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State Public Health Enabling Authorities: Results of a Fundamental Activities Assessment Examining Core and Essential Services

Hoss, Aila JD; Menon, Akshara JD, MPH; Corso, Liza MPA

Journal of Public Health Management and Practice: November/December 2016 - Volume 22 - Issue 6 - p 529–536
doi: 10.1097/PHH.0000000000000347
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Context: Public health enabling authorities establish the legal foundation for financing, organizing, and delivering public health services. State laws vary in terms of the content, depth, and breadth of these fundamental public health activities. Given this variance, the Institute of Medicine has identified state public health laws as an area that requires further examination. To respond to this call for further examination, the Centers for Disease Control and Prevention's Public Health Law Program conducted a fundamental activities legal assessment on state public health laws.

Objective: The goal of the legal assessment was to examine state laws referencing frameworks representing public health department fundamental activities (ie, core and essential services) in an effort to identify, catalog, and describe enabling authorities of state governmental public health systems.

Design: In 2013, Public Health Law Program staff compiled a list of state statutes and regulations referencing different commonly-recognized public health frameworks of fundamental activities. The legal assessment included state fundamental activities laws available on WestlawNext as of July 2013. The results related to the 10 essential public health services and the 3 core public health functions were confirmed and updated in June 2016.

Results: Eighteen states reference commonly-recognized frameworks of fundamental activities in their laws. Thirteen states have listed the 10 essential public health services in their laws. Eight of these states have also referenced the 3 core public health functions in their laws. Five states reference only the core public health functions.

Conclusions: Several states reference fundamental activities in their state laws, particularly through use of the essential services framework. Further work is needed to capture the public health laws and practices of states that may be performing fundamental activities but without reference to a common framework.

This article describes a fundamental activities assessment on state public health laws to examine state laws referencing frameworks representing public health department fundamental activities.

Carter Consulting, Inc., contractors with the Public Health Law Program (Mss Hoss and Menon) and Division of Public Health Performance Improvement (Ms Corso), Office for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention, Atlanta, Georgia.

Correspondence: Aila Hoss, JD, Public Health Law Program, Office for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop E70, Atlanta, GA 30341 (ahoss@cdc.gov).

Research conducted for this article was supported by the Oak Ridge Institute for Science and Education. The authors thank Duiona Baker, Lindsay Culp, Lorre Cuzze, Matthew Penn, and Tara Ramanathan for their research and editorial assistance.

The Public Health Law Program at the Centers for Disease Control and Prevention (CDC) cannot provide legal advice on any issue and cannot represent any individual or entity in any matter. The Public Health Law Program recommends seeking the advice of an attorney or other qualified professional with questions regarding the application of law to a specific circumstance. The findings and conclusions in this summary are those of the authors and do not necessarily represent the official views of CDC.

The authors declare no conflicts of interest.

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.