1. KPHLI Change is hard
September 2015

2. IOM recommendations for a minimum package
All levels of government should endorse the need for a minimum package of public health services that includes foundational capabilities and an array of basic programs that no health department should be without.
Stakeholder process to determine elements of the Minimum Package, made up of foundational capabilities and basic programs

3. Washington State David Fleming

5. How Public Health in Kentucky is Funded
State
Federal
Local
Medicaid
Grants!!!
Medicare

6. How to get the Most Bang for our Buck

8. Is 47th good enough for Kentucky?

9. Current Smokers – 28.3%
Current High School Smokers – 24.1%

10. We spend the 15th greatest amount per capita ($43
We spend the 15th greatest amount per capita ($43.19) to be 45th in health status.

11. Ideal Public Health Department$
David Fleming, Washington State

12. Actual Public Health Department$
David Fleming, Washington State

13. Current State of the Public’s Health in Kentucky
Decentralized local public health system;
Chronic under-funding of Public Health;
Acute state and local budget reductions;
Vulnerability of a pool of state dollars for core support of local Public Health services;
Proposed elimination of these resources in legislative session after session.

14. Change will not happen immediately or without pain..
What do we need to be doing at a minimum?
Be specific enough on what needs to be in place to determine its cost.
Realize that the current structure may not survive.

15. Access to and Linkage w/
Framework
Additional Services
Chronic
Disease &
Injury Prev
Comm
Disease
Control
Maternal
Child
Family
Health
Environ-
mental
Public Health
Access to and Linkage w/
Clinical Care
Foundational Public Health Programs
Across all Programs
Assessment (surveillance and epidemiology)
Emergency preparedness and response (all hazards)
Communications
Policy development and support
Community partnership development
Organizational/business competencies (governance, equity, IT, HR, etc.)
Foundational
Public
Health
Capabilities

16. Access to and Linkage w/
Framework
Additional Services
Chronic
Disease &
Injury Prev
Comm
Disease
Control
Maternal
Child
Family
Health
Environ-
mental
Public Health
Access to and Linkage w/
Clinical Care
Foundational Public Health Programs
Across all Programs
Assessment (surveillance and epidemiology)
Emergency preparedness and response (all hazards)
Communications
Policy development and support
Community partnership development
Organizational/business competencies (governance, equity, IT, HR, etc.)
Foundational
Public
Health
Capabilities

17. Access to and Linkage w/
Framework
Additional Services
Chronic
Disease &
Injury Prev
Comm
Disease
Control
Maternal
Child
Family
Health
Environ-
mental
Public Health
Access to and Linkage w/
Clinical Care
Foundational Public Health Responsibilities
Across all Programs
Assessment (surveillance and epidemiology)
Emergency preparedness and response (all hazards)
Communications
Policy development and support
Community partnership development
Organizational/business competencies (governance, equity, IT, HR, etc.)
Foundational
Public
Health
Capabilities

18. Framework Additional Services Foundational Programs
Chronic
Disease &
Injury Prev
Comm
Disease
Control
Maternal
Child
Family
Health
Environ-
mental
Public Health
Access to
Clinical Care
Foundational Programs
Across all Programs
Assessment (surveillance and epidemiology)
Emergency preparedness and response (all hazards)
Communications
Policy development and support
Community partnership development
Business competencies
Foundational Capabilities

20. Access to and Linkage w/
Framework
Across all Programs
Assessment (surveillance and epidemiology) - 844, 890
Emergency preparedness and response (all hazards) - 746, 747, 749, 757, 759, 763, 771, 815, 821, 822, 823, 824, 825
Communications
Policy development and support – 836, 890
Community partnership development – 735, 736, 740, 756, 761, 837, 893
Organizational/business competencies (governance, equity, IT, HR, etc.) – 724, 750, 888, 894, 897, 898
Chronic
Disease &
Injury Prev
Comm
Disease
Control
Maternal
Child /Family
Health
Environmental
Public Health
Access to and Linkage w/
Clinical Care
Programs/Activities specific to Local Community Need
Cost Centers – 715, 718, 730, 748, 769, 810, 813, 858, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 882, 891
801, 806, 807, 842, 843, 845
722, 723, 738, 765, 805, 809, 818, 832, 836, 841, 856, 857
500, 520, 540, 560, 580, 591
760, 766, 767, 768, 803, 804, 808, 816, 833, 848, 852, 853, 854
712, 741, 770, 800, 802, 811, 883
Additional Services
Foundational Public Health Programs
“Responsibilities”
Foundational
Public
Health
Capabilities
Regardless of Cost Center: Function Code Assessment; Function Codes 173, 175 – Policy Development; Function 123 – Chronic Disease and Injury Prevention

21. Current
$ $33.38
Projected
$ $56.53

22. Current
$ $49.93
Projected
$ $81.79