Reaching Readiness:

1. Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit Reaching Readiness: Steps Toward Accreditation, Performance Management, and Quality Improvement Performance Management, Quality Improvement, & Accreditation Summit California Department of Public Health May 1, 2012Patricia Zerounian, MPP

2. Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit Reaching Readiness Monterey County Steps Toward Accreditation, Performance Management, and Quality Improvement • Review potential documents to fulfill prerequisite deliverables • Taking stock of our staff resources and partnerships • Reinforcing our data-driven, PM, and QI culture • Planning further system upgrades and links • Strategizing our communications

3. Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit Reaching Readiness • Review potential documents to fulfill prerequisite deliverables • Annual Health Assessments • Periodic Reports and Briefs • Strategic Plan Community Listening Sessions • Process for completing Strategic Plan Initiatives

4. 1. Prerequisite Deliverables: PHAB and NACCHO Guides, Reports, Forms Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit

5. 1. Prerequisite Deliverables: Annual Health Assessments, Reports, Briefs Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit

6. 1. Prerequisite Deliverables: Community Presentations, Listening Sessions Strategic Plan 2011-2015 Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit

7. 1. Prerequisite Deliverables: Initiative Identification, MAPP Process #1: Empower the community to improve health through programs, policies, and activities. #2: Enhance community safety. #3: Ensure access to culturally and linguistically appropriate, customer-friendly, quality health services. Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit

8. Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit Reaching Readiness • 2. Taking stock of our staff resources and partnerships • Health in All Policies • Health Department-convened Coalition Meetings • Collaborations with Social Services, Probation, First 5 Monterey County, Children’s Council, others • Partnerships with TCE Building Healthy Communities, Community Foundation, others

9. 2. Taking Stock: Promoting Health in All Policies & Collaborating with County and City Planning Departments Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit

10. 2. Taking Stock: Collaboratives, Coalitions, & Committees Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit

11. 2. Taking Stock: Internal Collaboration with Behavioral Health, Probation, Social Services, Public Health, Clinic Services, Sherriff, Parks, Planning, others Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit

12. 2. Taking Stock: Grant and Contract Partnerships Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit

13. Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit Reaching Readiness • 3. Reinforcing data-driven, PM, QI, evaluation culture • Raising the “data comfort level • Inter-department data analysis • Staff trainings • Staff evaluation training & services • External evaluation services • Survey research development & processing • New unit: Planning, Evaluation, & Policy

14. 3. Data, PM, QI, Evaluation Culture: Staff & Community Workshops & Trainings Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit

15. 3. Data, PM, QI, Evaluation Culture: Prevention-Focused Approaches Discrimination Race/Ethnicity Gender Citizenship Sexual Orientation Disability Institutional Perpetration Schools Government agencies Corporations Neighborhood Conditions Physical deterioration Social segregation Crime/Gangs Poor performing schools Choices Smoking Chronic Stress Nutrition Violence Risk-taking Disease/Injury Chronic disease Communicable disease Homicide Suicide Accidents Years of Life Lost Infant Death Premature Death Poor Quality of Life Socio-Ecological Model: Social Influences on Community Health Medical Model: Personal Choices for an Individual’s Health

16. 3. Data, PM, QI, Evaluation Culture: Staff Data Presentations Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit Youth Comments #1: Most helpful thing about services in past 6 months?

