Strategic Plan Progress Update 2017

Strategic Plan Progress Update 2017 Read Ahead 6/13/2017 Tri-County Health Department

Tri-County Health Department Strategic Plan 2014-2019 In early 2014, TCHD staff in coordination with the TCHD Board of Health (BOH) initiated a strategic planning process. The resulting Plan was intended to help TCHD maintain excellence in carrying out core public health functions and to address emerging health priorities over the next 5 years. The selection of goals was based on the principle that the Strategic Plan should support TCHD in continuing its longstanding trajectory of excellence by combining continued high performance in current programs that support core public health functions with efforts to address new strategic priorities relevant to the changing landscape of public health. Goal 1: Improve and Expand Informatics and Technology Capacity Goal 2: Improve and Expand Strategic Communication Capacity Goal 3: Improve and Expand Policy and Partnerships Capacity Goal 4: Improve and Expand Sustainability of Key Organizational Resources Goal 5: Reduce the Health Burden of Obesity/Chronic Disease Goal 6: Reduce the Health Burden of Tobacco/Substance Abuse Goal 7: Improve and Expand Public Health Interactions with Health Care Delivery System Goal Goal 8: Improve and Expand Efforts to Promote Healthy Human Environments Goal 9: Reduce the Health Burden of Mental Health This update reflects annual progress on the Strategies for each of the nine Goals, covering the nine-month period from Aug, 2016- May 2017. Each Action Step is reported as complete, on track (based upon the originally projected timeframe for completion), or delayed, and a summary score of Percent Complete or on Track is provided for each Strategy. Delays in completing Action Steps are 1

due to a variety of factors, including limited resources/capacity (e.g., key staff working to complete Public Health Accreditation documentation), previous steps needing to be completed, or other unforeseen circumstances. Goal 1: Improve and Expand Informatics and Technology Capacity Strategy 1b: Collaborate with external organizations to share data and resources to improve health outcomes. Define a common set of mental health indicators with Metro Denver Regional Partnership Develop a web based shared work space with regional partners to share mental health data and information Work with system partners to ensure adequate data are being collected for measuring progress toward key health outcomes Indicator development is completed Web site is live Content of BRFSS, PRAMS, CHS, and HKCS contain key health indicators Strategy 1c: Create a strong public health informatics infrastructure. Form and charter an agency-wide Data and Informatics Work Group Group meets regularly Develop an Informatics Plan that includes vision, mission, strategic goals and a detailed work plan Informatics Work Plan is in place 25 On track 2

Goal 1: Improve and Expand Informatics and Technology Capacity Strategy 1d: Develop and maintain a sustainable information technology (IT) master plan to support program and population health efforts. (e.g., assess need for IT system update, enhanced security audits, improved HIPAA compliance efforts, and electronic document management system). Implement daily monitoring of firewall events to include DLP incidents, virus / bot activity, and HIPAA compliance blade. Reach 90% compliance on HIPAA Checkpoint Blade. Establish uptime SLA of networking systems of 95% Achieve 90% survey satisfaction rate for IT services. Placed as objective for Sr, Netwk/Sec/Admin Implementation of HIPAA guided rules. Measure uptime minus maintenance. Improve and monitor IT survey results. 3

GOAL 2: Improve and expand strategic communication capacity Strategy 2a: Increase visibility of the TCHD brand in the community 75% complete or on track Hire new Strategic Communication Coordinator New SCC starts work Revise and update TCHD Strategic Communication Plan Revised plan Meet with TCHD Board of Health on communication priorities Meeting minutes Begin implementation of TCHD Brand Strategy Presentation to staff 0 Delayed Strategy 2b: Coordinate external communication efforts with key partners Hold joint meeting with PIOs from Adams, Arapahoe and Douglas Counties to explore Meeting minutes coordinate communication efforts Work with regional LPHA partners to launch HPV, Healthy Beverage, and mental health stigma reduction campaigns New communication efforts Work with City of Aurora to launch health outreach campaign for immigrant and refugee populations Campaign plan Begin outreach to city PIOs regarding coordination of communication efforts as we are doing with County PIOs # of city PIOs reached 50 On-track 4

GOAL 2: Improve and expand strategic communication capacity Strategy 2c: Develop and implement a multi-channel internal communication plan for the staff of TCHD 0% complete or on track Convene a cross-agency workgroup to identify internal communication priorities and potential tactics Meeting minutes 25 Delayed Develop Internal Communication Action Plan. Completed plan 0 Delayed Work with IT staff to consider Intranet development Recommendation to EMT 0 Delayed 5

