Public Health Strategic Plan Douglas County, Oregon Douglas County 2014
Letter from the Director Dear Colleagues It is with great enthusiasm that I present the Public Health Strategic Plan for 2014-2015. As you know, Public Health is responsible for protecting, promoting and improving the health of all Douglas County residents. Every day, Public Health employees work in cooperation with medical care providers, community organizations, and others to protect individuals and communities from health threats, such as infectious disease outbreaks and preventable illness and injury. We also work to improve the long-term health and vitality of our community by addressing the underlying causes of many chronic, costly and life-threatening diseases such as cancer, heart disease, and diabetes. This Strategic Plan provides Public Health and our local stakeholders with a clear picture of where we are headed, what we plan to achieve, and the methods by which it will succeed. As we move forward, we will develop specific strategies and methods to implement and evaluate our Strategic Plan. Along the way, we will identify new and existing partnerships to build a healthier Douglas County. We all have a role to play in creating opportunities for all citizens to live a long, healthy life, regardless of their income, education or geography. Working together with our partners, we will continue to have a positive impact on the health and well-being of individuals, families and communities we serve. Sincerely, Dawnelle Marshall, RN, BSN Public Health Division Director Douglas County Health and Social Services 621 W. Madrone St. Roseburg, OR 97470 Phone: (541) 440-3544 Fax: (541) 957-3704 ii
Douglas County Public Health Strategic Map Vision Healthy people and places in Douglas County Mission The mission of Douglas County Public Health is to prevent disease and injury, promote wellness and protect individual and community health Core Values Douglas County, Oregon Client-focused: provide quality, timely and accessible services to reduce health disparities Culture of quality improvement: ensure effectiveness of public health programs, systems, and services Collaboration: promote, recognize and build collective efforts to achieve common goals Respect: embrace the dignity and diversity of individuals, groups, and communities Evidence and science based: support and promote evidence-based practice and innovation Integrity and stewardship: ensure transparent, ethical, sustainable and accountable performance Leadership: provide leadership in promoting and protecting health Access Outreach and communication to clients Access and availability of services, hours and location Staffing Financial Sustainability Health Equity Community Collaborations Staff training, orientation and development Staff recruitment and retention Public-Private community partnerships Diversified and reliable funding base Organizational effectiveness in support of health equity Community outreach and collaboration to foster Understanding and the will to achieve health equity Improve public health visibility Community engagement to increase support for public health
Douglas County Public Health Strategic Plan 2014 Contents Letter from the Director ii Vision, Mission and Values 1 Local Needs and Impact of Public Health 2 Assessment Of Strengths, Challenges and Opportunities 4 Process 5 Goals and Objectives 6 Appendix 9
Vision, Mission and Values The vision, mission and guiding values of Douglas County Public Health were reviewed as part of the strategic planning process. The process resulted in an updated vision, mission and guiding values and served to affirm the work that is conducted daily by staff. Mission The mission of Douglas County Public Health is to prevent disease and injury, promote wellness and protect individual and community health. Vision Our vision is healthy people and places in Douglas County. Douglas County Public Health evaluated and revised their vision and mission statement as part of a comprehensive strategic planning process. The Vision and Mission statements emphasize the core principles of public health and speak to the ultimate impact of the services provided. Douglas County Public Health is guided by the following values: Client-focused: provide quality, timely and accessible services to reduce health disparities Culture of quality improvement: ensure effectiveness of public health programs, systems, and services Collaboration: promote, recognize and build collective efforts to achieve common goals Respect: embrace the dignity and diversity of individuals, groups, and communities Evidence and science-based: support and promote evidence-based practice and innovation Integrity and stewardship: ensure transparent, ethical, sustainable and accountable performance Leadership: provide leadership in promoting and protecting health 1
Local Needs and Impact of Public Health To implement our core activities, Douglas County Public Health delivers ten essential services: 1. Monitor health status to identify community health problems including health disparities 2. Detect and investigate health problems and health hazards in the community 3. Inform, educate and empower people and organizations to adopt healthy behaviors to enhance health status 4. Partner with communities and organizations to identify and solve health problems and to respond to public health emergencies 5. Develop and implement public health interventions and best practices that support individual and community health efforts and increase healthy outcomes 6. Enforce laws and regulations that protect health and ensure safety 7. Link people to needed personal health services and ensure the provision of populationbased health services 8. Ensure a competent public health workforce and effective public health leadership 9. Evaluate effectiveness, accessibility and quality of public health services, strategies and programs 10. Research for insights and innovative solutions to public health problems 2
The impact of services provided by Douglas County Public Health is vast and broad, including improved personal and community health. Individual Counseling & Education decreasing impact Clinical Services increasing impact Long lasting Prevention Efforts Immunizations, dental sealants, cancer screenings Making the Healthy Choice the Easy Choice fluoridated water, safe food and water, tobacco-free environments, baby-friendly environments Socioeconomic Factors: Where Health Begins education, safe housing, employment, access, equity Douglas County Public Health achieves its mission through the following core activities: * Promotes healthy lifestyles for residents in their communities, schools and workplaces * Prevents disease, disability and premature death * Protects the public from unhealthy and unsafe environments * Reduces or eliminates health disparities * Provides or ensures access to quality, population-based health services * Prepares for and responds to public health emergencies * Produces and disseminates data to inform and evaluate public health status, strategies and programs 3
