NLC’s Clarence Anthony Tells Leaders: Health Issues are Local Priorities
"Equity and access are central issues in improving the health of citizens in the U.S.," said Clarence Anthony, CEO & executive director of the National League of Cities (NLC), at Governing Magazine's Health and Human Services (HHS) Summit in Washington last week.
The summit was designed to give a group of leaders from the national, state and local levels an overview of what state and local governments foresee happening in state legislatures around the nation related to health and human services. Anthony was joined by Dan Crippen of the National Governors Association (NGA) and Emilia Istrate of the National Association of Counties (NACo).
Having grown up in a migrant community with terrible access to health care, Anthony noted that he quickly learned that the lack of health care can have very serious consequences for those who live there. In areas with poor health access, infant mortality rates rise, access to dental services can be nonexistant and often the nearest hospitals are out of reach. That's why "discussing the challenges around delivering health care, and how these challenges can be addressed" is extremely important for residents across the U.S.
Anthony said that he has learned that an effective intergovernmental partnership is key to addressing the problems associated with delivery of and access to health care.
"The Ebola crisis currently taking place is a perfect example of how important partnerships are. Local leaders stepped up. They did what had to be done," Anthony said. But what was lacking was an effective partnership between those cities, their states, and the federal government.
"We have heard from local health departments that the coordination between federal, state and local health departments was not sufficient, and that the communications between them must be strengthened. We also heard that they are short on supplies and that some health departments cannot even order the necessary protective gear," he said.
How does this get addressed? The solution is to strengthen intergovernmental partnerships between all levels of government. Both the federal and state governments must make these partnerships a priority. Anthony noted that this can be done through legislation that recognizes the importance of the partnership and that puts in place ways to improve it. But most of all, there must be a process that includes state and local voices. Every state needs to make sure that legislatively, this issue is addressed, he concluded.
Istrate and Crippen echoed Anthony's comments, and offered their own perspectives on what states need to do to improve health and human services. For counties, Istrate said the issue was better coordination around mental health issues and Medicaid expansion. For Crippen it was also health care, which he said was the number one issue for governors, and that states have a lot of legislative work to do around cost containment, health care education and training, health insurance and the healthcare workforce.
Both Istrate and Crippen mentioned the need for intergovernmental partnership, expressing their support for NLC's position that an effective multi-tiered partnership is the only way to develop an effective health care and social services system, and the only way to ensure that any response to a crisis is effective.
The plenary session ended with questions that focused on health information exchanges (a solution in search of a problem) and better funding for the public health infrastructure (local leaders will have to take the lead and do what is necessary to ensure that health departments have the resources they need).