17. 3. Data, PM, QI, Evaluation Culture: GIS Services

18. 3. Data, PM, QI, Evaluation Culture: Staff Evaluation Trainings & Workshops Resources Rancho Cielo, Vocational programs, employment opportunities • Outputs • Participation in • training • education • peer activities • independent living skills programs • individual support plans Outcomes Greater percentage of youth discharged from Youth Center do not reoffend Strategy Engage youth in constructive activities and independent living skills Activities Provide transitional housing and support services Stakeholders MCBH, Probation, Contracted Agency Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit Problem: Too many juvenile offenders re-engage in criminal activities Program Goal: Decrease recidivism

19. 3. Data, PM, QI, Evaluation Culture: Evaluation Design & Monitoring Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit

20. 3. Data, PM, QI, Evaluation Culture: Research and Reporting Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit 2011 CA Conference of Directors of Environmental Health Excellence in Environmental Health Award Winner June 30, 2011 Agricultural Field Toilet Inspection Program Monterey County Health Department Environmental Health Bureau Director John Ramirez, MPA, REHS

21. 3. Data, PM, QI, Evaluation Culture: Survey Research Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit

22. 3. Data, PM, QI, Evaluation Culture: External Research Contracts Knowledge Network Evaluation Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit Girls’ Health in Girls’ Hands

23. 3. Data, PM, QI, Evaluation Culture: New Planning, Evaluation, & Policy unit Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit

24. Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit Reaching Readiness • 4. Systems Upgrades and Links • New EHR System for Behavioral Health, Use of Common Assessment Forms • New EMR System for Clinic Services and upcoming link to Public Health • Future (!) Health Information Technology Linking 4 hospitals and 60 clinics

25. 4. Systems Upgrades & Links: EHR and EMR Systems, Behavioral Health Common Assessment Forms, Links between Public Health & Clinic Services Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit

26. 4. Systems Upgrades & Links: Future (!) Health Information Technology will Link four acute care hospitals and 60 clinics Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit

27. Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit Reaching Readiness • 5. Communications • Improved Website • Quarterly “Director’s Message” to All Staff • Quarterly Reports to Board of Supervisor’s Health & Human Services Commission • Weekly Staff Newsletter • New Leadership, New Facility

28. 5. Communications: Improved Website Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit Bookshelf pubs

29. 5. Communications: Quarterly, Monthly, Weekly communications Message from the Director To ensure employee awareness of critical initiatives and policies 2011-2012 Quarter 3 Recent Grant Awards From CDPH/Public Health Institute for Community Transformation: $253,000 From CDC for youth violence prevention: $225,000 From Blue Shield CA Fnd. for ViaCare Low Income Health Plan planning: $200,000 From Blue Shield CA Fnd. for ViaCare execution: $120,000 From CHOMP for Seaside and Marina clinics: $75,000 From Medicare for Laurel Internal clinic quality improvement: $35,000 From Children's Miracle Network for school-based influenza program: $20,000 From the Ad Council for mental illness anti-stigma campaign: $20,000 From the City of Gonzales for a community health assessment: $10,328 TOTAL $958,328 Pending Applications To Centers for Medicare & Medicaid for health care reforms: $24,967,518 MCHD Approaching Accreditation with Training & Evaluation Public health departments across the U.S. are adopting specific standards and measures to assess their performance capacity and outcomes, thereby seeking accreditation that the health department has the ability to accomplish its mission and purpose. Monterey County Health Department (MCHD) is poised to embark on its accreditation process within the next 30 days as a portion of work done by a new unit, Systems Policy and Analysis (SPA) unit, which will be housed within the Administration Bureau. A series of trainings concerning the elements of accreditation will be held over the next few months, followed by a roll-out of methods for identifying, selecting, assessing, and documenting specific programs for accreditation review. Assessment tools will be developed or identified by SPA staff to engage in several program evaluation and ontinuous quality improvement studies. PHAB has beta-tested a seven step process for health departments to follow that covers the pre-application phase to reaccreditation, which occurs five years later. Eventually, receipt of some types of federal grant funding will likely be contingent upon a health department being in good accreditation standing.

30. 5. Communications: New leadership, new facilities for conferencing Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit

31. Monterey County Health Department •PEP•••Planning Evaluation and Policy Unit Reaching Readiness: Steps Toward Accreditation, Performance Management, and Quality Improvement Patricia Zerounian, MPPcontactzerounianp@co.monterey.ca.us831.755.4583