GOAL 3: Improve and Expand Policy and Partnership Capacity Strategy 3a: Improve TCHD policy analysis, promotion, and dissemination capacity and impact 50% complete or on track Hire Policy/Partnerships Coordinator Coordinator hired 0 Delayed Initiate Policy Workgroup in coordination with Local Government Workgroup Workgroup initiated 0 Delayed Identify priority areas and policy strategies for proactive efforts Policy priority plan 25 On track Identify priority areas and policy strategies for reactive efforts Tally of policy activities (e.g., letters/emails written, testimony made, etc.) 50 On track Strategy 3b: Strengthen TCHD Alliances through partnership engagement 32% complete or on track Update Partnership inventory and gap analysis Updated inventory 25 Delayed Work with EMT, Strategic Plan goal leads, and leads of core public health programs to create a Partnership development plan to focus on strengthening current and developing new partnerships Address strengthening or creation of two priority partnerships Partnership Development Plan Summary of initial partnerships effort with plans for collaboration 25 Delayed 50 On track 6

GOAL 3: Improve and Expand Policy and Partnership Capacity Strategy 3c: Strengthen TCHD capacity to convene discussions among community stakeholders to support and advance public health activities Work with EMT, Strategic Plan goal leads, and leads of core public health programs to identify priority convening efforts Summary of priority convening efforts 25 On track Work with EMT, Strategic Plan goal leads, and leads of core public health programs to carry out one priority convening efforts Summary of convening effort outcomes Strategy 3d: Strengthen collaboration with Local Public Health Agencies (LPHAs) in the region. 25% complete or on track Action Steps Measure Status (% complete 0, 25, 50, 75, 100) Complete, On Track, Delayed or Eliminated Develop a strategy to enhance administrative support for the Metro Denver Partnership for Health Develop methods to communicate progress in the priority areas of collaboration (Healthy Eating Active Living, Behavioral Health, Strategic Partnerships, Data Sharing, Health Equity) to LPHA Directors Review opportunities for improved collaboration on LPHA Community Health Assessments Summary of strategy 50 Delayed Summary of methods 50 Delayed Plan on CHA collaboration 25 Delayed Review opportunities for a new strategic partnership (e.g., county Departments of Human Services) Initial meeting to discuss enhanced collaboration 25 On track 7

Goal 4: Improve and Expand Sustainability of Key Organizational Resources Strategy 4a: Enhance workforce development and targeted competency based trainings. Complete needs analysis and RFP for identification of a training tracking system (Learning Management System-LMS) RFP sent Implement training tracking system- LMS Cultivate a two way relationship with SPH/other academic and educational programs (PHAB) Conduct a salary and benefit comparisons and develop additional strategies for retention of staff that meet PHAB criteria. Go-live complete of new system Identify current programs and possible new ones and refresh- ongoing goal 2017 pay range complete, Compressional Analysis complete, 2017/2018 benefit review complete/new retention program complete 25 On track Enhance policies that support employees in their roles. Includes easy access to policies and refresh and clarification of all HR policies Review of all HR policies and placement on intranet 50 On track Strategy 4b: Update and maintain an agency facilities plan that considers market conditions, operational needs and location of client populations. Write Facilities Plan Last update 08/31/16: Action: Draft of plan provided to Bob for his review and comments. Bob has reviewed/edited approximately 50% of the draft plan. 8

Goal 4: Improve and Expand Sustainability of Key Organizational Resources Strategy 4c: Pursue becoming an accredited public health agency via the Public Health Accreditation Board (PHAB) process Submit required PHAB documentation via e-phab (a) gather, review, select & format all documents for the 12 domains: 9/1/15-12/31/16; (b) upload to e-phab: 1/31/17) Acknowledgement of receipt by PHAB Complete PHAB Team Site Visit a) Completeness review response 3/31/17; b) Pre-site review response 5/15/17-7/15/17; c) schedule, plan, prepare all teams & functions 4/17/17-8/15/17; site visit TBD Report received from PHAB 50 On track Receive PHAB Accreditation Accreditation decision received from PHAB 0 On track 9

Goal 4: Improve and Expand Sustainability of Key Organizational Resources Strategy 4d: Develop and implement an organizational Performance Management system with a Quality Improvement component. 50% complete or on track Compile and document requirements to meet PHAB Domain 9 criteria Development of QI Council A performance management software system will be in place and functional Documents approved by Accreditation Manager and ready for review QI Council charter approved and implementation beginning Performance Management system in use by goal leads d 0 Delayed 25 Delayed Initiate and facilitate QI projects within the agency 3 projects (min) d 10

