AN ACT Relating to regional health promotion and disease prevention; adding new sections to chapter 43.70 RCW; and creating new sections.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. The legislature finds that:

(1) The current system of health care and public health has been remarkably successful in identifying and reducing or eradicating many contagious or infectious diseases that were major public health threats in years past.

(2) Much of the illness and injury in recent years is the result of heart disease, substance abuse, cancer, accidents, intentional and unintentional injuries, perinatal conditions, and other conditions that can be prevented if individuals receive early detection of disease and periodic screening, and modify their personal behaviors and life styles.

(3) State, local, and private agencies have been established to plan and deliver social and health services. Many of these services are designed to arrest, treat, or cure illnesses and injuries, not to prevent them.

(4) No entity in state or local government is presently charged with the authority to address the risk factors that lead to diseases and intentional and unintentional injuries that are the leading causes of morbidity and mortality or to take action to reduce them, to promote health, and to prevent illness and injury, both intentional and unintentional.

(5) These activities are essential to the protection and promotion of public health and should be pursued by individual citizens, communities, local governments, businesses, and public and private agencies with leadership from local health departments, the department of health, and the board of health through the state health report.

The purpose of this act is to provide health promotion and disease and injury prevention efforts within the public health system to empower individuals, voluntary community associations, health organizations, and others by providing information and resources to protect and promote health.

NEW SECTION. Sec. 2. There is established within the department of health a center for health promotion and disease and injury prevention whose principal administrator shall report to the secretary. The center shall contain departmental functions that the secretary determines are most directly related to the promotion of health and the prevention of diseases and intentional and unintentional injuries, consistent with the organizational principles set forth in RCW 43.70.020. The center shall collaborate with other entities within the department and other state, local, federal, and private agencies to use available information to:

(1) Identify the leading causes of death, disease, and injury to Washington citizens;

(2) Isolate the causes and risk factors for these illnesses and injuries, both intentional and unintentional;

(3) Identify geographic areas and population groups at risk for these illnesses and intentional and unintentional injuries;

(4) Identify strategies that have been demonstrated to be effective in reducing these illnesses, intentional and unintentional injuries, causes, or risk factors;

(5) Act as a clearinghouse and consultive resource for local health departments, other public and private groups, and voluntary community associations that wish to implement these strategies;

(6) Request and receive funds, gifts, grants, or appropriations from the legislature, the federal government, or private sources to pursue the department's duties under this section;

(7) Provide grants to local health jurisdictions for health promotion and disease and injury prevention to enable citizens and communities to adopt behaviors that have demonstrated effectiveness in promoting health and preventing illness and injury, both intentional and unintentional;

(8) Biennially establish state-wide objectives after consultation with the local health jurisdictions and state board of health as recommended in the state health report and considering United States public health service year 2000 objectives. Using data on Washington residents, the department shall adopt the following national objectives to be achieved by the year 2000:

(a) Reduce cigarette smoking among people twenty years and over from 29.1 percent to no more than fifteen percent;

(b) Reduce cigarette smoking among people less than twenty years from 29.5 percent to no more than fifteen percent;

(d) Reduce prevalence of cholesterol levels of two hundred forty milligrams per deciliter among people twenty and older from 26.8 percent to no more than twenty percent;

(e) Reduce deaths from cancer of the uterine cervix from 3.2 per one hundred thousand women to no more than 1.5 per one hundred thousand women;

(f) Reduce serious nonfatal head injuries from one hundred eleven per one hundred thousand people to no more than eighty-three per one hundred thousand;

(g) Reduce drowning deaths from 2.6 per one hundred thousand persons to no more than 1.7 per one hundred thousand persons;

(h) Improve control of diabetes, as measured by a reduction in hospitalization from 13.8 per one thousand people with diabetes to 6.9 per one thousand people with diabetes;

(i) Reverse the rising incidence of physical abuse of children under age eighteen from 10.7 per one thousand children to no more than 10 per one thousand children;

(j) Reduce alcohol-related motor vehicle crash deaths from 9.7 per one hundred thousand people to 8.5 per one hundred thousand people; and

(k) Reduce by fifty percent the use of alcohol, marijuana, and cocaine among young people ages twelve to seventeen years from 25.2 percent for alcohol, 6.4 percent for marijuana, and 1.1 percent for cocaine;

(9) Biennially evaluate local health jurisdictions' progress in meeting objectives, according to subsection (8) of this section.

NEW SECTION. Sec. 3. The department shall establish a state-wide system of health promotion and disease prevention regions as follows:

(1) The department, in consultation with local health jurisdictions, shall designate regions and establish the health promotion and disease and intentional and unintentional injury prevention priority objectives for those regions based on analysis of the information in section 2 of this act. Regions shall be consistent with the organizational principles in chapter 43.70 RCW, and, to the extent possible, reflect unique grouping of disease or injury incidence or populations identified at risk.

(2) Using information already available, the department shall establish a minimum of three regions encompassing no less than thirty-five percent of the state's population by July 1, 1990. The three regions shall include a metropolitan area, a rural area, and at least one area located in eastern Washington. The regions shall begin implementation of strategies to address the objectives of sections 2 through 4 of this act by October 1, 1990.

(3) The department shall designate regions incorporating the balance of the state by May 1, 1991.

(4) Each region shall prepare, through a cooperative effort of local health departments, community, business, and health organizations within the region, a regional health promotion and disease and intentional and unintentional injury prevention strategy that addresses the objectives established under subsection (1) of this section. The strategy shall incorporate existing efforts where appropriate. The strategies shall place emphasis on collaboration with local voluntary organizations within the region. Regions designated under subsection (3) of this section shall submit a regional health promotion and disease prevention strategy within six months of regional designation. All regions shall submit a regional health promotion and disease and intentional and unintentional injury prevention strategy for the following biennium by July 1, 1992, and biennially thereafter.

(5) The department shall biennially prepare a statement of progress toward meeting state-wide health promotion and disease and intentional and unintentional injury prevention objectives specified in section 2 of this act. The statement shall also reflect regional strategy implementation accomplishments of the preceding biennium.

(6) Health promotion and disease and intentional and unintentional injury prevention interventions under sections 2 through 4 of this act may include at least health screening services and assessments, public education campaigns, and targeted education efforts. In no case may interventions under sections 2 through 4 of this act include the delivery of primary health or social services.

(7) The regional health promotion and disease and intentional and unintentional injury prevention strategy shall be developed and administered by the local public health jurisdiction within the region. If a region encompasses more than one local public health jurisdiction, those jurisdictions shall select a jurisdiction to develop and administer the regional strategy. In the event agreement cannot be reached, the department shall determine the lead jurisdiction.

(8) Available funding for health promotion and disease and intentional and unintentional injury prevention regions shall be allocated in grants based on priorities established under subsection (1) of this section and the relative costs of interventions associated with those priorities.

(9) If the department is not able to establish a region by agreement solely with local health jurisdictions, it may contract with nonprofit agencies for any or all of the development and administration of the regional health promotion and disease and intentional and unintentional injury prevention strategy.

(10) The department shall reflect the funds necessary to implement this section in its departmental biennial budget request.

NEW SECTION. Sec. 4. The state board of health shall review the health promotion and disease and intentional and unintentional injury prevention objectives established in section 2 of this act and recommend modification as part of the state health report.

NEW SECTION. Sec. 5. Sections 2 through 4 of this act are each added to chapter 43.70 RCW.

NEW SECTION. Sec. 6. If specific funding for the purposes of this act, referencing this act by bill number, is not provided by June 30, 1990, in the omnibus appropriations act, this act shall be null and void.