1. A New Public Health for the 21st Century
Kaye Bender, RN, PhD, FAAN
President and CEO, PHAB 1

2. Session Objectives
Describe the national trend toward performance and quality improvement in public health.
Discuss the key public health elements included in the health reform discussions.
Recognize the potential future scenarios for public health practice.

3. What Was Wrong with the Old Public Health?
Public health in disarray—governmental only (Institute of Medicine Report,1988)
Public health in disarray—broader public health (Institute of Medicine Report, 2003)
Accountability and performance (Blueprint for a Healthier America, 2008)
Accountability, performance, and QI (Lessons Learned from the MLC Projects, 2007)

4. Poll Question
Do you agree with the comments about the problems of the old public health?
A. Yes
B. No
Click on the down arrow if you can’t see the response choices.

5. What’s Changed Over the Past Decade?
Increasing emphasis on performance and quality improvement
More programs focused on health promotion
Decreased funding and overall economic pressures
Emergency preparedness

6. What’s next for public health?

7. Congressional Interest in Public Health Reform
Not health care reform
Not about funding streams
Prevention and wellness (focus of Senate and House bills)
Interested in prevention and wellness (Policy makers comments)

8. APHA’s Health Reform Suggestions
Invest in population-based services Address chronic underfunding Have more fiscal accountability Require methods to study impact of federal policies & programs on public health

9. APHA’s Health Reform Suggestions
Develop, expand, and monitor programs aimed at reducing health disparities Have the healthiest nation in one generation Provide health care coverage for all

10. Report of PHLS/NACCHO Session on Health Reform
What part of health reform should public health not be interested in?
Some public health programs are best coordinated statewide.
Population-focused public health programs increase the likelihood of success in clinical programs.

11. Report of PHLS/NACCHO Session on Health Reform
Public health programs can reach populations not covered in health care reform.
The public health infrastructure has to also prepare itself for a new day in public health if health care reform occurs as planned.

12. PHAB Board of Directors Vision for the Future
High performing health departments contributing to a healthier nation!
60% of the population will be covered by accredited health departments by 2015.

13. PHAB’s Partners NACCHO APHA ASTHO NALBOH NIHB PHF NNPHI CDC
RWJ Foundation

14. Developmental Work Standards development & vetting Assessment process
Beta test
Research & evaluation
A great deal of work is currently underway
Great care is being given to ensure that the development of the program is thoughtful and inclusive
Evaluation and CQI will always be an important part of how PHAB operates
Program development work being done largely by workgroups, all of which are comprised primarily of public health practitioners in state and local health departments
[Workgroup members are posted on phaboard.org for those who would like to see individual names and affiliations]
Work includes:
Developing standards and measures and assessment process
Undertaking a beta test of standards, measures and the process
Determining how to recognize state-based accreditation programs for LHDs that are sufficiently similar so as to confer national accreditation benefits on LHDs that have been accredited through “equivalent” state programs
Getting the word out about accreditation and its value – not only to health departments, but also to their governing bodies, as their support will be critical
Planning up front for careful, ongoing evaluation of the accreditation effort, and also establishing a research agenda
Developing a robust set of incentives for participating LHDs
Fees & incentives
Information systems development

15. Why Accreditation for Public Health?
Baldrige for health systems and businesses
Joint Commission for Health Systems
PHAB is planning a system that blends the two

16. The Value of Accreditation: Agency Benefits & Public Benefits
Improved public health outcomes
A tool for quality and performance improvement
Accountability
Credibility
Recognition of excellence
Clarification of expectations
Increased visibility
Improved community health status
We are in conversation with researchers

17. Which Public Health Departments Are Affected?
Territorial health departments
Local health departments
State health departments
Tribal health departments
Organizational structure does not matter!

18. Three required components
Community health assessment Community health improvement plan Agency strategic plan
Three required components

19. Potential Vision for the New Public Health Department
No longer the safety net
Stronger links to the health care system for assuring the health of the public
Focus on high performance, accountability, and a culture of improvement
Increase visibility
Improved recruitment and retention

20. Poll Question
This national picture that we’ve just discussed has a lot to do with the daily work of health departments.
A. Strongly agree
B. Agree
C. Disagree
D. Strongly disagree
Click on the down arrow if you can’t see the response choices.