What Makes Effective Public Health Advocacy?
South Dakota Association of Healthcare Organizations
& 340B Education
Lia Pak
Background
In the summer of 2023 I was selected for a CDC Undergraduate Public Health Scholars (CUPS) program. Now known as the John R. Lewis Scholars Program, CUPS encompasses partnerships with several institutions where the CDC funds undergraduate public health training and experiences. My specific program was the Maternal Child Health Careers/Research Initiatives for Student Enhancement - Undergraduate Program (MCHC/RISE-UP) run by the Kennedy Krieger Institute (KKI,) a Johns Hopkins- affiliated nonprofit that conducts research, professional training, and provides services for those with developmental disabilities.
Through MCHC/RISE-UP, I attended a week-long health equity and professional development training at KKI in Baltimore, where I heard from public health experts from KKI, Johns Hopkins, and the CDC. I was part of a cohort that then went to Sioux Falls, South Dakota for eight weeks, where we received further training at the University of South Dakota (USD) and where I interned full time at the South Dakota Association of Healthcare Organizations (SDAHO). At SDAHO, I was able to work on a range of projects related to healthcare delivery, workforce, and health policy. After the eight weeks, I presented on my internship and projects at USD and the CUPS Symposium.
My Host Site: SDAHO
The South Dakota Association of Healthcare Organizations (SDAHO) is a nonprofit dedicated to “advancing healthy communities through a unified voice across the healthcare continuum”. SDAHO staff work to support their more than 160 member hospitals and healthcare organizations (including nursing homes and assisted living facilities) through five key focus areas:
Advocacy and Member Relations
Acute & Post Acute Services
Education
Business Development
Quality Integration
In order to do this work, SDAHO has an extensive intersectoral network. One focus area is reaching legislators through education on healthcare issues and through lobbying from the Political Action Committee arm. SDAHO also works with business partners through Enterprises, its for-profit subsidiary focused on connecting members with products and services. Finally, a series of outside partners and groups at the state and national levels help provide members with resources, guidance, and networking.
My Work
At SDAHO I worked on a broad range of projects across their different departments. This included compiling data on healthcare workforce for each South Dakota legislative district, researching state abortion laws after the Dobbs decision, and researching details for state Medicaid expansion (a ballot initiative that passed in November 2022). One of my bigger projects was to create informational materials on the 340B drug pricing program aimed at both member institutions and legislators.
Created in 1992, 340B requires drug manufacturers whose products are covered by Medicaid and Medicare to sell outpatient drugs at discounted prices to certain types of healthcare providers. The program was established to grant specific providers relief from high drug costs, stretch federal resources, and reach more patients. The inner workings of 340B are quite complicated, involving insurance companies, the federal government, hospitals, and pharmacies. One of the most difficult parts of this project was understanding how the program works and how to explain it simply. It can get so complicated that there are businesses entirely dedicated to helping hospitals manage 340B benefits. The below graphic is one I created as part of an educational handout for SDAHO.
Internship Takeaways
Me presenting on SDAHO & 340B at USD
Through my time at SDAHO in addition to learning a lot of details about hospitals and specific health policies there were several big lessons I came away with. First, it became clear to me how SDAHO’s large network and variety of services furthered its ability to advocate. As someone who is interested in policy and advocacy as well as program implementation and health service provisions, it was enlightening to see how these focuses could coexist in one organization and enhance each other. Second, I saw firsthand how complicated economic and political structures that do not directly involve citizens can still greatly influence public health. 340B primarily involves money flow between the government, hospitals, and businesses. But, it became clear how, by helping hospitals, it greatly influences access to care for rural and vulnerable populations. Additionally, creating educational materials on 340B emphasized the importance of tailored education and considering audience needs.
Finally, it was really interesting to have my internship at SDAHO situated within the larger RISE-UP and CUPS programs. It was fascinating to go from health equity training in Baltimore to South Dakota politics. I saw cultural and political differences across the locations and I enjoyed the chance to bring perspectives from one to the other and vice versa. I am extremely grateful to have had this opportunity and thankful for all the support I received from KKI and SDAHO staff.
Lia Pak
Hello! My name is Lia and I am from Northfield, Minnesota. I am graduating with majors in Biology and Political Science in addition to my Community and Global Health Concentration. At Mac, I have spent my time outside of classes competing with the mock trial team, leading the political science honors society, and volunteering with the League of Women Voters St. Paul. I plan to work for a few years before returning to school for further studies in public health.