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Health Departments

	Doctor and child patient

To strengthen the delivery of clinical services for HIV/AIDS, viral hepatitis, STD, and TB prevention to at-risk populations, state and local health departments (HDs) should be mindful of three critical and inter-connected transitions in the health system.

Medicaid Expansion

Millions of Americans have enrolled in Medicaid, in addition to those who obtained private insurance coverage, through the Health Insurance Marketplace. This influx of new enrollees opens up new opportunities for health department engagement to advance public health priorities. One key area of focus is leveraging Medicaid expansion.

In light of the Supreme Court decision of June 2012, states can voluntarily extend Medicaid eligibility for low-income individuals. Many, but not all, states have expanded their Medicaid program.1 In states that have expanded Medicaid, there may be new opportunities for state HDs to collaborate with Medicaid agencies in facilitating Medicaid enrollment, promoting delivery of recommended preventive services, utilizing Medicaid data to monitor access to and utilization of preventive services, and offering additional opportunities for Medicaid reimbursement for direct services HDs provide to enrollees.

Preventive Services Covered Without Cost-Sharing

Persons enrolled in a variety of health plans may be able to receive recommended HIV/AIDS, viral hepatitis, STD, and TB preventive services without being responsible for a copayment, co-insurance, or deductible. HDs can increase the provision of these critical preventive services by increasing public awareness of this benefit and communicating to providers the importance of offering these services.

Community Health Center Strengthening

Substantial investment in community health centers (CHCs) provides an opportunity for HDs to work with these core safety net providers to deliver services, assist with community outreach and education, implement new quality improvement programs, and use CHC data, as appropriate, to identify gaps in service delivery.

1 Department of Health and Human Services. What if my state is not expanding Medicaid? Accessed 2014 April 16. Available at:

  • Page last reviewed: May 5, 2014
  • Page last updated: October 21, 2014
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