1. Pacific Island Health Officers Association
ASTHO Insular Area Health Officials Summit August 11, 2014 Honolulu, Hawaii
Pacific Island Health Officers Association
Emi Chutaro
Executive Director

2. Pacific Island Health Officers Association (PIHOA)
Established in 1986 by Pacific health officials – regional voice for the six US- affiliated Pacific island countries and territories
Non-profit 501(c)3 – chartered in the CNMI and the State of Hawaii
3 offices – Honolulu (HQ), Guam and Palau; 1 staff currently on extended on- site assignment to American Samoa
8 staff and 3 contract retainers; hosting 2 regional CDC Immunization staff (with plans for 2 more from CDC Chronic Disease and Preparedness)
Funding sources: CDC, CDC ASTHO, HRSA and membership dues

3. PIHOA Board Membership
Executive Members – voting members
President - Dr. Vita Skilling, Secretary of Health, FSM National DHSA
Vice-President – Motusa Tuileama Nua, Director of Health, American Samoa DOH
Mr. Jim Gillan, Director of Health and Social Services, Guam DPHSS
Mrs. Esther Muna, Chief Executive Officer, CNMI CHCC
Mr. Gregorio Ngirmang, Minister of Health, Palau MOH
Mr. Philip Muller, Minister of Health, Marshall Islands MOH

4. PIHOA BOARD ASSOCIATE Members
Dr. Livinson Taulung, Director of Kosrae Health Services, FSM
Mr. Paulino Rosario, Director of Pohnpei Health Services, FSM
Mr. Julio Marar, Director of Chuuk Health Services, FSM
Mr. James Gilmar, Director of Yap Health Services, FSM
Mrs. Julia Alfred, Secretary of Health, RMI
Mr. Joe Verga, CEO, Guam Memorial Hospital
Mr. Joseph Fleming, CEO, American Samoa LBJ Hospital
Dr. Debbie Ngemaes, Director of Hospital Services and Administration, Belau Hospital
Ms. Berry-Moon Watson, Director of Public Health, Palau MOH

5. PIHOA Board Affiliate Members
American Pacific Nursing Leaders Council (APNLC)
Cancer Coalition of the Pacific Islands (CCPI)
Secretariat of the Pacific Community (SPC)
Association of USAPI Labs (AUL)
Pacific Resources for Education and Learning (PREL)
Pacific Basin Medical Association (PBMA)
Pacific Basin Dental Association (PBDA)
Pacific Islands Primary Care Association (PIPCA)
Pacific Basin Behavioral Health Collaborating Council (PHBCC)
Pacific Post-Secondary Education Council (PPSEC)

6. Current Implementation Partners
WHO and SPC
USAPI health agencies
UH JABSOM and School of Nursing, UoG and FNU CMNHS
Local colleges – CMI, COM, PCC, ASCC and NMC
ASTHO
APHL and DLS (Hawaii and Guam)

7. Board Mandates Promote improved health practices
Provide a forum for the exchange of information and knowledge
Be a vital link/network between and among visiting medical and health professionals
Promote health-related research beneficial to the welfare of the people of the Pacific
Increase the knowledge and practice of public health in the region by promoting high professional and medical education standards

8. Foster and support other organizations that have similar public health purposes and objectives
Research on funding mechanisms to maximize the quality and quantity of health services available to the Pacific
Foster regional efforts in providing appropriate means of improving the accessibility, quality and cost-effective delivery of healthcare services to the address the needs of Pacific communities

9. Strategic Plan 2013-17 Outcomes
Outcome 1 – Demonstrated political leadership at the highest level to take responsibility for and address health at national and regional levels
Outcome 2 – Have ensured appropriately adapted, contextualized and relevant multi-sectorial policy environment to mainstream health responses
Outcome 3 – Priority cost-effective and evidence-based interventions with appropriately set performance monitoring frameworks, including research and surveillance efforts, are supported and strengthened

10. Outcome 4 – Have ensured that priority public health responses are adequately resourced and sustainable, including appropriate and relevant human resources, infrastructure, financial resources and technical assistance
Outcome 5 – Have ensured accountability of all sectors, including pertinent non-health sectors, for their respective contributions to stated health priorities
Outcome 6 – Strengthened advocacy and community engagement in health
Outcome 7 – Strengthened health systems to effectively respond to health priorities

11. Scope of Work 2013-17 Ancillary and Support Services
Health Information Management Systems (HIMS)
Performance Improvement
Human Resources for Health (HRH)
Strategic Planning and Engagement
Policy Development
Strategic Planning and Policy Development bits will be discussed in NCD presentation on Thursday; will just highlight key areas of work in lab, HIMS and HRH in this presentation

12. Ancillary and Support Services
TA and consultation on laboratory system improvement process for Level I and II labs
Improvement of influenza lab-based surveillance and other infectious diseases
Strengthening specimen shipping networks, including diagnostic referrals and IATA certification (Specimen Referral Revolving Fund)
Consultation and TA to strengthen local lab potential and accreditation, including LQMS
Communication and networking with regional USAPI lab networks, including local health agencies and regional partners (CDC, WHO and SPC)

