By Terri Lewis, PhD.
2017 has been a frustrating year for the chronic pain community, especially as the government crackdown on opioid prescribing has taken hold. The lack of alternatives to reducing opioid prescribing has many patients and their families struggling. Terri Lewis, PhD, has issued a call to arms for chronic pain community to fight back. In Step 1, which we published in November, she outlined some suggestions for how to get involved. Her series continues.
Step 2 - Understanding the System in Which Your Healthcare is Organized
Health care is organized within a system of states. In order to draw down federal dollars earmarked for public health, each state files a plan with the federal government that is essentially a working plan. This plan is developed for the purpose of linking the commitment of each state to the plan for delivery of health services.
These plans are updated periodically. They reflect federal legislative objectives and a commitment proposed by the state as to how the state will meet the obligations associated with the drawdown of federal program funding and legislative matching dollars.
So, let’s walk through the process of becoming familiar with your state’s plan for public health. Begin with the organization of your state public health program. Examine these links to state resources closely. Copy and paste them into your files tabs on your Facebook, Twitter groups, and blogs to make sure that your collaborators have access to the information found on these weblinks:
- Review these state health organizations & links
|Association of State and Territorial Health Officials||https://www.astho.org/
|American Public Health Association
|State health system performance scorecards||https://www.commonwealthfund.org/interactives/2017/mar/state-scorecard/|
|Federation of State Medical Boards
The state scorecards track 40 public health indicators. Review these indicators and see how your state shapes up. My state scorecard is located at this link: https://datacenter.commonwealthfund.org/scorecard/state/44/tennessee/?_ga=2.262933647.2027253234.1513949097-623044024.1513949097
As you can see, we are ranked 40 out of 50 states in the overall indicators of well-being. As a nonexpanded Medicaid state, we acutely feel the influence of lack of access to care for more than 260,000 Tennesseans.
- Review your state health department organizational chart and locate the telephone and email addresses by key personnel and program areas -
- Now, using my state, Tennessee as an example, take a cruise through your state’s weblinks and if you want to, use my links as an example:
|Tennessee State plan for public health
|2006 State Departmental Plan||https://www.tn.gov/content/dam/tn/health/documents/DepartmentalPlan06.pdf|
|State plan for public health 2016 update||(https://www.tn.gov/content/dam/tn/health/documents/2016_Update_to_the_State_Health_Plan.pdf)|
|State Boards of Medicine
|State Boards of Pharmacy
|State Department of Mental Health and Substance Abuse Services||(https://www.tn.gov/behavioral-health.html)
- Use the notes and information you have collected to begin to prepare to meet with your elected officials and their state office staff. Review this toolkit and begin to organize your thoughts against a future meeting. Develop a plan for your meeting that incorporates references to the information you have found at these links.
|Meeting with your congressional delegation at home: 2017 Toolkit
Keep in mind that your health department meets regularly to review state pain laws, pharmacy and medical board actions, licensure and disciplinary actions. These meetings are subject to sunshine laws and in many cases are livestreamed online. I encourage you to attend these meetings as an observer, to share these links, and to review the material within your state and study groups on social media. Put them into online files, or make 3 ring binders. Use whatever method works best for you.
This is our government and our democracy. It only works if we do. I’ll be looking for evidence that you’re ready for Step 3 – The Legislative framework. Step 4 will focus on the building of working alliances with likeminded citizens and groups. Let me know what you’re learning by checking into twitter and sending me a message at @tal7291!