Displaying 1-20 of 271 results for

Partnering with Legislative Staff to Improve Long COVID Outcomes Partner with Legislators to Improve Long COVID Outcomes Amelia Poulin and Sidnie Christian Learn how health departments can secure legislative understanding and support for Long COVID recovery efforts. Long COVID challenges public health systems, impacting individuals’ health, workforce participation, and community well-being. State and territorial health departments are leading efforts to track, understand, and mitigate the health and economic effects through surveillance, education, and coordinated care initiatives.  To maintain and expand these efforts, health department programs can secure legislative understanding and support. This requires cultivating longstanding, trust-based relationships with legislators and their staff. Strategic engagement helps legislators view health departments as indispensable partners in addressing complex public health issues with broad social and economic implications. Build Longstanding Relationships with Legislative Staff Legislative staff are often the most consistent points of contact in a lawmaker’s office and play a central role in shaping policy advice. Regular engagement strengthens trust and visibility, helps maintain productive relationships, and ensures consistent communication with legislative offices. Health agencies can achieve this by: Engaging early and often: Identify key legislative staff for health department programs to brief on emerging Long COVID data, evolving needs, and program outcomes throughout the year. These conversations provide context and set the stage for trust before policy requests. Over time, they can lead to invitations for health department representatives to provide expert input. Positioning the program as a trusted, nonpartisan source: Health department leaders can provide timely, objective information about Long COVID’s impact on local hospitals, schools, and employers. Demonstrating responsiveness: Following up on constituent inquiries related to Long COVID testing or benefits shows legislators that the health department is directly addressing concerns in their districts.   Program staff can play a key role by developing briefing materials, success stories, and district-level data to share internally with leadership or policy offices for dissemination to legislators.   Note: Health department staff should align engagement with internal communication protocols. They may centralize outreach through a legislative or government affairs office that coordinates messaging and ensures compliance with statutes and lobbying restrictions. Identify Objectives and Tailoring Asks Before reaching out to legislative staff, health department leaders should clearly define their goals (e.g., funding for post-COVID clinics, data infrastructure, or research partnerships). When health departments align requests with legislative priorities, those proposals may seem more feasible or be more likely to gain support. Keys to doing so include: Understanding legislator priorities: Review voting history, public statements, and committee membership (e.g., health, workforce, budget). Identify shared interests such as workforce participation, economic productivity, or small business resilience. Choosing the right messenger: Personal narratives from constituents affected by Long COVID related to the sub-issue (e.g., a small business owner struggling to return to work, a teacher navigating disability benefits, or a parent managing caregiving responsibilities) can be effective. Consider pairing stories with district-specific data to illustrate scope. State health departments can also amplify impact by working with local health jurisdictions to paint a larger picture of how Long COVID impacts communities in the region. For example, drawing connections between workforce impacts across multiple counties can demonstrate to legislators that Long COVID affects the state’s overall economic resilience, not just isolated communities. This approach can help legislative staff see statewide trends and understand how targeted investments could yield system-wide benefits. Crafting the message: Use plain, non-technical language to describe Long COVID (e.g., “lingering symptoms after COVID infection” rather than “post-acute sequelae”). Consider emphasizing economic impacts (e.g., missed work or school days, productivity losses, and long-term disability claims) and framing the health department as a problem solver that helps businesses/families recover and navigate challenges, rather than a requester for resources. Communicate Effectively Legislators are often time constrained. Clear, concise, and locally relevant messages are most effective. To build an effective ask of a legislator’s office, health department staff can: Use their language: Translate public health concepts into legislative priorities (e.g., “economic competitiveness,” “community stability,” “health care access”). Incorporate local data: Share district-level statistics on Long COVID cases or workforce absences, as data allows (e.g., “in your district, an estimated 5,000 workers have missed more than two weeks of work due to Long COVID”). Combine data with moral resonance: Pair values-based appeals (e.g., “every resident and their family deserve the chance to live and work at their full potential”) with supporting evidence (“yet one in four adults in this district continue to experience symptoms six months after infection, limiting their ability to contribute to the workforce and community”). Leave behind resources: Provide one-page infographics or briefing sheets summarizing data and program activities. Follow up to reinforce conversations with updates, success stories, and progress metrics. Anticipate Policy Dynamics and Counterarguments Legislative discussions may surface alternative policy ideas or misconceptions about Long COVID and health agency program roles. Consider preparing for opportunities to: Answer questions: Public health leaders should be prepared to clearly explain the department’s legal authority, the evidence base for Long COVID programs, and the partnerships that support implementation. Consider explaining how scientific research, emerging epidemiologic data, and best practices inform Long Covid programs and how partnerships with hospitals, clinics, and community organizations help ensure effective service delivery. Clear, concise explanations help legislators understand the health department’s scope and role, build credibility, and preempt misconceptions that could undermine support for program priorities. Acknowledge unintended consequences: Demonstrate awareness of policy trade-offs and propose pragmatic solutions. For example: A proposal to expand Long COVID benefits might raise concerns about budget constraints. Health department leaders could suggest phased implementation or pilot programs in high burden areas. Understand alternatives: Be prepared to discuss other proposed interventions and show how the health department’s approach complements them. For example: If a legislator suggests employer-led sick leave policies as the primary solution to Long COVID, the health department could explain that monitoring Long COVID prevalence and providing patient support can help ensure workers’ safe return to their jobs, complementing workplace policies. Leverage rulemaking: When statutory change is limited, use administrative rulemaking and public comment to align implementation with public health intent.   Conclusion Building lasting, credible relationships with legislative staff allows health departments to move from reactive engagement to a proactive strategy. By pairing constituent stories with district-specific data, aligning messages with economic and moral values, and maintaining year-round communication, public health leaders can secure sustained support for Long COVID initiatives. These strategies not only advance Long COVID priorities but also strengthen the overall policy capacity and visibility of public health agencies, positioning them as trusted, solutions-oriented partners in state governance.   article yes

