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Local public health structure in New York State:
New York State is one of twenty-nine states with a decentralized or largely decentralized public health structure, in which local health agencies are not directly governed and operated by the state agency. This is opposed to the centralized public health structure, where the state government directly governs and operates all local public health agencies.
In New York State, fifty-seven county health departments and the New York City Department of Health and Mental Health provide services at the local level. In twenty eight counties, the local health department is governed by the county legislature. In fourteen counties, the local Board of Health governs the local health department. In eleven counties, the local health department falls under the jurisdiction of both the County Legislature and the Board of Health. In four counties, the County Board of Supervisors is responsible for overseeing affairs at the local health department. In one county, we have the County Executive and the County Legislature governing the local health department.
In addition, twelve local health departments are led by Commissioners of Health. Commissioners are required to be qualified doctors with a combination of a master's degree in public health (or related field) and at least three years administrative experience working in public health. Forty-six local health departments are led by public health directors. Public health directors are required to have at least a master's degree in public health (or related field) and at least three years experience working in public health, or any relevant combination of education and work experience.
Seven local health departments serve counties with a population of more than 450,000 people. Eight local health departments serve counties with a population from between 200,000 and 450,000 people. Forty-three local health departments primarily serve rural areas with populations of less than 200,000 people.
1)All local health departments offer core services such as family health services, diagnosis of health, and disease control and prevention. An extra core service, environmental health, is provided by thirty-seven local health departments.
2)Fifty-three local health departments administer the Early Intervention program.
3)Forty-seven local health departments operate certified home health agencies.
4)Twenty local health departments manage WIC nutrition programs for women, infants, and children.
5)Thirty-two local health departments operate Well Child Clinics.
6)Thirty local departments operate comprehensive diagnostic and treatment clinics.
7)Ten local departments oversee public health laboratories.
How local public health authorities interact with the state authority.
1)The state provides some services not provided by local public health authorities. For example, twenty-one local health departments rely on the New York State Department of Health to provide environmental services to their counties.
2)Local health departments may also work as contractors on behalf of the New York State Department of Health. These local departments may contract to work in Healthy Heart, Tobacco Control, or Lead Poisoning and Prevention programs on behalf of the state.
3)The state may provide monetary aid to local health authorities. Article 6 of the New York State public health law allows for the reimbursement of expenses at the local public health level in five areas: family health, disease control, health education, environmental health, and community health assessment. Reimbursement may also be provided for optional health services such as certified home health agencies, public health laboratories, emergency medical services, or some types of environmental health services.
4)The New York State Department of Health has established partnerships with a variety of community health partners to tackle local health priorities. To that end, the state has awarded grants to local health departments for the purposes of establishing these community based partnerships.
5)The Internet-based and web-enabled applications of the Health Provider Network (HPN), Health Information Network (HIN), and the Health Alert Network (HAN) provide an enterprise-wide, central database for the sharing of data, information, and knowledge, from physicians' profiles and hospital records to surveillance of deadly diseases, for example.
6)The New York State Department of Health has established a partnership with the State University of New York at the Albany School of Public Health to facilitate continued training of medical personnel at the local level.
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