GOOD MORNING! We will be starting shortly.

1. GOOD MORNING!We will be starting shortly. • Please orient yourself to Live Meeting including use of Q and A • Please mute your microphones and/or telephone • Please email Tegan Ruland at tegan.ruland@wisconsin.gov if you are having any difficulties

2. Performance Improvement in Public Health Learning Session #1:Wisconsin Public Health Improvement Initiative 101

3. Welcome and Introductions • Brief description of Learning Sessions • Brief introduction of those participating • Overview of Live Meeting process including muting, accessing handouts, and asking questions

4. Learning Sessions Planned: • Today: Wisconsin PH Improvement Initiative 101 • 5/9/2011: PH Performance Management 101 • 5/16/2011: PH Quality Improvement 101 • 5/23/2011: PH Accreditation 101

5. By the end of this session you should be able to: • Describe current efforts in Wisconsin related to public health performance improvement and accreditation. • Access additional information and resources for learning.

6. The significant problems we face cannot be solved at the same level of thinking we were at when we created them. --- Albert Einstein

7. Where is Public Health at now? • Nationally • Wisconsin

8. Essential Services of Public Health • Monitor health status • Diagnose and investigate • Inform, educate, and empower • Mobilize community partnerships • Develop policies and plans • Enforce laws and regulations • Link people to needed services / assure care • Assure a competent workforce • Evaluate health services • Research

9. Public Health Framework: • What is done by governmental public health – standards we operate by • What communities collaborate on • What all of us should expect

10. Why Public Health Essential Services? Wisconsin Statute says we have to!

11. Public health infrastructure includes the systems, competencies, frameworks, relationships, and resources that enable public health agencies to perform their core functions and essential services. Infrastructure categories encompass human, organizational, informational, legal, policy, and fiscal resources.

12. Where are we at in Wisconsin?

14. Goal: Everyone Living Better, Longer

16. WIQI Wisconsin's Public Health Quality Initiative (WIQI) Began in 2008 and was funded by the Robert Wood Johnson Foundation (RWJF). This national effort is aimed at improving the nation's public health system by setting benchmarks to measure health department quality. Partners included the Institute for Wisconsin’s Health, Inc. (IWHI), Wisconsin Division of Public Health (WDPH) and the Wisconsin Association of Local Health Departments and Boards (WALHDAB). 

17. WIQI Goals:1.Contribute to the development of an effective national voluntary accreditation program. 2.Engage Wisconsin communities in improving their health departments through adoption of assessment and quality improvement methods 3.Prepare Wisconsin's local and state health departments for national voluntary accreditation

20. Prevention Block Grant 2011 Federal block grant dollars allocated to support accreditation, quality improvement and Community Health Improvement Planning though competitive application and grants to Local Health Departments and Tribal Health Departments

21. Prevention Block Grant 2011 Competitive Grant – Focus on improving resources available to local health departments and tribes related to Accreditation - $30,000. • Polk County Health Department was recipient • Grant focusing on doing rapid assessment of local health departments related to accreditation, developing website as repository of local accreditation document examples, and providing basic support of accreditation.

22. Prevention Block Grant 2011 Local and Tribal Health Department Template Objectives • Accreditation: By December 31, 2011, Health Department will implement continuous quality improvement, strategic planning, and/or self assessment to prepare for accreditation. (18) • CHIPP: By December 31, 2011 will be complete a community health assessment and community health improvement plan with measurable objectives. (18)

24. Healthiest Wisconsin 2020: Everyone Living Better, Longer HW2020 Capacity and Quality State health plan infrastructure focus area that identifies two objectives for all health departments (state, tribal, local).

25. HW2020 Objectives • By 2020, all Wisconsin health departments will implement established quality improvement processes in daily practice. • By 2020, all Wisconsin health departments will be accredited using an established standard.

26. HW2020 Objectives Next Step….tentative proposal to look at development of a state-wide leadership group to provide leadership and move forward with action related to these state health plan objectives. Interested???

28. Wisconsin Statutes and Administrative Rules • Draft 140 rule change includes definition and language that links to PHAB • Legislative Study Committee proposal to change statute to include PHAB language

30. CDC Infrastructure Grant Goal of this national funding is for State, local, tribal health departments to have the support to develop the culture and infrastructure for performance management (PM), quality improvement (QI), and accreditation. Nationally, $42.5 million given to 76 state, tribal, local, and territorial health department as part of the Affordable Care Act.

