1. Support for this program was provided by a grant from the Robert Wood Johnson Foundation

2.  During the first year of PHAB accreditation, only one state in the top ten most populous states applied for accreditation.  Large states face unique barriers to become accredited

3.  Robert Wood Johnson Foundation has set a goal that 60% of the US population will be served by accredited public health agencies by 2015.  Through this project, RWJF and ASTHO are supporting 4 large states in organizing and applying for accreditation, and paving the way for other large jurisdictions.

4.  Provide targeted technical assistance to meet states’ unique needs for a successful accreditation application  Collect lessons learned and disseminate to the entire public health community  Identify best practices to include in the RWJF practice exchange.  States will submit their Statement of Intent to PHAB no later than November 15, 2014.

5.  Funding and technical assistance will be provided to support these states to: ◦ Compile and collect documentation from across the state ◦ Document and create processes that the states need to develop to meet PHAB standards ◦ Align local and state departments with effective processes ◦ Build a performance management system ◦ Create a workforce development plan ◦ Develop an on-going Quality Improvement (QI) Initiative ◦ Complete PHAB pre-requisites: State Health Improvement Plan, State Health Assessment, the Strategic Plan

6.  After an application process, the RWJF selected four states to participate in this project: ◦ Illinois ◦ Florida ◦ California* ◦ New Jersey* *California and New Jersey Health Departments are awaiting final approval of funding from Robert Wood Johnson Foundation

7. RWJF  Dr. Pamela Russo-Senior Program Officer ASTHO Performance Team  Jim Pearsol-Chief Program Officer  Donna Marshall – Senior Director  Lia Katz – Performance and Quality Analyst Subject Matter Experts  To be identified

8. Planning and Outreach to States October 2012 – December 2012 State applications to RWJF and selections January 2013 – June 2013 States prepare for accreditation using Subject Matter Experts and initial funding to support their efforts Conference calls provide states the opportunity to share lessons learned ASTHO collects lessons learned to compile and disseminate to Public Health Community All states submit Statement of Intent to apply to PHAB by November 2014, with all applications finalized by November, 2015 July 2013 – December 2014

10. Big Cities, Big States: Working Toward Accreditation in Illinois Jerome Richardson, PhD Deputy Director, Office of Performance Management Illinois Department of Public Health 10

11. Presentation Objectives Previous accomplishments Shift to accreditation in large jurisdictions Possible models Next steps, future goals 11

12. Previous Accomplishments Created Grants Management Office Established standard grant application and budget form Developed review and approval process Organized grant review committees Developed scoring rubrics Created a uniform grant agreement 12

13. Previous Accomplishments (con’t) Identified business requirements Prioritized requirements Published RFP, selected vendor and began implementation Transitioned from paper to electronic grant system 13

14. Shift to Accreditation in Large Jurisdictions Build performance measurement system Use similar methodology Conduct baseline assessment Develop indicators (business processes) Stress efficiency and effectiveness Prioritize indicators Create master list 14

15. Possible Models Baldrige criteria a. Leadership b. Strategic planning c. Customer focus d. Measurement, Analysis, and Knowledge Management e. Workforce focus f. Operations focus g. Results 15

16. Possible Models (cont.) Public Health Informatics Institute a. Taking Care of Business b. Common Ground series c. Requirements for Information Systems d. The Big Picture: Developing an Enterprise View of Public Health Information Systems 16

17. Next Steps, Future Goals Determine reporting frequency Create SharePoint dashboards Create SharePoint Lists Deploy Visual Indicators Automate Notification with Alerts 17

18. Big Cities, Big State: A Big Approach to Accreditation June 12, 2013

19. 19 Florida Department of Health Centralized Health Department Key Demographics –State Population: 19,042,458 + Visitors –FDOH Budget: $2,767,574,448 (Fiscal Year 2012-2013) –Agency Workforce: 16,000 positions (June 2013)

20. Service Model

21. Improvement Efforts By December 31, 2015 implement the components of a sustainable performance management system. (Agency Strategic Plan Objective) Performance Management is a repeatable process that involves: –all employees; –setting objectives based on an organization’s mission and goals; –measuring performance over time; and –making improvements based on data.