13. Performance Improvement and HIMS
Strengthen QA & QI programs in local health agencies – design and implement QI projects / develop policies and procedures
Building Quality & Performance Communities of Practice through workshops, conference calls, listserv and cross-jurisdiction attachments
Development, dissemination and mentoring for local college QI certificate curriculum
Rapid performance and quality program assessments
Assistance to health officials to identify performance indicators that match agency priorities, develop data definitions and methods for collection, assemble dashboards, and integrate use of dashboards into QI program plans and management routines

14. Development & delivery of EpiTech curriculum for preparedness, environmental health, NCD and outbreak-prone disease surveillance
Development of advanced applied epidemiology fellowship – Field Epidemiology Training Program
Health Metrics Network/Pacific Rapid Assessment and Strategic Planning Process consults
Cross-jurisdiction mentored peer consultations – SWAT team approach
As needed, assistance with preparing systems requirements sets for proposed EHR projects
As needed, arranging expert review of IT contracts and arranging informatics consultations
Facilitation and review of Planning for Agency Reform/Project Design

15. USAPI NCD Core Surveillance Framework
Indicators
Tobacco
Alcohol
↑BMI
Diseases
(adult)
Deaths
(30-69 years)
Cigs- Youth
Cigs- Adult
Chew- Youth
Chew- Adult
Youth
Adult
HTN DM
↑Cholesterol
All Cause
Cardiovascular
Cancer
Diabetes
Chronic Lung
Am Samoa ↓ N ↑
CNMI
FSM
Chuuk
Kosrae
Pohnpei
Yap
Guam
Palau
RMI
Out of 144 Indicators:
15 – Improved
15 – Worsened
33 – No Change
81 – Insufficient Data

16. Human Resources for Health
Home Caregiving training to families for the homebound
Oral Health Workforce Education Plan implementation in partnership with WHO
Formal undergraduate Public Health training network
Environmental Health strategic planning and workforce training and education
HR Management mentoring and coaching
Foundations Sciences implementation

17. TA to local and regional health licensure boards and professional associations, including coordination/networking
Nursing Education - local clinical faculty training, Bachelors in Public Health Nursing, Nurse Practitioner training, and support to the APNLC - Chief Nurse Association
Updating HRSA HPSA designations and improving NHSC recruitment and retention
Continuing health professional development – all levels

18. Strategic Engagement and Policy
Building consensus and regional response to health issues of regional significance
Declaring a Regional State of Emergency to the NCD Crisis in the USAPIs - PIHOA Resolution 48-01, May 2010
APIL Resolution No. 31-GA-05, CD1
“Relative to strengthening formal collaborative efforts between the Association of Pacific Island Legislatures (APIL) and Micronesia Chief Executives’ Summit (MCES).”
BE IT RESOLVED that APIL fully supports the work and initiative of Pacific Island Health Officers Association (PIHOA) in "Calling for a Health, Non-Communicable Law and Policy Summit" to bring together MCES, APIL, Micronesian Traditional Leaders, Chief Health Executives (PIHOA), and world experts (WHO, CDC, SPC, etc.) to review the large body of law and policy experience in addressing NCDs with the view that templates of such NCD laws and policies may assist chief executives and legislators in addressing the NCD crisis in their respective jurisdictions;

19. Endorsed by the PIHOA Board in 2013
THE COMMITMENT
Fifteen Essential Policies for Reversing the Epidemic of NCDs in the USAPIs
 Risk Factor: Tobacco
 Commitment 1: Increase taxes on tobacco products
Commitment 2: Pass and enforce model comprehensive smoke-free air acts
Commitment 3: Restrict all forms of tobacco product advertising
Commitment 4: Establish and sustain tobacco cessation programs
Risk Factor: Alcohol
 Commitment 5: Restrict all forms of alcohol advertising
Commitment 6: Restrict access to alcohol
Commitment 7: Increase taxes on alcohol
Risk Factor: Poor Nutrition
 Commitment 8: Implement policies that reduce salt consumption
Commitment 9: Implement policies that reduce sugar consumption
Commitment 10: Implement policies that reduce fat consumption
Commitment 11: Implement policies that promote breastfeeding
Commitment 12: Implement policies that promote local foods
Risk Factor: Lack of Physical Activity
 Commitment 13: Develop the built environment to promote physical activity
Commitment 14: Promote physical activity in the work place
Commitment 15: Promote physical activity in the schools
Endorsed by the PIHOA Board in 2013
Currently being streamlined into new USAPI NCD Plans (Guam completed)
USAPI NCD Law and Policy Summit

20. Online USAPI NCD Policy Toolkit aligned to the USAPI NCD Commitment Package
Under development in partnership with UH JABSOM