Northwest Portland Area Indian Health Board Quarterly Meeting A New Vision for Public Health in Washington State Rebuilding Core Services & Modernizing the System Chris Northwest Portland Area Indian Health Board Quarterly Meeting January 18, 2017 This work is partially funded by grant number 73401 from the Robert Wood Johnson Foundation

http://publichealthisessential.org/ 2 Chris Public health is essential. Every day people, communities, and businesses rely on the governmental public health system to protect health and promote healthier communities. http://publichealthisessential.org/ 2

Website & Video Chris 3

Washington’s Governmental Public Health System State Board of Health Department of Health Sovereign Tribal Nations Local Public Health Agencies Chris The governmental public health system in Washington includes: State Board of Health (SBOH) State Department of Health (DOH) Sovereign Tribal Nations Local Health Jurisdictions (LHJS) Each of these organizations work hard every day to protect and improve the health of our communities. 4

The Problem Changing nature of preventable disease Increasing demand for core public health services Diminished and inequitable funding for core public health services Demand + Funding = Crisis Jennifer 5

Increasing Demand + Diminished Core Funding = Increased Risk Jennifer Source: BERK Consulting, 2016.

Rebuilding Core Services & Modernizing the System The Solution Rebuilding Core Services & Modernizing the System Jennifer 7

2017 & Beyond Legislative Proposal – policy bill & budget request System-wide Assessment – evaluate current FPHS capacity and update cost, current spending and funding need estimates Service Delivery – implement and evaluate pilot projects; further develop ideas and models; identify which FPHS fit best at local, zone, state level Accountability – tracking the investments, spending, capacity, performance, impacts Funding Allocation – funding to follow the work Process for Routine Updates – definitions, costs, services delivery, accountability, allocation Jennifer 8

Why I/T/Us are Part of our Governmental Public Health System Respecting sovereignty: Tribal governments provide public health functions and services to their communities; Tribal FPHS framework must be tribal-driven State and local health departments have no jurisdiction on Tribal lands I/T/U, state and local partnerships will be enhanced where shared services are needed 2017 LEGISLATION – includes defining the governmental public health system in Washington as: DOH, SBOH, LHJS and their boards and the sovereign Tribal Nations of Washington. When we talk of our governmental public health system, it includes not only local health and state health jurisdictions but Tribes and urban Indian programs, too. This is out of the knowledge that: Expand on each bullet point. 9

Tribal Participation History 2014 FPHS Policy Workgroup Tribal Leader Representation Co-chaired by Tribal Leader 2015 – Tribal Consultation Secretary ‘ask’ to determine I/T/U interest in pursuing Tribal-specific FPHS Positive response to move forward 2015-2016 - Presentations at Tribal meetings AIHC, NPAIHB, Other 2016 FPHS Tribal Technical Workgroup Formed 10

Foundational Public Health Services (FPHS) Tribal Technical Workgroup DRAFT Workgroup Goal Assure I/T/Us are a key component of the overall WA State governmental public health system by considering & evaluating FPHS concepts and framework and assessing & identifying Tribal-prioritized foundational public health services and funding opportunities Workgroup Objectives Through continuous I/T/U engagement: Identify current I/T/U public health services, gaps, and desired role in overall system Develop foundational services and definitions Identify current FPHS expenditures and funding sources Estimate potential FPHS funding gaps Convene decision makers to determine funding sources Create strategies for funding advocacy The Tribal Technical Workgroup meets monthly. In December, an in-person strategic planning meeting took place to determine goals for the upcoming year. Expand on goal and objectives.

Tribal Technical Workgroup Roster Revised: 12-12-16 Here is the list of workgroup members and contact information – any of these members can answer questions and provide additional information. Project Management Team: Jan Olmstead, Public Health Projects Consultant, American Indian Health Commission; jan.Olmstead@gmail.com Sheryl Lowe, Tribal Liaison, WA Department of Health; Sheryl.lowe@doh.wa.gov Marie Flake, FPHS Manager, WA Department of Health; marie.flake@doh.wa.gov 12

2017 & Beyond for Tribal Work Engage I/T/Us Tribal Survey - What services are already being provided? Regional Meetings - What FPHS services should be provided everywhere? Shared services discussion - Where might tribal, local and state core/FPHS services be shared for efficiency and effectiveness? Develop I/T/U FPHS Model (Services/Capabilities) Prepare FPHS definitions for Tribal input Identify FPHS Costs and funding gaps Identify Sources of Funding and Policy Options After January’s meeting, these milestones have been established for 2017 and 2018. 13

www. doh. wa. gov/fphs http://publichealthisessential www.doh.wa.gov/fphs http://publichealthisessential.org Modernizing the Governmental Public Health System, Together! Modernizing the Governmental Public Health System, Together! 14