This brief highlights legislative actions that states are taking to remove financial burdens for women who struggle to afford period products and mitigate existing stigma.

Increasing tobacco taxes in states is an effective method for encouraging cessation among youth. This brief outlines leading tobacco taxation strategies implemented by New York state, Washington, D.C., and Connecticut.

State Health Agencies’ Role in Implementing Pharmacist-Prescribed Contraception Health Agencies’ Role in Pharmacist-Prescribed Contraception Sophia Durant, Brittany Lee Learn about three primary barriers to successful implementation of pharmacist-prescribed contraception and actionable solutions. State health agencies lay the groundwork for sustainable and equitable contraceptive access. They play a pivotal role in expanding access to contraception by supporting the implementation of pharmacist-prescribed contraception (PPC). This report walks readers through three major areas for doing so: Mechanisms That Expand Pharmacist Roles in Contraceptive Access: Learn about policy levers jurisdictions can utilize to support pharmacists playing a more active role in contraceptive care, including collaborative practice agreements and standing orders. Payment for Services: Explore legislative, Medicaid, and commercial insurance strategies to address payment for services as a key barrier to PPC programs. Workforce, Education, and Consumer Awareness: Delve into final considerations that can impact the implementation of PPC from workforce development to pharmacy/regional champions and education. Get the Report (PDF) Padding Block - Large Related Content - Report - State Health Agencies’ Role in Implementing Pharmacist-Prescribed Contraception article yes

Learn how Hawaii and Iowa have leveraged policy change to improve overdose prevention.

