CALPHO Meeting June 8, 2009 Office of Planning and Partnerships Colorado Department of Public Health and Environment

Office of Planning and Partnerships A new office in CDPHE that: Meets the implementation goals of the 2008 Public Health Act Maintains positive relationships with local public health Establishes credibility in planning within CDPHE and among local agencies Works closely with CALPHO, the Public Health Alliance, the Colorado School of Public Health and other partners Funding from the Caring For Colorado Foundation Office of Planning and Partnerships Colorado Department of Public Health and Environment

The Public Health Re-authorization, Re-vitalization, Re-organization Re-Act of 2008 One type of local public health agency with a local board of health A statewide public health plan approved by the State Board of Health Local public health plans based on the state plan, health status indicators and local needs Public health services, standards and funding formula for Colorado established by the State Board of Health Office of Planning and Partnerships Colorado Department of Public Health and Environment

…but what does it mean? Assures the provision of basic public health and environmental health services Promotes boards of health Encourages state and local collaboration Considers financial feasibility and funding Supports regional cooperation Prepares CO for national accreditation Office of Planning and Partnerships Colorado Department of Public Health and Environment

Steps in the Act and progress State Board of Health establishes minimum qualifications for local health directors and medical officers. Counties establish their local/district public health agencies, appoint BOH and health directors. CDPHE creates Statewide Public Health Improvement Plan “on or before December 31, 2009…and…every 5 years thereafter. State Board of Health approves core services, funding formula and minimum quality standards for public health services. Local Public Health Agencies create local plans “as soon as practicable after the approval of…statewide…plan.”

Core Services/ Standards For today: Core Services/ Standards Office of Planning and Partnerships Colorado Department of Public Health and Environment

Services/Standards Charge: What public health services should be available to all residents of Colorado regardless of where they work, live and play? In the Act: To establish, by rule, the core public health services that each county and district public health agency must provide or arrange for the provision of said services; To establish, by rule, the minimum quality standards for public health services; Office of Planning and Partnerships Colorado Department of Public Health and Environment

Services vs. Standards Services is the “what” Standards is the “how” What services, programs, activities are offered Tied to budgets and funding requests Standards is the “how” How services are offered in relationship to …. Capacity of Agency Evidence-based using best practices Follow functions of the 10 Essential Services in preparation for national accreditation Office of Planning and Partnerships Colorado Department of Public Health and Environment

How are we developing Core Services How are we developing Core Services? Asking for input and incorporating changes as we go… As CALPHO members, you are seeing the first draft today Send to all divisions at CDPHE Post on our website for comment Present at meetings throughout state Include in statewide plan draft Office of Planning and Partnerships Colorado Department of Public Health and Environment

Input CALPHO meeting at CCI-June 8 3 former Nursing Service regions-June 17 3 former Nursing Service regions-July 15,22 Environmental health directors meeting- July 16 PPHR-Southwest-TBD Critical Input meetings-open to all Office of Planning and Partnerships Colorado Department of Public Health and Environment

Services Considerations Local though identifying state role Relationship to other statutes Relationship to funding Relationship to size of population served Prioritized by local assessments and demographics (a standard) Office of Planning and Partnerships Colorado Department of Public Health and Environment

What drives services and programs now… Funding Interest of the PH director, board of health Sometimes data, not always History Political will Mandated Can core services escape this? Office of Planning and Partnerships Colorado Department of Public Health and Environment

What services are we providing now? NACCHO 2008 survey data

Office of Planning and Partnerships Colorado Department of Public Health and Environment

Office of Planning and Partnerships Colorado Department of Public Health and Environment

Office of Planning and Partnerships Colorado Department of Public Health and Environment

Office of Planning and Partnerships Colorado Department of Public Health and Environment

Office of Planning and Partnerships Colorado Department of Public Health and Environment

Office of Planning and Partnerships Colorado Department of Public Health and Environment

What services, programs, activities would you choose not to do What services, programs, activities would you choose not to do? If it is: Not a major cause of morbidity and mortality Not a primary prevention measure Not targeted at a high risk group No legal requirements No community demand No political demand Disproportionate use of time and resources Duplicated effectively elsewhere Office of Planning and Partnerships Colorado Department of Public Health and Environment

Proposal-the Core Services document: Preamble on what a core service is Broad Category Brief narrative Services a local health agency shall provide Examples of what it could include State role Office of Planning and Partnerships Colorado Department of Public Health and Environment

Broad Categories of Services Monitor, Assess, and Plan Vital Records and Statistics Investigate and Control Communicable Diseases Population-Based Primary Prevention/Health Promotion Maintain a safe, healthy environment Ensure safety of consumer services and products Prepare and respond to emergencies and disasters Assure access to personal health services Additional State Services-EMS, Laboratory, Health Facilities Office of Planning and Partnerships Colorado Department of Public Health and Environment

