Mobilizing Action Through Planning and Partnerships MAPP: The Cowlitz County, Washington Journey

1
Mobilizing Action Through Planning and
Partnerships (MAPP)The Cowlitz County,
Washington Journey

• September 21st, 2005
• Sue Grinnell, Director
• Cowlitz County Health Department
• Paul Youmans, Director
• Pathways 2020

2
Presentation Objectives

• Share experiences from a local attempt at MAPP
  process
• Share lessons learned from the local process

3
Cowlitz County, Washington

• Rural community 50 miles north of Portland and
  130 miles south of Seattle
• Population approximately 95,000
• Gateway to Mt St Helens
• Resource economy
• 92 Caucasian population
• High Unemployment
• Low educational attainment
• Poor Health Status Indicators

4
Cowlitz County Health Department

• Associated with the County Government
• Oversight provided by County Commissioners (3)
  who also serve as the Board of Health
• 25 staff
• 1 lead supervisor and no other exempt staff
• Community and Environmental Health Programs
• Beginning of process subcontracted
  epidemiologist using local funds

5
Pathways 2020

• Non Profit organization based out of the Cowlitz
  Economic Development Council
• History
• Membership
• Mission
• Report card

6
MAPP Overview
7
Cowlitz County TWEAKED MAPP Process

• Attended a one day introduction to MAPP process
  (HD)
• Agreement to go forward on the process
• Worked together to identify all known/existing
  assessments
• Very limited resources to complete work
• No new staff
• No additional dollars identified
• Identified who would do what and what assessments
  would be used
• Utilized the Pathways existing membership as the
  core group
• Utilized the Pathways vision

8
The Four Assessments

• Community Themes and Strengths
• Local Public Health System
• Community Health Status
• Forces of Change

9
Community Themes and Strengths Assessment

• The Community Themes and Strengths Assessment
  answers the following questions
• "What is important to our community?"
• "How is quality of life perceived in our
  community?"
• "What assets do we have that can be used to
  improve community health?"
• Quality of Life Survey
• Pathways 2020
• Focus Groups
• Pathways 2020

10
Cowlitz Quality of Life Survey

• Used the MAPP Quality of Life survey example as
  the basis
• Utilized the County Health Department contracted
  Epidemiologist for review and guidance
• Distributed to various locations
• 1004 respondents
• Outcomes

11
Cowlitz ResultsWhat Do You Think Are the Most
Important (3) Factors for a Healthy Community?
12
Cowlitz ResultsIs This Community a Safe Place
to Live?
13
Cowlitz ResultsDo All Residents Perceive That
They- Individually and Collectively Can Make
the Community a Better Place to Live?
14
Local Public Health System Assessment

• The Local Public Health System Assessment
  (LPHSA) answers the following questions
• What are the components, activities,
  competencies, and capacities of our local public
  health system?"
• "How are the Essential Services being provided to
  our community?"
• LPHSA Survey
• Cowlitz County Health Dept

15
Local Public Health System
Police
EMS
Corrections
MCOs
Health Department
Parks
Schools
Elected Officials
Mass Transit
Hospitals
Environmental Health
Civic Groups
CHCs
Fire
Tribal Health
Mental Health
Drug Treatment
Laboratory Facilities
16
Cowlitz County Local Public Health System
Assessment

• Reviewed the National Performance Standards
• Reviewed Washington State Performance standards
• Worked with Health Department contracted
  Epidemiologist to develop survey
• Distribution was through our Health Alert Network
  List
• Sent out a cup of tea with the survey and letter

17
Cowlitz ResultsWhat Resources Does Your Agency
Lack? (56 of respondents reported lacking
adequate resources)
18
Community Health Status Assessment

• The Community Health Status Assessment (CHSA)
  answers the following questions
• "How healthy are our residents?"
• "What does the health status of our community
  look like?
• Utilized the 11 data categories from the CHSI
  project
• Cowlitz County Health Dept

19
Cowlitz Community Health Assessment

• Met with local community assessment work group
• Reviewed the community health status indicators
  selected data from MAPP examples
• Reviewed other local health community health
• Created a data template with the final selected
  indicators and data sources

20
Community Health Status Assessment Indicator
Component Areas

• Demographic
• Socio-economic
• Health resource availability
• Quality of life
• Behavioral Risk factor surveillance system survey
  
• Environmental health indicators
• Social and Mental Health
• Maternal and Child Health
• Death, Illness and injury
• Infectious Disease
• Sentinel events

21
Data Template Cowlitz County Health Indicators
22
Maternal Smoking During Pregnancy
23
Percent of Adults That Smoke
Source Behavioral Risk Factor Surveillance
System (BRFSS), Centers for Disease Control and
Prevention and Washington Department of Health.
24
Percent of Adults That Are Obese or
Overweight(Body Mass Index gt25)
Source Behavioral Risk Factor Surveillance
System (BRFSS), Centers for Disease Control and
Prevention and Washington Department of Health.
25
Percent of Women Starting Prenatal Care in First
Trimester of Pregnancy
Source VISTA, Vital Registration System. Annual
Statistical Files, Birth Certificate Data
Washington State Department of Health
26
Cowlitz ResultsCommunity Health Status
Indicators Assessment Findings

