142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

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Libby, Montana: A model for successful community influence on federal health policy

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 3:10 PM - 3:30 PM

Tracy McNew, LPN, MPA , Center for Asbestos Related Disease, Libby, MT
Tanis Hernandez, M.S.W. , Center for Asbestos Related Disease, Libby, MT
Rebecca J. W. Cline, PhD , School of Communication Studies, Kent State University, Kent, OH
Michelle Boltz, NP-C , Center for Asbestos Related Disease, Libby, MT
Objective: Provide a model for local/community perspective’s influence on federal public health policy. Background: Geographically isolated in northwest Montana, Libby is the site of the only EPA-declared Public Health Emergency.  In 1999, media reported widespread health effects of decades-long exposure to particularly toxic asbestos originating from local vermiculite mining operations.  In 2000, as government agencies (i.e. EPA, ATSDR) investigated, the Center for Asbestos Related Disease (CARD) was formed to meet healthcare needs of people with asbestos related disease (ARD).  CARD’s mission is to provide healthcare, engage in political activism and patient advocacy, promote research, and enhance community support systems. Methods: CARD coordinated with community partners advocating for local stakeholders.  Subsequently, county and state government officials engaged with CARD to represent local stakeholders’ perspectives in federal policy formulation. Results: Over 14 years, this integrative approach resulted in significant federal health care policy outcomes,  including  a provision for Libby, MT in the Affordable Care Act that provides access to Medicare for patients diagnosed with ARD from Libby asbestos exposure regardless of their age;  and a Medicare Pilot Program that provides free medically-necessary care not covered by Medicare.  Additional policy outcomes include federally grant-funded free asbestos health screening and federal research funding secured by academic partners. Conclusion: Policy outcomes contribute to ensuring health care access and building a knowledge base that will influence EPA clean-up processes and enhance medical and psychosocial understanding and interventions for Libby and beyond. The Libby case serves as a model for other communities responding to similar environmental disasters.

Learning Areas:

Advocacy for health and health education
Occupational health and safety
Public health administration or related administration
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
Describe how local perspective about Libby Montana's environmental health disaster successfully influenced national health policy. Discuss strategies that led to successful community, county, and state engagement in development of national health policy. List successes from a community perspective on how public health policy met the needs of local stakeholders in Libby, Montana's public health emergency.

Keyword(s): Advocacy, Federal Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I manage the clinical care of patients and implementation of research projects at the Center for Asbestos Related Disease in Libby, MT. I have been directly involved in advocacy for local stakeholders, working with politicians and government agencies, health screening program implementation, and applying for and implementing research projects in the Libby community with academic/agency partners. I am also a nurse and have a masters degree in Public Administration from the University of Montana.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.