Public Health Infrastructure Update

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Public Health Infrastructure Update

• Presented by
• Executive Committee, Statewide Coordinating
  Council for Public Health
• Maine CDC/DHHS Office of Local Public Health

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• Existing players, new
• model for coordination
• 8 DHHS Districts
• Strengthened Local Health Officer system
• Some core public health functions carried out by
  Healthy Maine Partnerships
• 8 District Coordinating Councils (DCCs)
• District Public Health Units
• MCDC Office of Local Public Health

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DCC Progress

• 8 DCCs convened
• Developing membership, governance, mission.
• Providing education about public health
• Some DCCs have chosen priority projects
• Working on PH system assessment
• Gathering nominations for SCC membership
• Engagement in district and community-level
  activities

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Other Infrastructure Activities

• Public health units in process of being convened
  and co-located
• Co-location
• Convening staff
• Work beginning with county Emergency Management
  Agencies
• Many involved in DCCs
• OLPH staff meeting with EMA directors
• Health improvement planning underway in all
  communities
• Healthy Maine Partnerships, with technical
  assistance from OLPH

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Local Health Officers

• LHOs exist by statute in all Maine municipalities
• Some towns share an LHO
• Resolve local PH nuisances and link to
  resources
• Law passed last year requiring Maine CDC to
  provide greater training and oversight
• Certification training for all LHOs by June 09
• OLPH activities for LHOs
• Ongoing technical support
• In-person meetings
• Participation on DCCs
• Online certification training completed being
  beta tested
• HMPs and city health departments have involved
  LHOs in local and regional PH activities

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• Q What is the new infrastructure and how is it
  working to help make Maine the healthiest state?
• A The new infrastructure pulls together the many
  diverse partners that make up a public health
  system. It streamlines, integrates and
  coordinates existing resources.

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Partners that comprise a typical public health
system
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Partners convene at the district level
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Greater partnership is developed at the state,
district and local levels
Local Health Officers
HMP
HMP
Other District Health Partner
Other District health Partner
District Liaison and Public Health Unit
District Coordinating Council
Statewide Coordinating Council
Maine CDC/DHHS Office of Local Public Health
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• Q Will cost efficiencies be achieved through
  streamlining?
• A1 Streamlining has simplified a complex and
  disjointed contracting process involving multiple
  state agencies.

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• Q Will cost efficiencies be achieved through
  streamlining?
• A2 We anticipate that streamlining will ensure
  that public health efforts are aligned,
  coordinated and unduplicated.

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• Q Will cost efficiencies be achieved through
  streamlining?
• A3 SCC, DCCs and HMPs are creating a streamlined
  system for health assessment, gathering
  stakeholder input, and planning.

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Success with coordination and streamlining
early examples

• Improving transportation and access to care in
  the Midcoast District
• 25K EPA Environmental Justice Grant for United
  Somali Women of Maine
• Response to Eastern Equine Encephalitis (EEE) in
  York County

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• Q How will we measure success? What are
  examples of success?
• A1 During the first year, progress will be
  measured through success in implementing the
  planned infrastructure
• (and implementation of priority projects in
  some districts)

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• Q How will we measure success? What are
  examples of success?
• A2 During years 2 3, community and district
  public health improvement plans will be developed
  and implemented. PH improvement plans will
  create metrics for success.

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• Q How will we measure success? What are
  examples of success?
• A3 Future metrics of success PH accreditation
  in Maine improved health outcomes at community,
  district, state levels.

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• Q What is public health accreditation? Why must
  we seek it? How will it help us?
• A Accreditation is a national credentialing
  process for public health systems will begin in
  2010.
• Provides QA, credibility, and accountability.
  Will help Maine be competitive when applying for
  PH funding.  

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• Q How will our new infrastructure help us
  achieve accreditation?
• A Infrastructure is required for coordination
  and integration at the local level
• Mechanism for workforce development
• Will improve delivery of the 10 EPHS
• DCCs and SCC will provide QI to PH System

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• Q What would happen if the infrastructure went
  away?
• A Slower progress in improving health outcomes.
• Fragmentation at local and district level
• Decreased ability to deliver PH services
• Potential for duplication of effort
• Decreased ability to earn accreditation
• Decreased ability to efficiently use funds
• Less coordinated and educated PH workforce
• Loss coordination for PH planning and stakeholder
  input
• Missed opportunities for collaboration

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PH Improvement Planning
HMPs develop Community Health Improvement Plans
DCCs develop District Public Health Improvement
Plans
SCC provides input into State Health Plan
DCCs need specific guidance from SCC and ACHSD
about Plan format and structure