1. CALPHO Meeting June 8, 2009
Office of Planning and Partnerships Colorado Department of Public Health and Environment

2. Office of Planning and Partnerships
A new office in CDPHE that:
Meets the implementation goals of the 2008 Public Health Act
Maintains positive relationships with local public health
Establishes credibility in planning within CDPHE and among local agencies
Works closely with CALPHO, the Public Health Alliance, the Colorado School of Public Health and other partners
Funding from the Caring For Colorado Foundation
Office of Planning and Partnerships Colorado Department of Public Health and Environment

3. The Public Health Re-authorization, Re-vitalization, Re-organization Re-Act of 2008
One type of local public health agency with a local board of health
A statewide public health plan approved by the State Board of Health
Local public health plans based on the state plan, health status indicators and local needs
Public health services, standards and funding formula for Colorado established by the State Board of Health
Office of Planning and Partnerships Colorado Department of Public Health and Environment

4. …but what does it mean?
Assures the provision of basic public health and environmental health services
Promotes boards of health
Encourages state and local collaboration
Considers financial feasibility and funding
Supports regional cooperation
Prepares CO for national accreditation
Office of Planning and Partnerships Colorado Department of Public Health and Environment

5. Steps in the Act and progress
State Board of Health establishes minimum qualifications for local health directors and medical officers.
Counties establish their local/district public health agencies, appoint BOH and health directors.
CDPHE creates Statewide Public Health Improvement Plan “on or before December 31, 2009…and…every 5 years thereafter.
State Board of Health approves core services, funding formula and minimum quality standards for public health services.
Local Public Health Agencies create local plans “as soon as practicable after the approval of…statewide…plan.”

6. Core Services/ Standards
For today:
Core Services/ Standards
Office of Planning and Partnerships Colorado Department of Public Health and Environment

7. Services/Standards Charge:
What public health services should be available to all residents of Colorado regardless of where they work, live and play?
In the Act:
To establish, by rule, the core public health services that each county and district public health agency must provide or arrange for the provision of said services;
To establish, by rule, the minimum quality standards for public health services;
Office of Planning and Partnerships Colorado Department of Public Health and Environment

8. Services vs. Standards Services is the “what” Standards is the “how”
What services, programs, activities are offered
Tied to budgets and funding requests
Standards is the “how”
How services are offered in relationship to ….
Capacity of Agency
Evidence-based using best practices
Follow functions of the 10 Essential Services
in preparation for national accreditation
Office of Planning and Partnerships Colorado Department of Public Health and Environment

9. How are we developing Core Services
How are we developing Core Services? Asking for input and incorporating changes as we go…
As CALPHO members, you are seeing the first draft today
Send to all divisions at CDPHE
Post on our website for comment
Present at meetings throughout state
Include in statewide plan draft
Office of Planning and Partnerships Colorado Department of Public Health and Environment

10. Input CALPHO meeting at CCI-June 8
3 former Nursing Service regions-June 17
3 former Nursing Service regions-July 15,22
Environmental health directors meeting- July 16
PPHR-Southwest-TBD
Critical Input meetings-open to all
Office of Planning and Partnerships Colorado Department of Public Health and Environment

11. Services Considerations
Local though identifying state role
Relationship to other statutes
Relationship to funding
Relationship to size of population served
Prioritized by local assessments and demographics (a standard)
Office of Planning and Partnerships Colorado Department of Public Health and Environment

12. What drives services and programs now…
Funding
Interest of the PH director, board of health
Sometimes data, not always
History
Political will
Mandated
Can core services escape this?
Office of Planning and Partnerships Colorado Department of Public Health and Environment

13. What services are we providing now?
NACCHO 2008 survey data

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19. Office of Planning and Partnerships Colorado Department of Public Health and Environment

20. What services, programs, activities would you choose not to do
What services, programs, activities would you choose not to do? If it is:
Not a major cause of morbidity and mortality
Not a primary prevention measure
Not targeted at a high risk group
No legal requirements
No community demand
No political demand
Disproportionate use of time and resources
Duplicated effectively elsewhere
Office of Planning and Partnerships Colorado Department of Public Health and Environment

21. Proposal-the Core Services document:
Preamble on what a core service is
Broad Category
Brief narrative
Services a local health agency shall provide
Examples of what it could include
State role
Office of Planning and Partnerships Colorado Department of Public Health and Environment

22. Broad Categories of Services
Monitor, Assess, and Plan
Vital Records and Statistics
Investigate and Control Communicable Diseases
Population-Based Primary Prevention/Health Promotion
Maintain a safe, healthy environment
Ensure safety of consumer services and products
Prepare and respond to emergencies and disasters
Assure access to personal health services
Additional State Services-EMS, Laboratory, Health Facilities
Office of Planning and Partnerships Colorado Department of Public Health and Environment

