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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 needs to assist other PHNs in COVID-19 pandemic response work. All confirmed COVID-19 cases require contact investigation and tracing. In addition, community vaccination clinics are under way. Coordinating this work at the local and state levels is important because the pandemic response involves numerous roles and duties for local public health, and partnering with state agencies to handle the many demands is critical.
Dan has never worked for the government. During 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. Dan 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 systems
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 (American Nurses Association [ANA], 2022)
Describes the role of government in the delivery of community health services
Identifies the components of the healthcare system:
Funding streams such as Medicare, Medicaid, prepaid medical assistance plan (PMAP), and categorical grants
Programs utilized by state and local health departments such as Women, Infant and Children's (WIC) program, home visiting, and school health
Community resources
Source: Henry Street Consortium, 2022
USEFUL DEFINITIONS Funding Stream: Source of revenue to support implementing 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” (NACCHO, 2019, p. 12).
Medical Model: Focuses on the individual; concerned with restoring health for individuals who seek care; the majority of services are midstream and downstream at the secondary and tertiary levels of prevention (Magnan, 2017).
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 2030, 2020b).
Public Health Model: Focuses on the health of populations; concerned with promoting, protecting, and maintaining the health of every citizen. Primary prevention at the upstream level is stressed, although secondary and tertiary services are ...