Welcome to Public Health INsights & INnovation Developing Public Health Policies and Plans Join via: https://connect.iu.edu/ph-insights-innovation/ Presenters: Dorothy Boersma, MD, MPH, Health Officer Rush County Health Department Cynthia Stone, DrPH, Professor IU Richard M. Fairbanks School of Public Health 1
Objective: Participants will be able to 1) serve as a primary and expert resource for establishing and maintaining public health policies, practice and capacity, and 2) conduct a comprehensive planning process resulting in a Community Health Improvement Plan. National Public Health Accreditation Board Standards and Measures, Version 1.5 http://www.phaboard.org/wp-content/uploads/sm-version-1.5-board-adopted-final-01-24-2014.docx.pdf IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
Public Health Insights & Innovation Community Health Improvement Plan Cynthia Stone DrPH, RN July 31, 2015
Outline Welcome- JoBeth McCarthy-Jean Research and/or evidence-based practices in Community Health Improvement Plans-Cynthia Stone, IU FSPH Presentation by Practice Partner: Dr Dorothy Boersma, Rush County Health Officer Question Session
Objectives for Domain 5: Develop Public Health Policies and Plans Part I public health personnel are able to: 5.1 Serve as a primary and expert resource for establishing and maintaining public health policies, practice and capacity 5.2 Conduct a comprehensive planning process resulting in a Community Health Improvement Plan
Standard 5.1 Expert Resource Includes: Monitor and track issues being discussed Beware of : issues being considered by state legislature, governor, ISDH, mayor, county commissioners, County board of health, school board, US-DHHS
Documentation- 2 examples within 2 years Document monitoring: minutes of meetings you attended and agendas, Log of legislation you are following at the state level, show membership on list-serves: Kaiser Family Foundation is one example, state legislator newsletter, professional organizations (APHA does monthly, ISNA does weekly etc); retain emails that you sent about issues
Measure 5.1.2A-Engage in activities to develop or modify policies Health department must show action in this area with policy maker directly or other stakeholders Two examples one from different areas: Informational materials Provide public testimony Participate in advisory or work group appointed by elected official
Examples of Public Policy practice and impact Informational: issue brief, statement to the media, provide fact sheet, write a white paper-examples on our IU Center for Health Policy Public testimony: at a state study committee hearing or senate or house committee hearing or during a county council meeting Advisory work: Must have a stated purpose to provide advise and influence policy ex. Attorney General Prescription Drug Abuse Prevention Task Force
Measure 5.1.3A Inform government entities of potential intended or unintended health impacts of a policy Document informed policy maker Two examples are needed Can be non-health sector (housing, education, transportation) Two examples from different areas: Impact statement or fact sheet Correspondence, emails, briefing statement, report Presentation of an evaluation
Examples of informing government entities Fact sheet must have references (be science based), must show who was the audience If the information through a discussion: minutes, including participants, action steps to follow up If the information through a presentation: keep a copy of the presentation and agenda or participant sign up form
Standard 5.2 Conduct a Community Health What is a CHIP? Improvement Plan (CHIP) Long term plan to address issues found in CHA What is the purpose? Determine how the health department and community partners will work together to improve the health of the community served Why such a broad partnership? More than just the health department can do
Measure 5.2.1 Process to develop a CHIP Must document collaborative planning process an accepted national, state or local model is required. If a specific model is not followed than the key steps used and an outline must be provided National models can include: Mobilizing for Action through Planning and Partnership (MAPP)
CHIP National models continued Association for Community Health Improvement Assessment Toolkit (ACHI) Assessing and Addressing Community Health Needs (Catholic Hospital Association of the US https://chausa.org/docs/default-source/generalfiles/cb_assessingaddressing-pdf.pdf?sfvrsn=4) University of Kansas Community Toolbox (http://ctb.ku.edu/en/node/9)
Tools that can be adapted NACCHO s Resource Center for Community Health Assessments and Community Health Improvement Plans Community Indicators Process project Asset Based Community Development model National Public Health Performance Standards Program Assessment Protocol for Excellence in Pubic Health
