One of the most exciting prevention reforms included in the Affordable Care Act is the National Prevention, Health Promotion, and Public Health Council. The full Council, which met for the first time this week, is composed of cabinet officials (see list below) and is chaired by the Surgeon General, Regina Benjamin. With such high-level involvement, the idea is to elevate the status of prevention in federal activities, and foster collaboration throughout agencies.
Members of the Council are:
(1) the Secretary of Health and Human Services;
(2) the Secretary of Agriculture;
(3) the Secretary of Education;
(4) the Chairman of the Federal Trade Commission;
(5) the Secretary of Transportation;
(6) the Secretary of Labor;
(7) the Secretary of Homeland Security;
(8) the Administrator of the Environmental Protection Agency;
(9) the Director of the Office of National Drug Control Policy;
(10) the Director of the Domestic Policy Council;
(11) the Assistant Secretary for Indian Affairs;
(12) the Chairman of the Corporation for National and Community Service; and
(13) the head of any other federal agency that the chairperson determines is
The Council is tasked with submitting an annual report to Congress and the President. This year’s report was released in July: http://www.hhs.gov/news/reports/nationalprevention2010report.pdf
The Council is also charged with writing a National Prevention and Health Promotion Strategy, which is due before the one year anniversary of the signing of health reform.
At this point, the Council is in the formative stages. Designees from each of the member agencies have met on several occasions to develop a framework for the Strategy. This past Wednesday, the full Council met for the first time, at the White House, and reviewed that framework. The full Council will meet again before March in order to finalize the Strategy.
Basically, the Strategy sets goals and the Annual Report outlines progress towards those goals. The law mandates that smoking cessation, proper nutrition, appropriate exercise, mental health, behavioral health, substance use disorder, and domestic violence screenings be a focus of the Council’s activities, as well as taking preventive measures for the 5 leading causes of death in the United States (heart disease, cancer, stroke, chronic lower respiratory diseases, and unintentional injury).
Beyond those explicit directives, there is some philosophical wrangling over how broad to make the Council’s scope. At one extreme is Healthy People, the government’s comprehensive, stakeholder driven set of health objectives which numbered 467 in Healthy People 2010. At the other, are Tom Frieden’s 6 winnable battles, which include: healthcare associated infections, HIV, motor vehicle injuries, obesity nutrition physical activity and food safety, teen pregnancy, and tobacco. What wins out is anyone’s guess.
That’s why DFA can and should get involved in the Council’s activities. There are a couple of ways to do this. First, the White House is fielding nominations for a 25-member Advisory Group, and you can submit your nominations now. Second, you can reach out to the players involved—the Surgeon General’s office, CDC, etc.—to lend your voice. According to the Annual Report, the Council will at some point engage various stakeholders in developing the Strategy, including practitioners with experience in prevention and wellness, but the more proactive you are, the more influence you will have.