Stephanie R. Paulmeno MS, RN, NHA Director, Community Health Planning

1. Local Public Health Performance Standards Assessment & the MAPP ProcessTransitioning Your Community From Perception to Reality Stephanie R. Paulmeno MS, RN, NHA Director, Community Health Planning Greenwich Department of Health Greenwich, CT

2. Performance Standards in Public Health The Core Public Health Steering Committee of the CDC, the American Public Health Association (APHA), NACCHO and other major national public health agencies initiated the process of identifying performance standards for public health in 1994.

3. Greenwich: A long tradition of Community partnerships • Public health infrastructure is strong & visible in Greenwich • Partnerships have existed for decades • Public health leadership and visibility was dramatically increased with the appointment of a designated Community Health Planner who works within the Town, Region and State

4. The Community Health Planner • Assessment based planning focus • Outcome focused planning strategies • Works to develop, support, or work within partnerships and coalitions • Focuses on the use of resources, identifying/filling gaps and avoiding unnecessary duplication of services • Provides introduction to Town services

5. The process evaluates public, private and municipal service delivery programs that impact health and emergency preparedness within a town or city, and not merely the capacity of their Local Departments of Health. The process is a partnership effort to improve public health practiceand performance as well as the infrastructure that supports these efforts. Survey Purpose & Process

6. Is Perception Reality? The survey is a perceptual tool It can reflect either the knowledge base of the participants or provide an accurate depiction of the various assessment components

7. The benefit of group evaluation The traditional vs. “fast track” process Advance Preparation Time saving pre assessment strategies Rapid visual depiction of the community Pre-Planning Issues

8. Designing pre-assessment participant worksheets The benefits of charts and posters Getting the right partners to the table Explaining the 10 Essential Services of Public Health Pre-Planning Issues

9. Building Community Ownership Of The Assessment Process Buy-in is important to the quality & level of participation & to the outcome The view is different from different agency levels All participants have equal standing All opinions are important and valid

10. Pre-Assessment Preparation • Draft information letters/make follow-up phone calls seeking participants • Develop display charts for review areas • Pre-distribute the 10 Essential Services of Public Health • Design/Distribute work sheets for pre-analysis • Conduct Town website review

11. Letters & Phone Calls • Explain the rationale and process • Define a “public health system” as opposed to the core functions of a health department (“all public, private & voluntary entities that contribute to the delivery of essential public health services within a jurisdiction”)

12. Monitor Health Diagnose/Investigate Inform, educate, empower Mobilize partnerships Policy Development Enforce laws & regs Link people/health care Assure a competent workforce Evaluate quality Research for new insights 10 Essential Services of Public Health

13. Collaborations Coalitions & Partnerships Community Assessments Disaster Preparedness Task forces/projects Health Surveillance Activities Agencies/Town Depts. that had under gone evaluations Advocacy Groups Emergency Equipment Developing Charts to Educate the Public Health System Evaluators

14. Collaboration Posters Senior Provider Network ~ Advisory Boards ~ United Way Youth & Planning Councils ~ Senior Health Fair Team ~ Late Life Issues Committee ~ Underage Drinking Coalition ~ Greenwich Health Improvement Partnership & Committees ~ Time for Lyme Task Force ~ Regional B-T Group ~ Assessment Committees ~ Disease-based Advisory Councils ~

15. Community Assessments Posters Greenwich Department of Health: • Latino Study • Public Health Systems Assessment United Way: • Community Needs Assessment • Statistical Portrait (w/GDoH) Greenwich Hospital Advisory Board: • Community Health Assessment

16. Disaster Preparedness Posters B-T Coordinator/Team ~ Disaster Plans ~ Mass Immunization Protocols ~ Communicationmodalities ~ Incident Command Training ~ Mock Disasters ~ PPE/Training ~ Broadcast Fax ~ Radiology Meters ~ Decontamination Units ~ SARS & Avian Flu monitoring/tracking~ Highest # of certified Hazmet Techs in CT (96) ~ 50 MOP II test kits ~ “Decon” trailer & portable unit ~ 50 docemeters ~ Fully equipped Hazmat truck w/ mobile command unit, picture transmission on order

17. Other Poster Displays • Policy and planning forums/collaborators • Town’s Surveillance System Components: Equipment Monitoring Partners Training Capacity Drills • Essential Services of Public Health • Agencies that had undergone internal studies or major reviews within 5 years

18. Pre-Assessment Worksheets

19. Pre-Assessment Website Review • Assessments conducted • Data gathering and report sharing • Research studies/Findings • Linkages/Collaborations

20. Pre-Assessment Preparation Identify The Invitees/Construct Your Mix • Local Hospital, nursing homes, practitioners, etc. • 1st Responders (police, fire, ambulance, E.R.) • Red Cross • School and business representatives • Town health & social service provider agencies • Consumers, local government, funding sources • Clergy, service organizations

21. Pre-Assessment Preparation Two Breakout sessions were designed: 1) Greenwich Department of Health 2) 1st Responders Information gathering sessions were held with key people who could not attend

22. Pre-Assessment Preparation Seek representation that reflects your culturaland ethnicgroups and various age groups and special needs populations Seek participation from people at various levels of organizations Seek people from Town government

23. Assessment Day On site monitor Orientation AM and PM Breakout sessions Model standard vs. Town performance Facilitating the discussion Scoring the group responses

24. Post Assessment Entering the response Scores Getting the report results Drafting the final report Community Forum Using the report findings

25. Utilizing Report Results 1 of 2 Even good results can offer opportunities for improvement: • The standard may be met but individual indicators may be lacking • The raters perception may be erroneously positive • Intra/inter agency communications may be editorialized in a group setting

26. Utilizing Report Results 2 of 2 Community forums and press releases Guide the development or revision of a strategic or operating plan Guide the development of outcome based budgeting Motivate a workforce capacity study Enhance communication of data, research findings, and surveillance

27. Don't be Intimidated!