Goal 5: Reduce the Health Burden of Obesity/Chronic Disease Strategy 5a: Utilize a strategic framework to guide chronic disease and obesity prevention efforts Finalize framework and supporting documentation for internal use Completed documents Present framework to EMT Presentation provided Complete targeted system mapping or other planning as needed around framework priorities; consider creation of external facing document(s) for sharing with community partners HEAL planning documents (e.g. system maps, prioritization plans) 25 On track Strategy 5b: Work with partners to develop or advocate policies and programs to ensure welcoming safe places for physical activity and active living for all. 75% complete or on track Conduct exploratory research with local government agencies and schools to determine opportunities for TCHD to support them in their HEAL efforts. (see also strategy 8d) Continue work on priorities of local government work group (LGWG) as identified in Progress Report, including plans for integration of services and communications/outreach Support childcare, school and worksite implementation of physical activity and physical education programs, policies, and regulations by providing technical assistance and responding to advocacy opportunities. Completed reports from focus groups Integration and Communication Outreach Plans Number of organizations provided with TA and list of advocacy efforts on local/state/federal policy 25 Delayed 11

Participate in at least 3 local or regional initiatives on active living policies and programs. (see also strategy 8d) Description of initiatives where policies and program TA provided 50 On track Strategy 5c: Work with partners to develop or advocate policies and programs to make affordable healthy food and beverages available to everyone in the community, and support breastfeeding. 75% complete or on track Participate in at least 3 local or regional initiatives on healthy eating policies and programs, including breastfeeding Expand and leverage partnership with community organizations on food access to increase utilization of WIC, SNAP, Food Banks, Summer Feeding Programs and Farmers Market programs Support childcare, school and worksite implementation of healthy eating policies and regulations by providing technical assistance and responding to advocacy opportunities. Provide support to hospitals on breastfeeding and healthy eating strategies through alignment with Community Benefit Plans and promotion of Healthy Hospital Compact (see also strategy 7c) Description of initiatives where policies and program TA provided # new WIC stores/authorized farmers/stands, # of WIC Rx referrals, food bank assessment and healthy food promotion Number of organizations provided with TA and list of advocacy efforts on local/state/federal policy Description of collaboration with area hospitals 25 Delayed Strategy 5d: Connect community partners and individuals with evidence based resources and programming for prevention and self-management of chronic disease Utilize results of TCHD staff survey to create and pilot new employee wellness programming and communications Summary of feedback and evaluations of pilots, wellness program plan 12

Promote enrollment and referrals to DPP, CDSM, DSME, and other evidencebased lifestyle education programs internally and externally Create billing system(s) to support sustainability of obesity and chronic disease related services in nursing and nutrition divisions. CHT grant data on # of referrals and enrollments, WW grant data on employer coverage of DPP through benefits plans Billing system plan and timeline for implementation 50 On track 13

Goal 6: Reduce the Health Burden of Tobacco/Substance Abuse Strategy 6a: Prevent youth initiation of substances through partnerships, education, and evidencebased strategies. Establish new Communities that Care coalitions in Englewood/Sheridan and along the I-70 corridor to address youth prevention Coalitions are established Work with partners in Douglas County to develop a plan of action based on assessment data for youth prevention Plan of action complete Support at least 3 schools in assessing existing health education curriculum and researching and proposing updated curriculum focused on skill development School curriculum Work with youth coalition and adult stakeholders, including city staff and Boys and Girls Club leadership, to propose a tobacco retailer license in the City of Brighton. Coalitions engaged, proposal planned Strategy 6b: Reduce public health and safety risks associated with substance use and misuse 66% complete or on track Work with partners in the Tri-County Overdose Prevention Partnership (TCOPP) to secure at least one additional drug disposal location in Adams County and promote disposal opportunities across the jurisdiction. Work with partners to place at least four community-based needle disposal containers to promote safe disposal of used needles and syringes across the jurisdiction. Conduct two convenings of local partners for capacity building and collective policy development opportunities that incorporate smoke-free with other healthy planning processes Drug disposal locations in Adams County Needle disposal containers in communities Meeting/discussion outcomes 50% On track 0 Delayed 14

