Local health departments (LHDs) have served as important providers of services to the uninsured or underinsured. However, there are indications that LHDs' capacity to serve as safety net providers is eroding. Our recently completed survey of LHDs revealed qualitative information about LHDs' changing role in the provision of safety net services, but did not provide systematic quantification or description of these changes. Therefore, we are conducting telephone interviews with a nationally representative sample of LHD directors to study recent changes in the capacity and role of LHDs as safety net providers. Combining qualitative data with quantitative information, we examine the effect of various state policies, especially Medicaid managed care, on LHDs' capacity and role as a safety net providers of Primary Care, Maternal and Child Health, and HIV services. One hypothesis is that the more that the proportion of Medicaid beneficiaries enrolled in managed care has increased, and the more that overall Medicaid enrollment has dropped, the lower LHDs' Medicaid revenue, and thus the more difficulty LHDs have in serving the uninsured. We examine LHDs' capacity and role as safety net provider of care, including how LHDs' assure provision of these services when they do not directly provide them. Interest in this topic arises at a time when many LHDs are making decisions about their ongoing role in the direct delivery of personal health services. The study examines those decisions and how they are influenced by LHD directors' professional and managerial beliefs. HRSA is the sponsoring agency for this research.
Learning Objectives: To understand local health departments' changing role in the provision of safety net services.
Keywords: Local Public Health Agencies, Safety Net Providers
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.