1. Environmental Public Health Tracking and EH Assessments in Montana National PACE EH Summit Louisville, KY - March 2006 Marjean Heisler Magraw

2. EPHT and EH Assessment: What is EPHT Why we did EH Assessments Use of PACE EH as a tool Benefits and Challenges

3. Origin of Environmental Public Health Tracking Pew Report to Congress- 2000 2001- Montana HB 582 called for a feasibility study March 2002 The National Health Tracking Act was signed

4. ENVIRONMENTAL PUBLIC HEALTH TRACKING

5. CDCs Vision For EPHT Healthy Informed Communities

6. CDC EPHT Mission To provide information from a nationwide network of integrated health and environmental data that drives actions to improve the health of communities.

7. Challenges Data collected by environmental and health entities nationwide is neither comprehensive nor standardized. We need to begin by defining our needs, enhancing relevant data, and building bridges between agencies.

8. WA OR NV ID MT WY SD ND NE UT CO AZ TX KS GA ALMS MN AR MO IL IA MI OHIN TN KY SC NC VA WV PA NY ME RI VTNH CT DE MD New York City, NY NJ Washington, D.C. OK NM CA Houston, TX Tulane University University of California, Berkeley Planning & Capacity Building Activities Infrastructure Enhancement & Data Linkage Demonstration Projects (with a planning & capacity building component) Academic Partners for Excellence Data Linkage Demonstration Projects LA FL WI MA University of Pittsburg

10. First Steps in Montana for Building an EPHT Program Identify partners Assess EH needs and concerns

11. Key Partners Local public health agencies Universities Advocacy Groups Related Agencies Tribes Health Care Providers

12. Statewide EH Needs Assessment Survey of PH workforce and partners Community Level EH Assessments

13. Community EH Assessments Just one piece of the EPHT plan Objectives: To obtain community input for EPHT To increase understanding of health concerns with possible links to the environment. To increase capacity at the County/Tribal level

14. Involving Local PH Departments Provided training and support for EH assessments at local level Provided support for selected action items

16. Assessment Requirements Establish community team and/or advisory group Involve/inform decision makers (Dept. managers, Boards of Health) Obtain community input Surveys Community Forums/Discussions Focus Groups

17. Assessment Requirements (cont.) Analyze data & generate a ranked list of EH concerns Prioritize EH concerns for local action Set action steps Write a final report which characterizes the area, describes assessment process and results

18. Challenges for Local PH Departments Minimal staffing Minimal resources Many demands Lack of technical knowledge/skills Fear of controversy and inability to address identified concerns

19. Benefits of EH Assessments Obtained community level input for EPHT Increased county/tribal support/understanding of the need to integrate public health & environmental data Increased community discussion around EH issues Allowed local Health Departments to be proactive

20. Benefits Involved/engaged a new group of citizens Identified EH issues of concern Developed assessment skills at local level

21. Comments From Contractors The community outreach has been good for the department and the community. It (the assessment process) increased cooperation between Health Department programs. Several citizens commented that they had concerns about issues and never knew who to talk to about it, and that they were glad to see the survey being conducted.

22. Comments From Contractors Its good to hear other strategies and solutions to common problems. Keeping in touch through the trainings and conference calls gives more unity to the project. I feel we are working as a group and not just one county in the state.

23. Special Follow-up Projects Purpose: Provide resources and support to contractors to implement a local action step that addressed a priority concern identified through their EH Assessment. $5000 max/project.

24. Benefits of the Special Projects Some local environmental health concerns identified through the Community Environmental Health Assessments are being addressed. Citizens see their health department working proactively. Public knowledge/awareness of EH issues increases.

25. Benefits of the Special Projects Local PH professionals are gaining technical skills, and building their capacity to work positively at the community level. Health departments are working with new community and agency partners. Health departments are improving communication among local agencies and programs about environmental health issues.

26. Missoula County Action Items 1. Refer vehicle emissions item to the Air Quality Advisory Council for in-depth discussion. 2. Work with other partners and planners in a variety of ways to reduce vehicle miles. 3.Implement an indoor air education campaign focusing on all possible contaminants (radon, mold, tobacco smoke, asbestos, and other chemicals found in homes or workplaces.

27. Rocky Boys Reservation Action Steps 1.Fund an educator position to manage the recommended environmental health priorities and develop agency response protocol. 2.Provide community education about all aspects of the community water system. 3. Publish/distribute a newsletter to update citizens about environmental issues.

28. Recommended Action Steps – Rocky Boys Reservation 4. Develop a sampling and analysis plan, and a source water protection plan for vulnerable private wells. Identify and map locations of abandoned wells. 5.Establish a system for removal, storage, and disposal of car bodies from waterways. 6.Identify resources for a pilot project to remove abandoned mobile homes.

29. Dawson County Special Project EH Assessment Priority Concern Addressed: Water Quality Action Step: Offered water testing for private wells, and provided public education about water quality threats, well testing and disinfection.

30. Yellowstone County Special Project (1) EH Assessment Priority Concern Addressed: Food Safety Action Step Selected to Address Concern: Create a Yellowstone County Food Safety Advisory Group to identify/address food safety related concerns.

31. Next Steps Expand local projects Offer PH Institute Course on Assessment Link local HDs through web- based reporting systems Improve availability of quality health and environmental data

32. http://www.dphhs.mt.gov/epht/ http ://www.cdc.gov/nceh/tracking/