Responding to Disruptions in Access to Controlled Substance Medications: A Guide for State Health Departments and Their Partners Responding to Disruptions in Access to Controlled Substance Medications astho, association of state and territorial health officials, public health official, state health, territorial health, island areas, island jurisdictions, opioid prescriptions, access to opioid prescriptions, opioid rapid response program, opioid therapy, withdrawal symptom, rapid response, opioid crisis, opioid overdose, mental health, prescription monitoring, united states, discontinuation of opioid, opioid withdrawal, symptoms of withdrawal, opioid use disorder, type of drug, opioid medications, department of health, stop drinking, drinking alcohol, prescription drugs, opioid prescribing, drug withdrawal, opioid pain, physical dependence ASTHO | A guide on responding to disruptions in access to opioid prescription. Responding to Disruptions in Access to Controlled Substance Medications: A Guide for State Health Departments and Their Partners (2025) provides important updates to the 2022 edition and ASTHO’s 2020 document Responding to Pain Clinic Closures: A Guide for State Health Departments. This guidebook reflects the current state and federal landscape regarding disruptions, shares updated recommendations on strategies states might use to mitigate risks to patients affected by a disruption, and includes additional state examples. These updates are informed by the CDC’s Opioid Rapid Response Program (ORRP) and states’ coordinated responses to ORRP notifications since the program was formally established in late 2020, as well as tabletop preparedness exercises ASTHO has conducted with states. Get the Report (PDF) Content Updated - Report - Responding to Disruptions in Access to Controlled Substance Medications website yes

Learn how state health agencies can support brain health and caregiving through policy and innovation.

Learn in this report how Colorado is using policy to address rising syphilis and congenital syphilis cases.

Policy Options to Improve Data Sharing Between State and Local Health Departments Organizational policies on data sharing between state and local public health agencies. This report explores organizational policies related to data sharing between state and local public health departments. ASTHO, in collaboration with the National Association of County and City Health Officials and the Network for Public Health Law developed this report, which aims to serve as a guide for state and local public health leaders as they consider organizational policy options to improve state and local data-sharing efforts. Get the Report (PDF) website yes

Investing in Indiana’s Public Health Infrastructure Through Community-Driven Policy Change public health infrastructure, community driven policy, indiana state health commissioner, public health system, indiana department of health, outpatient facilities, technical assistance, data and information integration, emergency preparedness, child and adolescent health, legislative action, state and local elected officials, health problems, health care, health system, health departments, federal agencies, essential public health services, centers for disease control, state and local levels, health outcomes, health organization, covid-19 pandemic, health infrastructure, promoting health, public health organizations, states public health, federal funding, astho, association of state and territorial health officials Maggie Davis, Keith Coleman Indiana enacts historic public health funding through community engagement and legislative support. In April 2023, Indiana passed bill SB 4, which was a historic investment in the state's public health funding and restructuring its public health system. This case study shares how the Governor's Public Health Commission and the Indiana Department of Health approached community listening sessions, formulated recommendations, and successfully built legislative support to reform the public health system in the state. Get the Report (PDF) website yes

This ASTHOReport highlights the public health importance of three harm reduction policies and practices to reduce overdoses: facilitating community distribution of naloxone, facilitating community distribution of fentanyl test strips, and overdose prevention centers.

This product identifies strategies for preventing ACEs, the role of public health in ACEs across levels of government, and policy development strategies to inform ACEs prevention.

This report focuses on promising strategies in four different policy areas to address rising congenital syphilis rates. While no single policy solution will address the structural challenges to diagnosing and treating syphilis among people who are pregnant, public health leaders can leverage several policy options that may reduce barriers to care.

This report identifies and breaks down seven core value areas that emerge from taking a health in all policies approach to policymaking and programming.

This report analyzes way that public health officials can mitigate the impact of disasters on pregnant people, neonates, and infants through a variety of policies, including policies related to preparing for, responding to, and recovering from a public health emergency.

Breastfeeding is considered the gold standard in postnatal care for both birthing persons and infants. Yet racial disparities in breastfeeding initiation and duration rates continue to persist. Effective intervention strategies require a multi-level approach that includes comprehensive legal, policy, and programmatic efforts.

