Only 73 (29%) of 254 Texas counties have an appointed health authority.3 Expanding the number of counties with LHAs may help to make public health services more available in rural areas. The Ministry of Health works together with a provincial health authority, five regional health authorities, and a First Nations health authority to provide high quality, appropriate and timely health services to British Columbians. Although the Regional Health Authorities all have advanced public health degrees, the result of counties having no LHA is an inequity in the presence of public health services between counties with appointed LHAs and counties without an appointed LHA. Counties without an LHA do not have weight loss diet a locally based health official who citizens and public officials can consult.
The US Department of Health and Human Services recently identified priority drivers of public health quality and outcomes. The role of the LHA is essential to assuring a vision of healthy people in healthy communities. This analytic essay describes a collaborative approach to facilitate clinician education and lifelong learning, contributing to the national goal of population health improvement. Only one fourth of Texas counties have a local health authority or health district.
Although by Texas law NPs and PAs cannot perform the duties of a health authority, they can assist Regional Medical Directors and LHAs in the performance of their duties. Possibly, a new class of LHA could be created for NPs and PAs as Deputy Health Authorities to assist LHAs and Regional Medical Directors.
TALHO could partner with the TMA and TAFP to provide TALHO information and training experiences at TMA and TAFP medical meetings. TALHO could offer full membership to LHAs at an attractive rate because in most cases it is paid for by the physicians themselves, not by the county or city that the physician serves.
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The course would be developed and administered by a school of public health. Once the model is validated, the courses could be offered statewide to primary care physicians on an ongoing basis. This would extend public health information and skills among the primary care physician community and would potentially provide a trained reserve of physicians who could respond to public health issues in their area and who could possibly become appointed LHAs. The courses could also be offered to primary care residencies and to medical schools to build a public health knowledge base among physicians in training.18–21 The training could additionally be expanded to nurse practitioners and physician’s assistants .
Providing an automatic free membership for LHAs would be a perk that might make the LHA position more attractive to physicians. By contrast, many LHAs are part-time primary care physicians who cannot cancel patient appointments to participate in meetings during regular working hours. TALHO should consider developing programs that would meet the needs and time constraints of primary care physicians.
- Among them are well known functions such as social care, schools, housing and planning and waste collection, but also lesser known ones such as licensing, business support, registrar services and pest control.
- These were most recently made in 2014 for all except Cork City, which was made in 2008.
- In England, more than one million people work in local government across a range of different types of authorities, providing more than 800 different services to local communities.
- Local government is responsible for a range of vital services for people and businesses in defined areas.
Counties are not required to have a health department or a health authority. If the county chooses not to appoint a health authority, the director of 1 of the state’s 8 regional health departments acts as the health authority for that county.
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These laws provide a starting point for understanding local public health services, but they do not paint the complete picture. Local public health agencies also must provide services or perform activities to comply with other laws. The cornerstone of the LHA initiatives is an evidence-based public health training course to prepare LHAs to discharge their legal duties. The course would be primarily designed for appointed LHAs and primary care physicians.
For instance, Region Eleven of the Texas DSHS, located in Harlingen, Texas, is responsible for 19 counties with an area of square miles. For a single health authority to provide and administer public health services to 13 counties in an area larger than Maryland and Massachusetts combined is a challenging task. An LHA is responsible to 1 county judge for public health activities in the county.
The Region Eleven director must deal with 13 county judges while providing guidance and support to the other 6 counties that do have health departments. The 2012 Act, which established PHE as a national body, also returned to local authorities the responsibility for a range of community and public health services. Each upper tier local authority is required to appoint a director of public health, an officer of the authority who is responsible for the authority’s public health functions including responding to emergencies.