• High rate of pregnant women with lack of high
  school education, Medicaid, smoking
• Low rate of educational attainment
• 24 tobacco use
• Youth substance abuse
• High rate obesity/ low rate physical activity
• STD rates

27
Forces of Change Assessment

• The Forces of Change
• Assessment answers
• the following questions
• "What is occurring or might occur that affects
  the health of our community or the local public
  health system?
• "What specific threats or opportunities are
  generated by these occurrences?"
• Scenario planning project
• Pathways 2020

28
Cowlitz Forces of Change Assessment

• Pathways 2020 Scenario Planning
• Picture of our future
• Victimized
• Legacy
• Destiny
• Focus on workforce development
• Buy in from the business community
• EDC provided 5,000 for this project
• Used by community partners

29
Cowlitz ResultsForces of Change Assessment
Findings

• Strategies
• Create medical and education partnerships to
  address health care occupation needs
• Provide better and earlier advisement on
  vocational and educational paths to careers
• Utilize national skills standards and skill
  assessment tools to advance and educate local
  workforce
• Maintain and enhance local social services
  collaborations for workforce development

30
Cowlitz ResultsForces of Change Assessment
Findings

• Necessary community improvements
• Develop or expand opportunities to train and
  attract community leaders
• Streamline all processes for new business
• Support improvements in local transportation
• Provide more social and recreational activities
  for youth and adults
• Promote life long learning

31
Cowlitz County Report Card

• Healthy Lifestyles
• Economy
• Education
• Families
• Community
• Environment
• Hopes and Dreams
• Diversity

32
Identify Strategic Issues

• Strategic issues are fundamental policy
  choices or critical challenges that must be
  addressed in order for a community to achieve its
  vision.

33
Strategic Issues Relationship Diagram
Relationship to Vision Community Places a High
Value on Healthy People

• Provide more social/
• recreational opptys for
• youth and adults

Community Themes and Strengths Assessment
Community members do not feel it is a safe place
to live
Forces of Change Assessment
Strategic Issue
How can we Encourage Healthy Lifestyles?
Local Public Health System Assessment
Low commitment to school
DASA
22 of respondents monitor health status of
their program populations
Obesity Physical activity Sexual Transmitted
Infections High rate of drug use
Community Health Status Assessment
34
Strategic Issues Relationship Diagram
Relationship to Vision Community Places a High
Value on Education ____________________
Community values Good schools

• Community has not needed
• education until recently
• Promote life long learning
• Beginning change in
• demographics

Community Themes and Strengths Assessment
Forces of Change Assessment
Strategic Issue
How can we Enhance Learning Opportunities?
Local Public Health System Assessment
Low commitment to school
Lack of trained skill staff
DASA Needs Assessment

• Educational attainment (bachelor degrees)
• High rate of dropouts

Community Health Status Assessment
35
Strategic Issues Relationship Diagram
Relationship to Vision Community Places high
value on Healthy Families

• Community does not
• feel like they
• can make a
• difference

Community Themes and Strengths Assessment
Promote more social and recreational oppty for
youth and families
Forces of Change Assessment
Strategic Issue
How can we Strengthen Families, Parents,
Children and Elderly ?
Local Public Health System Assessment

• Family conflict
• Family management problems
• Community disorganization

• Faith based opptys not
• being utilized
• More programs in community
• geared towards youth
• (concentrated in Longview/Kelso)
• not
• Elderly
• Community disorganization

DASA Needs Assessment
Community Health Status Assessment

• Foster parent
• Domestic violence
• Child abuse

36
Priority Area Healthy Lifestyles

• Physical Activity /Nutrition
• Awarded a 50K Grant (Preventive Health Block
  Grant Funds)
• Sub contracted with Pathways 2020 for
  facilitation
• Formed a Healthy Lifestyles Coalition
• Completed various community assessments
• Kaiser Permanente offered funds for the
  development of a web page
• Methamphetamine
• Meth initiative
• Maternal smoking
• Maternal smoking Summit

37
Priority AreaEducation

• Reducing the number of high school dropouts
• Southwest Washington Workforce Development
  Council
• Working on strategies to meet the needs of the
  health industry
• Collaboration for vocational offerings Skills
  Center
• Support afterschool programs and early childhood
  education

38
Priority AreaStrengthening Families

• Formation Of A A Children Psychiatric Coalition
• Utilization Of DASA Funding For County Prevention
  Specialist
• Working To Empower Communities Through
• ABCD
• Appreciative Inquiry
• Communities That Care
• Out-based Community Services
• Establishment Of One Local Agency To Be
  Identified As The Parenting Resource
  Collaboration
• Grant Writing Collaborative
• Seniors First organization

39
Priority Area Infrastructure

• Community Assessment Workgroup
• Community workgroup focused on data
• Resource Directory
• Community Data Repository
• Local webpage with data links and other
  information

40
Cowlitz County Lessons Learned

• Ongoing process
• Make information available as soon as possible
• Resource tracking
• Continuing re/education of partners
• Organizing for success
• Can be done with limited resources
• Increased collaboration
• Provides credibility for collaboration

41
Contact Information

• Sue Grinnell, Director
• Cowlitz County
• Health Department
• grinnells_at_co.cowlitz.wa.us
• www.co.cowlitz.wa.us/health
• Paul Youmans, Director
• Pathways 2020
• youmans_at_cowlitzedc.com