Many health departments are engaging in voluntary or required accreditation processes. The accreditation of public health agencies is expected to play a significant role in strengthening the performance, effectiveness and accountability of the public health system. The Public Health Accreditation Board (PHAB) serves as the national accrediting organization for state, local, tribal, and territorial health departments. A few states also operate their own accreditation programs.
Besides accreditation, the structure and organization of public health agencies are also responding to changes in the way health care is delivered and paid for. The Affordable Care Act (ACA) requires that health care organizations and local health agencies work toward systems of care and reimbursement that focus on health outcomes rather than volume of health care delivered. Local public health agencies are reacting to those requirements by exploring collaborations with Federally Qualified Health Centers regarding clinical care provision, and with nonprofit hospitals in the areas of community health needs assessment and action planning. Local agencies are also examining how they can align with newly defined ACA entities such as Accountable Care Organizations and Health Insurance Exchanges.
To reduce costs and meet increased demand for services, many local health departments (LHDs) are exploring innovative ways to improve efficiency by partnering with other LHDs, agencies and entities. This 50-state resource examines the interlocal agreements that permit LHDs to collaborate with other entities to provide health and other services.
A local health department in Maryland recently asked the Network for guidance on whether state law preempted a local ordinance restricting the sale of tobacco products to minors. The issue isn’t simple or clear. While the State has the authority to preempt or preclude local jurisdictions from enacting local laws dealing with the same issue, this does not mean that counties cannot regulate in an area just because the State already has enacted a law on that issue.
State and local public health agencies, boards of health and other stakeholders often need legal assistance to address numerous legal and policy questions regarding changing organizational structures. They also need a strong legal and policy foundation to support participation in accreditation programs. Examples of health agency structure and accreditation questions:
Network attorneys are able to provide legal technical assistance and training on issues related to the structure and organization of local health agencies. The Network and its partners have extensive experience with reimbursement and payment programs as well as expertise regarding the Affordable Care Act. Additionally the Network has also developed expertise in legal structures supporting current state-based accreditation programs. Case studies developed by the Network and its partners provide lessons learned from states that implemented accreditation through three distinct legal structures: policy implementation, formal rule making (regulation) and statute.
For legal assistance and support on public health agency structure, organization and accreditation:
You can also call your region to get legal assistance at:
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The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided does not constitute legal advice or legal representation. For legal advice, please consult specific legal counsel. For more information on the type of legal assistance the Network can provide, please see frequently asked questions.