Work with Adams County Housing Authority to draft smoke-free housing policy language for at least one ACHA property Draft policy language Work with partners in TCOPP and the Colorado Consortium to promote naloxone among first responders and achieve goal of at least 10 law enforcement agencies in the Tri-County area carrying naloxone Law enforcement agencies carrying naloxone Research prevalence of youth accidental exposure to marijuana, possible prevention strategies, and messaging. Determine appropriate steps for TCHD to take to address this public health issue. Research and suggested plan of action completed 25 Delayed Strategy 6c: Promote evidence-based cessation and treatment access Work with TCOPP to identify gaps in substance use disorder (SUD) treatment access and develop plan of community action TCOPP plan of action 50 On track Develop/increase staff capacity in tobacco cessation best practices to better support housing providers, worksites, schools, and other partners. increased cessation support capacity 50 On track 15

GOAL 7: Improve and expand public health interactions with the health care delivery system Strategy 7a: Work with key community partners to improve health access by assessing health care service capacity and access to health care services and identifying and implementing strategies to improve access. Review, share and analyze data for the purposes of assessing health care service capacity and access to health care services Progress summary Participate in collaborative efforts that include the involvement of the health care system to assess health care service capacity and access to health care services Summary of collaborative efforts Consider emerging issues that may impact access to care, including ACC 2.0 Progress summary Through collaborative efforts that include the involvement of the health care system, identify and implement strategies to improve access to health care services Summary of collaborative strategies In partnership with CCMU and the Statewide Network of Health Alliances, participate in efforts to support the common agenda of health alliances, including local health alliance sustainability Summary of collaborative efforts Strategy 7b: Work with key sources of data to and from the health care system to allow for appropriate electronic public health and clinical data exchange through the use of the Health Information Exchange (HIE) and Electronic Health Records (EHR) systems. 50% complete or on track Ongoing review of data utilization with the Colorado North Central Region (CO- NCR) colleagues partnering on Syndromic Surveillance Progress summary 16

Provide summary reports to include routine analysis and special topics from syndromic surveillance system Syndromic Surveillance Reports Utilize current EHR system and/or upgraded EHR to provide better analytics of patient health conditions and trends. Data conversion from current system to upgraded EHR. 0 Delayed Establish a bi-directional connection between the Health information Exchange (CORHIO) and/or CIIS and the TCHD EHR system Bi-directional connectivity Established with CIIS or/and CORHIO 0 Delayed Strategy 7c: Work with the hospital systems through alignment of shared health priorities Review Community Health Implementation Plans from not-for-profit hospitals and identify common initiatives to address shared health priorities Summary of collaborative initiatives Support alignment to improve population health by identifying and convening community partners working on shared health priorities, with a focus on the State Innovation Model grant for stigma reduction Summary of partnerships and progress Share strategies that align with public health improvement plans, not-for-profit hospital community benefit efforts and other for-profit hospital efforts to collaborate around shared resources Ongoing updates 17

Strategy 7d: Work with key sectors of the health care system to measure and promote select recommended clinical preventive services to improve health status among vulnerable populations. 66% complete or on track Design and Implement a communication tool, including an analytical component, with cross divisional TCHD staff that interact with the healthcare delivery system; incorporate PDSA cycle quarterly. Communication Tool/Smart Sheet/Power Bi 25 Delayed Plan and Implement the Regional Health Connector grant Grant deliverables Implement program specific requirements, such as action plans and grant or program deliverables, targeting partnership work with primary care Ongoing review of program updates Establish bi-directional relationships with PTO's, CHETA's and PF's to increase TCHD involvement in ongoing practice transformation efforts Review new and ongoing transformation efforts in Colorado and identify areas that TCHD can strategically participate Monitor the Communication Tool field notes and dashboard to identify ways to implement quality improvement methods to increase interaction with healthcare delivery systems Summary of partnerships and progress Ongoing summaries of Transformation efforts Communication Tool/Smart Sheet/Power Bi 25 Delayed 18

GOAL 8: Improve and Expand Efforts to Promote Healthy Human Environments Strategy 8a: Support community resiliency through promotion of water quality, water supply, reuse, and conservation opportunities Develop educational materials on well testing, graywater, and well permitting in Colorado Attend meetings and conferences to present educational information on well testing, well permitting requirements in the state to realtor associations. Completed articles, documents, etc. Numbers of presentations given 25 On track 25 On track Schedule meetings with local jurisdictions to educate them on graywater reuse. Meet with 2 jurisdictions 25 On track Conduct background planning to determine feasibility of implementing graywater programs in their areas. Draft model graywater ordinance Model ordinance created 50 On track Strategy 8b: Reduce human exposure to indoor environmental pollutants through outreach and public education and support regional and statewide initiatives to improve air quality. 67% complete or on track Conduct home visits for asthma triggers in conjunction with Denver Health and Clinica staff # home visits conducted 50 Delayed Provide training to additional TCHD staff to conduct home visits for asthma triggers # of staff trained 0 Delayed Conduct presentations to realtors/realtor associations # of presentations given Conduct residential tests for radon and outreach to childcare centers # of residential and childcare tests conducted Present HCR permanent site proposals to all 3 Counties complete presentations to counties 50 On track Attend RAQC and CDPHE AQCC regulation and SIP stakeholder meetings # of meetings attended 19

