Implications of Managing Health related Records and Relevant Information Systems within Intergovernmental Agencies

The implications of intergovernmental agencies may forever change the way in which governments provide common services within a federated Australia. As governments seek to reduce duplication and inconsistencies across state and territory borders, intergovernmental agencies are faced with the challenge of managing health related records under differing laws and with lack of clarity on ownership of each record. As records and cost of records increases within these entities we examine if an intergovernmental agencies can ever dispose of a record or does the legal frameworks for these agencies mean that the information systems need to evolve to support these new and emerging entities? This paper will examine the introduction of intergovernmental agencies and the challenges of managing health related records and relevant information systems within these agencies, to explorer how recent legal precedents or the concept of information citizenship may provide guidance on how to manage transient records and cloud services, while also mitigating the impacts of data sovereignty

South Carolina: Round 1 - State Level Field Network Study of the Implementation of the Affordable Care Act

This report is part of a series of 21 state and regional studies examining the rollout of the ACA. The national network -- with 36 states and 61 researchers -- is led by the Rockefeller Institute of Government, the public policy research arm of the State University of New York, the Brookings Institution, and the Fels Institute of Government at the University of Pennsylvania.South Carolina has its work cut out for it. As a state with one of the highest poverty rates and poorest health outcomes indicators, one thing stakeholders from all perspectives agree on is the need for improvement in the state's health status. Successful implementation of the ACA in South Carolina -- for those who believe that is the goal -- will require building greater public understanding of the ACA and enrolling all who are eligible in a state in which government distrust is high and public insurance program take-up rates have traditionally been low. It will also require a shift in position on the Medicaid expansion option. As long as the state's poorest uninsured remain without assistance, the aims of the ACA to promote widespread access to health care will never be realized

Impacts of climate change on public health in Australia

Provides information, opinions and recommendations relevant to assessing the potential impacts of climate change on public health in Australia, as well as guidelines for decision-making in responding to these impacts. It aims to: draw attention to the potential impacts of climate change on health in Australia; discuss the policies and issues related to the impacts of climate change on health; present prioritised recommendations to decision-makers on policies and practices which may assist mitigation of and adaptation to the most serious of the identified impacts; provide guidance which will assist appropriate people and agencies to allocate resources to the highest priority problems; and provide a comprehensive list of references which provide reliable evidence about the potential impacts of climate change on health in Australia. The immediate and longer-term impacts of climate change have the potential to affect Australian health and social environments seriously, and as such, demand and deserve attention by Federal and State Governments and agencies within the Australian public health sector. Policymakers are faced with pressing issues of funding and delivering health services for an ageing society with an ever increasing burden of chronic disease and expectations of access to high-technology, high cost interventions. However, the impacts of future climate change on public health may potentially generate very large healthcare costs if current strategies for healthcare are inadequate. Successful advocacy of new policies and practices by credible and influential groups must use language which can be understood by the people who are to be influenced. This advocacy must be supported by reliable evidence. Climate-related catastrophes (droughts, floods, cyclones, other storms, bush fires) occur frequently in Australia. The demonstrably high variability in the incidence and severity of such phenomena present a challenge to scientists to discover and demonstrate any correlations between the catastrophes and the slow changes of climatic indices due to climate change. Public health organisations must start to develop alternative, more effective, practices to manage the complex issues related to climate change while continuing to implement their traditional primary, secondary and tertiary preventive models. A new approach, based on ecological principles, will be required to navigate through the complex and interrelating health causes. The public health sector must strengthen existing approaches for effective climate change adaptation strategies, including assessing regional health risks to identify vulnerable and resilient populations, collecting enhanced surveillance data and developing monitoring indicators. This approach must be based on: providing sound scientific evidence for predicting the likely outcomes and thus to take preventive or responsive action; and reorienting the public health sector towards greater comprehension and use of ecological understandings and approaches. Recommendations Politicians, health bureaucrats and other interested parties must formulate comprehensive, coherent policies to address the direct and indirect impacts of climate change on public health, including allocation of appropriate financial resources as part of a National Plan for Health in Responding to Climate Change. The National Health and Medical Research Council should be tasked with ensuring coordinated, comprehensive funding to support research into the health impacts of climate change. Research organisations and health institutions must collaborate to develop cost-effective, long-term, longitudinal studies on the impacts of climate change on the physical, biological and social environments that will affect Australian’s public health. Advocates must develop proposals which demonstrate cost savings to government over three to six years, or one or two electoral cycles. Little will be achieved in the current fiscal environment if proposed policies and practices will incur significant new budgetary expenses to governments or their agencies. Managing the impacts of climate change on public health will also involve several other sectors, such as water, planning, building, housing and transport infrastructure. Appropriate institutions should work towards a multi-level, interdisciplinary and integrated response to raise the importance of the impacts of climate change on public health. A comprehensive surveillance system would monitor the inter-relationship of environmental, social and health factors. Observational studies are important to monitor recent and present disease patterns and incidence to inform modelling of future disease patterns. They could also provide baselines for environmental health indicators, which can periodically be monitored and measured in order to inform program evaluation. The public health sector must integrate planned, evidence-based adaptations into existing preventive activities. Useful methodologies might include: a risk assessment approach such as Health Impact Assessment (HIA); an appropriate range of Environmental Health Indicators (EHIs); a “Driving force-Pressure-State-Exposure-Effect-Action (DPSEEA) framework”; and a systematic ecological health framework. The opposite of vulnerability is resilience – our capacity to respond to challenging or new circumstances. The factors which encourage resilience needs to be better understood. The public health sector must communicate concepts of risk, and develop strategies to encourage greater resilience. To understand how we can minimise vulnerability of individuals and communities to climate change we must identify those populations which are most at risk, including those for whom climate change will act as a stress multiplier for existing public health problems. The health sector must communicate climate change as a human health issue rather than just an “environmental problem”. The focus should be on effective, realistic and sustainable solutions rather than problems characterised as bleak and unresolvable

Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation: Special Report of the Intergovernmental Panel on Climate Change

This Special Report on Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation (SREX) has been jointly coordinated by Working Groups I (WGI) and II (WGII) of the Intergovernmental Panel on Climate Change (IPCC). The report focuses on the relationship between climate change and extreme weather and climate events, the impacts of such events, and the strategies to manage the associated risks. The IPCC was jointly established in 1988 by the World Meteorological Organization (WMO) and the United Nations Environment Programme (UNEP), in particular to assess in a comprehensive, objective, and transparent manner all the relevant scientific, technical, and socioeconomic information to contribute in understanding the scientific basis of risk of human-induced climate change, the potential impacts, and the adaptation and mitigation options. Beginning in 1990, the IPCC has produced a series of Assessment Reports, Special Reports, Technical Papers, methodologies, and other key documents which have since become the standard references for policymakers and scientists.This Special Report, in particular, contributes to frame the challenge of dealing with extreme weather and climate events as an issue in decisionmaking under uncertainty, analyzing response in the context of risk management. The report consists of nine chapters, covering risk management; observed and projected changes in extreme weather and climate events; exposure and vulnerability to as well as losses resulting from such events; adaptation options from the local to the international scale; the role of sustainable development in modulating risks; and insights from specific case studies

A Guide to Evaluating Marine Spatial Plans

Marine spatial plans are being developed in over 40 countries around the world, to distribute human activities in marine areas more sustainably and achieve ecological, social, and economic objectives. Monitoring and evaluation are often considered only after a plan has been developed. This guide will help marine planners and managers, monitor and evaluate the success of marine plans in achieving real results and outcomes. This report emphasizes the importance of early integration of monitoring and evaluation in the planning process, the importance of measurable and specific objectives, clear management actions, relevant indicators and targets, and involvement of stakeholders throughout the planning process.

