Preparing for the Assessment

1. Preparing for the Assessment Liza Corso (CDC) Jennifer Jimenez (ASTHO)

2. Objectives Today’s session will allow participants to: • Become familiar with the NPHPSP Instruments • Determine readiness to engage in the process • Explore the types of leadership needed to sponsor and sustain the process • Consider how the assessment can be used as a tool for initiating a performance improvement effort

3. Providing performance standards for public health systems and encouraging their widespread use; Engaging and leveraging national, state, and local partnerships to build a stronger foundation for public health preparedness; Promoting continuous quality improvement of public health systems; and Strengthening the science base for public health practice improvement. NPHPSP Vision and Goals To improve the qualityof public health practice and performance of public health systems by:

4. 1. Based on the ten Essential Public Health Services 2. Focus on the overall public health system 3. Describe an optimal level of performance 4. Support a process of quality improvement Four Concepts Applied in NPHPSP

5. Assessment Instruments State public health system Local public health system Local public health governance Partners CDC APHA ASTHO NPHPSP • NACCHO • NALBOH • NNPHI • PHF

6. History of the NPHPSP • Key Dates • Began in 1998 • Version 1 instruments released in 2002 • 2002-2007 – Version 1 instruments used in 36 states • Development of Version 2 instruments – 2005-2007 • Release of Version 2 instruments – Fall 2007

7. Version 2 Instruments • Process • Guided by peer-driven work groups • Utilized a variety of subject matter experts • Limited field testing in 2006 • Release with OMB clearance in Fall 2007 • Key Changes • Modernized and updated the content • Streamlined and identified opportunities for greater user-friendliness • Added “discussion boxes” feature • Altered response options • Included optional priority and agency contribution questionnaires

8. Key Steps in the Process • Prepare for the NPHPSP Assessment • Become familiar with the assessment instruments • Determine how the assessments will be structured and facilitated • Identify and invite participants • Conduct the NPHPSP Assessment • Orient participants • Complete the assessment instrument • Complete supplemental questionnaires • Submit assessment data • Facilitate Post-assessment and performance improvement activities

9. Monitor health status Diagnose and investigate health problems Inform, educate and empower people Mobilize communities to address health problems Develop policies and plans Enforce laws and regulations Link people to needed health services Assure a competent workforce - public health and personal care Evaluate health services Conduct research for new innovations The Essential Public Health Services

10. Instrument Format Essential Service Model Standard

11. Instrument Format Measures or Questions Discussion Toolbox

12. The Three Instruments • Content • Common themes addressed in all instruments • Common glossary and consistency in terminology • Key topics mutually reinforced across two or all instruments, as appropriate • Similar supplemental questionnaires • Structure • Similar structure (Essential Service, optimal model standards followed by questions, same response options) • Some variance in the model standards or content structure within each ES…

13. State Public Health System Instrument • Same 4 model standards for each of the ten Essential Services (40 model standards total) • 1 – Planning and Implementation • 2 – State-Local Relationships • 3 – Performance Management and Quality Improvement • 4 – Public Health Capacity and Resources

14. Local Public Health System Instrument • 2-4 model standards per Essential Service(30 Total) • Model standard titles change to address local activities in each Essential Service. ES #3 example: • 3.1 Health Education and Promotion • 3.2 Health Communication • 3.3 Risk Communication

15. Local Public Health Governance Instrument • Focuses on the public health governing body: The individual, board, council, commission, or other body with legal authority over the public health functions of a jurisdiction of local government; or region, or district, or reservation • One Model Standard for each Essential Service (10 model standards total) • Focuses on oversight of and authority for public health activities with attention to: • Resources to support… • Policies to support… • Review and evaluation of…

17. Discussion Toolboxes

18. Supplemental Questionnaires • Priority Questionnaire (optional) • “On a scale of 1 to 10, what is the priority of this model standard?” • Use throughout the assessment or after • Recommend completion by consistent group • Agency Questionnaire (optional) • “How much of the model standard is achieved through the direct contribution of the agency?” • Use throughout the assessment or after • Recommend completion by consistent group (can be agency-only or include system partners) • Respondent information form (required) • A series of questions about jurisdiction’s demographics, assessment process, and planned next steps • Completed only by lead agency to accompany the on-line data submission

19. Questions ?

20. Making the Decision Overview • Assess Readiness • Purpose and Benefits • Resources • Strategic Fit • Leadership • Determine Who Will Lead the NPHPSP • Consider a Statewide Coordinated Approach • Move Forward

21. Purpose and Benefits Questions to consider: • What is the impetus for undertaking the assessment? • Have the purpose and expected benefits been clearly articulated? • Is there a plan for use of the assessment results?

22. Why NPHPSP? • Establish a baseline measure of public health performance • Identify strengths and weaknesses of state and local public health systems and boards of health • Initiate a public health improvement process • Build a stronger level of collaboration among public health partners • Improve public health system effectiveness • Prepare for agency accreditation

23. Resources Questions to Consider: • Have staff support and other resources been identified to support assessment and post-assessment activities?

24. Strategic Fit Questions to Consider: • Is there general agreement about how NPHPSP complements existing activities (performance improvement, strategic planning, community health improvement, etc.)? • How is the timing for undertaking such an effort?

25. Leadership Commitment • What type of leadership is needed – to sponsor the process, create buy-in and sustain, coordinate activities, etc.? • The “executive sponsor” • Lead coordinator(s) • Opinion leaders

26. Issues for Leadership (of all types) • Making the decision • Messages • What messages will “sell” this to leadership? • What messages can leadership use to promote the process? • Connect with other initiatives • Orienting activities around QI • Resources

27. Who Will Lead the Process? Identify a lead and/or coordinating organization: • State or local health department, public health institute, university, other?

28. Lead Organization Questions to Consider: • Who is the decision-maker within your organization? • Will a planning committee be used? • Is there an existing public health partnership or coalition that might be involved in planning?

29. Considering a Statewide Approach • What is a “statewide process?” • Use of multiple NPHPSP instruments through a coordinated approach • Coordinated use of the Local or Governance instruments throughout the majority of local jurisdictions • Why use a coordinated statewide approach? • Benefits in technical assistance and coordinated improvement planning For more on this topic. . . www.naccho.org/topics/infrastructure/MAPP/TAWebcastJanuary2008.cfm

30. Moving Forward! • Review User Guide, Online Tool Kit and other supporting materials • Develop timeline and work plan to identify next steps http://www.cdc.gov/od/ocphp/nphpsp/

31. Thank You! Technical Assistance 1-800-747-7649 phpsp@cdc.gov Visit our website http://www.cdc.gov/od/ocphp/nphpsp/ Next User Call November 18, 2:00 PM eastern