Local Public Health Local Public Health Performance Standards Performance Standards Assessment & the MAPP Assessment & the MAPP

ProcessProcessTransitioning Your Community Transitioning Your Community

From Perception to RealityFrom Perception to Reality

Stephanie R. Paulmeno MS, RN, NHA Director, Community Health Planning

Greenwich Department of HealthGreenwich, CT

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Performance Standards in Performance Standards in Public HealthPublic Health

The Core Public Health Steering Core Public Health Steering

CommitteeCommittee of the CDCCDC, the American

Public Health Association (APHAAPHA),

NACCHONACCHO and other major national

public health agencies initiated the

process of identifying performance identifying performance

standards for public healthstandards for public health in 1994.

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Greenwich: A long Greenwich: A long tradition tradition

of Community of Community partnershipspartnerships• Public health infrastructure is strong

& visible in Greenwich• Partnerships have existed for

decades• Public health leadership and visibility

was dramatically increased with the appointment of a designated Community Health Planner who works within the Town, Region and State

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The Community Health The Community Health PlannerPlanner

• Assessment based planning focus

• Outcome focused planning strategies

• Works to develop, support, or work

within partnerships and coalitions

• Focuses on the use of resources,

identifying/filling gaps and avoiding

unnecessary duplication of services

• Provides introduction to Town services

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Survey Purpose & Survey Purpose & ProcessProcess

The process evaluatesevaluates

public, private and

municipal service deliveryservice delivery

programs that impact

healthhealth and emergency emergency

preparednesspreparedness within a

town or city, and not not

merely the capacity of their merely the capacity of their

Local Departments of Local Departments of

Health. Health.

The process is a

partnership effortpartnership effort to

improve public

health practicepractice and

performanceperformance as well

as the infrastructureinfrastructure

that supports these

efforts.

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Is Perception Reality?Is Perception Reality?

The survey is a perceptual toolThe survey is a perceptual tool

It can reflect either the knowledge It can reflect either the knowledge

base of the participants or provide base of the participants or provide

an accurate depiction of the various an accurate depiction of the various

assessment componentsassessment components

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Pre-Planning IssuesPre-Planning Issues

The benefit of group

evaluationThe traditional vs. “fast

track” processAdvance Preparation

Time saving pre assessment strategies

Rapid visual depiction of the community

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Pre-Planning IssuesPre-Planning Issues

Designing pre-assessment participant worksheets

The benefits of charts and posters

Getting the right partners to the table

Explaining the 10 Essential Services of Public Health

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Building Community Building Community Ownership Of The Ownership Of The

Assessment ProcessAssessment Process Buy-in is important to the quality & Buy-in is important to the quality & level of participation & to the outcomelevel of participation & to the outcome

The view is different from different agency

levels

All participants have equal standing

All opinions are important and valid

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Pre-Assessment Pre-Assessment PreparationPreparation

• Draft information letters/make follow-up phone calls seeking participants

• Develop display charts for review areas

• Pre-distribute the 10 Essential Services of Public Health

• Design/Distribute work sheets for pre-analysis

• Conduct Town website review

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Letters & Phone CallsLetters & Phone Calls

• Explain the rationale and process

• Define a “public health systempublic health system” as opposed to the core functions of a health department

(“all public, private & voluntary entities that contribute (“all public, private & voluntary entities that contribute to the delivery of essential public health services to the delivery of essential public health services within a jurisdiction”) within a jurisdiction”)

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10 Essential Services of Public 10 Essential Services of Public HealthHealth

Monitor Health

Diagnose/Investigate

Inform, educate, empower

Mobilize partnerships

Policy Development

Enforce laws & regs

Link people/health care

Assure a competent workforce

Evaluate quality

Research for new insights

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Developing Charts to Educate Developing Charts to Educate the Public Health System the Public Health System

EvaluatorsEvaluatorsCollaborations

Coalitions & Partnerships

Community Assessments

Disaster Preparedness

Task forces/projects

Health Surveillance Activities

Agencies/Town Depts. that had under gone evaluations

Advocacy Groups

Emergency Equipment

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Collaboration PostersCollaboration Posters

