Legislation Related to Health Care and the Role of Government at Different Levels

Factors Influencing Legislation:

• Federal policies play a significant role in shaping health care practices and influencing state and local government actions.
• Coordination of services often occurs under the umbrella of the Department of Health and Human Services (HHS), ensuring that different levels of government work together to provide health services.

Government’s Role in Health Policy:

1. Local Level:
   • Local Health Departments (LHD):
     • Funded by state-level allocations and local taxes, often supplemented by federal funds.
     • Primary focus is on the health of local citizens, implementing community-level programs.
     • Responsibilities include identifying and meeting the health needs of the community, offering a range of services and programs, and working closely with local officials, businesses, and stakeholders.
     • Local health departments report notifiable communicable diseases to the state health department.
     • Nurses in local health departments serve in roles such as caregiver, advocate, case manager, counselor, educator, outreach worker, disease surveillance expert, community mobilizer, and disaster responder.
     • Not all communities have a local health department.
2. State Level:
   • State Departments of Health:
     • Receive funding from state legislatures and federal public health agencies.
     • Manage programs like Women, Infants, and Children (WIC) for low-income families and the Children’s Health Insurance Program (CHIP) for uninsured children who do not qualify for Medicaid.
     • Responsible for establishing public health policies, administering the Medicaid program, and providing support to local health departments.
     • Reports notifiable communicable diseases within the state to the Centers for Disease Control and Prevention (CDC).
   • State Boards of Nursing:
     • Develop and oversee the state’s Nurse Practice Act.
     • Handle the licensure of Registered Nurses (RNs) and Licensed Practical Nurses (LPNs).
     • Oversee nursing education programs within the state.
3. Federal Level:
   • United States Department of Health and Human Services (HHS):
     • Oversees most health-related activities at the federal level.
     • Composed of 11 major agencies and operates under the direction of the Secretary of Health.
     • Funded through federal taxes.
   • Veterans Health Administration:
     • Finances health services for active and retired military personnel and their dependents, operating within the Department of Veterans Affairs.
4. National Level:
   • World Health Organization (WHO):
     • Provides daily information on globally significant diseases.
     • Establishes international standards for antibiotics and vaccines.
     • Focuses primarily on healthcare workforce education, environmental sanitation, infectious diseases, maternal and child health, and primary care.