The detail-next level under each service category: Understandable, no unintended consequences, acceptable to multiple stakeholders Services that must be included: Is it statutorily required? How is it funded? Could include or examples: Examples of specific, established programs Address concern of inclusion Office of Planning and Partnerships Colorado Department of Public Health and Environment

Facilitated discussion Small group: Review, comment, and edit preamble Review, comment, and edit assigned category (s) Re-convene: Review category titles Summarize preamble suggestions Report on category (s) recommendations

Coming to consensus on Core Services Office of Planning and Partnerships Colorado Department of Public Health and Environment

Using a community health assessment and plan to determine programs that meet core services: Can assessments drive services and programs? Will that be acceptable to your boards of health? Can we accept the time interval needed to produce assessments before major changes? Office of Planning and Partnerships Colorado Department of Public Health and Environment

Next section of Plan-developing Capacities Workforce development Data and Technology Valuing and promoting public health Policy development recommendations Capacity assessment Community Health Assessment and Planning Funding Partnerships to strengthen community capacity Office of Planning and Partnerships Colorado Department of Public Health and Environment

Strategic Priorities Initiating Workgroup Critical Input Meetings Core Services Mar – May June – July Health Outcomes April – June July Data and Technology May – July August Workforce Development Marketing Partnerships Policy/Legislation Financing May – August September Service Delivery Office of Planning and Partnerships Colorado Department of Public Health and Environment

Stakeholder Input for Plan Initiating Workgroup Advisory Group Review and Input Critical Input Meetings Regional, open to all Critical Input Meetings Critical Input Meetings Advisory Group Review Compiled Plan Uniting Public Health Conference September 30, 2009 State Board of Health November 2009 Office of Planning and Partnerships Colorado Department of Public Health and Environment

Join us for the following dates: We need to hear from you! Join us for the following dates: July 23 Grand Junction August 3 Denver August 4 Ft. Collins August 11 Pueblo August 13 Broomfield *RSVP to Katy Rice (303)692-2350 CDPHEEDPlanningandPartnerships@state.co.us Office of Planning and Partnerships Colorado Department of Public Health and Environment

e-mail: CDPHEEDPlanningandPartnerships@state.co.us Contact information: phone (303) 692-2350 e-mail: CDPHEEDPlanningandPartnerships@state.co.us  website: www.cdphe.state.co.us/opp Office of Planning and Partnerships Colorado Department of Public Health and Environment

BACKGROUND SLIDES

Office of Planning and Partnerships Colorado Department of Public Health and Environment

Office of Planning and Partnerships Colorado Department of Public Health and Environment

Office of Planning and Partnerships Colorado Department of Public Health and Environment

Office of Planning and Partnerships Colorado Department of Public Health and Environment

Office of Planning and Partnerships Colorado Department of Public Health and Environment

Office of Planning and Partnerships Colorado Department of Public Health and Environment

The picture now… Colors: Organized Health Departments White: Nursing Services : Environmental Services Office of Planning and Partnerships Colorado Department of Public Health and Environment

Implementing the Act Infrastructure minimum qualifications funding formulas internal CDPHE standards core services PH nursing environmental health Improvement Plan goals/outcomes core services indicators/data environmental health workforce development health disparities Office of Planning and Partnerships Colorado Department of Public Health and Environment

Statewide Public Health Improvement Model Short-Term Outcomes Intermediate Outcomes Long-Term Outcomes Inputs Strategies Outputs Improvements in Determinants of Health Existing Public Health Infrastructure Establishment of formalized planning office Statewide Improvement Plan Strong Public Health System Public Health System that Equitably, Efficiently, and Effectively provides the 10 Essential Public Health Services Recognized value of public health Existing Knowledge Base Convene partners as advisors and ad-hoc workgroups Improved Partnerships Across Multiple Sectors Improved community, environmental, and personal Health Status Public Health science base is strengthened Colorado’s history and momentum toward Public Health improvement Implement Statewide quality improvement Stakeholder input Integrated community, environmental, and personal health Prepared for accreditation Local Public Health Improvement Plans Improved Quality and Quantity of Life Experience of others on this path Office of Planning and Partnerships Colorado Department of Public Health and Environment

Goals of the Statewide Public Health Improvement Plan Set Colorado’s public health priorities based on health status indicators Guide the public health system in targeting core public health services and establishing standards Consider available resources and identify areas needing greater resource allocation Recommend legislative or regulatory action Provide a strategy for coordinating services delivery within the public health system Provide measurable indicators of effectiveness and successes Office of Planning and Partnerships Colorado Department of Public Health and Environment

Office of Planning and Partnerships Colorado Department of Public Health and Environment