SHP Five Year Timeline

1. STRATEGIC HEALTH PLAN 2010-2015Annual Report April 2012Pam Jahnke, , RN, CNOMark Guidry, MD, MPH, CEO 4/1/12

2. SHP Five Year Timeline • Period: 2010 to 2015 • SHP adopted by both Boards February 2010 • 2010 progress report given February 2011 • Added Wellness Priority February 2012 • 2011 progress report given April 2012 • 2012 progress report due 2013 • 2013 progress report due 2014 • 2014 final progress report and report card due for five year plan 2015 • Early 2015 establish new SHP for 2015-2020

3. Priorities of the SHP 2010-2015 • Improve access to care for the Indigent and Uninsured • Improve the health of our community and environment • Prepare for and respond to public health emergencies • Modernize facilities and use of technology • Strengthen the efficiency and effectiveness of business practices • Developing a competent and professional public health workforce • Continue to improve and strengthen the credibility of the Health District • Promote wellness in worksites and throughout Galveston County and cities

4. Priority 1: Improve Access to Care for the Indigent and Uninsured Major Accomplishments Planned for Coastal Health & Wellness (CH&W) clinic site at Mid County Annex: 8 more exam rooms, 2 more treatment rooms, improved flow and security, etc. Explored partnership with UTMB Family Medicine Residency Program for educational opportunities Adopted CH&W Billing and Collections Policy to increase operational revenue Planned for CH&W discount Walgreen’s pharmacy services Planned Same Day appointment process Redesigned and simplified County Indigent Health Care Program eligibility process. Shared information at community forum CEO appointed to statewide Public Health Policy and Funding committee Wrote expansion grant (unfunded due to federal budget freeze) Enrolled providers for Medicaid Meaningful Use Continued funding partnerships with local hospitals for case manager

5. Priority One: Improve Access to Care for the Indigent and Uninsured Next Steps Complete three-phase move of CH&W to Mid County Annex Implement Same Day appointments for medical and dental patients Seek grant funding opportunities to expand clinic hours, locations Explore opportunities for CH&W revenue generation: Medicaid 1115 Waiver, Patient Centered Medical Home accreditation, Meaningful Use, billing and collections Track and discern changes in state and federal healthcare policy and plan for impacts Inform and educate the public and policy makers: continue community forums

6. Priority Two: Improve the Health of our Community and Environment Major Accomplishments Issued numerous health advisories (e.g. pertussis, mercury and ciguatera poisoning) Implemented secure online school surveillance reporting system for flu and other reportable diseases Increased the capacity to quarantine more animals after bite injuries Educated elected officials and the public on preventing storm water pollution Implemented obesity workshops for WIC clients Developed a coalition to decrease infant mortality by promoting work site breastfeeding (grant) Developed clinical screening guidelines for adults, electronic educational materials and preventive peer review measures Worked with Mainland Medical Center to improve EMS care for stroke patients

7. Priority Two: Improve the Health of our Community and Environment Next Steps Improve clinical services for STDs and TB in Mid County Annex Improve compliance with state requirements for STD/HIV, TB , WIC and Title V operations through internal quality assurance activities Inform and educate policy makers about current environmental issues and threats Integrate awareness activities among public health programs that serve similar target populations; collaborate with school districts and faith-based organizations Train and educate CH&W staff on ways to promote wellness in clinic patients (for example, tobacco and obesity interventions) Improve preventive screenings in CH&W by monitoring reports of applicable measures as part of quality assurance process Establish tobacco cessation group counseling for clinic patients

8. Priority Three: Prepare For and Respond to Public Health Emergencies Major Accomplishments Expanded and improved the use of technology for emergency notifications Promoted hurricane preparedness activities in a Daily News guest column submission by the CEO Enrolled and trained 140 new Medical Reserve Corp volunteers Purchased equipment for readiness: two trailers, boxes for delivering medications to the public at mass vaccination outreach sites, stanchions, dollies, radios, identification clothing Preparedness staff collaboratively trained and prepared for emergencies with multiple community partners , attending 59 events Established an animal services agreement with the Humane Society of the United States to provide support in disasters

9. Priority Three: Prepare For and Respond to Public Health Emergencies Next Steps Continue to attend local and regional preparedness drills and exercises Continue to recruit and train volunteers for Medical Reserve Corp Organize storage of equipment and supplies in planned storage areas in Mid County Annex for most efficient use in a public health emergency Continue annual hurricane preparedness activities to train staff and inform the public Assure contract compliance with the state during audits

10. Priority Four: Modernize Facilities and Use of Technology Major Accomplishments Opened state-of-the art Animal Resource Center with a public friendly environment that promotes adoption and education Planned the Mid County Annex facility to meet outlined goals Implemented digital medical and dental x-rays in CH&W Trained CH&W staff and rolled out NextGen electronic medical record Trained CH&W staff and rolled out NextGen electronic dental record Implemented billing improvements related to new practice management system Trained staff and implemented Shelter Pro, an animal services data management system that can link animals and their owners Continued roll out of electronic accounting and payroll system: cash drawers, fixed asset module, budget module and reporting systems Purchased and configured new contract management software program to improve access and tracking

11. Priority Four: Modernize Facilities and Use of Technology Next Steps Complete three-phase move to Mid County Annex Work with Animal Services Interlocal Agreement members to approve a funding formula , scope of services, etc. starting in FY 2013 Renovate Galveston CH&W site for improved productivity and flow Continue development of NextGen documentation to meet Meaningful Use and improve quality of care Continue development of NextGen systems to improve billing and collections Utilize Shelter Pro to report field animal control data by jurisdiction and to bill clients through an accounting system interface Complete accounting interfaces to other GCHD software, develop HR module and identify and build standard management reports Explore ways to electronically file and store government documents

