Health, area officials call for passage of ‘PREPARE Act’
ALBANY, N.Y. » The New York State Association of County Health Officials (NYSACHO) recently joined with county leaders and public health advocates to call for the passage of the “PREPARE Act” — a series of funding initiatives necessary to stabilize New York’s overburdened public health system.
The “Public Health Reinvestment and Emergency Pandemic Adaptability, Readiness and Efficiency (PREPARE) Act” calls for the immediate infusion of $216.5 million in state funding critically necessary to sustain six core public health activities, including: pandemic response (communicable disease control); chronic disease prevention; emergency preparedness; environmental health and drinking water supply (including child lead poisoning prevention); maternal and child health; and community health assessment.
Partners joining NYSACHO to call for the passage of the PREPARE Act include; the New York State Association of Counties (NYSAC); the New York State Public Health Association (NYSPHA); Clean and Healthy New York; the Lead Free Kids New York Coalition; and the Commission on the Public’s Health System (CPHS).
While many factors have combined to destabilize the public health system, the most damaging elements have been the aggregation of 10 years of state budget cuts to New York’s 58 local health departments totaling more than $150 million, and an explosion of local public health department responsibilities stemming from the COVID pandemic and numerous state mandated public health programs.
The impact of these factors has been profound, creating a shortage of public health workers in every corner of the state, and generating backlogs of critically important public health services. According to the Public Health Center for Innovations and the de Beaumont Foundation, local health departments nationally need approximately 54,000 new staff to be able to provide adequate infrastructure and a minimum package of public health services. Moreover, according to data from the New York State Department of Health, the number of full time local health department (LHD) staff working on core services declined by 7% between 2015 and 2020.
Further, according to a NYSACHO survey, 90% of New York’s LHDs do not have enough staff to adequately provide basic foundational public health services to their communities. In total, more than 1,000 additional full-time staff are needed statewide to provide an adequate infrastructure and a minimum package of public health services. These LHD staff shortages will only worsen in the next few years due to both current and an anticipated wave of staff retirements. A recent study by SUNY Oneonta, Bassett Healthcare Network Research Institute and NYSACHO found that many LHD staff are fatigued and demoralized due to staff shortages, growth of re
sponsibilities and the impact of adverse public reaction to the pandemic. In fact, 14 of the state’s 58 local health department leaders have left their jobs in recent months due to a variety of these factors and others.
“In the last ten years we have seen explosive growth of responsibilities for local health departments without any added resources, instead we saw consistent cuts in funding to the public health system. Despite these constraints, for the past two years local health departments have been leading their communities during the worst pandemic of the century, and will continue to do so during the current exponential surge in new cases due to Omicron variants and beyond. The ongoing COVID-19 pandemic has exposed vulnerability and weaknesses within the current public health system, but it has also provided state lawmakers a once in a lifetime opportunity to change course and strengthen our public health infrastructure to better prepare New York for future public health emergencies. Therefore, we are asking state leaders to adopt the PREPARE Act as part of the 2022-23 State Budget,” Dr. Indu Gupta, NYSACHO President and Onondaga County Commissioner of Health, said.
“The unprecedented threat of the COVID19 pandemic has put on display how vital local health departments are to protecting and promoting the health of all New Yorkers. As the pandemic wears on and new public health challenges emerge, we cannot continue to expect our local health departments to battle 21st-century health threats with 20th-century resources. The PREPARE Act would help to correct more than a decade of state budget cuts by making critically important investments in core public health services like communicable disease control and child lead poisoning prevention. We urge state lawmakers to include the PREPARE Act in the 2022-23 State Budget to support counties in building a well-resourced public health infrastructure that is prepared to confront the real and deadly public health threats facing our local health departments,” Stephen Acquario, NYSAC President, remarked.
“New York’s county and the New York City health departments have been on the front lines of the response to the COVID pandemic since the beginning, providing critical contact tracing programs and mass vaccination clinics among other public health services. Their efforts are made doubly heroic despite experiencing major staff attrition and funding cuts dating back to the financial crisis of 2008, and before, from which they had never recovered. The PREPARE Act will provide urgently needed relief and stable ongoing support to local health departments, allowing them to continue meeting the challenges of the pandemic, while resuming their many other critical public health functions to protect the health of their communities, and to be prepared for the next public health crisis, which history has shown will inevitably occur. Now more than ever is the time to invest in the health of all New Yorkers. We strongly support passage of the PREPARE Act and urge state officials to pass this critical legislation to keep New Yorkers healthy,” “Denise C. Tahara, PhD, NYSPHA President, explained.
“New York State needs a significant infusion of resources to end lead poisoning at the source, and to identify and care for children
who already suffer. Clean and Healthy New York and the Lead Free Kids New York Coalition strongly encourage funding the PREPARE Act, as part of our broader ask for this year’s budget: $200 Million in Article 6 funding, and a billion dollar investment overall. We are paying the cost each and every year that we don’t remove lead hazards once and for all,” Bobbi Wilding, Executive Director of Clean and Healthy New York, noted.
“It is almost always true that communities or their elected representatives will decide their health status by how they allocate funding. The PREPARE Act is critically necessary to support well-functioning public health departments and the community based efforts central to building a healthy population and a just recovery. Changes are needed in the public health infrastructure— specifically in how funding is allocated, used, and tracked—to support greater effectiveness in population health improvement. Reports over the years, including a 2003 report to the then Commissioner of Health Antonia C. Novello, focused on strengthening the public health system, but in the end New York State has done the opposite by making cuts, exacerbating inequities, and weakening effective public health efforts, especially by community based organizations. CBOs have an essential role in our public health infrastructure and we are very aware how funding plays an important role,” Anthony Feliciano, Director of CPHS, added.
The PREPARE act calls for several reinvestments in the public health system, including:
— $132.8 million in funding (known as Article 6 funding) for the six core public health functions: pandemic response (communicable disease control); chronic disease prevention; emergency preparedness; environmental health and drinking water supply (including child lead poisoning prevention); maternal and child health; and community health assessment. — $30.3 million in child lead poisoning prevention funding to support numerous activities mandated by 2019 state legislation that appropriately lowered the acceptable blood lead level for children but provided no additional funding to support the numerous onthe ground activities necessary to implement the new policy. — $53.4 million for medical examiner activities. Death investigations are a critical public health activity. While the popular view of these services focuses on investigations related to criminal activity, under New York state statute, coroners or medical examiners have jurisdiction and authority to investigate every suspicious or unattended death within their county. These services presently are grossly underfunded by the state.