In 1926, the City of Fort Worth created a Department of Health and Welfare and began providing public health services to its residents.
During the ensuing decades, the Fort Worth Public Health Department worked closely with the Tarrant County Health Department, eventually the two departments began sharing an administration while maintaining separate programs, funding sources and employees.
The Fort Worth Public Health Department established a system of maternal and child health clinics during the early 1980s to give residents basic, preventive care outside of a hospital setting. As health care changed, local hospitals, including the ad valorem tax-supported public hospital district, created their own neighborhood-based systems of full-service health centers to provide both preventive care and acute medical treatment.
The Fort Worth Public Health Department was increasingly faced with competing for patients against full-service, better funded providers. In 1996, the State of Texas prepared to launch a pilot Medicaid managed care program in Tarrant County, which mandated that Medicaid recipients have a primary care provider to manage their health care needs. Recognizing that this change would have a tremendous impact on its maternal and child health clinics, the Public Health Department began to address the issue of how to provide public health services (clinical and otherwise) within a managed care environment.
In addition to the changing environment, the resignation of the city employee who served as director of public health and medical director for both the City of Fort Worth and Tarrant County created a further imperative to address these issues before recruiting a new director. Replacing the director would be especially difficult because of the issues facing the clinics: the onset of Medicaid managed care, declining patient numbers, declining revenues and an uncertain future.
In the fall of 1996, a Blue Ribbon Panel on Public Health was created to study the services and structure of the City of Fort Worth and Tarrant County Public Health Departments. This panel was composed of elected and appointed officials and staff from the City of Fort Worth, Tarrant County and the Tarrant County Hospital District, as well as regional and national leaders in public health. Together, the panel members examined the future direction of public health services throughout Tarrant County and recommended restructuring the public health system to end competition for clients and duplication of services.
The goal was to create new partnerships that would provide all residents with a single system of health care: a "continuum of care" that ranged from population-based prevention to individual medical care. In February 1997, the governing bodies of the City of Fort Worth, Tarrant County, and the Tarrant County Hospital District issued resolutions calling for development of an implementation plan related to public health functions, consolidation of services and governance issues.
In October 1997, the City of Fort Worth approved a new structure for its public health department and began a transition into a new era of public health.
The City's maternal and child health services and clinics became part of the Tarrant County Hospital District, which operates John Peter Smith Hospital and the JPS Health Network system of community health centers. Disease control services and clinics, including those for HIV/AIDS, sexually transmitted diseases and tuberculosis, were previously operated jointly by the City of Fort Worth and Tarrant County. The re-organization consolidated these programs, as well as the Special Supplemental Program for Women, Infants and Children (WIC) program and the regional laboratory, under the auspices of the Tarrant County Health Department.
The Fort Worth Public Health Department has been streamlined as a result of the county-wide reorganization of public health. It continues to enforce city ordinances related to animal control and consumer health protection. These services include impoundment of stray dogs and cats, inspection of food service and child care facilities and education and enforcement of smoking regulations. The Department strengthened its health promotion and education section to inform the community about health issues and the value of healthy behaviors.
The Fort Worth Public Health Department also created an innovative population-based outreach and assessment program that expanded upon the traditional roots of public health while addressing the current changes in health care and the future needs of Fort Worth residents. Today, staff members assess individual, family and community strengths, weaknesses and health trends and enable the community to have a voice in addressing its concerns.
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