1. 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

2. 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

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

4. 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

5. North Carolina Local Public Health North Carolina

6. Public Health and Hospital System Funding Differences NC Local Public Health $750 Million System NC Medicaid $13 Billion System NC Hospitals $60 Billion System

7. 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

8. North Carolina Rural – Urban Continuum 3 Economic Tier Designations Source: NC Department of Commerce Tier 1 Most Economically Distressed: 40 Counties Tier 2 Distressed: 40 Counties Tier 3 Urban or Least Economically Distressed: 20 Counties

9. Improving Health in Our Communities Current Situation Challenges Innovative Approaches

10. North Carolina Mandated services Provide:Provide/contract/certify: Food, lodging & institutional sanitation Adult health Individual on-site water supplyHome health Sanitary sewage collection, treatment & disposal Dental public health Communicable disease controlGrade-A milk sanitation Vital records registrationMaternal health Child health Family planning Public health laboratory

11. 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

12. 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 21 st century public health.

13. 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

14. 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

15. 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

16. 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.”