Illinois Project for Local Assessment of Needs (IPLAN)

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Illinois Project for Local Assessment of Needs
(IPLAN)

• Office of Epidemiologyand Health Systems
  DevelopmentDivision of Health PolicySeptember
  28, 2001

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What is IPLAN?

• Primary goals
• To establish a process for community involvement
  and
• participation in community health assessment and
• planning
• To make local health departments accountable to
  their
• communities rather than to the state
• Essential elements
• Organizational capacity assessment
• Community health needs assessment
• Community health plan, focusing on a minimum of
  three
• priority health problems

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What led to IPLAN?

• Over a decade of strategic planning in public
  health

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What led to IPLAN?

• 1984 - The Roadmap Committee Report

• Four principles for change
• Service delivery should be improved.
• Societal benefits should be effectively
• communicated.
• Quality of services should be improved and
• standardized.
• Funding should be increased.

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What led to IPLAN?

• 1984 - The Roadmap Committee Report

• Underlying belief
• Services are most efficiently and effectively
• provided at the local level.

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What led to IPLAN?

• 1988 - Roadmap Implementation Task Force

• Examined existing policies, statutes,
• regulations, funding and administration of
• public health
• Visioned an optimal public health system and
• compared it with the current system
• Developed 29 recommendations that were
• published in The Road to Better Health for All
• of Illinois

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What led to IPLAN?

• 1990 - Project Health The Illinois Public Health
  Improvement Project

• Conducted by more than 200 public health
• professionals from state and local health
• departments, public health academia, and public
• health associations
• Adopted 27 of the RITF recommendations
• Catalyzed the development of progressive rules
  for
• certification of local health departments in
  Illinois

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Requirements for Certification of Illinois Local
Health Departments

• Before and After 1993

Before July 1993 To be recognized as a local
health department in Illinois, LHDs MUST DO
After July 1993 To be certified as a local health
department in Illinois, LHDs MUST

1. Potable Water
2. Food Sanitation
3. Maternal Health/Family Planning
4. Child Health
5. Communicable Disease Control
6. Private Sewage
7. Solid Waste
8. Nuisance Control
9. Chronic Disease
10. Administration

1. Assess community health needs
2. Investigate hazards within the community
3. Analyze identified health needs for their
   determinants
4. Advocate and build constituencies for public
   health
5. Prioritize among identified community health
   needs
6. Develop policies and plans to respond to priority
   needs
7. Manage resources and organizational structures
8. Implement programs and services to respond to
   priority needs
9. Evaluate programs and services
10. Inform and educate the community

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Illinois Administrative CodeTitle 77 Public
Health

• Chapter 1 Department of Public Health

Subchapter H Local Health Departments Part 600
Certified Local Health Department Code
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Illinois Administrative Code

• Section 600.400 Certified Health Department
  CodePublic Health Practice Standards

The local health department shall, at least once
every five years, perform an organizational
capacity self-assessment that meets the
requirements set forth in Section 600.410.
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Illinois Administrative Code

• Section 600.400 Certified Health Department
  CodePublic Health Practice Standards

A community health needs assessment that
systematically describes the prevailing health
status and health needs of the population within
the local health departments jurisdiction shall
be conducted once every five years.
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Illinois Administrative Code

• Section 600.400 Certified Health Department
  CodePublic Health Practice Standards

Develop a community health plan that addresses at
least three priority health needs, identified
pursuant to Section 600.400, during each
certification period.
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Community
The IPLAN Process
Health Needs
Assessment
Community
Health Plan
Evaluation
Program Development
Implementation
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What is the States role?

• Established the framework for the assessment
  and plan (APEX-PH model)
• Developed, enhances and maintains IPLAN data
  system
• Conducts training and provides technical
  assistance
• Reviews submitted assessments and plans for
  substantial compliance with the administrative
  rules (every 5 years) and provides follow-up
  technical assistance

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A Community Health Needs Assessment should
contain--

• A description of the health status and health
  problems most meaningful for the community in the
  data groupings contained in the IPLAN Data
  System Demographic Socioeconomic
  Characteristics General Health Access to
  Care Maternal Child Health Chronic
  Disease Infectious Disease Environmental,
  Occupational, Injury Control (Sentinel Events)

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A Community Health Needs Assessment should
contain--
A description of the process and outcomes of
setting priorities A statement of purpose of
the community health needs assessment that
includes a description of how the assessment will
be used to improve health in the community A
description of the community participation
process, a list of community groups involved in
the process, and method for establishing
priorities
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Community Health Committee

