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Dan was recently employed as a public health nurse (PHN) by a county health department. After two months on the job, he is asked to assist other PHNs in responding to a recent outbreak of measles. All confirmed cases to date are in the Somali population. Unfortunately, the Somali communities have been targeted with misinformation about vaccine risks and have subsequently struggled with low rates of MMR immunization.
Dan has never worked for the government. Through the orientation process, he begins to wonder whether he will ever understand how the different levels of government work together. He refers to his orientation materials for Population-Based Public Health Nursing Competency #5, which focuses on working with governmental systems. He comments to his supervisor, Carol, “This competency has so many parts. How will I ever understand what all these terms mean for the work I am doing?”
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DAN'S NOTEBOOK: COMPETENCY #5 Works Within the Responsibility and Authority of the Governmental Public Health System
Describes the relationship among the federal, state, and local levels of public health system
Identifies the individual's and organization's responsibilities within the context of the Essential Public Health Services and Core Functions
Understands practice implications for laws, regulations, and rules relevant to public health
Adheres to legal mandates such as data privacy and mandated reporting
Differentiates the public health model from the medical model
Understands the independent public health nursing role as described in the Scope and Standards of Public Health Nursing
Describes the role of government in the delivery of community health services
Identifies components of the healthcare system:
Funding streams such as Medicare, Medicaid, Prepaid Medical Assistance Plan (PMAP), categorical grants
Programs utilized by state and local health departments, such as Women, Infants, and Children (WIC) program, home visiting, and school health
Community resources
Source: Henry Street Consortium, 2017
USEFUL DEFINITIONS Funding Stream: Source of revenue for public health programs and services.
Local Public Health Department: An “administrative or service unit of local or state government concerned with health, and carrying some responsibility for the health of a jurisdiction smaller than the state” (National Association of County and City Health Officials [NACCHO], 2016, p. 12).
Medical Model: Focuses on the individual; concerned with restoring health for individuals who seek care.
Public Health Infrastructure: The underlying framework for the public health system, which includes: 1) a qualified workforce, 2) up-to-date data and information systems, and 3) capable agencies for assessing and responding to public health needs (Healthy People 2020, 2017b).
Public Health Model: Focuses on the health of populations; concerned with promoting, protecting, and maintaining the health of every citizen.
Statutory Authority: A set of rules or a statute that gives an agency authority to determine rules to carry out assigned duties (Minnesota Department of Health [MDH], 2016).
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Taking Responsibility for Improving Population Health
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PHNs work in all levels of government; in urban, ...