Services provided by public health are rooted in local needs. Several services provided by public health are not provided elsewhere. Douglas County Public Health has a long history of successfully providing programs and services to meet the needs of our community. Staff leadership and community input list the following as some services that make Douglas County Public Health unique: * Our primary clients are low-income and need services that they can t get elsewhere * We are good at providing wrap-around services * We meet government mandates for public health and safety * We provide the 317 Immunization program * Our nurses provide home-visiting * We are the only public health agency in the county * All of our services follow best practices * We respond to issues that nobody else does: such as communicable disease, foodborne illness, school law * We enforce laws such as indoor clean air act * We excel at the care of populations and understand social determinants of health * We design our services to reduce barriers for specific populations * We respond to emerging public health issues such as antibiotic resistance, nationwide vaccine shortage, preparedness and disease outbreaks Managers from the public health program areas identified strengths, challenges and opportunities. Data from the 2013 Community Health Assessment and Community Health Improvement Plan, internal surveys and data collection and staff input were referred to in order to inform the strengths, challenges and opportunities. 4
Assessment Of Strengths, Challenges and Opportunities Strengths * Dedicated staff and management * Good community support/ collaboration and partnerships * Significant staff expertise * Viewed as a community resource * Strong relationships and advocacy with State of Oregon and Federal government * History of securing and managing grant dollars successfully * Successful media advocacy * State and regional committees/ leadership positions * Access to outside training opportunities and continued staff development * Strong community support from business, government and nonprofits * Track emerging public health issues successfully Challenges * Recruitment and retention of qualified, trained staff * Data collection and management * Fleet vehicle management and availability * Multiple divergent reporting timelines and requirements * Budget and policy constraints of being part of a bigger organization * Budget constraints and limited resources * Facilities, space, management and upkeep * IT equipment and processes that often create work instead of making it easier * Categorical, restricted funding * Lack of consistent messaging and outreach * Staff development, morale and recognition * Quality improvement * Maintaining high level consistent customer service * Political influences * Limited availability of resources for highly specialized staff Opportunities * Expanded contractual relationships * Develop further QI culture * Expand funding opportunities * Increase efficiencies in programs * Enhance data system to collect and report on critical PH data, internal and external (dashboard) * Collaborative relationships with Early Learning Hub, Coordinated Care Organizations * Evaluation of processes and business flow to be more lean * Increase awareness of adolescent health offerings * Continue to integrate patient care from program to program * Improve staff morale, time management and employee development * Celebrate and recognize our successes and accomplishments * Acquire new funding * Better utilize technology * Integrate tobacco cessation & chronic disease self management into all HD practices * Increase leadership buy-in for public health initiatives * Accreditation 5
Process Douglas County Public Health began their strategic-planning process in February of 2014. The process coincided with the Community Health Improvement Plan (CHIP) and several other department-wide planning processes. The completion of the strategic plan provides the final prerequisite for National Public Health Accreditation. The process was based on successful planning methodologies, including input from internal and external stakeholders. The first part of the process included gathering and analyzing current data about community health. The Douglas County Community Health Assessment was completed in December 2013 and included input from the community via focus groups and key informant interviews. The CHIP process also included significant community input from surveys and public meetings. Internal stakeholder input included survey data from several department workgroups, including performance improvement, risk assessment and quality improvement. Douglas County Public Health leadership staff reviewed the data, revised the mission and vision statements, set guiding values of the plan and prioritized strategies. Douglas County Public Health Planning Process 2013 CHA 2014 CHIP DCPH Strategic Plan The Strategic Plan document, 2013 Community Health Assessment and 2014 Community Health Improvement Plan position Douglas County Public Health for future planning and collaborative work. Work plans have been developed to achieve the strategic goals and objectives. Outcome indicators, tactics, performance metrics, integration with the Public Health Annual report, 2013 Community Health Improvement Plan (CHA) and 2014 CHIP, staff champions have been identified. This level of detail was not included in the Strategic Plan document as they are more operational in nature. 6
