Built late, but for the future: Nebraska’s local public health system Sorry not here yesterday. April 2017 www.nalhd.org

Prior to 2001, only the counties in color here were covered by a local public health department.

LHDs in Nebraska In 2001, the state invested a large chunk of it’s tobacco settlement resources in laying the groundwork for the system. That system is a district system 20 districts These districts cover from 1 to 11 counties. Some of the area’s covered are larger in size than several eastern states. They are all independent (as in each is a stand alone agency, each is governed by an independent board, and health department staff are not State employees—though they do work closely with the State [primarily DHHS’s Division of Public Health]). This district structure is the first piece of how I think we are built for the future.

The second way we are built for the future relates to the PH 3 The second way we are built for the future relates to the PH 3.0 concepts of Chief Health Strategists and to Cross Sector Partnerships. Because they were built late. Came in as Chief Health Strategists Working Across Sectors to do community planning, to identify gaps and to assure those gaps were filled. Most do NOT act as a safetynet provider of health care services… in many cases because that role was filled to some extent already. So the provision of direct services was never ”the thing” that our locals did… Chief Health Strategist is second nature to LHDs in Nebraska. They work with diverse system players, their expertise and their resources In ways that maximize whole communities’ opportunities for health and safety. The bricks here highlight some areas of shared strength, statewide.  

Public Health in Nebraska 2 LHDs are accredited. Almost all LHDs are actively moving toward PHAB accreditation. PHAB adjustments for small health departments has helped and we anticipate will continue to help our LHDs. Are districts are large in area, but many have very small staffs and budgets.

Public Health 3.0 Chief Health Strategists Actionable Data Cross Sector Partnerships Sustainable Funding PHAB Accreditation The second piece of

Susan Bockrath Executive Director nalhd@nalhd.org Thank you