Maryland Commission on Public Health to conduct assessment of state’s public health capabilities

By

Hannah Saunders

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Meenakshi Brewster is the co-chair of Maryland’s Commission on Public Health. She will be speaking at the 2024 Maryland State of Reform Health Policy Conference on June 7 at the Baltimore Marriott Waterfront. Brewster discussed the commission’s work with State of Reform. 

Maryland Gov. Wes Moore signed House Bill 214 into law last year, which established the commission. It is tasked with studying the state’s public health system, including its state and local health departments, to see how it is meeting the needs of the public. 

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Brewster was appointed as co-chair of the commission last December. She said the commission will identify opportunities for improvement in Maryland’s public health system, and conduct an assessment with recommendations for reforming it for the General Assembly. 

“We launched in December officially, but really most of the work began in January (and) February this year,” Brewster said. “For the remainder of 2024, our focus is going to be to conduct that assessment of the public health system.”

The commission will distribute surveys, visit health departments, conduct stakeholder interviews, and hold public listening sessions to gather input from communities about how the public health system is serving them. By 2025, the commission will shift from studying the public health system to analyzing its findings and making recommendations. 

“[We] will move into analysis, and then into formal recommendations during 2025. By Oct. 1, 2025, we hope to issue a final report,” Brewster said. 

The commission’s greatest challenge thus far has been related to funding, Brewster said. When HB 214 passed in 2023, there was no designated funding for the initiative. The commission utilizes five workgroups in its work: the Data and Information Technology Workgroup, the Communication and Public Engagement Workgroup, the Funding Workgroup, the Governance and Organizational Capabilities Workgroup, and the Workforce Workgroup. About 130 people work with the commission and its workgroups, which requires significant financial resources, Brewster said. 

“Funding is definitely a huge challenge,” Brewster added.

Maryland has a local health department in each of its 24 jurisdictions. Each department is administered by a health officer who is responsible for addressing the distinct public health needs in their city or county. Maryland’s health officers act collectively under the Maryland Association of County Health Officers (MACHO) on statewide education, policy, and legislative initiatives. MACHO is working with the CDC Foundation, a national organization that supports fundraising and staffing efforts within public health organizations, to support the commission financially. 

The commission recently conducted a site visit at St. Mary’s County Health Department, Brewster said. 

“It’s very clear that the major and persistent gap and how our system’s ability to prepare and respond to public health emergencies has to do with having (an) adequate public health workforce at local and state levels,” Brewster said. 

Staffing issues persisted in the state’s healthcare system during the COVID-19 pandemic, and Brewster said it has been challenging for healthcare facilities to acquire an established workforce with significant experience since then. Prior to the pandemic, St. Mary’s had about 100 employees. That number climbed to about 330 during the pandemic. Many of the employees who joined during the pandemic were new graduates, so there wasn’t an increase in leaders or managers with requisite knowledge of the state’s healthcare system during that time. 

“We had to train them in the moment while the managers and leaders were not just leading, but also delivering the services needed in the pandemic,” Brewster said. “It was an extraordinary strain on the established public health workforce. While we needed that surge (in) staff, we didn’t have adequate capacity in an established public health workforce to supervise and manage that.” 

St. Mary’s continues to try to recover from the pandemic and fill workforce gaps with experienced workers, Brewster said. There’s a lot of turnover when it comes to new workers because there are not enough experienced workers to help supervise and train them. 

“Unfortunately, it’s got this cascading and continuing effect,” Brewster said. 

Readers interested in learning more about Brewster and the commission’s work can register to attend the 2024 Maryland State of Reform Health Policy Conference. She will speak on the “Using Data to Build a Stronger Public Health System” panel at 9:30 a.m. It will be the first State of Reform conference for Brewster. 

“I’m looking forward to the other sessions. I looked at the agenda and was thinking, ‘Wow, I can totally talk on this panel.’ All of these topics are so relevant to what we do every day at the local health department,” Brewster said. 

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