Senior Provider Network ~ Advisory Boards ~ United

Way Youth & Planning Councils ~ Senior Health Fair

Team ~ Late Life Issues Committee ~ Underage

Drinking Coalition ~ Greenwich Health Improvement

Partnership & Committees ~ Time for Lyme Task

Force ~ Regional B-T Group ~ Assessment

Committees ~ Disease-based Advisory Councils ~

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Community Assessments Community Assessments PostersPosters

Greenwich Department of Health:– Latino Study– Public Health Systems Assessment

United Way:– Community Needs Assessment – Statistical Portrait (w/GDoH)

Greenwich Hospital Advisory Board:– Community Health Assessment

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Disaster Preparedness Disaster Preparedness PostersPosters

B-T Coordinator/Team ~ Disaster Plans ~ Mass Immunization Protocols ~ Communication modalities ~

Incident Command Training ~ Mock Disasters ~

PPE/Training ~ Broadcast Fax ~ Radiology Meters ~ Decontamination Units ~ SARS & Avian Flu monitoring/tracking~ Highest # of certified Hazmet Techs in CT (96) ~ 50 MOP II test kits ~ “Decon” trailer & portable unit ~ 50 docemeters ~ Fully equipped Hazmat truck w/ mobile command unit, picture transmission on order

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Other Poster DisplaysOther Poster Displays

• Policy and planning forums/collaborators

• Town’s Surveillance System Components:Equipment Monitoring Partners

Training Capacity Drills

• Essential Services of Public Health

• Agencies that had undergone internal

studies or major reviews within 5 years

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Pre-Assessment Pre-Assessment WorksheetsWorksheets

List each of the 10 EssentialServices of Public Health

Pre-Identify some specific examples within your community

Pre-Identify some agencies involved in fulfilling each essential service

Members provide additional input based on their own experience

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Pre-Assessment Website Pre-Assessment Website ReviewReview

• Assessments conducted

• Data gathering and report sharing

• Research studies/Findings

• Linkages/Collaborations

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Pre-Assessment Pre-Assessment PreparationPreparation

Identify The Invitees/Construct Your MixIdentify The Invitees/Construct Your Mix

• Local Hospital, nursing homes, practitioners,

etc.

• 1st Responders (police, fire, ambulance, E.R.)

• Red Cross

• School and business representatives

• Town health & social service provider agencies

• Consumers, local government, funding sources

• Clergy, service organizations

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Pre-Assessment Pre-Assessment PreparationPreparation

Two Breakout sessionsBreakout sessions were designed:

1) Greenwich Department of Health 2) 1st Responders

Information gathering sessions were Information gathering sessions were held with key people who could not held with key people who could not

attend attend

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Pre-Assessment Pre-Assessment PreparationPreparation

Seek representation that reflects your

culturalcultural and ethnicethnic groups and various

age groupsage groups and special needsspecial needs populations

Seek participation from people at various various

levels of organizationslevels of organizations

Seek people from Town governmentTown government

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Assessment DayAssessment Day

On site monitor

Orientation AM and PM

Breakout sessions

Model standard vs. Town

performance

Facilitating the discussion

Scoring the group responses

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Post AssessmentPost Assessment

Entering the response Scores

Getting the report results

Drafting the final report

Community Forum

Using the report findings

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Utilizing Report Results Utilizing Report Results 1 1

of 2of 2

Even good results can offer Even good results can offer opportunities for opportunities for

improvement:improvement:

• The standard may be met but individual indicators may be lacking

• The raters perception may be erroneously positive

• Intra/inter agency communications may be editorialized in a group setting

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Utilizing Report Results Utilizing Report Results 2 2

of 2of 2

Community forums and press releases Guide the development or revision of a strategic or operating planGuide the development of outcome based budgeting Motivate a workforce capacity studyEnhance communication of data, research findings, and surveillance

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