Tools that can be adapted continued Guide to Community Preventive Services Healthy People 2020
Why are we doing this? Counseling & Education Clinical Interventions Long lasting protective interventions Changing the Context Socioeconomic Factors National Network of PH Institutes
Process must include Participation by a wide range of community partners Identification of the data that was provided to use in the planning Evidence of discussion Identification of assets and resources Overall description of the process, how priorities were developed
Examples of process Broad participation: parks and recreation, hospitals and health care providers, faith community representation, veterinarians, local schools, military representative, planning or housing or zoning department representatives, mayor, city council members, county commissioners, police, chamber of commerce, local businesses, not-for-profit groups, civic groups, foundations, youth organizations, senior citizen organizations- Document with minutes/sign in forms
Examples of process Information used from CHA List of data sets provided Specific information referred to in the CHA in the minutes Evidence of discussion: definition of health used What does a healthy community mean to them? List of issues identified in minutes
Examples of process Community assets and resources: What could be utilized to improve health of the community? Skills of residents Service associations, professional associations Local institutions (faith based, schools etc) Community factors: parks, businesses, resilience, social capital Document how priority steps were determined
How is this different? Emphasis on process Based on broad definition of health Expectation that engagement will be meaningful Show connection between evidence, values, vision, objectives and strategies Emphasis on quality improvement
Examples of CHIP-Jamestown, WI Table of contents Core team members Community Prioritization process Modified MAPP: community wide meetings, telephone survey, one-one interviews, key informant surveys, online survey County Health Rankings model County data used Health indicators identified Prioritization process Obesity Safe driving Youth alcohol and smoking Mental health awareness Looked at how to change behavior
Jamestown CHIP continued-obesity Priority Goal: explore ways to increase physical activity Performance measures: Explore funding for new fitness facility Seek community support for fitness facility Determine interest in bone building program Long term: Determine location of fitness facility Develop business plan for fitness facility Also identified who would do and when it would be done
Objective 1: Establish a fitness facility details Activity Target date Year Lead Anticipated result Framework level Research funding for start up costs Dec 31, 2012 One year Director Economic Development Funding prospect list Motive Provide an update to interagency group Promote the process Jan 14, 2013 Two and Three Central Valley Health Community Support Education Determine location and business plan Dec 2015 Two and Three Economic Development Location options Business plan Ability
Community Partner Support List of agencies involved their Mission Vision History CHIP initiatives they would work on
Next parts of report Letters from key community partners Table of Community Health Assets by priority area How they will sustain their efforts Contact information
Questions/Contact Information Cynthia Stone IU Fairbanks School of Public Health cylstone@iu.edu
References National Network of PH Institutes: PHABulous Health Assessments & Improvement Plans: Achieving PHAB Standards PHAB Standards and Measures v. 1.5 Using the MAPP Model at the State and Community Levels: https://www.astho.org/displan/assetdisplay.aspx?id=6589 CHA/CHIP Resource Center http://www.nacho.org/chachipresources Jamestown Community Health Improvement Plan https://www.jrmcnd.com/community_health_improvement_plan/
Rush County Community Health Improvement Plan JULY 31, 2015 DOROTHY C. BOERSMA, MD, MPH RUSH COUNTY HEALTH OFFICER IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
RCHD CHIP Laying the Foundation ISDH RCHD Purdue University Local stakeholders Motivation 2009 Community Health Needs Assessment Accreditation Funding Regionalization Coalition Formed IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
RCHD CHIP Partners for a Healthy Rush County 2010 RCHD Rush Memorial Hospital Boys and Girls Club Purdue County Extension Clean Green Rush County Rushville High School SADD Rushville School Nurses IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH Researched other community coalition efforts
