1. The Public Health Revitalization Act A look at what this means for you and examples from Washington State. Michael Wallingford, MPA, REHS Colorado Directors of Environmental Health July 17, 2008 Durango, Colorado

2. The Public Health Revitalization Act Public health history was made by the Colorado Legislature during the 2008 session with the passage of SB08-194, the Public Health Revitalization Bill. SB08-194 will restructure and update Colorado’s public health laws.

3. The Public Health Revitalization Law  Requires the State Board of Health to establish public health standards for Colorado.  Each local public health agency will develop a local public health plan based on the state plan. Local plans will be approved by the local board of health and reviewed by the state board of health.  A statewide public health plan will be approved by the State Board of Health.

4. Principles of Implementation  Assuring the Provision of Basic Public Health Services through a community assessment and the creation of a local and state PHIP.  State and Local Collaboration a must  Financial Feasibility  Functional Regionalization

5. The Public Health Improvement Plan How will I ever get through this?

6. The Washington State Public Health Improvement Plan Public Health Improvement Partnership (PHIP) Overview 5-28-08

7. The Washington State Public Health Improvement Plan Despite increased demands and strained resources, Washington’s public health leaders have created a strong and innovative partnership, addressing public health challenges by working as a coordinated system.

8. The Washington State Public Health Improvement Plan The PHIP Board of Directors, implementing RCW 43.70.520 and.580, have: Developed performance standards and measured the capacity of the public health system to carry out basic functions, Estimated the costs of filling gaps in public health services statewide, Created a list of key health indicators to measure health outcomes at the local level, and Implemented workforce training and technology coordination efforts to improve the effectiveness of services. For more information, see: www.doh.wa.gov/phip

9. 1993 – Health Reform (RCW 43.70.520) In partnership…… Set standards – who does not meet? Budget & staffing plan to meet standards Costs & benefits of meeting standards Strategies for improvement Strategies for transferring personal health care services Link PH funding to performance Recommended level of dedicated funding Biennial plan / report

10. 1995 – PHIP Law (RCW 43.70.580) Identify key health outcomes for population Identify capacity needed to improve outcomes Distribute state funds to encourage effectiveness and efficiency Performance based contracts with LHJs Community assessments as basis for identifying health outcomes Evaluate capacity and effectiveness of the public health system

11. 1995 – PHIP Law (RCW 43.70.580) Urgent Need/Local Capacity Development Fund Originally $10 million/biennium Now $15.7 million/biennium Of this, a portion is set aside as the Partnership Fund (~$450,000/biennium)

12. PHIP Vision for Public Health Key health indicators guide investments Performance standards are used statewide Financing is stable, sufficient and equitable Information technology is standardized, secure Workers receive continuous training Access is provided for critical health services Communication about public health is effective Strong alliances support public health

13. Products and Progress Standards set for Public Health in Washington State Exemplary Practices Compendium Finance Studies Local Public Health Indicators Communication Tools Workforce Enumeration Learning Management System Information Technology Access Compendium

14. Standards 1. Conduct community health assessment 2. Communicate to public, stakeholders 3. Involve community members 4. Monitor and report health threats 5. Respond to emergencies 6. Provide prevention and health education 7. Address gaps in services 8. Plan and evaluate programs 9. Maintain management, finance 10. Maintain workforce/ Human resources 11. Maintain information systems 12. Provide leadership, governance

15. Local Public Health Indicators 32 Indicators - Maternal-Child Health - Communicable Disease - Environmental Health - Health Promotion - Access to Care County-level data Used along with Standards On-line in mid-2008

16. Prioritized list of activities and services performed by LHJs Communicable Disease Health Promotion Healthy Families Environmental Health Health Information Access to Health Services Emergency Response

17. The Public Health Improvement Plan What is next for Colorado?

18. What’s next for Colorado? Immediate Action for Counties without an established LHA:  Each County designates a Local Public Health Agency by July 2009.  County designates Local Board of Health 90 days later.  County appoints Public Health Director.

19. What’s next for Colorado LHA’s?  Participate in the Public Health Summit work groups in Fall 2008.  CDPHE creates Statewide Public Health Plan “on or before December 31, 2009” and every 5 years thereafter.  LHA’s create local plans “as soon as practical after the approval of statewide plan.”  State Board of Health develops minimum quality standards for public health services.  State Board of Health establishes minimum qualifications for local health directors and medical officers.

20. On Colorado’s PHIP A quote from a colleague: “The Public Health Improvement Plan must be a statewide plan, not a state plan.” Dr. Chris Urbina Executive Director Denver Health

22. Questions?? Contact Information: Michael Wallingford, MPA, REHS Environmental Health Services Administrator Broomfield Public Health and Environment 6 Garden Center Broomfield, CO 80020 (720) 887-2236 mwallingford@broomfield.org