Wednesday, February 6

2. Wednesday, February 6 / Noon-1:00 PMJuneau State Capitol / Beltz Room 211 The Constitution: Protecting Public Health

4. Constitutional Foundations of Public Health Legislative Health Caucus February 6, 2008 Prepared by Brian Saylor

5. Definitions of Public Health �Fulfilling society's interest in ensuring conditions in which people can be healthy.� (Future of Public Health, IOM) �An organized community effort aimed at the prevention of disease and the promotion of health.� (National Conference of State Legislators, 2002) �Public health affects all of us all of the time.� (Dr. C. Everett Koop, Former Surgeon General) Public health concerns itself with the population as a whole. Health care provides services to individual consumers

6. Examples of Public Health Successes Vaccinations Motor vehicle safety Safer workplaces Control of infectious diseases Decline in deaths from coronary heart disease and stroke Safe food supply Healthier mothers and babies Family-planning Better oral health through fluoridation of water supplies Recognition of the dangers of tobacco use

7. The impact of public health successes Increased the average lifespan by nearly 30 years during the past century Behavioral and environmental risk factors have replaced infectious diseases as the leading causes of premature death smoking poor diet lack of exercise increased pollution stress and unsafe sexual practices

8. Federal Government Responsibility for Public Health Health does not appear in the US Constitution �Protect and provide for the general welfare� (Preamble and article 1 section 8) Regulate Commerce (article 1 section 8) Federal ability improved through 16th Amendment: ability to levy federal taxes

9. Article VII of the Alaska Constitution: Health, Education and Welfare �The legislature shall provide for the promotion and protection of the public health.� One of the shortest sections of the Constitution Non controversial

10. Public Health Law after IOM Assessment To regularly and systematically collect, assemble, analyze and make available information on the health of the community Policy Development Informing, educating and empowering the people about health issues Mobilizing community partners to identify and solve health problems Develop policies and plans that support individual and community health efforts Assurance To assure constituents that services necessary to achieve agreed upon goals are provided either by encouraging actions by other entities or requiring such actions through regulation or providing services directly

11. Alaska Public Health Law Reform Public Health Authority and Powers Article 6 of Title 18: Health, Safety and Housing Implemented many of Future of Public Health recommendations

12. Protecting Public Health: Concerns of Our Constitution Katie Hurley

13. Katie Hurley Former: Chief Clerk to the Alaska Constitutional Convention State Senate Secretary Executive Director, Alaska Status of Women Chair, Alaska State Commission on Human Rights President, State Board of Education

15. Delegate R. Rolland Armstrong �These are important parts of our living day by day, and when we say the promotion of the protection of public health, we weighed those words. [�] and I think we put them in there because of the philosophy that we held that these departments should carry out.� --January 9, 1956

16. Delegate George Sundborg �I ask the delegates to note that Section 2 says, "The State shall", so that means one thing. Section 3 says "The State may". If we knock them out, as Mr. Buckalew suggests, it may be that the state has the power to do such things, but the legislature may either do it or not at its discretion. But if we leave them in the legislature must provide for the promotion and protection of public health.� --January 9, 1956

17. Providing for the Public Welfare PRESIDENT EGAN: The Chief Clerk will please read the proposed amendment. CHIEF CLERK: "Strike all of Section 3 and substitute the following: 'The State may provide for the public welfare.'" ARMSTRONG: I am afraid that that phraseology is far too broad and you are saying "for the public welfare" but the connotation does not tie it down to the establishment of a department, and it does not give the instructions as to the philosophy we have here in mind. I think that you need the retention of this section. The amendment to strike this language failed.

24. A History of Alaskan Nursing Elfrida Nord, RN, MS

25. Elfrida NordRN, MS Scholar on the History of Nursing in Alaska Former: Nurse, Indian Health Services in Bethel Public Health Nurse Chief Public Health Nurse, State Department of Health and Social Services

33. John O. Riley Physician Assistant and Medical Co-Director at Anchorage Neighborhood Health Center and UAA�s PA Program Coordinator

36. Health in the Hinterlands Paul Hansen

37. Paul Hansen Health Services Administrator, Maniilaq Health Center, Kotzebue

38. Tele-Cart, Telemedicine Hookup at Maniilaq Health Center The medical center incorporates 17 acute care beds, three delivery rooms, a laboratory, radiology, emergency treatment areas, and large outpatient areas for dental, medical care, and counseling.

39. The health center also provides service to rural residents, with specialty clinics one to six times a year, with itinerant doctors providing orthopedic, pediatric, urology, cardiology, dental, and other services.