County Health County Health AuthorityAuthority

TheThe office ofoffice of

Phase II: 2.010

ObjectivesObjectives

• Legal authority• Requirements for appointment• Primary functions • Scope of public health

Public Health: A DefinitionPublic Health: A Definition

An approach to health care concerned with the health of the community as a whole. Medical Care

focuses on individual patients

vital to all of us some of the time

saves lives one at a time

disease treatment

Public Health focus on entire

populations vital to all of us all

of the time saves lives

thousands at a time prevention,

protection and promotion

Increased Life Expectancy Driven Increased Life Expectancy Driven by Public Health Improvementsby Public Health Improvements

Source: Ten Great Public Health Achievements -- United States, 1900-1999 MMWR, April 02, 1999 /

48(12);241-243 http://www.cdc.gov/mmwr/preview/mmwrhtml/00056796.htm

77 years

47 years

0

20

40

60

80

1900 2000

Increased years due to

medical care advances:5

Increased years due to

public health measures:25

Health AuthorityHealth Authority

• A health authority is a physician appointed under the provisions of Local Public Health Reorganization Act, Health and Safety Code, Chapter 121 to administer state and local laws relating to public health within the appointing body's jurisdiction.

• A “physician” means a person licensed to practice medicine by the Texas Medical Board.

Health AuthorityHealth Authority• Appointed by county judge, city council, county

commissioner’s court, or health department/district director for 2 year term.

• Mandatory only in jurisdictions that receive funding from DSHS for essential public health services.

• Duties include aiding the state with quarantine, sanitation enforcement, public health law enforcement, reportable diseases, vital statistics collection.

Texas Public Health MapTexas Public Health Map

Requirements for a Health Requirements for a Health AuthorityAuthority• Be a competent physician with a reputable

professional standing who is legally qualified to practice medicine in Texas

• Be a resident of Texas• Take and subscribe to the official oath of office

required by the Texas Constitution, Article 16, §1• File a copy of the oath and statement of

appointed officer with the appropriate DSHS Regional Office within ten working days of the date of taking the oath

Required Health Authority Required Health Authority FormsForms• Statement of Appointed Officer

(To be completed and signed by newly appointed HA and submitted to the Secretary of State’s Office before the Oath of Office and Certificate of Appointment forms can be completed.)

• Certificate of Appointment(To be completed by elected official within the jurisdiction and mailed to DSHS Regional Office with HA Oath of Office form.

• HA Oath of Office(To be completed by HA and seal of the person administering the oath should be visible. Form should be mailed to DSHS Regional Office with Certificate of Appointment.)

Clinical Prevention Skills helpful Clinical Prevention Skills helpful for HAsfor HAs

• Rabies Risk Assessment, treatment and prophylaxis of bites/exposures.

• Diagnosis of childhood exanthems/rashes and infestations.

• Vaccine Preventable diseases.• Contact prophylaxis for specific

diseases: TB, Meningococcal Meningitis, Hepatitis A…

• Evaluation and Management of blood borne pathogen exposures.

Benefits of Health AuthorityBenefits of Health Authority

• Gives counties local control over Public Health issues and emergencies.

• Provides a rapid response to locally occurring conditions, crisis situations and disease outbreaks.

• Higher degree of legal protection for commissioners court members in areas relating to public health responsibilities.

• Could provide an advantage to a local jurisdiction competing for state and federal funding for health initiatives.

Texas Counties without Local Texas Counties without Local Health DepartmentsHealth Departments• A county without a local health department is not

obligated to have a local health authority.

• A DSHS Regional Medical Director (RMD) shall perform the duties of a health authority in a county/jurisdiction where there is no local health authority.

• No monetary contribution is required by a county to sustain a local health authority.

Rural Counties- HA FunctionsRural Counties- HA FunctionsWork with appropriate DSHS Regional Office by:•Supporting efforts to establish, maintain, and enforce control measures regarding communicable or infectious diseases.•Reporting the presence of contagious, infectious, and dangerous epidemic diseases. •Assisting in enforcement of state & local public health laws, rules, and ordinances regarding food safety, sanitation and nuisance control measures.

• Ensure local adherence to state law regarding reportable diseases and vital statistics collection.

• Arrange for and/or carry out local court ordered testing for blood-borne and/or sexually transmitted infections in cases of persons accused of offenses that pose a potential risk of disease transmission.

• Act as liaison between DSHS, local officials, and local medical community during outbreaks and natural disasters.

Rural Counties- HA Functions Rural Counties- HA Functions

Rural Counties- Additional HA Rural Counties- Additional HA FunctionsFunctions• Inform/educate the community about the

importance of reporting contagious and infectious communicable diseases.

• Engage in health planning and disaster planning for the community.

• Prepare/disseminate public health information to the community regarding outbreaks and public health threats.

• Respond to questions or concerns about public health threats from local elected officials, community leaders or community groups.

Duties Typical of HA Affiliated with a Duties Typical of HA Affiliated with a Local Health Department:Local Health Department:

• Set priorities, review long and short range plans, and assess progress.

• Regularly evaluate Staff performance.

• Sign standing orders for Health Department Staff and assure compliance with state and federal laws.

• Review and submit reports, etc. relating to funding source requirements.

FundingFunding

• Health Authorities• Remuneration is allowed by law,

but not required

• Local Health Departments or Districts

SuggestionsSuggestions

• Rotate the HA appointment among different physicians.

• Encourage close working relationships.• Keep HA’s duties in line with legal

requirements.

ReviewReview

• Definition of a health authority • Requirements for appointment to office • Basic responsibilities

ResourcesResourcesDSHS Regional and Local Health Services

http://www.dshs.state.tx.us/rls

DSHS Regional and Local Health Services – LHA webpagehttp://www.dshs.state.tx.us/rls/lha/default.shtm

DSHS Communicable Disease Control Measures Manualhttp://www.dshs.state.tx.us/rls/lha/communicabledisease.shtm

Texas Legislature Online http://www.capitol.state.tx.us/statutes/statutes.html