Evolving roles of public health nurses in the implementation of the Affordable Care Act

Public health nurses (PHN) are the largest occupational group of public health workers and central to the delivery of essential services. Traditionally, PHNs concentrated on sanitation and communicable disease. Currently, PHNs focus largely on preventing and managing chronic illness. As public health priorities have changed, nursing has transformed to meet the needs of the population. Since the passage of the Patient Protection and Affordable Care Act (ACA) in 2010, the PHN workforce is evolving to address the opportunities and challenges it affords.

Dr. Georges Benjamin, Executive Director of the American Public Health Association, described expected changes with the implementation of the ACA. Expanded insurance coverage will change clinical services provided by governmental public health agencies, transferring some to the private sector. New delivery system models, such as Accountable Care Organizations and medical homes, will allow for integration of population health principles into primary care. Finally, traditional public health services such as home visiting programs and health care linkage services can be made more widely available.

This presentation will examine recommendations of the American Nurses Association, the Institute of Medicine, and the American Public Health Association for the optimization of PHN roles under the ACA. Examples of successful models of PHN services will be presented.