23. The detail-next level under each service category:
Understandable, no unintended consequences, acceptable to multiple stakeholders
Services that must be included:
Is it statutorily required?
How is it funded?
Could include or examples:
Examples of specific, established programs
Address concern of inclusion
Office of Planning and Partnerships Colorado Department of Public Health and Environment

24. Facilitated discussion
Small group:
Review, comment, and edit preamble
Review, comment, and edit assigned category (s)
Re-convene:
Review category titles
Summarize preamble suggestions
Report on category (s) recommendations

25. Coming to consensus on Core Services
Office of Planning and Partnerships Colorado Department of Public Health and Environment

26. Using a community health assessment and plan to determine programs that meet core services:
Can assessments drive services and programs?
Will that be acceptable to your boards of health?
Can we accept the time interval needed to produce assessments before major changes?
Office of Planning and Partnerships Colorado Department of Public Health and Environment

27. Next section of Plan-developing Capacities
Workforce development
Data and Technology
Valuing and promoting public health
Policy development recommendations
Capacity assessment
Community Health Assessment and Planning
Funding
Partnerships to strengthen community capacity
Office of Planning and Partnerships Colorado Department of Public Health and Environment

28. Strategic Priorities Initiating Workgroup Critical Input Meetings
Core Services
Mar – May
June – July
Health Outcomes
April – June
July
Data and Technology
May – July
August
Workforce Development
Marketing
Partnerships
Policy/Legislation
Financing
May – August
September
Service Delivery
Office of Planning and Partnerships Colorado Department of Public Health and Environment

29. Stakeholder Input for Plan
Initiating Workgroup
Advisory Group
Review and Input
Critical Input Meetings
Regional, open to all
Critical Input Meetings
Critical Input Meetings
Advisory Group
Review Compiled Plan
Uniting Public Health Conference
September 30, 2009
State Board of Health
November 2009
Office of Planning and Partnerships Colorado Department of Public Health and Environment

30. Join us for the following dates:
We need to hear from you!
Join us for the following dates:
July 23 Grand Junction
August 3 Denver
August 4 Ft. Collins
August 11 Pueblo
August 13 Broomfield
*RSVP to Katy Rice (303)
Office of Planning and Partnerships Colorado Department of Public Health and Environment

31. e-mail: CDPHEEDPlanningandPartnerships@state.co.us
Contact information:
phone (303)
website:
Office of Planning and Partnerships Colorado Department of Public Health and Environment

32. BACKGROUND SLIDES

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39. The picture now…
Colors: Organized Health Departments White: Nursing Services : Environmental Services
Office of Planning and Partnerships Colorado Department of Public Health and Environment

40. Implementing the Act Infrastructure minimum qualifications
funding formulas
internal CDPHE
standards
core services
PH nursing
environmental health
Improvement Plan
goals/outcomes
core services
indicators/data
environmental health
workforce development
health disparities
Office of Planning and Partnerships Colorado Department of Public Health and Environment

41. Statewide Public Health Improvement Model
Short-Term Outcomes
Intermediate Outcomes
Long-Term Outcomes
Inputs
Strategies
Outputs
Improvements in Determinants of Health
Existing Public Health Infrastructure
Establishment of formalized planning office
Statewide Improvement Plan
Strong Public Health System
Public Health System that Equitably, Efficiently, and Effectively provides the 10 Essential Public Health Services
Recognized value of public health
Existing Knowledge Base
Convene partners as advisors and ad-hoc workgroups
Improved Partnerships Across Multiple Sectors
Improved community, environmental, and personal Health Status
Public Health science base is strengthened
Colorado’s history and momentum toward Public Health improvement
Implement Statewide quality improvement
Stakeholder input
Integrated community, environmental, and personal health
Prepared for accreditation
Local Public Health Improvement Plans
Improved Quality and Quantity of Life
Experience of others on this path
Office of Planning and Partnerships Colorado Department of Public Health and Environment

42. Goals of the Statewide Public Health Improvement Plan
Set Colorado’s public health priorities based on health status indicators
Guide the public health system in targeting core public health services and establishing standards
Consider available resources and identify areas needing greater resource allocation
Recommend legislative or regulatory action
Provide a strategy for coordinating services delivery within the public health system
Provide measurable indicators of effectiveness and successes
Office of Planning and Partnerships Colorado Department of Public Health and Environment

43. Office of Planning and Partnerships Colorado Department of Public Health and Environment