Public Health Infrastructure Update

1. Public Health Infrastructure Update Presented by: Executive Committee, Statewide Coordinating Council for Public Health Maine CDC/DHHS Office of Local Public Health

2. Existing players, new model for coordination • 8 DHHS Districts • Strengthened Local Health Officer system • Some core public health functions carried out by Healthy Maine Partnerships • 8 District Coordinating Councils (DCCs) • District Public Health Units • MCDC Office of Local Public Health

3. DCC Progress • 8 DCCs convened • Developing membership, governance, mission. • Providing education about public health • Some DCCs have chosen priority projects • Working on PH system assessment • Gathering nominations for SCC membership • Engagement in district and community-level activities

4. Other Infrastructure Activities • Public health units in process of being convened and co-located • Co-location • Convening staff • Work beginning with county Emergency Management Agencies • Many involved in DCCs • OLPH staff meeting with EMA directors • Health improvement planning underway in all communities • Healthy Maine Partnerships, with technical assistance from OLPH

5. Local Health Officers • LHOs exist by statute in all Maine municipalities • Some towns share an LHO • Resolve local PH “nuisances” and link to resources • Law passed last year requiring Maine CDC to provide greater training and oversight • Certification training for all LHOs by June ’09 • OLPH activities for LHOs • Ongoing technical support • In-person meetings • Participation on DCCs • Online certification training completed; being beta tested • HMPs and city health departments have involved LHOs in local and regional PH activities

6. Q: What is the new infrastructure and how is it working to help make Maine the healthiest state? A: The new infrastructure pulls together the many diverse partners that make up a public health system. It streamlines, integrates and coordinates existing resources.

7. Police EMA Corrections MCOs Health Department Churches Community Centers Philanthropist Nursing Homes Home Health Parks Doctors Schools Elected Officials Hospitals EMS Environmental Health Civic Groups HMPs Fire Tribal Health Employers Laboratory Facilities Economic Development Drug Treatment Mental Health Partners that comprise a typical public health system

8. Partners convene at the district level

9. Greater partnership is developed at the state, district and local levels Local Health Officers HMP HMP Other District Health Partner Other District health Partner District Liaison and Public Health Unit District Coordinating Council Statewide Coordinating Council Maine CDC/DHHS Office of Local Public Health

10. Q: Will cost efficiencies be achieved through streamlining? A1: Streamlining has simplified a complex and disjointed contracting process involving multiple state agencies.

11. Q: Will cost efficiencies be achieved through streamlining? A2: We anticipate that streamlining will ensure that public health efforts are aligned, coordinated and unduplicated.

12. Q: Will cost efficiencies be achieved through streamlining? A3: SCC, DCCs and HMPs are creating a streamlined system for health assessment, gathering stakeholder input, and planning.

13. Success with coordination and streamlining: early examples • Improving transportation and access to care in the Midcoast District • 25K EPA Environmental Justice Grant for United Somali Women of Maine • Response to Eastern Equine Encephalitis (EEE) in York County

14. Q: How will we measure success? What are examples of success? A1: During the first year, progress will be measured through success in implementing the planned infrastructure (and implementation of priority projects in some districts)

15. Q: How will we measure success? What are examples of success? A2: During years 2 & 3, community and district public health improvement plans will be developed and implemented. PH improvement plans will create metrics for success.

16. Q: How will we measure success? What are examples of success? A3: Future metrics of success: PH accreditation in Maine; improved health outcomes at community, district, state levels.

17. Q: What is public health accreditation? Why must we seek it? How will it help us? A: Accreditation is a national credentialing process for public health systems; will begin in 2010. • Provides QA, credibility, and accountability. Will help Maine be competitive when applying for PH funding.  

18. Q: How will our new infrastructure help us achieve accreditation? A: Infrastructure is required for coordination and integration at the local level • Mechanism for workforce development • Will improve delivery of the 10 EPHS • DCCs and SCC will provide QI to PH System

19. Q: What would happen if the infrastructure went away? A: Slower progress in improving health outcomes. • Fragmentation at local and district level • Decreased ability to deliver PH services • Potential for duplication of effort • Decreased ability to earn accreditation • Decreased ability to efficiently use funds • Less coordinated and educated PH workforce • Loss coordination for PH planning and stakeholder input • Missed opportunities for collaboration

20. PH Improvement Planning HMPs develop Community Health Improvement Plans DCCs develop District Public Health Improvement Plans SCC provides input into State Health Plan DCCs need specific guidance from SCC and ACHSD about Plan format and structure