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73 <br />Assurance means making sure that needed health services and functions are available. Assurance focuses <br />on maintaining the capacity of public health agencies to manage day - today operations and provide the core <br />public health functions. Part of that capacity includes the ability to respond to critical situations and <br />emergencies, such as disease outbreaks, toxic spills or product recalls. <br />The assurance function also requires monitoring the quality of health services provided in both public and <br />private sectors. Population -based health protection and health promotion services are most often provided <br />directly by public health agencies, as are quality assurance activities. <br />While it is the responsibility of government health agencies to assure that necessary health resources are <br />available, the actual provision of health services can come from a variety of sources: private practitioners, <br />non -profit agencies such as community health centers and health maintenance organizations, and public <br />healthagencies. <br />State Role <br />The state department of health needs adequate legal authority, resources and trained leadership and staff to <br />provide a range of services, including maintenance of emergency response capacity at the state level, <br />enforcement of standards and laws, andmaintenance ofquality assurance in the service delivery system. The <br />state must also assure that there is adequate provision of the core functions throughout the state. <br />Local Role <br />Local health departments need the capacity to advocate, serve as catalysts for, coordinate and organize <br />responses to priority needs in the communities served Local health departments also need the capacity to <br />respond to majorregionalorlocalemergencies , enforce regulations, andprovideessentialoutreachfunctions, <br />including transportation and foreign language assistance, to assure that people experiencing barriers to <br />getting necessary health care services have access to the service delivery system. <br />Incases where no other resources are available in the community, local health departments need the capacity <br />to purchase or provide directly those personal health care services identified locally as priorities. <br />Finally, local health departments and/or other community organizations need the capacity to provide <br />population- basedhealthpromotion, healthpro= donandpreventivehealth services totirecommunity. Such <br />efforts are crucial if costs of the overall system are to be contained <br />• <br />• <br />