Goals and Objectives Goals and objectives for 2014-2015 are based on a thorough assessment of department strengths, challenges and opportunities. Objectives and strategies for programs and services in public health fall into six general categories. Those categories are: Access, Staffing, Financial Sustainability, Health Equity, and Community Collaborations. Access Goal 1: Improve outreach and communication about available services to clients Objective 1.1 Objective 1.2 Research and develop new education and outreach practices and materials to strengthen the delivery of Nurse Home Visiting and Prenatal Care programs Research and develop communication tools and strategies to increase awareness of public health programs and services, e.g., social media, website, community health dashboards Objective 1.3 Objective 1.4 Objective 1.5 Increase awareness of and access to evidence-based tobacco cessation benefits, increase proactive provider referral to the Oregon Tobacco Quit line and build capacity for delivery of evidence based chronic disease self-management programs Improve employee health by engaging local business and communities in establishing healthy worksite policies, programs and environments Increase availability of chronic disease self-management programs by engaging media, supporting provider referral and encourage health systems to implement comprehensive nutrition standards Goal 2: Address barriers to accessing public health services Objective 2.1 Objective 2.2 Objective 2.3 Research opportunities to improve efficiency and effectiveness of client check-in processes for Public Health programs Research opportunities to improve client reminder and referral systems for Public Health programs Monitor effectiveness of flexible appointment policy and walk-in services for Public Health programs 7
Access Goal 1: Improve outreach and communication about available services to clients Objective 2.4 Assure that Public Health services are consis tent with evidence-based recommendations and standards through use of continuous quality improvement Goal 3: Evaluate and improve availability of services including hours and location of services Objective 3.1 Objective 3.2 Assess current availability of services to ensure county-wide access to all programs and services Assess possibility of expanding hours to include evening and/or weekend Hours for clinical activities, e.g. WIC, immunizations, reproductive health Staffing Goal 4: Improve staff training, orientation and development Objective 4.1 Objective 4.2 Assess and enhance core competencies of new and existing public health workforce Evaluate and improve nurse orientation process Objective 4.3 Assure that programs and services are consis tent with evidence-based recommendations and standards through use of continuous quality improvement Goal 5: Develop staff recruitment and retention plan Objective 5.1 Objective 5.2 Objective 5.3 Evaluate current staff salary structure and implement market analysis recommendations Develop and implement a standardized professional development policy to support recruitment and retention Identify staff recruitment opportunities and partnerships, e.g., schools of nursing, public health programs 8
Financial Sustainability Goal 6: Analyze current billing structures to identify new and expanded funding Objective 6.1 Objective 6.2 Objective 6.3 Advocate at State level for improved recognition and funding for Public Health Research and expand contractual relationships and billing opportunities for improved sustainability Explore opportunity for preferred provider designation for improved billing Goal 7: Expand scale and scope of services to diversify funding Objective 7.1 Identify new strategies to expand client case loads Objective 7.2 Explore opportunities for increased revenue through third party billing Objective 7.3 Improve collections and donations from clients for service delivery Objective 7.4 Advocate for increased funding for Public Health Objective 7.5 Increase grant funding applications for special projects 9
Health Equity Goal 8: Collaborate to improve access to needed public health services Objective 8.1 Objective 8.2 Objective 8.3 Objective 8.4 Objective 8.5 Objective 8.6 Assess consistency of depression, ATOD and IPV screening of pregnant women in OB community Explore opportunities to improve wrap-around service delivery of clients in community settings Explore opportunities to expand collaboration with CCO and Early Learning HUB partners to improve access to public health services Explore policy opportunities to reduce barriers for delivery of long-acting birth control methods Ensure that all public health materials are accessible, actionable, and conform to plain language principles Increase public health workforce understanding of health equity and social determinants of health Objective 8.7 Protect people from harm by facilitating community partnerships to advance tobacco-free policies, systems and environments including workplaces, health systems and public places Goal 9: Increase community knowledge of social determinants of health Objective 9.1 Provide training for providers on motivational interviewing Objective 9.2 Support training opportunities for understanding generational poverty Objective 9.3 Objective 9.4 Objective 9.5 Identify and build upon existing Health Literacy resources and partnerships to improve health outcomes Increase understanding of health equity and social determinants of health using multiple methods, including training, presentations, and Public Health communications Implement a systematic process for assessing customer needs and satisfaction with public health services 10
Community Collaborations Goal 10: Develop and utilize consistent branding and messaging about public health services and value Objective 10.1 Provide staff training and information on Public Health messaging Objective 10.2 Develop branding strategies to promote Public Health branding and recognition of Prevent, Promote, Protect Objective 10.3 Educate local decision makers, business leaders, and other stakeholders on the physical and economic harms of tobacco Goal 11: Support current and new community collaborations Objective 11.1 Identify new opportunities for unique ways to support delivery in a changing environment Objective 11.2 Reduce pro-tobacco influences by monitoring pro-tobacco influences in retail environments, engage local stakeholders to reduce exposure and educate decision makers about what works to reduce tobacco use. 11
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Appendix For copies of 2013 Community Health Assessment, 2014 Community Health Improvement Plan or the 2013 Public Health Annual Plan please contact: Public Health 621 W Madrone Roseburg, OR 97470 Phone: (541) 440-3571 Toll Free: (800) 234-0985 Fax: (541) 957-3704 TTY: (541) 440-3548 https://www.co.douglas.or.us/health/ph/ Helpful Acronyms: CCO PH HD QI CHIP CHA IPV ATOD Coordinated Care Organization Public Health Health Department Quality Improvement Community Health Improvement Plan Community Health Assessment Alcohol Tobacco and other Drugs Intimate Partner Violence 13