Abstract

An Overview of Public Health Services in Nevada

John Packham, PhD, Associate Dean, Office of Statewide Initiatives, University of Nevada, Reno School of Medicine. Past President, past APHA Affiliate Representative, and current Policy Director, Nevada Public Health Association.

APHA 2022 Annual Meeting and Expo

In Nevada, local public health services in urban areas of the state are provided by the Southern Nevada Health District (Las Vegas, Clark County), Washoe County Health District (Reno, Sparks, and Washoe County) and Carson City Health and Human Services. In contrast, public health services in Nevada’s fourteen rural and frontier counties are administered by the State’s Division of Public and Behavioral Health in the Nevada Department of Health and Human Services. Additionally, in rural areas of Nevada, public health services are governed by county boards of health comprised of county commissioners, the local sheriff, and a local health officer. In contrast, urban public health services are governed by district boards of health comprised of two members from each county, city, or town that participated in creation of the district who are appointed by their respective governing bodies and a physician licensed in the State of Nevada. In Nevada, a seven-member, Governor-appointed State Board of Health is supreme in all non-administrative health matters in all jurisdictions.

Abstract

Case Study-Struggles of a Rural County in Nevada and the Impact of COVID-19 on the Development of Public Health Infrastructure

Gerald Ackerman, Bachelors of Behavioral Science and Health, Masters of Science in Health Education University of Nevada, Reno School of Medicine

APHA 2022 Annual Meeting and Expo

April 24, 2022

APHA Health Administration Abstract Proposal November 2022

Section: Seeking solutions that positively impact the health of the communities in which we live, work and play.

Topic Area: Partnerships for Improving Healthcare Services, Delivery and Outcomes.

Presentation Title: Case Study-Struggles of a Rural County in Nevada and the Impact of COVID-19 on the Development of Public Health Infrastructure

Presenter: Gerald Ackerman, Assistant Dean, Rural Health; Director, Nevada State Office of Rural Health; Director, Nevada AHEC Program School of Medicine, Office of Statewide Initiatives University of Nevada, Reno School of Medicine

Abstract
The Nevada State Office of Rural Health is in a unique position in which its Office is located in a Rural County in the Northeastern Nevada. Over the years, the State Office has worked with the county on the development of a health department/district. This process came close to the formal organization and then came COVID-19. With political changes and the onset of the pandemic, the challenges of not having a formalized district became evident. This county struggled both politically and structurally in meeting the challenges brought on by the pandemic. Infrastructure had to be developed utilizing local resources, clinics, hospital and school districts. Although the county did meet many challenges, the one challenge that was not met was the steps lost on the development of the local health department/district. This challenge was not due to the lack of need, but to the issues of county resistance to control measures put in place by the CDC and State Health Department.
The County Health Officer, School Boards and other elected officials were provided challenges throughout the pandemic and although the Counties board of health still meets, the process of moving towards that health district will require a new round of education with newly elected officials, county leaders and other key decision makers. The county even declined a grant to support this development because of the funding source and the vocal negative influence of a small but organized group of citizens.
Attendees in this section will explore how the pandemic has taken a county that once was close to developing a health department/district and through the impact of pandemic and political challenges delayed and stopped the process. The session will provide a case study of how one counties response to the pandemic has negatively affected public health infrastructure from occurring.

Abstract

Navigating a Path Forward for County-level Public Health Infrastructure in Nevada

Taylor Allison, MBA Nevada Association of Counties (NACO)

APHA 2022 Annual Meeting and Expo

Following the height of the COVID-19 pandemic, community leaders and policymakers in Nevada recognize the need to build capacity and/or reform various levels of public health infrastructure where appropriate to lessen the impacts of emerging public health threats and future pandemics. While Nevada’s hybrid State/local government public health system faces many challenges with limited capacity and resource deficits, cross-sector stakeholders are determined to navigate a path forward that meets the increasing demand for services. Nevada’s county governments evaluated baseline public health infrastructure as mandated services in Nevada law and compared those services to foundational program areas recognized by the Public Health National Center for Innovation’s Foundational Public Health Services. The Nevada Association of Counties consulted with Nevada’s 17 counties to evaluate each community’s unique needs based on the Bipartisan Policy Center’s Public Health Forward six core areas: Laws and Governance, Financing, Community Engagement, Partnerships, Workforce, and Data and Information Technology.

The baseline assessment resulted in tailored solutions and recommendations for each of the six core areas. County governments are utilizing the results to explore the establishment of local health districts and cross-jurisdictional collaborations. To move forward with implementation of local health districts, counties will need to follow the process outlined in Nevada Revised Statutes and Nevada Administrative Code including submitting a proposal to the Governor’s Office to carry out services that are currently being provided through the State of Nevada and funded by county assessments.

Abstract

Developing a Rural/Frontier District Health Department in Nevada

Marena Works, MSN, MPH, RN University of Nevada, Reno, School of Medicine

APHA 2022 Annual Meeting and Expo

In Nevada, the lack of local public health services and trained workforce became evident at the start of the Covid-19 pandemic as there was not the infrastructure to set up testing and vaccine stations. In the rural and frontier areas the public health cause was taken up by either social services directors or county managers. While they did a stellar job in some counties, others were not so fortunate and suffered a severe lack of access to testing and later vaccination sites. County employees worked overtime, but it was especially difficult on the staff who were also learning foundational public health along with communicable disease control. Nevada has two health districts, formed in the 1960’s and 1970’s, in its two largest population centers, and one local health department formed in 2003. The majority of Nevada geography has services performed to some degree by the state health division, leaving many areas lacking public health infrastructure.
Nevada has taken the opportunity with current grants, such as the CDC workforce funding, to pursue the best way to expand the public health workforce in rural and frontier areas of the state and Churchill County grasped this money and other revenue sources to examine the feasibility of developing a four-county district health department. A workgroup was formed that included a county commissioner from each county, to develop a plan and work through the process Nevada set up for a new health district. This will be the first health district in Nevada to join county to county and the first rural/frontier health district.