RCHD CHIP Introduction of Partners and mission Health Summit Agenda Review of 2009 Community Health Needs Assessment Review of other health data Breakout sessions 1. The World Around Us (Environmental) 2. Keep it Safe (Safety) 3. Personal Responsibility (Behavioral Choices) 4. Beyond the Band-aid (Disease) 5. Everything's Okay (Wellness) Reports from breakout sessions Video contest winners viewed and awards given Conclusions IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
RCHD CHIP Health Summit results Attendees: 76 Refreshments donated by Rush Hospital Vendors/booths/displays Students: SADD, Family and Consumer Science class, video contestants Stimulated conversation Media coverage (newspaper, radio) Partners analyzed discussions IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
RCHD CHIP Priority Areas 1. Wellness/fitness/obesity 2. Parenting (teen pregnancy) 3. Distracted driving 4. Tobacco cessation. IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
RCHD CHIP Accreditation Journey Used Summit Report to develop CHIP with same focus areas CHIP approved in 2012 Applied for accreditation in 2013 IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
RCHD CHIP PHAB Standards and Measures (v1.0) 5.2.1 L Conduct a process to develop community health improvement plan Documentation: Completed community health improvement planning process that included: a. Broad participation of community partners (list of Partners, Health Summit attendees b. Information from community health assessments (2009 CHNA) c. Issues and themes identified by stakeholders in the community (Health Summit Report, CHNA) d. Identification of community assets and resources (CHIP) e. A process to set community health priorities (Partners) IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
RCHD CHIP PHAB Standards and Measures (v1.0) 5.2.2 Produce a community health improvement plan as a result of the community health improvement process Documentation: 1. Community health improvement plan dated within the last five years that includes: a. Community health priorities, measurable objectives, improvement strategies and performance measures with measurable and time-framed targets b. Policy changes needed to accomplish health objectives c. Individuals and organizations that have accepted responsibility for implementing strategies d. Measurable health outcomes or indicators to monitor progress e. Alignment between the community health improvement plan and the state and national priorities IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
RCHD CHIP Priorities: envisioning a more fit and active lifestyle for Rush County Residents: 1. Improve fitness in Rush County 2. Reduce obesity in residents of Rush County Measurable objectives: 1. Increase the percentage of Rush county citizens who exercise regularly 2. Reduce the rate of obesity in Rush county Improvement strategies 1. Increase the number of participants in the Walkabouts by 10% each year over the next 5 years 2. Develop a tracking system to record not only the number of participants but the number of individuals participating in each walk 3. Develop an incentive program for repeat participants to reward their participation 4. Increase participation in Small Steps for Health and Wealth TM Performance measures 1. Decrease the percentage of Rush county residents who are physically inactive 2. Decrease the percentage of Rush County residents who are obese IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
RCHD CHIP b. Policy Changes needed to complete the health objectives 1. Courthouse rules changed to allow indoor walks through courthouse 2. Permission to walk on private properties such as cemeteries 3. Arrangements made with the school corporation for use of Memorial gym 4. Agreements made to be able to use the Boys and Girls Club c. Individuals and organizations that have accepted responsibility 1. FIT members: 2. Purdue Cooperative Extension Office 3. Rushville Parks and Recreation Department IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
RCHD CHIP d. Measureable health outcomes or indicators to monitor progress 1. Reduce the percentage of Rush county residents who have not engaged in physical activity in the last month from 35.5% (2009) to 30% in 2017 (RCCHA) 2. Decrease the obesity rate in Rush county from 72.5% in 2009 to 65% in 2017 (RCCHA) e. Alignment between CHIP and state and national priorities 1. Alignment with Health People 2020 a. Improve health, fitness, and quality of life through daily physical activity b. Reduce the disease and economic burden of diabetes mellitus (DM) and improve the quality of life for all persons who have, or are at risk for, DM. (through prevention by reducing obesity 2. Alignment with state priorities (IN State Health Improvement Plan) Priority physical activity a. Goal 2: Increase opportunities for and engagement in regular physical activity b. Goal 5: increase the capacity of communities and settings within those communities to develop and sustain environmental and policy support systems that encourage healthy eating and active living IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
