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Improving Public Health’s Infrastructure: the Key to Transforming Public Health

Improving Public Health’s Infrastructure: the Key to Transforming Public Health. Dennis Lenaway, PhD, MPH Office of the Chief of Public Health Practice Centers for Disease Control and Prevention Colorado Public Health Association Annual Conference September 16, 2008.

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Improving Public Health’s Infrastructure: the Key to Transforming Public Health

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  1. Improving Public Health’s Infrastructure: the Key to Transforming Public Health Dennis Lenaway, PhD, MPH Office of the Chief of Public Health Practice Centers for Disease Control and Prevention Colorado Public Health Association Annual Conference September 16, 2008

  2. Why focus on Infrastructure? “The public health infrastructure has suffered from neglect…” “Weaknesses in the governmental public health infrastructure were clearly demonstrated in the Fall of 2001.” Institute of Medicine 2003

  3. Public Health Challenges

  4. Public Health Challenges Emerging Diseases (SARS, Pandemic Flu) Re-emerging Diseases (XDR-TB) Food Safety Bioterrorism Natural Disasters Obesity Aging Population Health Disparities Global Warming

  5. Health Care Crisis

  6. Health Care Crisis Aging Population Re-emerging Diseases Emerging Diseases Obesity Health Disparities Access to Quality Health Care Health Insurance Costs Uninsured and Underinsured

  7. Federal, State and Local Silos Health Care Emergency Management Education Law Enforcement Public Health

  8. Assets Functions Capacity Interventions Impact 3 Core Functions and 10 EPHS Public Health Agencies Key Elements in Public Health Programs and Activities Leadership Public Health Systems Healthiest Nation QI Community Engagement and Health Planning Workforce Portfolio Management Resources Leadership & Workforce Development Infrastructure

  9. Office of the Chief of Public Health Practice • Setting Agency Standards • Public Health Accreditation Board • Setting System Standards • National Public Health Performance Standards Program • Engaging with Communities • MAPP • Managing our Resource Portfolio • Senior Management Officials • Strategic Management Agreements • Public Health Apprenticeship Program • Excellence in Public Health Practice Council

  10. Public Health Accreditation Board A new non-profit organization dedicated to the development and implementation of a national voluntary accreditation program for state, local and tribal public health departments • Launched in May 2007 • Co-funded by CDC and RWJF

  11. Public Health Accreditation Board Goal Improve and protect the health of the public by advancing the quality and performance of State, local, and tribal public health departments

  12. Strengthening systems, improving the public’s health

  13. NPHPSP • Optimal model standards • Builds partnerships • Compliments accreditation • Used by 24 states and over 1,000 localities A State, local or governance assessment and quality improvement process that focuses on the entire public health “system”

  14. WA MT ND ME OR MN VT NH ID SD WI NY MA WY MI RI IA PA NE NV CT OH UT IL IN NJ CO WV CA KS VA DE MO KY MD NC TN OK AZ NM AR SC GA MS AL TX LA AK FL HI NPHPSP State Instrument Use(Thru September 2008, n = 24 states) NH MA RI CT *Also includes sites using field test versions of the NPHPSP State Public Health System Performance Assessment.

  15. WA MT ND ME OR MN VT NH ID SD WI NY MA WY MI RI IA PA NE NV CT OH UT IL IN NJ CO WV CA KS VA DE MO KY MD NC TN OK AZ NM AR SC GA MS AL TX LA AK FL Significant Use (67% or greater) Moderate Use (33% - 66%) Limited Use (1% - 32%) NPHPSP Local Instrument Use(Thru September 2008) HI *Also includes sites using field test versions of the NPHPSP Local Public Health System Performance Assessment.

  16. New Version 2.0 Instruments State Local Governance

  17. Mobilizing – community engagement • Action – implementation of a Health Improvement Plan • Planning – built on strategic planning concepts • Partnerships – the public’s health is more than the concern of the health department

  18. What is MAPP? • A community-wide strategic planning tool for improving public health. • A method to help communities prioritize public health issues, identify resources for addressing them, and take action.

  19. “If you want to travel fast, go alone. If you want to travel far, go together." Old African Proverb

  20. Portfolio Management Program

  21. Washington DC Senior Management Officials • Senior Management Officials • Definition/role • (how many) KarenWhite Joe Henderson DuionaBaker Bobbie Erlwein Mike Hughes H. Mac McCraw Steve Boedigheimer Candice Nowicki BillGallo VACANT Brock Lamont Melanie Duckworth

  22. Strategic Management Agreements (SMAs) • An agreement negotiated by the Portfolio Management Program with the CDC Director and the State Health Commissioner as Principals. • Engage and align state strategic planning efforts to CDC Goals • Establish agreed upon priorities • Advance efforts aimed at achieving specific health outcomes • Leverage and maximize CDC and state investments • Promote program flexibility linked to accountability. • First SMAs being drafted with Arkansas & California - 2008

  23. Public Health Apprenticeship Program (PHAP) • Purpose: to develop highly qualified candidates for employment with state and local health departments and CDC to meet the public health system challenges of the 21st century. • PHAP provides a career pathway for entry-level public health workers that includes: • Knowledge of the components, roles and functions of the public health system • Front-line service in public health practice in multiple programs • Skills in public health program implementation • 2007 - 10 Apprentices placed in Florida Local Health Departments 2008 - 35 Apprentices placed in Florida, Texas, Georgia, North Carolina and Arkansas

  24. Excellence in Public Health Practice Council • Provides a forum for a coordinated, enterprise-wide approach to addressing public health practice issues at CDC • Workgroups have developed recommendations on Practice Issues including: • Public Health Infrastructure Development • Performance of Public Health Systems • Translating Science into Practice

  25. Workforce Development • Competencies for Public Health professionals • Epidemiologists • Credentialing and certification • National Board of Public Health Examiners (2005) • Existing programs in nursing, environmental health, laboratories

  26. Leadership Development • National Public Health Leadership Institute • State and Regional Public Health Leadership Institutes • National Public Health Leadership Development Network • Governmental Leadership Programs for Health Officials • Association of Public Health Laboratories and CDC’s National Center for Environmental Health

  27. Transforming the Public Health System

  28. Building the platform towards a Healthiest Nation

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