Community Health Planning Purpose, Context, Mean

1
Community Health Planning Purpose, Context, Mean
Methods
September 2005
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• Questions Considered

• Purpose history of community health planning
• Planning context environment
• Commonly used planning methods means
• Applications opportunities

Community Health Planning Today MCH, SECCS
Workshop Washington, D C, September 2005
3

• Purpose

• Planning does not occur naturally or
  spontaneously
• It takes placeis requiredfor specific reasons
• Common reasons for planning
• More efficient effective use of resources
• Promote, assure fairness and equitable treatment
• Implement public policy
• Achieve specific social or economic goals for
  which market forces are inadequate, indifferent
  or inappropriate
• Identify Refine Purpose
• Key first step in effective planning
• Necessary to build consensus, support,
  cooperation

Community Health Planning Today MCH, SECCS
Workshop Washington, D C, September 2005
4

• History

• Community health planning grounded in
• Community betterment movement of 1930s-1940s
• Social Security Act etc
• Hill Burton Program hospital, health facility
  development
• Great Society Era 1960s
• Medicare, Medicaid, Social programs
• PL 89-749 PL 93-641 formal public support
• Categorical health social welfare programs
• MCH, WIC, Head Start, ESRD, etc.
• Recent History
• Diminution of public support for comprehensive
  planning
• Greater reliance of market forces
• Continuing struggle Competition/market vs
  planning
• Include planning in categorical health
  social welfare programs e.g., rural health care,
  emergency care, MCH

Community Health Planning Today MCH, SECCS
Workshop Washington, D C, September 2005
5

• Planning Context Environment

• Environmental awareness
• Planning takes place in market-oriented political
  climate
• Market orientation is the norm intensity varies
  among states
• Planning often is the policy choice of last
  resort
• But . . . growing recognition of need for
  planning, coordination, cooperation
• So . . . emerging efforts to incorporate more
  comprehensive planning in categorical services
  development and deliver
• DHSS/SECCS calls for internal external
  environment assessments/scans

Community Health Planning Today MCH, SECCS
Workshop Washington, D C, September 2005
6

• Planning Context

• Internal environmental scan
• Public resources, information and data needed to
  plan for a given service, activity or goal often
  will be found within a limited number of related,
  sometimes overlapping, entities
• These entities usually form the core of the
  natural allies of a venture
• A reliable inventory of these assets is useful
• Properly done, developing the inventory
  identifies and marshals the resources of
  potential allies supporters
• Those who may contribute to success are alerted
  to the venture and the need for help and
  cooperation
• Marshalling internal assets and support enhances
  the likelihood of gaining external recognition
  and support

Community Health Planning Today MCH, SECCS
Workshop Washington, D C, September 2005
7

• Planning Context

• External environmental scan
• Few successful planning efforts that involve
  broad social goals can be narrowly based
• External support, both public and private, is
  likely to be necessary for success
• An inventory of critical external resources, and
  potential allies, is desirable
• As with internal assessments, properly done,
  developing an inventory of external assets
  identifies and marshals the resources of
  potential allies supporters
• Those who may contribute to success are alerted
  to the venture and to the need for, and potential
  benefit of, help and cooperation
• External assets and support complements and
  amplifies internal resources and support

Community Health Planning Today MCH, SECCS
Workshop Washington, D C, September 2005
8

• Varieties of Community
• Health Planning

• Population-based planning
• Community oriented focused planning
• Institutional facility focused planning
• Categorical services planning
• Marketing vs. planning
• Broad social services planning appropriately
  combines elements of many or all of these
  varieties
• Satisfying DHHS/SEECS planning requirements may
  entail drawing on planning initiatives, and the
  data information they generate, in all of these
  categories

Community Health Planning Today MCH, SECCS
Workshop Washington, D C, September 2005
9

• Means Methods

• Common service planning taxonomy
• Examine service needs and operations in terms of
  
• Availability (need) for the service
• Access to the service
• Service quality
• Cost of (charges for) the service
• Continuity of service provision
• Acceptability of the service to recipients
• Service and/or goal specific variations on this
  taxonomy may prove useful