RCHD CHIP PHAB Standards and Measures (v1.0) 5.2.3 Implement elements and strategies of the health improvement plan, in partnership with others 1. Reports of actions taken related to implementing strategies to improve health 2. Examples of how the plan was implemented IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
RCHD CHIP Fitness Initiative Team of Rush County (FIT) Small Steps to Health and Wealth (Rutgers Cooperative Extension) Walkabouts Wellness campaign: school year 2014-2015 Free Family Fitness Fair-August 2014 Celebration-May 2015 Mayor s 5K-May 2015 Rush2Health website Strategic Planning-sustainability IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
RCHD CHIP Rush County Parenting Council Parenting Resource Guide 2011 and updated in 2014 Printed (RCHD covered cost in 2014, Schools in 2014 - Available online) Developing training sessions IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
RCHD CHIP IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
RCHD CHIP DASH (Driving Around Safely at Home) TRUCKS ROCK, THEY ALSO ROLL (billboard campaign) IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
RCHD CHIP Tobacco cessation Indiana state law change Indiana Quitline campaign at county fair 2013 RCHD community outreach coordinator hired 2015 IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
RCHD CHIP PHAB Standards and Measures (v1.0) 5.2.4 Monitor progress on implementation of strategies in the community health improvement plan in collaboration with broad participation from stakeholders and partners 1. Evaluation reports on progress made in implementing strategies in the community health improvement plan including: a. Monitoring of performance measures b. Progress related to health improvement indicators 2. Revised health improvement plan based on evaluation results IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
RCHD CHIP Annual Review Process of analyzing data Who is involved How decisions are reached Timelines Responsible persons Goals/objectives/measures IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
Rush County Health Department www.rushcounty.in.gov (has link to CHNA) rcdh@rushcounty.in.gov Dorothy C. Boersma, MD, MPH Rush County Health Officer Room 105, Courthouse Rushville, IN 46173 765-932-3103 rcdhhealthofficer@rushcounty.in.gov Open Door Health Services, Chief Medical Director 333 S. Madison Muncie, IN 47307 dcboersma@opendoorhs.org IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
Domain 5: Developing Public Health Policies and Plans Standard 5.1: Serve as a Primary and Expert Resource for Establishing and Maintaining Public Health Policies, Practices, and Capacity Standard 5.2: Conduct a Comprehensive Planning Process Resulting in a Tribal/State/Community Health Improvement Plan Standard 5.3: Develop and Implement a Health Department Organizational Strategic Plan Standard 5.4: Maintain an All Hazards Emergency Operations Plan Evaluation: http://survey.constantcontact.com/survey/a07eb5y26nxib1637p8/start IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
Resources Title Description Link Public Health Quality Improvement Exchange Public Health Accreditation Board Shared resources for creating a culture of quality improvement Tools, resources, information, research on voluntary public health accreditation https://www.phqix.org/ http://www.phaboard.org/ Rush County Health Department Community Health Needs Assessment (CHNA) www.rushcounty.in.gov National Association of City and County Health Officials Community Health Improvement Plan (CHIP) http://www.naccho.org/topics/infrastructure/chachip/ Minnesota Department of Health How to Develop a CHIP http://www.health.state.mn.us/divs/opi/pm/lphap/chip /howto.html Robert Wood Johnson Foundation Community Health Assessment and Improvement Plans for Public Health Accreditation http://www.rwjf.org/en/library/research/2014/02/com munity-health-assessment-and-improvement-plans-forpublic-hea.html IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH
Thank you for attending Public Health INsights & INnovation Please join us on August 28 for Part II Developing Public Health Plans and Policies IU RICHARD M. FAIRBANKS SCHOOL OF PUBLIC HEALTH 56