Impact of the Advisory Committee on Immunization Practices Recommendations on State Law Impact of the ACIP Recommendations on State Law Learn about the impact of ACIP recommendations on state law related to immunizations, insurance coverage, vaccine administration, and more. The Advisory Committee on Immunization Practices (ACIP) was formed in 1964 to “provide ongoing expert advice to the [HHS] Secretary on federal immunization policy.” Today, ACIP makes recommendations to CDC about vaccines with a focus on the control of vaccine-preventable diseases. ACIP recommendations help inform clinical and public health practice and include: “(1) the age and other population groups (e.g., by sex, occupation) recommended to receive that vaccine; (2) the recommended age or frequency to receive each dose and the interval between doses (for multidose vaccines); and (3) any precautions and contraindications.” The CDC director reviews ACIP’s recommendations and decides whether they should be formally adopted. While ACIP recommendations are just that, recommendations and not requirements, they have a far-reaching impact on vaccine policy with nearly 600 statutes and regulations across 49 states, three territories, and Washington, D.C., referencing ACIP. These laws often direct the use or consideration of ACIP recommendations in developing or implementing state or territorial vaccine policy. If the ACIP recommendations change, then any state or territorial policy that depends on them will be altered as well. References to ACIP recommendations appear in several different areas of vaccine policy including state and territorial laws related to: School immunizations. Mandatory insurance coverage. Provider scope of practice to dispense or administer vaccines. Required vaccine information. Mandatory and voluntary immunizations for health care workers and patients. Standing orders and protocols for dispensing or administering vaccines. Notifications for recommended or overdue immunizations. Vaccine purchasing determinations. Immunization Requirements for School Enrollment and Attendance State and territorial law, through statute or rule, may direct the use of or allow the consideration of ACIP recommendations when determining the jurisdiction’s vaccine requirements for school enrollment and attendance. This means any changes or deletions to the ACIP recommendations could automatically impact the jurisdiction’s school immunization laws. Some states give deference only to ACIP recommendations when determining school immunization requirements while other states include the recommendations of ACIP and other national organizations, such as the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), the American College of Obstetricians and Gynecologists (ACOG), and the American College of Physicians (ACP). The degree of adherence to ACIP recommendations also varies, with some jurisdictions requiring strict adherence to the recommendations and others taking ACIP recommendations into consideration for their vaccine policy decision making. In Hawaii, for example, the health department “may adopt, amend, or repeal as rules, the immunization recommendations of the United States Department of Health and Human Services, Advisory Committee on Immunization Practices.” Missouri’s statute permits school enrollment when a child “has been adequately immunized against vaccine-preventable childhood illnesses specified by the department of health and senior services in accordance with recommendations of the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices” while Alabama’s law provides that “vaccine doses should be administered according to the most recent version” of ACIP’s recommendations. New Mexico’s law states that “[t]he immunizations required and the manner and frequency of their administration shall conform to recommendations of the advisory committee on immunization practices of the United States department of health and human services and the American academy of pediatrics.” Jurisdictions can identify their statutes, rules, and other policies that are tied to ACIP recommendations and assess the impact any changes to the recommendations would have on current public health practices and activities. Earlier this year, Colorado enacted HB 1027, a bill relating to school immunizations. The bill changes the source for the health department’s list of recommended school immunizations from ACIP to the state board of health and directs the board to consider ACIP recommendations as well as recommendations by AAP, AAFP, ACOG, and ACP when establishing required school immunizations, their manner, and frequency. The new law also allows the state health department to use the guidelines from AAP, AAFP, ACOG, and ACP along with ACIP when conducting its annual evaluation of immunization practices. Required Coverage by Insurance Providers ACIP-recommended vaccines are often required