Improving Public Healths Infrastructure: the Key to Transforming Public Health

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Improving Public Healths Infrastructure the Key
to Transforming Public Health

• Dennis Lenaway, PhD, MPH
• Office of the Chief of Public Health Practice
• Centers for Disease Control and Prevention
• Colorado Public Health Association Annual
  Conference
• September 16, 2008

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Why focus on Infrastructure?

• The public health infrastructure has suffered
  from neglect
• Weaknesses in the governmental public health
  infrastructure were clearly demonstrated in the
  Fall of 2001.
• Institute of Medicine 2003

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Public Health Challenges
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Public Health Challenges

• Emerging Diseases (SARS, Pandemic Flu)
• Re-emerging Diseases (XDR-TB)
• Food Safety
• Bioterrorism
• Natural Disasters
• Obesity
• Aging
  Population
• Health
  Disparities
• 
  Global Warming

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Health Care Crisis
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Health Care Crisis

• Aging Population
• Re-emerging Diseases
• Emerging Diseases
• Obesity
• Health Disparities
• Access to Quality Health Care
• Health Insurance Costs
• Uninsured and Underinsured

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Federal, State and Local Silos
Health Care
Emergency Management
Education
Law Enforcement
Public Health
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Key Elements in Public Health
Assets Functions
Capacity Interventions Impact
Public Health Agencies
3 Core Functions and 10 EPHS
Programs and Activities
Public Health Systems
Leadership
Healthiest Nation
QI
Community Engagement and Health Planning
Workforce
Portfolio Management
Resources
Leadership Workforce Development
Infrastructure
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Office of the Chief of Public Health Practice

• Setting Agency Standards
• Public Health Accreditation Board
• Setting System Standards
• National Public Health Performance Standards
  Program
• Engaging with Communities
• MAPP
• Managing our Resource Portfolio
• Senior Management Officials
• Strategic Management Agreements
• Public Health Apprenticeship Program
• Excellence in Public Health Practice Council

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Public Health Accreditation Board

• A new non-profit organization dedicated to the
  development and implementation of a national
  voluntary accreditation program for state, local
  and tribal public health departments
• Launched in May 2007
• Co-funded by CDC and RWJF

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Public Health Accreditation Board

• Goal
• Improve and protect the health of the public
  by advancing the quality and performance of
  State, local, and tribal public health departments

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Strengthening systems, improving the publics
health
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NPHPSP
A State, local or governance assessment and
quality improvement process that focuses on the
entire public health system

• Optimal model standards
• Builds partnerships
• Compliments accreditation
• Used by 24 states and over 1,000 localities

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NPHPSP State Instrument Use (Thru September
2008, n 24 states)
NH
MA
RI
CT
Also includes sites using field test versions of
the NPHPSP State Public Health System Performance
Assessment.
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NPHPSP Local Instrument Use (Thru September 2008)
HI
Also includes sites using field test versions of
the NPHPSP Local Public Health System Performance
Assessment.
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New Version 2.0 Instruments
State
Local
Governance
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• Mobilizing community engagement
• Action implementation of a Health Improvement
  Plan
• Planning built on strategic planning concepts
• Partnerships the publics health is more than
  the concern of the health department

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What is MAPP?

• A community-wide strategic planning tool for
  improving public health.
• A method to help communities prioritize public
  health issues, identify resources for addressing
  them, and take action.

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• If you want to travel fast, go alone.
• If you want to travel far, go together."

Old African Proverb
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Portfolio Management Program
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Senior Management Officials

• Senior Management Officials
• Definition/role
• (how many)

KarenWhite
Joe Henderson
DuionaBaker
Bobbie Erlwein
Mike Hughes
H. Mac McCraw
Steve Boedigheimer
Candice Nowicki
VACANT
Brock Lamont
BillGallo
Melanie Duckworth
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Strategic Management Agreements (SMAs)

• An agreement negotiated by the Portfolio
  Management Program with the CDC Director and the
  State Health Commissioner as Principals.
• Engage and align state strategic planning efforts
  to CDC Goals
• Establish agreed upon priorities
• Advance efforts aimed at achieving specific
  health outcomes
• Leverage and maximize CDC and state investments
• Promote program flexibility linked to
  accountability.
• First SMAs being drafted with Arkansas
  California - 2008

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Public Health Apprenticeship Program (PHAP)

• Purpose to develop highly qualified candidates
  for employment with state and local health
  departments and CDC to meet the public health
  system challenges of the 21st century.
• PHAP provides a career pathway for entry-level
  public health workers that includes
• Knowledge of the components, roles and functions
  of the public health system
• Front-line service in public health practice in
  multiple programs
• Skills in public health program implementation
• 2007 - 10 Apprentices placed in Florida Local
  Health Departments
• 2008 - 35 Apprentices placed in Florida, Texas,
  Georgia, North Carolina and Arkansas

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Excellence in Public Health Practice Council

• Provides a forum for a coordinated,
  enterprise-wide approach to addressing public
  health practice issues at CDC
• Workgroups have developed recommendations on
  Practice Issues including
• Public Health Infrastructure Development
• Performance of Public Health Systems
• Translating Science into Practice

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Workforce Development

• Competencies for Public Health professionals
• Epidemiologists
• Credentialing and certification
• National Board of Public Health Examiners (2005)
• Existing programs in nursing, environmental
  health, laboratories

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Leadership Development

• National Public Health Leadership Institute
• State and Regional Public Health Leadership
  Institutes
• National Public Health Leadership Development
  Network
• Governmental Leadership Programs for Health
  Officials
• Association of Public Health Laboratories and
  CDCs National Center for Environmental
  Health

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Transforming the Public Health System
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Building the platform towards a Healthiest Nation