31. National Public Health Improvement Initiative Strengthening Public Health Infrastructure for Improved Health Outcomes Impact: • Fills gaps vital to improving health & controlling costs not covered by categorical funding streams • Increased efficiency and effectiveness in preparing for, preventing, and responding to acute and chronic threats to the Nation’s health • Provides economies of scale (e.g., through regionalization and shared resources) Outcomes: • Increase in dedicated staff’s time, systems’ capabilities, and routine performance tracking and reporting (Performance Management; 100% Component I; 63% of Component II grantees) • Increase in the number of evidence-based policies, laws, or regulations (Policy & Workforce Development; 42% of Component II grantees)

32. CDC Infrastructure Grant Wisconsin wrote for the non-competitive application ($300,000) as well as the competitive funding. We were awarded $1.96 million per year for 5 years starting 9/2010.

33. CDC Infrastructure Grant Funding is focused on: • Reaching goals and objectives in HW2020 • Achieving national accreditation standards for state, local, tribal health departments • Strengthening population metrics • Moving to a Quality Improvement culture in DPH, local, and tribal health departments

34. What is being done with the funding? (examples): • State infrastructure development – in process • Local Mini-Grants - awarded • QI training for DPH and local/tribal health departments – in process • Assessment and planning for Performance management in DPH – in process • Rapid cycle improvement related to HW2020 focus areas and business processes– in process • Development of detailed community data sets for surveillance and QI – in process • Start at preparing for PHAB accreditation in DPH • Development of DPH workgroup to focus on disparities – in process • Measurement of HW2020 – in process • TA to tribal health departments – in process • More….

35. Who are our partners? • IWHI • WALHDAB/Local Health Departments • Tribal Health Directors/Tribal Health Departments • PH Foundation • UW – NIATx • UW – Evaluators • CDC • Others

36. IWHI • Support for accreditation preparation of local health departments • QI training and consults to WIQI agencies - Team of three QI consultants • Continued web presence - blog and resources • Development of a Tribal accreditation work group

37. PH Foundation • Assessment of DPH for readiness to be an agency that is undertaking Performance Management. • Support to build culture of Performance Management in agency. • Support with Rapid Cycle Improvement related to Contracting process

38. UW • Contract to support evaluation of CDC grant • Contract to train all DPH managers in NIATx Change Leaders Academy – Quality Improvement

39. CDC Infrastructure Grant – supplemental funding in 2011 Additional funding ($34 million) is being released by CDC in May, 2011. Wisconsin is eligible for an additional $993,000 in infrastructure dollars.

40. CDC Infrastructure Grant – supplemental funding in 2011 Proposed focus for these dollars include: • Mini-grant funds • QI training and technical assistance • Increase DPH readiness for accreditation • Increase focus on health disparities • Electronic data exchange • Shared services support • More

41. National Resources: • CDC: http://www.cdc.gov/ostlts/NPHII/index.html • NACCHO: http://www.naccho.org/topics/infrastructure/ • ASTHO: http://www.astho.org/Programs/Accreditation-and-Performance/ • PHAB: http://www.phaboard.org/ • PHF: http://www.phf.org/focusareas/pmqi/pages/default.aspx • NALBOH: http://www.nalboh.org/Board_Governance.htm# • NIHB: http://www.nihb.org/public_health/accreditation.php

42. Primary Wisconsin Resources: • CDC Infrastructure Grant: Mary Young, DPH Southern Regional Office mary.young@wisconsin.org • Prevention Block Grant: Jackie Bremer, DPH Northern Regional Office Jacquelyn.Bremer@wisconsin.org • HW 2020 Capacity and Quality Focus Area: Lieske Giese, DPH Western Regional Office elizabeth.giese@wisconsin.gov • WIQI: Nancy Young, IWHI grayhorse@mac.com

43. Websites: • IWHI http://www.instituteforwihealth.org/project-portal/ • DPH http://www.dhs.wisconsin.gov/localhealth/index.htm • Accreditation site (soon tobe available) http://www.phawisconsin.com/

44. Conclusion: “Do what you can, with what you have, where you are.” Teddy Roosevelt

45. Tell us what you thought of today’s session: http://4.selectsurvey.net/dhs/TakeSurvey.aspx?SurveyID=n2M24m53