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Local Public Health Agencies in Colorado Baseline Review. Conducted in Summer 2011. Objectives. Present a summary of the purpose and results of Colorado’s 2011 Baseline Review Summarize how this effort connects with other national initiatives
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Local Public Health Agencies in Colorado Baseline Review Conducted in Summer 2011
Objectives Present a summary of the purpose and results of Colorado’s 2011 Baseline Review Summarize how this effort connects with other national initiatives Hear from you about how this information can be helpful
Why understanding public health activities, funding and staffing matters • Health care and other sectors • Measuring performance begins with understanding the current system • Comparisons with more or less robust systems helps to provide a rationale for your needs • Identifying your own capacity and needs for improvement through: • Comparisons to other, similar agencies • Information for sharing information and services with other agencies • Potential ideas for improvement or implementation that other agencies are doing
National Efforts • RWJF investments • National Surveys • NACCHO, NALBOH, ASTHO • Data Harmonization Project • PHSSR Agenda • PHAST • PHUD$ • MPROVE • CDC’s National Public Health Improvement Initiative (funding for this project) • IOM Report on measurement
Similar Efforts • Currently, service delivery measures are not well understood • Other states have struggled to collect service delivery across their state system • Minnesota • Washington • Ohio
Colorado Efforts NACCHO Profile response rates NACCHO Profile testing project PHAST participation Annual report (to OPP) Baseline Review PHSSR Core Services research project MPROVE
Today’s Focus NACCHO Profile response rates NACCHO Profile testing project PHAST participation Annual report (to OPP) Baseline Review PHSSR Core Services research project MPROVE With a little additional information thrown in
Baseline Review • Purpose: • Catalogue current capacity of the CO system • Inform core services and funding discussions • Identify areas for improvement • Fulfill CDC grant objectives • Serve as the Annual Report to then be updated yearly • Methods: • Tool questions reviewed by PHISC and task force members • Pre-populated tool with formerly gathered data (NACCHO profile) • 3-4 hour site visits March through August, 2011
Review Included: Core Services Sections: Assessment/Planning, Vital Records, Communicable Disease, Prevention and Population Health Promotion (Chronic Disease, Injuries, Behavioral and Mental Health, Maternal and Child Health), Environmental Health, Emergency Preparedness Other Direct Services Provided Administrative/ Governance Sections: Structure, Governance, Human Resources (workforce), Financial
Core Services: Core Questions • Who provides service in your jurisdiction • Do you share this service • Could this service be shared • Monitoring the service • FTE dedicated to service • Service adequately staffed • Trainings needed for staff dedicated to service • Funding for service • Funding % based on sources • Stability of funding • Resources that have been cut • Service adequacy for population • Additional resources needed • Rate CDPHE in consultation, TA and training • What improvements are needed in this service delivery
Methods: Baseline Review of LPHA’s • Conducted Spring/Summer 2011 • All local public health agencies participated • Extensive tool filled out prior to visit • 3-4 hour interview • Directors and staff members • Board of health members (uncommon) • Data review and resubmission for any additional gaps
Baseline Review Tool • Used existing and validated tools as a starting point for development of Baseline Review Tool • NACCHO Profile • Minnesota’s Local Public Health Planning and Performance Measurement Reporting System • Washington’s Activities and Service Inventory • McKinsey Capacity Assessment Grid
Baseline Review Tool • Included all Core Services • Assessment, Planning, and Communication • Vital Records and Statistics • Communicable Disease Prevention, Investigation, and Control • Prevention and Population Health Promotion • Emergency Preparedness and Response • Environmental Health • Administration and Governance
Baseline Review Tool • Service categories within each core service • Chronic Disease prevention within prevention and promotion • Service areas within each category • Nutrition Promotion in Chronic Disease prevention • Service activities within each area • Educational Materials or Policy Development within Nutrition Promotion
How is this service provided or assured? 3 = LPHA provides this service/activity. This includes main and satellite offices 2 = Provided by Another Agency (listed) 1 = This service/activity is needed but not available within jurisdiction 0 = This service/activity is not applicable within jurisdiction
Who provides a service in your jurisdiction? LPHA at Main Office Satellite Office Other County Office (please name) Obtained from another LPHA (please name) CDPHE Regional staff (CDPHE employees) CDPHE funded staff in regions Someone else (Please name) Contracted out by LPHA (Please name) Not available in jurisdiction Unknown Provided to another LPHA
Self-Reported Capacity • For each category within core services the following question was asked: • How would you rank your jurisdiction’s capacity to implement [core service category] at this point in time? • Selection Options • 1 = Clear need for increased capacity • 2 = Basic level of capacity in place • 3 = Moderate level of capacity in place • 4 = High level of capacity in place • Adapted from McKinsey’s Capacity Grid
Self-Reported Capacity 4 = High level of capacity in place defined as: • Stable funding, staffing, and facilities • Majority of target population is served, including those with health disparities • Ability to measure outcomes and address needed improvements • Uses current knowledge and best practices in delivery of service • Follows current national standards [if available] • Ability to seek new initiatives and access funding based on community needs • Service is supported by elected officials and well-connected with other system partners
Assessment and Planning • General Assessment and Planning Questions • What assessment had been done by last summer • Employees dedicated to Assessment and Planning • Funding dedicated to Assessment and Planning • Areas for improvement at the local jurisdictions • Capacity in Assessment and Planning
Assessment and Planning: Areas for Improvement Number of agencies
Staffing • How many contracted staff and FTE are dedicated to Assessment and Planning? • Mean Number of People = 2.4 • Mean FTE = 0.99 • 31% did not have any staff dedicated to Assessment and Planning
Funding • Sources of funding for Assessment and Planning • Percent of agencies reported by type of funding • STATE PER CAPITA (33% of agencies) • COUNTY (22% of agencies) • STATE DIRECT (not per capita) (18% of agencies)
Vital Records • 43% of LPHA’s provide vital records services, directly • 57% of LPHA’s have a formal MOU with county clerks, treasurers, etc, to perform vital records services. • 7 counties made positive changes since the Public Health Act by moving records out of homes.
Communicable Disease • General Communicable Disease Questions • Who is doing what within Communicable Disease • Employees dedicated to Communicable Disease • Funding dedicated to Communicable Disease • Areas for improvement at the local jurisdictions • Capacity in Communicable Disease
Staffing • How many contracted staff and FTE are dedicated to Communicable Disease? • Mean Number of People = 3.5 • Mean FTE = 2.3 • 11% did not have any staff dedicated to Communicable Diseases
Funding • Common sources for Communicable Disease • Percent of agencies reported by type of funding • STATE DIRECT (not per capita) (43% of agencies) • COUNTY (35% of agencies) • FEDERAL, PASSED THROUGH STATE (28% of agencies)
Prevention and Promotion • General Prevention and Promotion Questions • Who is doing what is Prevention and Promotion • Employees dedicated to Prevention and Promotion • Funding dedicated to Prevention and Promotion • Areas for improvement at the local jurisdictions • Capacity in Prevention and Promotion
Staffing • How many contracted staff and FTE are dedicated to Prevention and Promotion? • Mean Number of People = 5.2 • Mean FTE = 4.8 • 12% did not have any staff dedicated to Prevention and Promotion
Funding • Common funding sources for Prevention and Promotion • STATE DIRECT (not per capita) (41% of agencies) • STATE PER CAPITA (31% of agencies) • COUNTY (31% of agencies) • FEDERAL, PASSED THROUGH STATE (30% of agencies) • FOUNDATIONS (30% of agencies)
