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Departments of Health and Human Services are heroic and collaborative. Unless they aren’t.

Some say our lives are in the hands of our state departments of “Health” and “Human Services.” If so, are heroes or hydras running them?


This fifteen-part series introduces you to the heroic partners you and your community will require to survive and thrive during pandemics and economic disruptions. The articles also provide tips on avoiding the three-headed hydras of apathy, envy and fear, those people in positions of power who are fighting to keep a broken status quo.

Your State Department of Public Health and State Department of Human Services

These two state departments have the capacity to upgrade the health and safety of every state resident. They play a huge role in our daily lives at home, work, on the road and everyplace in between. As we have seen recently, these are departments that have a vital role to play during a public health crisis.

For the general public, the roles of the State Department of Public Health and the State Department of Human Services are vague at best — possibly having something to do with STD clinics, ensuring restaurants are vermin free and printing posters proclaiming that it’s “vaccinate your child month.”

All it takes is a global pandemic for the public to see how invaluable our public health professionals are.

Most people are not aware that the human services department is distinct from the public health department. And, quite frankly, it’s mind-boggling that these two large state bureaucracies are not one tightly coordinated entity focused on a single goal: ensuring the health of every resident, regardless of income level.

The Human Services Department administers the state’s programs funded under the Centers for Medicare and Medicaid services, and it is also in charge of mental health services delivery, so it receives federal funding from Substance Abuse and Mental Health Services Administration (SAMHSA), National Institute on Drug Abuse (NIDA), Center for Medicare & Medicaid Services (CMS) and others.

The Department of Health is responsible for tracking diseases, responding to outbreaks of infectious diseases and coordinating disaster response. It runs a state pharmacy as well as a number of programs aimed at providing disease prevention services (vaccine, injury prevention, hospital infections, HIV/AIDS, etc.). It is a federal grantee from the Department of Health and Human Services (DHHS) sub-agencies: the Centers for Disease Control (CDC) and Health Resources & Services Administration (HRSA).

Calling on Emergency management

You will most likely see on their website programs like Health Emergency Management, Crisis Standards of Care Plan, Hospital Disaster Preparedness Self-Assessment Tool, Pandemic Influenza Operational Plan and Emergency Response Education and Family Emergency Preparedness. What you won’t be able to know, until you dig deeper, is how well staffed and resourced these programs are. You might find in some states that the Healthcare Preparedness and Response is overseen by one person covering an entire county.

Now would be a good time to get very familiar with every helpful sounding department or program referenced on the website and do an informal assessment of just how well-resourced your state department of health truly is. If you are lucky enough to have a county health department with links to Emergency Preparedness, contact the program to see what support for families and communities is actually available.

The departments today and tomorrow

It would take days to explain what these two state entities, guided by two cabinet-level secretaries, do for the public. We are focused both on what they currently do and what they could do in the future — to address a long-standing or emergency public health crisis.

Every state is different. Some have departments of health in every county with robust services and education, while others have only a minimal presence on the county level. Depending on the cabinet secretary, public health entities are, to varying degrees, data-driven and focused on identifying and solving health challenges. One thing they all have in common is that they produce many reports, summits, podcasts and coalitions. And, meetings; they do many meetings.

However, if your governor has appointed result-focused and highly competent cabinet secretaries, with an understanding of health disparities, to run the Department of Health and Health and Human Resources, you are in a very good place. Those staff will be empowered to help you identify resources, connect you with epidemiologists and prevention specialists who support county initiatives that are data-driven and focused on increasing health, safety and resilience.

If departments funded to address health challenges are really data-driven and guided by the social determinants of health, then all their various (though possibly siloed) prevention programming — focused on preventing infection, injury, suicide, drug misuse, teen pregnancy, bullying, violence, STDs and domestic violence and sexual assault — will be working in coordination. They will understand that by addressing health disparities and working in each county to ensure ten vital interrelated surviving and thriving services, they can prevent a wide variety of related health and safety challenges. If you are lucky, you have a health department that has the staff and resources to make every county what we might call “crisis-ready.”

The workforces of the Department of Public Health and the Department of Human Services could, guided by two heroic and collaborative cabinet secretaries, can form a powerful engine leading to increased health equity and access to vital care in each community within each county.

What can public health and human services do at the local level?

First, these are mostly very earnest, community-minded folks. (I have had the honor of working with heroes at the health department.) Second, they are most likely working in a very rigid bureaucracy that is not always known for risk-taking, but they might surprise you. Decades ago, in the middle of the AIDS epidemic, many public health leaders became absolutely brave and fearless — advocating loudly for compassion and care.

Most likely, your Department of Health oversees two very important surveys. From the Youth Risk and Behavior Survey (YRBS) — also called Youth Risk and Resilience Survey (YRRS) in New Mexico — we learn valuable information about middle and high school students. And, from the Behavioral Risk Factor Surveillance System (BRFSS), we also gather vital information about adults and their health experience. Both surveys have the capacity to evolve and to ask questions about vital health issues. (Might there be some new questions to consider in a post-pandemic world experiencing economic free fall?)

In our perfect world, we need to support our Department of Health in working in partnership with county-based organizations that provide the surviving and thriving services that actually keep residents safe from harm. The state entity has the power, if it makes it a priority, to identify a key person/organization in each county and fund a “command center” from which to coordinate the work of survey departments and divisions of epidemiology and response.

In times both calm and chaotic, even a three-person command center team, with experience in public health models of prevention, data and continuous quality improvement, could make huge strides on strengthening the health of county residents.

Connecting with both departments

As for connecting for state leadership, you will have to do your best exploring contacts with local public health and some less-than-easy-to-navigate websites. When you do finally connect, share the goals of the work you are doing, along with the research behind it. Inquire about funding for local initiatives that ensure surviving and thriving services, and do ask about the agency’s capacity to conduct surveys on health disparities and residents’ access to the ten vital services.

A bold vision with visionary leadership

The state departments of health and human services can become a justice league dedicated to the health of every state resident. By combining superpowers, two agencies can ensure a seamless system of care and safety across every county. They can make it a priority that every county has the resources to address all forms of health disparities and any public health crisis. We have been given a wake up call by the pandemic, so we best commit to unprecedented collaboration to be prepared for the next virus.

The future is what we make it. Join the evolution.

Please excuse any typos as I construct an article at 3am on only one cup of Joe. These stories are mine and mine alone. I do not represent any organization here. If one of my illustrations looks like a real human or three-headed hydra, that’s total coincidence. Words and images ©Dominic Cappello but share with everyone you know. Any questions? The future awaits:

A NY Times bestselling author, social justice activist, Oprah guest, co-author of Attack of the Three-Headed Hydras, 100% Community and Anna, Age Eight.

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