Working Paper 89 - Come Rain or Shine - Integrating Climate Risk Management into African Development Bank Operations

Climate change is happening now, and further changes during the next decades are inevitable (IPCC, 2007a). During the last century, the global climate warmed by about 0.7°C. At the same time, there were distinct changes in rainfall patterns, an increase in both frequency and severity of extreme weather events, and a rise in sea levels. The impacts of these changes are already being felt, and will intensify as further changes take place. Another 2–4°C rise is projected for the current century, mostly as a result of greenhouse gases that have already been emitted. This means that, although aggressive mitigation of greenhouse gas emissions is crucial to prevent longer term, potentially catastrophic changes, most of the changes projected for the coming decades cannot be avoided.Africa is especially vulnerable. This is clear from the effects of current climate variability and weather extremes – such as floods, droughts and storms – which severely affect economic performance (AfDB, 2003; G8, 2005; Stern et al., 2006; IPCC, 2007b). The poor pay the highest price, because their livelihoods are most affected, and they have fewer resources to help them adapt to the changing climate. Box 1 describes some of the areas where climate change will have its most severe impacts in Africa.African policy-makers and stakeholders are beginning to recognize the need to address adaptation to climate change. There is growing awareness of the setbacks to development and poverty reduction that will result from climate change, threatening the achievement of the Millennium Development Goals (MDGs). This was articulated in the multi-agency document ‘Poverty and Climate Change’ (AfDB, 2003), and more recently at the African Partnership Forum in May 2007 (APF, 2007). Climate change was placed on the agenda of the AU Heads of State Summit for the first time in January 2007, which resulted in the adoption of a Decision and Declaration on Climate Change and Development in Africa and in the endorsement of the Climate Information for Development – Africa (ClimDev Africa) Stakeholders Report and Implementation Strategy (GCOS, 2006).

HIV/AIDS, climate change and disaster management : challenges for institutions in Malawi

Southern African institutions involved in disaster management face two major new threats: the HIV/AIDS pandemic (eroding organizational capacity and increasing vulnerability of the population), and climate change (higher risk of extreme events and disasters). Analyzing the combined effects of these two threats on six disaster-related institutions in Malawi, the authors find evidence of a growing gap between demand for their services and capacity to satisfy that demand. HIV/AIDS leads to staff attrition, high vacancy rates, absenteeism, increased workload and other negative effects enhanced by human resources policies and financial limitations. Many necessary tasks cannot be carried out adequately with constraints such as the 42 percent vacancy rate in the Department of Poverty and Disaster Management Affairs, or the reduction of rainfall stations operated by the Meteorological Service from over 800 in 1988 to just 135 in 2006. The authors highlight implications of declining organizational capacity for climate change adaptation, and formulate recommendations.Population Policies,HIV AIDS,Hazard Risk Management,Health Monitoring&Evaluation,Climate Change

Subnational credit ratings : a comparative review

This paper surveys methodological issues in subnational credit ratings and highlights key challenges for developing countries. Subnational borrowing from capital markets has been on the rise owing to fiscal decentralization and demand for infrastructure investments. A prerequisite for accessing capital markets, subnational credit ratings have also emerged as a part of broader reform for fiscal sustainability. They facilitate a more transparent budgetary and financial management system. The global financial crisis makes subnational credit ratings more relevant, as they contribute to fiscal risk evaluations and fiscal adjustment. In addition to subnationals’ own credit strength, the creditworthiness of the sovereign and the intergovernmental fiscal system are among the most critical rating criteria. Implicit and contingent liabilities are integral to the rating process. Indirect debt instruments including off-balance-sheet financing create fiscal risks. The ongoing financial crisis has reinforced the rating focus on the management of liquidity, debt structure, and off-balance-sheet liabilities.Debt Markets,Banks&Banking Reform,,Bankruptcy and Resolution of Financial Distress,Access to Finance

MSU EXTENSION SERVICE OFFERS PROGRAMS FOR LOCAL GOVERNMENT

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Health Problems Heat Up: Climate Change and the Public's Health

Examines the health effects of climate change, the needed public health response, concerns for communities at high risk, and state planning and funding for climate change assessments and strategies. Makes federal, state, and local policy recommendations