Community Health Planning Today MCH, SECCS
Workshop Washington, D C, September 2005
10

• Means Methods

• Identify/establish planning criteria and
  standards
• Criteria are those characteristics or aspects of
  a planning initiative that can and should be
  measured in assessing performance
• For example, immunization levels for common
  childhood diseases are widely used MCH planning
  criteria
• Standards are specific values or measures that
  can be used to assess performance under a
  criterion
• An example of standards under immunization
  criteria would include the numbers and
  percentages of children with recommended
  immunizations at various ages (e.g, 2 years, 3
  years)
• The number and type of criteria used, and
  standard established, vary by purpose and
  application
• Criteria and standards are carefully selected to
  ensure that they are relevant, practical,
  specific, and measurable

Community Health Planning Today MCH, SECCS
Workshop Washington, D C, September 2005
11

• Means Methods

• How to identify establish planning criteria
  standards
• Examine/evaluate related needs assessments
• Healthy People 2000 2010, state responses
• Established professional norms and measures
  Examples
• Nominal group processes
• Example Delbecq process Handout

Community Health Planning Today MCH, SECCS
Workshop Washington, D C, September 20058
12

• Means Methods

• Effective planning criteria and standards
  require
• Reliable data and information
• Population and demographic information
• Health system data and information
• Individual and public health data and information
• Demonstrate and require analytical rigor
• Provide de facto leadership and guidance
• Set expectations
• Establish a level playing field
• Permit assessment, evaluation

Community Health Planning Today MCH, SECCS
Workshop Washington, D C, September 20058
13

• Data Needs Sources

• Reliable data required for objective, successful
  planning
• Levels of aggregation
• National, state, regional, local
• Community level vs. agency level data
• Primary data vs. secondary data
• Internal data vs. external data
• Key data categories
• Demography
• Requirements Sources Examples
• Health Status
• Requirements Sources Examples
• Health behavior
• Requirements Sources Examples
• Resources
• Requirements Sources Examples

Community Health Planning Today MCH, SECCS
Workshop Washington, D C, September 2005
14

• Data Needs Sources

• Sources of Data
• Kaiser Family Foundation (http//www.kff.org)
• Discrete state health data, information
• National State Medicaid program data
• State health policy, minority health, womens
  health
• Annie E. Casey Foundation (http//www.aecf.org)
• Kids Count Data Book (online)
• State-level Kids Count information and data
• Congressional State legislative district data
• Urban rural data
• Community level information on kids (cliks)
• CDC, National Center for Health Statistics
  (NCHS)
• Wonder system (custom searches)
• U. S. Bureau of the Census
• American Community Survey
• Extensive, discrete data

Community Health Planning Today MCH, SECCS
Workshop Washington, D C, September 2005
15

• SECCS Applications

• SECCS planning example(s)
• For illustrative SECCS applications
• Identify refine the underlying planning
  question
• Apply appropriate, applicable planning criteria
  standard(s)
• Document data information needed
• Identify source(s) of required information and
  data required
• Assess data related information
• Examine the value and appropriateness of the
  criteria and standards used
• Useful websites Handout

Community Health Planning Today MCH, SECCS
Workshop Washington, D C, September 2005
16

• Message

• Basic message
• Planning must be community-oriented and focused
  to be effective
• Principal responsibility of public health
  planners
• Encourage and assist community-oriented planning
  by others, especially the private sector
• Provide leadership, establish expectations and
  boundaries
• Recognize that private sector cannot be truly
  community-oriented without guidance, assistance

Community Health Planning Today MCH, SECCS
Workshop Washington, D C, September 2005
17

• Thank You Good Luck

• For More Information Contact
• Dean Montgomery, AHPA
• Tel. [phone]
• email ahpanet_at_aol.com
• John Steen, AHPA
• Tel. [phone]
• Email jwsteen_at_expedient.net

Community Health Planning Today MCH, SECCS
Workshop Washington, D C, September 2005