22. Integrated Performance Management System Plan required work tasks & resources. Determine the issues. Measure progress towards desired outcomes. Do the work. Measure progress. Leadership, Workforce and Infrastructure Performance Management System Budget Management Evaluation Assessment Strategic Planning Operational Planning Decide priorities and how to attain them. Allocate resources. Build capacity to do work

23. State and local program/ activity/ operational Plans Routine performance review reports Agency Strategic Plan with CHD alignment State and local Program/Division Budgets Integrated Performance Management System Documents s Performance Management System Budget Management Evaluation Assessment Strategic Planning Operational Planning State and community health Improvement Plans State and Community Health Assessments Accreditation State and local Program/activity metrics Annual performance evaluation Leadership, Workforce and Infrastructure

24. 24 Integrated Performance Management System Operational planning Assessment Strategic Planning Budget Management Evaluation

25. Integrated Performance Management System Operational planning Assessment Strategic Planning Budget Management Evaluation

26. Integrated Performance Management System Operational planning Assessment Strategic Planning Budget Management Evaluation

27. Integrated Performance Management System Operational planning Assessment Strategic Planning Budget Management Evaluation Quality Improvement Plan

28. Integrated Performance Management System Workforce Development Plan –Undergoing a revision process –Guided by the Workforce Development Advisory Council. –Alignment with the State Health Improvement Plan and the Agency Strategic Plan Leadership, Workforce and Infrastructure Operational planning Assessment Strategic Planning Budget Management Evaluation

29. Integrated Performance Management System Documents s Performance Management System Budget Management Evaluation Assessment Strategic Planning Operational Planning Accreditation Leadership, Workforce and Infrastructure

30. Next Steps Decision by 9/3014 ApplicantStatement of Intent Application Submission Final Document Submission State Office4/22/136/30/139/30/13 County Health Departments 4/22/139/30/133/31/14 GOAL: Accreditation Decision by September 31, 2014 Total Population: 19,042,458 (Source: CHARTS - All County 2012 Population Estimate)

31. Accreditation Approach Identify Department systems, processes, programs, policies that are applicable statewide Identify relevant documentation based on requirements DOH Process: Infectious Disease Reporting

32. Are We There Yet? Plan required work tasks & resources. Determine the issues. Measure progress towards desired outcomes. Do the work. Measure progress. Leadership, Workforce and Infrastructure Budget Management Evaluation Assessment Strategic Planning Operational Planning Decide priorities and how to attain them. Allocate resources. Performance Management System

33. Office of Performance & Quality Improvement Rhonda White, Office Director and FDOH Accreditation Manager Rhonda_White@doh.state.fl.us 850-245-4018 Laura Reeves, Manager Laura_Reeves@doh.state.fl.us 850-245-4019

34. ACCREDITATION & QUALITY IMPROVEMENT AT HOUSTON Ololade G. Coker, MPH, MS

35. QUESTION

36. CITY OF HOUSTON DEPARTMENT OF HEALTH AND HUMAN SERVICES (HDHHS) 1 DATA SOURCE: U.S. CENSUS BUREAU, 2010 CENSUS SUMMARY FILE

37. CITY OF HOUSTON DEPARTMENT OF HEALTH AND HUMAN SERVICES (HDHHS)

38. PRIMARY ROLE WITHIN HDHHS

39.  Accreditation readiness and documentation review  Completed: 2nd Performance Management Self Assessment  Completed: Community Health Assessment (CHA)   Completed: Community Health Improvement Plan (CHIP)  Submitted: Statement of Intent  WILL APPLY FOR ACCREDITATION BY END of 2013  NPHII GRANT RECIEVED  PIAT Team Formed  Completed: 1st Performance Management Self Assessment

40. QI STATUS

41. P.M. / Q.I. AT “HDHHS” H OUSTON D EPARTMENT OF H EALTH AND H UMAN S ERVICES

42. HDHHS QI: BIRD’S EYE VIEW

43. SELF ASSESSMENT TOOL

44. SELF ASSESSMENT | QI PROFILE

46. PERFORMANCE MANAGEMENT!

47. SOME OF WHAT WE HEARD…

48. WHAT PERFORMANCE MANAGEMENT IS NOT

49. CHANGING PERCEPTION

50. FIRST REACTIONS TO QI

51. ADDRESSING FIRST REACTIONS TO QI

53. ROBERT WOOD JOHNSON FOUNDATION

54. PRIMARY FOCUS

55. RWJF BIG CITIES INITIATIVE

56. 1)Search for documents 2)Save documents 3)Repeat until done 4)Status report? 5)Piles of Work

57. ADMS

58. ADMS… BIRD’S EYE VIEW

59. QUESTIONS?

60. CONTACT INFORMATION