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2022 SESSION

22103635D
SENATE JOINT RESOLUTION NO. 14
Offered January 12, 2022
Prefiled January 11, 2022
Directing the Joint Commission on Health Care to study the Commonwealth's public health system. Report.
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Patron-- Mason
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Referred to Committee on Rules
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WHEREAS, in the Commonwealth, the provision of public health services is a partnership between the state and localities, with the Department of Health responsible for planning, oversight, and management of public health activities and local health districts responsible for the operation of local health departments for the delivery of public health services; and

WHEREAS, every locality in the Commonwealth is required to establish and maintain a local health department to provide basic public health services; local governing bodies may choose to operate independent health departments in accordance with the policies of a local board of health or may enter into a contract with the State Board of Health for operation of a local health department; and

WHEREAS, whenever, in the opinion of the State Health Commissioner, the operation of any local departments operated under contractual agreement with the Board of Health may be accomplished in a more efficient and economical manner by the consolidation of such local health departments, the Commission may propose the creation of a district health department composed of such local health departments; and

WHEREAS, currently, public health services are delivered through 35 local health departments serving local health districts that serve anywhere from a single to as many as 10 localities. Thirty-three of the 35 health districts are operated pursuant to a contract with the Board of Health, while two are operated independently; and

WHEREAS, service delivery models vary among local health districts, with some local health districts employing staff to provide services directly to clients while others contract with individual providers or nonprofits to ensure delivery of public health services; and

WHEREAS, while all local health districts provide a core of services, including communicable disease control, family planning, food establishment inspections, permitting of onsite sewage systems and well construction, and emergency preparedness, local health districts often provide additional services to meet the unique public health needs in the area served; and

WHEREAS, funding for local health districts is a mix of federal, state, and local funds, with the amount of funding available to local health districts and local match rates for localities participating in local health districts varying substantially; and

WHEREAS, during the COVID-19 emergency, local health departments played an important role in the Commonwealth's response, working to monitor and collect important data and information about public health and the spread of COVID-19, provide information regarding the prevention, diagnosis, and treatment of COVID-19 infections, provide testing and vaccinations, and provide other important health services to members of the public; and

WHEREAS, variations in size, organization, operation, oversight, funding, and services create significant challenges for the Commonwealth's local health districts impact local health districts' ability to respond to both the COVID-19 public health emergency and ongoing public health needs; now, therefore, be it

RESOLVED by the Senate, the House of Delegates concurring, That the Joint Commission on Health Care be directed to study the Commonwealth's public health system. Specifically, the Joint Commission on Health Care shall study (i) the current structure, operation, oversight, and funding of the existing public health system, and the local health districts and departments that compose the system, to understand how the current structure, operation, oversight, and funding impact access to and the quality of public health services in the Commonwealth and (ii) the response of the Commonwealth's public health system to the COVID-19 public health emergency in order to understand how the current structure, operation, oversight, and funding of the public health system impacted the ability of local health districts and local health departments to respond to the COVID-19 public health emergency and to identify areas of success and areas for improvement in such public health response in order to inform the Commonwealth's preparation for and response to future public health emergencies.

In conducting its study, the Joint Commission on Health Care shall (i) evaluate the structure, operation, oversight, and funding of local health districts and local health departments that make up the Commonwealth's public health system, (ii) determine the effectiveness of the current public health system in meeting ongoing public health needs as well as public health needs arising in response to public health emergencies, and (iii) develop recommendations for changes to the structure, operation, oversight, and funding of the local health districts and local health departments that make up the Commonwealth's public health system to improve the ability of the system to meet ongoing public health needs and public health needs arising in response to public health emergencies.

Technical assistance shall be provided to the Joint Commission on Health Care by the Department of Health. All agencies of the Commonwealth shall provide assistance to the Joint Commission on Health Care for this study, upon request.

The Joint Commission on Health Care shall complete its meetings for the first year by November 30, 2022, and for the second year by November 30, 2023, and the chairman shall submit to the Division of Legislative Automated Systems an executive summary of its findings and recommendations no later than the first day of the next Regular Session of the General Assembly for each year. Each executive summary shall state whether the Joint Commission on Health Care intends to submit to the General Assembly and the Governor a report of its findings and recommendations for publication as a House or Senate document. The executive summaries and reports shall be submitted as provided in the procedures of the Division of Legislative Automated Systems for the processing of legislative documents and reports and shall be posted on the General Assembly's website.