grant allows states to meet a broad range of health services for mothers and children. NCSL supports the MCH block grant and urges Congress to continue to provide adequate funding. NCSL opposes efforts to transfer program responsibilities to the MCH block grant without the funding to accompany it, thereby reducing the funding available to functions currently funded through the block grant.
The Maternal, Infant and Early Childhood Home Visiting Program (MIECHV)
The MIECHV program facilitates collaboration and partnership at the federal, state, and community levels to improve the health of at-risk children through evidenced-based home visiting programs. NCSL supports community-based, state-federal partnerships and initiatives that working with parents and caregivers provides a supportive environment to:
- improve maternal and child health;
- promote healthy child development and school readiness;
- improve parenting skills; and
- prevent child abuse and neglect.
NCSL urges Congress to continue financial support for the MIECHV program and to provide state flexibility in the administration of the program based on needs assessments that identify community and family vulnerabilities.
Universal Newborn Screening
The Universal Screening program provides competitive grants to states for the implementation of a national program of universal newborn screening ,that includes using a few drops of blood from a newborn’s heel within 24-48 hours after birth to screen for certain genetic, endocrine and metabolic disorders, as well as newborn hearing screening. Newborn hearing screening consists of: (1) physiologic testing prior to hospital discharge; (2) audiologic evaluation by three months of age; and (3) entry into a program of early intervention by six months of age. NCSL supports the State Universal Newborn Screening program and urges Congress to continue to provide adequate funding. NCSL supports the autonomy of each state to execute its state screening program and supports federal efforts that incentivize states to screen for every disorder included on the federal Recommended Uniform Screening Panel (RUSP) and to include new conditions added to the RUSP in the future to the state screening panel in a timely manner.
Teen Pregnancy Prevention
The federal government offers a range of programs and supports to state governments to help reduce teen pregnancies recognizing that state, tribal, and local governments are best situated to determine the best programs for their constituents. NCSL supports the full range of programs available to state, tribal, and local governments and researchers to help prevent unplanned teen pregnancies. NCSL supports continued funding for these critically important programs.