• ethnic racial groups
• medical hospital community
• mental health social service organizations
• cooperative extension service
• schools
• law enforcement organizations
• voluntary organizations
• faith community
• businesses and economic development
• unions
• youth, senior citizens, other target populations

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Prioritize Community Health Problems

• Hanlon Method
• Nominal Group
• Delphi Technique
• PEARL (Propriety, Economics,
• Acceptability, Resources, and Legality)

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Detailed Analysis of Community Health Problems
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Health Problem Analysis Worksheet
Indirect Contributing Factors
Direct Contributing Factors
Risk Factors
Health Priority
aka - NCAA Chart
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Health Priority A situation or condition of
people which is considered undesirable, is likely
to exist in the future, and is measured as death,
disease, or disability.
Indirect Contributing Factors
Direct Contributing Factors
Risk Factors
Health Priority
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Risk Factor A scientifically established factor
(determinant) that relates directly to the level
of a health problem.
Indirect Contributing Factors
Direct Contributing Factors
Risk Factors
Health Priority
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Direct Contributing Factor A scientifically
established factor that directly affects the
level of a risk factor.
Indirect Contributing Factors
Direct Contributing Factors
Risk Factors
Health Priority
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Indirect Contributing Factors A community
specific factor that directly affects the level
of the direct contributing factor.
Indirect Contributing Factors
Direct Contributing Factors
Risk Factors
Health Priority
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Outcome Objective The level to which a health
problem (priority) should be reduced.
Indirect Contributing Factors
Direct Contributing Factors
Risk Factors
Health Priority
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Indirect Contributing Factors
Direct Contributing Factors
Risk Factors
Health Priority
Impact Objective The level to which a risk
factor should be reduced.
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Indirect Contributing Factors
Direct Contributing Factors
Risk Factors
Health Priority
Intervention Strategy Demonstrated to be
effective or used as national model and should
address an impact objective.
Impact Objective The level to which a risk
factor should be reduced.
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Community Health Plan Worksheet
Outcome Objective
Health Problem
Risk Factor
Impact Objective
Contributing Factors
Proven Intervention Strategies
Barriers
Resources Available
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Community Health Plan Worksheet
Health Problem
Outcome Objective
By 2004, reduce stroke deaths to no more than 70
per 100,000 (Baseline 1997 crude rate 76.5 per
100,000).
Cerebrovascular Disease (Stroke)
Risk Factor
Impact Objective
By 2002, reduce cigarette smoking to a prevalence
of no more than 24 percent among people aged 18
and older. (Baseline 1996 BRFS percentage 27.3).
Tobacco Use
Contributing Factors
Proven Intervention Strategies
Addiction Sedentary Lifestyle Hypertension Adverti
sing (Indirect)
Coalition will implement CDCs community-based
tobacco control program, focusing on delaying
initiation, cessation programs, and advertising
control.
Barriers
Resources Available
Limited number smokers seeking counseling. Media
messages promote smoking. Peer pressure.
Coalition will provide support to LHD with
in-kind donations, staff, and clinical counseling
space.
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Community Health Plan
Description of the Health Problem, Risk Factors
and Contributing Factors
Corrective Actions
Proposed Community Organizations
Evaluation Plan
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Community Health Plan
Description of the Health Problem, Risk Factors
and Contributing Factors
The problem is the high death rate associated
with cerebrovascular disease (county CR 76.5,
state CR 61.7 p/100,000 or 23 above state
rate). The major risk factor is cigarette
smoking and county has higher percentage of
smokers (27.6) , especially males (31) than
state (24, 28, respectively). Addiction
appears to be the chief contributing factor.
Corrective Actions
In order to effectively address this health
problem a multi-sited and multi- targeted
campaign is required to delay initiation of
smoking behavior, assist persons attempting to
quit, and provide counter advertising to tobacco
promotions.
Proposed Community Organizations
A coalition of community groups, including the
LHD, Cancer Society, Lung Association, General
Hospital, Teens Against Butts will collaborate
with in- kind donations, staff, and clinical
counseling space to assist in meeting objectives.
Evaluation Plan
Coalition will meet quarterly to assess progress
in achieving goals. Coalition will use the
evaluation tool developed by the CDC to determine
effectiveness of programming efforts. Surveys
will be conducted amongst coalition members to
ascertain stakeholder satisfaction with program.