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Regionalizing Public Health Systems: A CyberSeminar. Presented by Dave Palm Office of Public Health Nebraska Health and Human Services System May 23, 2007. Development of Regional Health Departments. In 2001, 16 local health departments covered 22 counties
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Regionalizing Public Health Systems: A CyberSeminar Presented by Dave Palm Office of Public Health Nebraska Health and Human Services System May 23, 2007
Development of RegionalHealth Departments • In 2001, 16 local health departments covered 22 counties • Limited fiscal resources – no dedicated state funds • Lack of skills in most of the core competencies • Very limited visibility and understanding of public health
Development of New LocalHealth Departments • Turning Point was the impetus for change • New legislation passed in May 2001 that led to the creation of 16 new regional health departments
Criteria for Development of New Local Health Departments • Counties with more than 50,000 people could maintain a single county health department • Counties with less than 50,000 people must have a minimum of three contiguous counties and at least 30,000 people
Funding • In 2001, Tobacco Settlement Funds provided a stable, dedicated funding source for local health departments ($5.6 million) • Base funding of $100,000 to $150,000 • Per capita funding of about $2.00
Funding • In 2006, another $1.8 million was appropriated through State General Funds for local health departments • Only one regional health department receives financial support from local government
Rationale for Regional Approach • Takes advantage of economies of scale so fiscal and human resources can be spread more evenly across the state. • Creates a better opportunity to plan for and respond to public health emergencies, detect patterns of disease, and leverage new resources.
Rationale for Regional Approach • Improves the coordination of activities and programs between departments and the State agency • “Spreading resources too thin creates turf wars” • Bottom line: Nebraska could not support 93 health departments nor recruit qualified staff
Critical Success Factors • Providing autonomy and choice in selection of county partners • Avoiding duplication of services and programs (e.g. immunization) has allowed the new departments to become more balanced
Positive Impact of Regionalization • Public health capacity has been expanded • Health protection and emergency preparedness • Disease surveillance • Health promotion
Positive Impact of Regionalization • With greater capacity at the local level, the State agency has become more focused on providing technical assistance, monitoring and training
Challenges • Some regions may be too large geographically • Most new ordinances and regulations must be approved by each county and community
Challenges • Performance measures need to be developed to measure success of regional systems • Because staff is still limited, it is sometimes necessary to provide services in multiple regions (e.g. epidemiology)
Conclusion • It is possible to establish a regional public health system
Future success depends on... • Expanding the scope and capacity of local health departments • Continuing to develop personal relationships and collaborative partnerships • Establishing performance standards to evaluate the effectiveness of the public health system
Telephone: (402) 471-0146 Fax: (402) 471-8259 E-Mail: david.palm@hhss.ne.gov Dave Palm Office of Public Health Box 95007 Lincoln, NE 68509