by states to be covered by Medicaid managed care organizations or private insurers. Changes to ACIP recommendations could impact the vaccines covered by these insurers. In Delaware, a “health carrier shall provide coverage for […] immunizations for routine use in children, adolescents and adults that have in effect a recommendation from the Advisory Committee on Immunization Practices.” Colorado enacted SB 196 giving the state insurance commissioner the ability to maintain current ACIP recommendations. The revised law states that if the ACIP recommendations “are repealed, modified, or otherwise no longer in effect, the commissioner may adopt rules to require compliance with the guidelines or recommendations that were in effect in January 2025, or that comply with the recommendations of the Nurse-Physician Advisory Task Force for Colorado Healthcare.” Scope of Practice to Administer or Dispense Immunizations State law may give pharmacists, pharmacy technicians, and other health care providers the legal authority to dispense or administer vaccines. The vaccines allowed under this authority are often tied to ACIP recommendations so that altering the recommendations could result in these providers no longer able to dispense or administer certain vaccines. Maine law permits pharmacists to “administer vaccines licensed by the United States Food and Drug Administration that are recommended by the United States Centers for Disease Control and Prevention Advisory Committee on Immunization Practices, or successor organization, for administration to a person 18 years of age or older.” In Vermont, pharmacy technicians can “only administer immunizations […] pursuant to the schedules and recommendations of the Advisory Committee on Immunization Practices’ recommendations for the administration of immunizations, as those recommendations may be updated from time to time.” Dentists in Minnesota are permitted to give vaccinations if they “comply with guidelines established by the federal Advisory Committee on Immunization Practices relating to vaccines and immunizations.” Requirements to Provide Information About Vaccines In Alabama, information about the influenza vaccine that schools provide parents or guardians must include “related recommendations issued by the Advisory Committee on Immunization Practices of the federal Centers for Disease Control and Prevention.” Illinois law directs the state’s department of public health to develop an informational brochure relating to meningococcal disease that includes “the latest scientific information on meningococcal disease immunization and its effectiveness, including information on all meningococcal vaccines receiving a Category A or B recommendation from the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.” In Tennessee, hospitals are directed to provide parents of newborns with educational information about pertussis and the availability of a vaccine for pertussis “in accordance with the latest recommendations of the advisory committee on immunization practices.” Tenn. Code Ann. § 68-5-110. Oregon law requires post-secondary schools that provide housing to inform incoming students of vaccine-preventable diseases known to occur in young adults and ACIP recommendations for vaccines related to those diseases. Vaccination of Healthcare Workforce and Patients Some states instruct hospitals or long-term facilities to offer or require their employees and/or patients and residents certain vaccinations in adherence to ACIP recommendations. In New Mexico, every fall and winter hospitals are required to offer older patients vaccines for influenza and pneumococcal “in accordance with the latest recommendations of the advisory committee on immunization practices.” In Missouri, first responders who may be deployed for a bioterrorism event may be offered vaccinations for smallpox, anthrax, “and other vaccinations when recommended by the federal Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.” New Jersey law requires health care facilities to “establish and implement an annual influenza vaccination program in accordance with the current recommendations of the Advisory Committee on Immunization Practices.” Regulations in Texas direct nursing homes “to offer immunizations in accordance with the most recent recommendations of the Advisory Committee on Immunization Practices.” Standing Orders and Protocols Indiana law authorizes the state health commissioner to issue a statewide standing order for pharmacists to administer or dispense “[a]n immunization that is recommended by the federal Centers for Disease Control and Prevention Advisory Committee on Immunization Practices for individuals who are not less than eleven (11) years of age.” In California, the medical director at a skilled nursing facility can issue a standing order influenza and pneumococcal immunizations when the standing orders “meet the

