North Carolina Public Health is mission driven and policy focused: works to promote and contribute to the highest possible level of health for the people of North Carolina.

North Carolina

Creating conditions for every community to be

a healthier community

Creativi

ty

For the group to determine together … this comes to mind for me today: Hard to be specific to the world order and political landscape at the moment

NC Public Health Vision Statement 2015

North Carolina

Public Health in the US is built on 3 Core Functions and 10 Essential Services

North Carolina

• Federal Funding Streams• US Dept of Health and Human Services (DHHS)• Centers for Disease Control and Prevention (CDC)• Centers for Medicaid and Medicare (CMS)

• State-Level Infrastructure• NC Dept of Health and Human Services (NC DHHS)• Division of Medical Assistance (DMA)• Division of Public Health (DPH)

• Local Entities• Local Health Departments (LHD)• Local Boards of County Commissioners• Consolidated Health and Human Services

North Carolina Prevention Infrastructure

North Carolina

North Carolina Local Public Health

North Carolina

Public Health and Hospital System Funding Differences

NC Local Public

Health $750 Million

System

NC Medicaid $13 Billion

System

NC Hospitals

$60 Billion System

NC has great diversity in its 100 counties and its ~10,000,000 citizens

North Carolina

“From the Mountains to the Sea”“From Manteo to Murphy”

Public health is local and focused on what each community needs: Public health fills gaps in access, serves as a safety net and convenes partnerships

North Carolina

Rural – Urban Continuum 3 Economic Tier Designations

Source: NC Department of CommerceTier 1 Most Economically Distressed: 40 CountiesTier 2 Distressed: 40 CountiesTier 3 Urban or Least Economically Distressed: 20 Counties

Improving Health in Our Communities

Current SituationChallengesInnovative Approaches

North Carolina

Mandated servicesProvide: Provide/contract/certify: Food, lodging & institutional sanitation

Adult health

Individual on-site water supply Home healthSanitary sewage collection, treatment & disposal

Dental public health

Communicable disease control Grade-A milk sanitationVital records registration Maternal health

Child healthFamily planningPublic health laboratory

North Carolina

Coordinated Services and Programs• Child Health (well checks & home visiting)• Maternal Health (prenatal care)• Case Management (OBCM and CC4C)• Health Education & Health Promotion• WIC (Women, Infant and Children program)• Preparedness and Response • Management Support and Billing Services• HIV and STD Services

The New Local Public Health• Quality Improvement methods such including Lean and The

Model for Improvement are the way public health does business. • Evidence-based public health practice, policy and environmental

change, and health-in-all-policies approaches are supported across public health.

• New approaches to data management in health care: Practice management, patient satisfaction, flow analysis, and financial indicators / dashboards are necessary like never before and the public health workforce is up to the challenge of leading 21st century public health.

Change: Leading and Responding (internal vs external)• Quality Improvement• Public Health Accreditation• Practice Management • Emerging Disease• Funding sources vary tremendously:

Local, State, Federal, other• Rural – Urban Continuum

Healthier Communities Moving Forward• Local stakeholder engagement in community is key• Evidence-based policy, programs and interventions• Statewide health objectives inform policy• Innovative approaches to funding and financing are

valued

Emerging Issue – Prescription Drug Abuse

• Drug overdoses are the leading cause of unintentional injury death in America

• 16,651 overdoses from Opioid painkillers

• There is a relationship of sales of opioid painkillers and overdose death rates

North Carolina

Benjamin Disraeli

“The health of the people is really the foundation upon which all their happiness and all their powers as a state depend.”