12. Priority Five: Strengthen the Efficiency and Effectiveness of Business Practices Major Accomplishments Provided Program snapshots at Board meetings Set up a reserve fund for emergencies (e.g. rabies prophylaxis for uninsured) Increased Board participation in community meetings and Health District activities (e.g. TACHC conference, joint Board tour, CH&W transformation brainstorming meeting, community forum) Explored opportunities to consolidate administrative functions with the county (e.g. phone system, IT, document management, security systems) Rolled out electronic accounting system for fixed asset management, cash drawers and electronic receipts, budgets and HR Incorporated preventive safety training into monthly GAAA staff meetings Updated Animal Services and Immunization fees Improved reports to Boards on state or other audits including findings and corrective actions Implemented CH&W payment plans and collection processes Improved CH&W customer service surveys and established a baseline Developed customer service tool for new food service openings

13. Priority Five: Strengthen the Efficiency and Effectiveness of Business Practices Next Steps Facilitate Boards review of monthly financial reports to the Boards for feedback and possible improvement Pursue grant opportunities to fund personnel and resources needed to accomplish strategic goals and activities (e.g. wellness initiatives) Track and trend risk and safety compliance issues, analyze trends and suggest improvements Explore on-line payment options for fees Develop customer feedback tools for GAAA Improve CH&W registration and billing processes Track and trend customer service measures for CH&W

14. Priority Six: Developing a Competent and Professional Public Health Workforce Major Accomplishments Implemented a letter to new employees from CEO on values, roles and responsibilities in government and offered coaching and guidance Tracked annual trainings to meet legal requirements Revamped orientation program for new employees Performed market-based salary analyses on selected positions Updated policies and guidelines on employee intranet Developed employee mentoring programs in GAAA , Community Health Services and Environmental Services Trained employees intensively on new electronic software and processes: • Coastal Health & Wellness: digital X-rays, electronic medical record, electronic dental record, new billing and collections procedures • GAAA: Upgraded field software so EKG and vital signs transmit to run sheets • Animal Services: new Shelter Pro software track data on animals, owners, revenue and field services such as complaint calls Elicited employee feedback on CH&W Transformation Plan; recognized employees “Going From Good to Great!” Developed an exit survey for employees that voluntarily leave

15. Priority Six: Developing a Competent and Professional Public Health Workforce Next Steps Complete the GCHD guide for new supervisors Survey continuing education needs for licensed/certified staff Improve orientation for new employees Expand and improve activities to promote employee wellness Continue to roll out electronic enhancements for HR module to include: Employee access to enrollment forms and ability to update personnel information Managers’ access to their staff’s personnel information

16. Priority Seven: Continue to Improve and Strengthen the Credibility of the Health District Major Accomplishments Met with League City officials, at their request, regarding potential collaboration model for animal services and rabies control {Target: cities} Developed the STAR volunteer program to support the Animal Resources Center {Target: the public} Improved Health District and CH&W public websites for ease of navigation and more professionalism {Target: the public} Informed the public and stakeholders of changes to programs such as CH&W through filmed DVDs, fliers, website notification and a planned community forum {Target: the public} Developed Transformation Plan for CH&W with Board and employee input to improve public perception of the clinic {Target: the public} Worked with health partners to explore technology to share electronic data to better manage patient care {Target: partners} Continued to meet with community groups: Lead Task Force and new Healthy Babies Coalition {Target: partners} Enforced new collections policy, which changed the perception that CH&W is a free clinic {Target: clients}

17. Priority Seven: Continue to Improve and Strengthen the Credibility of the Health District Next Steps Continue planning and execution of an environmental risk assessment for county and member city jurisdictions {Target: cities} Explore new technologies such as Facebook and Twitter, and strategies to reach segments of the public {Target: youth, public that uses social media} Review Consumer Health inspection processes and propose changes that support standardization and monitoring {Target: businesses} Prepare and disseminate to stakeholders a report by jurisdiction to show average response times of animal control officers to calls for assistance {Target: interlocal cities} Lead community discussions on health policy and funding issues as begun in the community forum meeting {Target: local partners} Complete Phase I of CH&W Transformation Plan and develop Phase II to improve community perceptions and market the clinic {Target: local community}

18. Priority Eight: Promote Wellness in Worksites and Throughout Our Community Major Accomplishments Boards prioritized wellness initiative February 2012 Developed wellness website to link users to national and local resources, www.wellRU.org Produced “What is Wellness” video infomercial Began Health District employee wellness initiative: weight challenge, nutrition displays and physical activity classes Worked with county wellness committee to develop and implement a worksite wellness program for county employees focusing on tobacco cessation, improving nutrition and physical activity Planned for Eat Well Galveston County program to identify restaurants with healthy choices Developed and adopted adult preventive screening guidelines and quality measures for CH&W patients

19. Priority Eight: Promote Wellness in Worksites and Throughout Our Community Next Steps Expand and improve GCHD worksite wellness program Implement Eat Well Galveston County and enroll local restaurants Seek funding opportunities to sustain wellness activities Promote preventive health visits Track and trend preventive measures for CH&W patients Train clinical staff on interventions and approaches to prevention Engage community groups in wellness initiatives Provide technical assistance to employers initiating worksite wellness programs Establish 10 mother-friendly worksites to promote breastfeeding (grant)

20. Assessment of SHP Accomplishments in 2011 We are on target to complete the Strategic Health Plan 2010-2015 goals and objectives as drafted THANK YOU!