Work with the land use team to develop strategies for air related policy inclusion for city/county comprehensive plans # of strategies developed 50 On track Conduct inspections of tire facilities and provide compliance assistance to support state tire recycling objectives. Begin discussion at Green team for messaging to TCHD staff for RAQC indicatives, e.g. Every Trip Counts Program # of inspection of tire facilities Issue discussed and path forward developed 25 Delayed 67% complete or on track Strategy 8c: Establish high quality standards that will assure an effective Retail Food Safety Program Assess standard 3 and 5 Review and assess feasibility of standards Complete the requirements of standard 3 and 5 Complete requirements of the standards Get audited to become compliant for standard 3 and 5 Satisfy requirements of standards and approval Participate in State ratings work group # of meetings attended Get rating system presented and approved Ratings system approved by workgroup 50 Delayed Complete evaluation of what it would take to implement within Decade and on the TCHD website Ratings system active on TCHD webpage 25 Delayed 20

Strategy 8d: Promote and utilize a Health in All Polices approach to land use, transportation, and built environment policy development. 83% complete or on track Research opportunities for a centralized policy tracking platform. Summary report of platforms Delayed Conduct exploratory research with local governments to better understand strategic opportunities for engagement and promotion of health in policy and program development. Summary report of findings Provide technical assistance to 3 local communities on policy development processes. Number of communities assisted Participate in CALPHO's Health in All Policies work group Number of meetings Conduct two convenings of local partners for capacity building and collective policy development opportunities Number of convenings 50 On track Develop a vision for a property based data system and identify IT solutions Vision developed and solutions identified 50 On track 21

GOAL: 9 Reduce the Burden of Mental Health issues Strategy 9a: Reduce stigma associated with mental and behavioral health Establish SIM LPHA Grant Focus Area 1 workgroup made up of community partners - stigma reduction "Message Action Team" (MAT), determine common messaging, develop dissemination plan and disseminate message to at least identified partners. Grant deliverables completed Identify opportunities to integrate Early Childhood Colorado Partnership messaging platform internally and externally. Identified opportunities Pregnancy-Related Depression (PRD) Campaign: Implement cross-sector use of consistent public awareness messaging among community providers & organizations and increase the number of community targeted providers & organizations promoting PRD messaging in Adams, Arapahoe & Douglas County. Grant deliverables completed and number of placements of campaign materials. Strategy 9b: Increase prevention and early intervention of mental health Establish SIM LPHA Grant Focus Area 2 workgroup made up of community partners - assessment workgroup regarding screening and referral, develop assessment tool, complete assessments, evaluate gaps and prepare report. Grant deliverables completed PRD: Strengthen local referral networks for providers to address PRD and increase the number of primary care practices and providers who understand how to navigate referral networks in Adams, Arapahoe & Douglas County. Grant deliverables completed and QI data and training/education metrics. 22

Early Childhood screening: Increase the number of PH, community, and health care partners who implement at 50% of the ABCD Quality Standards Grant deliverables BUILD Grant partnership with WIC to increase access to psy/social screening through a Children's community health worker co-located in Alton/Colfax WIC office. Grant deliverables In partnership with TCHD Human Resources completed assess of state TCHD Family- Friendly Policy and develop action plan based on assessment feedback. Completed Assessment and Action Plan Strategy 9c: Enhance access to mental health care services in the community. 50% complete or on track Work with partners - county and state efforts for one referral system to include mental/behavioral services. A referral system that works across partners. 50% On track In partnership with the Regional Health Connectors for Adams, Arapahoe and Douglas Counties increase connections between providers and referral services. TCHD tracking process 25% Delayed Strategy 9d: Enhance existing population-level data collection and dissemination efforts. 50% complete or on track In collaboration with mental health partners begin implementation the CHORDS grant by bringing at least 1 mental health center on board. 1 mental health center sharing data 25 Delayed In partnership with Centura apply to add 5 "mental health stigma" questions to BRFSS process for 2017. Questions added to Colorado survey 23

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