GLORIA BUTLER BALDWIN

At last, the outdated public health system is getting a much needed facelift.
In June, Orlando hosted the The Academy Health Annual Research Meeting focusing on “State Public Health Law Modernization: Assessing the Impact of the Turning Point Model State Public Health Act (Turning Point Act).”

As of August, it was revealed that 33 states have introduced a total of 133 legislative bills or resolutions regarding the Turning Point Act and 48 of those have passed.

Ironically, Florida isn’t one of those states.

The Turning Point Model presented by the Public Health Statute Modernizations Excellence Collaborative and funded by The Robert Wood Johnson Foundation, was an effort to develop a tool for governments to use to improve their public health statutes. The model language is intended as a way for governments to assess their existing public health laws and identify changes needed to incorporate newer methods in providing a more effective public healthcare system.

Numerous attempts have been made to streamline and update the public health system since the 1980s, but no standard model has been adopted across the board.

Until now.

Turning Point is one of five National Excellence Collaboratives that focus on strengthening certain aspects of the country’s public health system, which includes information technology, performance management, social marketing, and leadership development.

James G. Hodge, Jr., executive director of the Centers for Law and the Public’s Health at Johns Hopkins and Georgetown universities, was one of the drafters of the Turning Point Act.

“My role now is to help states understand the act and how it’s being used at the state and local levels.” Hodge explained. “This act was completed in September 2003. At that time, there was a massive campaign to inform states about the act and its various provisions. Although these initial efforts are geared down now, the act is still actively used. The Turning Point Act was not written for the short term; it was drafted for the long term and continues to be used across the nation.”

Benjamin Mason Meier, Columbia University Public Health Law Project Manager, Center for Health Policy, said Turning Point began with a collaboration of academics, non-profits like the American Cancer Society and the American Lung Association, public health advocates, and attorneys from five participating states. Those states have taken active ownership, but many more have followed suit.

“I think the reasons some states haven’t used it is state-specific,” Meier said. “The five states that participated in the beginning applied to The Robert Wood Johnson Foundation to take part in one of the collaboratives. Those states came together over a period of three years to develop this act. At that time, The Robert Wood Johnson Foundation created a book, announced it and sent them out to all public health players across the country. States were told and they knew.”
Meier said the Turning Point Act model is to use as a template for states when drafting their own public health legislation.

“This is based on the Institute of Medicine earlier report that public health law revitalization was vital to promote and protect the public health infrastructure, with the understanding that states needed to modernize their laws,” said Meier. “A lot of states lacked the capability. States can draw upon the Turning Point Act model at any time they want. They can take a sentence out of it; take the whole thing or just part of it in developing their laws. The idea is that this is what a comprehensive public health law should look like. If you’ve got a model of what a number of states have done, it makes it easier for you to draft your own. Look at the language and see … does this language work for our state? How can we tailor this to meet the needs and circumstances for our state? In states that are interested in public health law reform, this is a valuable tool giving them language they can use when going to their legislators and say this represents the best practices from a number of states. The Turning Point Health Act has been modernizing their public health laws. It sets a valuable precedent.”

Amy Lew Alexander, spokesperson for the Florida Department of Health (DOH), said because Florida has not participated in the Turning Point Act, DOH does not have a subject matter expert at the state level to address the issue. However, she did provide information on what the state is doing to promote public health.

In the 2007 session, 12 bills were passed by the Florida legislature that affects the DOH. Among those were SB 1034-Public Records/Physician Workforce Surveys that provides an exemption from Florida’s public records law for all personal identifying information held by the DOH in response to a physician workforce survey collected. HB 1155 requires the Agency for Health Care Administration to promote the process and advantages of electronic prescribing to healthcare practitioners, healthcare facilities, and pharmacies. It also makes several changes to the laws relating to dispensing of controlled substances, such as requiring the DOH to develop a counterfeit-resistant prescription blank to be used voluntarily by prescribing practitioners and provides third degree felony penalties for intentionally possessing counterfeit-resistant prescription blanks for unlawful purposes.

Dr. Kevin Sherin, director of the Orange County Health Department, who is familiar with the Turning Point Act, said diseases “don’t respect political boundaries or public health laws.

“Updating public health laws and making them more uniform appears to be in everyone’s interest,” he said. “Because what’s paramount and most important to us is doing whatever we can to protect the public’s health.”

To learn more about the Turning Point Act and how it’s being used, visit www.publichealthlaw.net.




December 2007