This toolkit is designed to support public health leaders in leveraging the policy development process to achieve health equity in their jurisdiction.

Learn about state regulation of hemp, following federal deregulation and public health challenges including adverse effects of hemp products.

States Pursue Policy Options to Support Access to Over-the-Counter Contraception State Policy to Support Over-the-Counter Contraception Access Christina Severin Learn about state policy options that can help to support over-the-counter contraception access including levers within Medicaid programs. Effective contraceptive care improves maternal health outcomes by helping individuals plan if and when they become pregnant. Additionally, some contraceptive methods may reduce the risk of certain cancers and protect against sexually transmitted infections. While the most effective methods generally require a visit to a health care provider, over-the-counter (OTC) options may address certain barriers to accessing contraception (e.g., taking time off work for a medical appointment and lack of health insurance or access to health care providers/settings). The New Age of Nonprescription Oral Contraceptives A significant change in the marketplace of OTC options occurred in 2023 when FDA approved the first daily non-prescription oral contraceptive. This progestin-only pill —known as Opill — is considered both safe and highly effective at preventing pregnancy when taken correctly. Opill reached stores in early 2024 and has a suggested retail price of about $20 per month or $50 for a three-month supply. While OTC oral contraceptives like Opill may improve access among individuals not currently using contraception or those using a less effective method, high out-of-pocket costs can be a barrier. One way to limit out-of-pocket costs is to require private health insurance coverage of contraception without cost-sharing. ACA requires most private health insurance plans to do this, but it does not extend to all health insurances or contraceptives. For OTC contraceptives, the landscape is even more complex: While plans are encouraged to cover OTC emergency contraception at no cost and without a prescription, it is not required. HHS and the Departments of Labor and Treasury issued a proposed rule in 2023 that would have required broader coverage of OTC contraception without a prescription or cost-sharing, but the rule was later withdrawn. Without a federal mandate, states can pursue coverage requirements through the health insurance products they regulate. Jurisdictions can also support OTC contraception access in their Medicaid programs. While Medicaid requires coverage of family planning supplies without cost-sharing, jurisdictions have some flexibility in how they design this benefit, and the scope of coverage depends on jurisdiction and state plan-specific factors. Jurisdictions also have flexibility in determining how they provide prescription drug coverage for contraceptive medications and what OTC products are covered. State Legislative Action Legislation is one way for states to promote access to OTC contraceptives, including hormonal contraceptives, through state-regulated plans and provider scope of practice considerations. Since 2024, several states have enacted laws requiring coverage of OTC hormonal contraception, including Delaware (SB 232), which directs insurance carriers to cover FDA-approved OTC contraception with or without a prescription, and Maine (LD 163), which requires coverage of nonprescription oral hormonal contraception. At least two states have clarified the role of pharmacists in supporting access to OTC contraceptives. Massachusetts (HB 4800) allows pharmacist dispensing of OTC oral contraception per a standing order and provides liability protections, while California (AB 50) allows pharmacists to furnish self-administered OTC hormonal contraception without complying with the state’s protocols for prescription-only oral contraceptives. States have also enacted laws to explore or support broader access to OTC contraception, including at least three bills enacted in Maryland since 2024: HB 367/SB 527 requires community colleges to develop an OTC contraception access plan and allows the health department to serve as a resource, including for consultation on vending machine access. HB 1171/SB 944 allows local health department registered nurses to dispense OTC contraception. SB 674/HB 939 creates a collaborative tasked with studying and making recommendations on OTC contraceptive access, with a final report due to the governor and legislature by Jan. 1, 2027. Other Policy Levers Legislation isn’t the only policy lever available to jurisdictions looking to support OTC contraception access. A number of states have taken executive actions to improve access, including (but not exclusively) through Medicaid. While jurisdictions already have the flexibility to support OTC contraceptive access in their Medicaid programs, Medicaid rules require a prescription even for OTC products, which may present a barrier for some individuals. One potential solution is to use standing orders, which allow individuals direct access to OTC products at a pharmacy, without having to visit a separate provider for a prescription first. To ease access to OTC hormonal contraception specifically, several states have recently utilized standing orders that facilitate Medicaid coverage, including Wisconsin, Massachusetts, and New Mexico. Additionally, in 2024, North Carolina announced that it was removing barriers to OTC oral contraception, and would cover condoms and spermicide as OTC products. Outside of Medicaid, several other states have taken action to support access to OTC hormonal contraception: In 2024, the Governor of Arizona issued an executive order directing the Department of Administration to designate Opill and OTC hormonal contraception as a no-cost essential health benefit for state employees, among other actions to expand coverage and access. Also in 2024, Pennsylvania issued guidance to health insurers encouraging coverage of OTC hormonal contraception and highlighting two insurers intending to comply with the guidance. Finally, Michigan’s health agency, in partnership with the Governor’s office, implemented a Take Control of Your Birth Control campaign. This initiative distributed OTC contraception at hundreds of community sites across the state, with a stated goal of connecting individuals to insurance coverage, including Medicaid. While the campaign recently ended, the state distributed more than 400,000 OTC contraceptive resources (e.g., condoms, emergency contraception, and oral contraceptives) and saw an increased number of Medicaid applications. Jurisdictions can play a significant role in connecting public health and health care industry leadership, providers, and other experts — promoting awareness, increasing utilization, and encouraging connection to existing resources. Related Content - Blog - State Policy to Support OTC Contraception Access article yes