Working w/in Health Working w/in Health Departments to Promote Departments to Promote

Harm ReductionHarm Reduction

Larry Cuellar, Texas Department of State Health ServicesRachel McLean, MPH, California Department of Public Health

Emalie Huriaux, MPH, San Francisco Department of Public HealthLaura Thomas, MPP, Drug Policy Alliance

8th National Harm Reduction Conference

November 19, 2010 Austin, Texas

What state and local health departments CAN do

• Fund programs • Validate best practices through guidelines, strategic plans, reports, conferences, research• Work with other government agencies

• Provide health information materials, expertise

• Mobilize communities to solve health problems

What state and local health departments CANNOT do

• Take public positions supporting or opposing: - legislation - budget cuts

- candidates - court decisions• Talk to the media without getting talking points cleared first by office of public affairs

What community-based organizations & individuals CAN do

• Ask for what you want • Hold government agencies accountable• Participate in community planning groups• Educate the press and policymakers • (Take public positions on legislation, etc.)

Ways health departments and CBOs can work TOGETHER

Health department leads Health department supports community

Community supports health department

Community leads

Examples: TEXAS

Why work with the health department?

• Statewide impact

• Access to additional resources

• Information network

• Disease surveillance (special studies)

• Access to epidemiologic expertise

Harm Reduction and the Texas State Health Department

• History of harm reduction initiatives in TX- Condom access- Syringe access- Other programs

• State Health Department policies & procedures- Permissible activities- Gray areas

- Non-permissible activities

Examples of Texas Health Department Activities

• Texas Viral Hepatitis Summits

• Hepatitis education and training activities

• Hepatitis awareness activities

Examples: California

California Adult Viral Hepatitis (VH) Prevention Strategic Plan, 2010-2014

Health department leads- Inviting government reps. (mental health, drug and alcohol, corrections, etc.)- Finalizing plan, coordi-nating implementation

Health department supports community- Drafting the plan

- Convening meetings

- Paying for space, facilitator, travel

Community supports health department- Approval for the plan- Media coverage for plan

Community leads- Sharing plan with media, legislature, policymakers

Plan: Harm Reduction-Specific Recommendations

• Research projects:– Pilot syringe access, safer tattooing in prisons– Pilot safer injection facilities– Effective HCV prevention strategies for young IDUs

• Programs:– Expanded HCV testing, hepatitis A/B vaccine access– Statewide viral hepatitis referral guide– Expanded syringe access programs

• Policies:– Ensure implementation of health reform addresses

health issues of uninsured individuals with chronic VH

Plan Implementation: Programs

Health department leads- Provider education w/ medical associations

Health department supports community- Funding for syringe exchange, HCV testing- Free hepatitis A/B vaccine- Referral guide contacts

Community supports health department- Community advisory group, clinical task force

Community leads- Service delivery- Fundraising to develop statewide VH referral guide

Plan Implementation: PoliciesHealth department leads

- Healthy People 2020 objectives on HCV testing, HBV vaccination- Analysis of health reform-Overview of viral hepatitis costs, epidemiology in CA

Health department supports community- Recommendations to HHS on health care reform implementation and VH

Community supports health department- Appointment, info. requests to CDPH Public Health Advisory Committee

Community leads

- CA Health Policy Forum on viral hepatitis- Syringe access legislation

Examples: San Francisco

What community-based organizations & individuals CAN do

• Ask for what you want • Hold government agencies accountable• Participate in community planning groups• Educate the press and policymakers • (Take public positions on legislation, etc.)

Questions for Discussion

• What has worked well in health department/community collaborations that you have been a part of?

• What surprised you?• What challenged you?• What did you learn?• How will you work differently with your

health department/community partners differently after this presentation?

Contact Information

Larry Cuellar

Adult Viral Hepatitis Prevention Coordinator

Texas Department of State Health Services

TB/HIV/STD Branch MC 1873

P.O. Box 149347

Austin, Texas 78714-9347

(512) 533-3124

Contact Information

Rachel McLean, MPHAdult Viral Hepatitis Prevention Coordinator

California Department of Public HealthSTD Control Branch

(510) 620-6403Rachel.McLean@cdph.ca.gov

www.cdph.ca.gov/programs/pages/ovhp.aspx

Contact information

Emalie Huriaux, MPHSan Francisco Department of Public HealthCommunity Behavioral Health Services &

HIV Prevention Section25 Van Ness Avenue, Suite 500

San Francisco, CA 94102emalie.huriaux@sfdph.org

415-437-4694 ph; 415-431-7154 faxwww.sfdph.org