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Board of Health Advocacy in Challenging Political Times

Friday, June 9, 2017   (0 Comments)
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Board of Health Advocacy in Challenging Political Times

Submitted by: Beth Lovette, MPH, BSN, & Ken Richardson, Appalachian District Board of Health (NC)

Appalachian District Board of Health serves Alleghany, Ashe and Watauga counties in the beautiful mountains of northwest North Carolina.  In NC, our District Board of Health is structured in general statutes, but the short version is that each of our three Boards of County Commissioners appoint one commissioner to our board and those three commissioners work together to appoint board of health members representing specific professional and public appointments for 3 year terms, trying to maintain equitable representation across the 3 counties.  I have worked with Appalachian District Health Department, (aka AppHealthCare) under the leadership of the Board of Health for the last 7 years.  In that time, the commissioners have worked harmoniously and without partisanship for board of health appointments that they believe fairly represent their constituents.

The District Board of Health has the same governance and rule-making authority as any single county Board of Health in NC, but has the additional challenge of complete fiscal responsibility for the work of Appalachian District Health department.  Believe me, when you are responsible for a district health department with no ability to raise revenue beyond asking for county dollars or finding revenue through grants and fee for service, advocacy around funding becomes job #1!

But what else about advocacy?  With the Board’s interest and guidance, I serve as the connector and educator for our board, related to federal and state legislative issues.  I carefully review information from state and federal public health associations, the NC Division of Public Health and the NC County Commissioner Association.  I try to offer a legislative update during our board meetings and via email between board meetings.  Our meetings are managed by seasoned Chair, Ken Richardson, Public Member, Alleghany County.  When the Board of Health convenes, they really do leave the party politics at the door.  In the past few years this board has adopted resolutions encouraging increasing the tobacco tax, supporting Medicaid expansion, educating federal officials about the danger of inadvertently losing the federal Public Health Prevention Fund with the repeal of the Affordable Care Act and other items.  I have thoroughly enjoyed the robust, respectful conversations at the board level.  And I appreciate their desire to be informed so that they can interact as individuals regarding important public health concerns if they choose. 

I heard at a recent conference:  “If our elected officials fail to read all of the details of the many pages of legislation they are voting on, shame on them.  But if they haven’t heard from public health about our concerns, shame on us!”