A New Public Health for the 21

st

Century

Kaye Bender, RN, PhD, FAAN President and CEO, PHAB

Session Objectives • Describe the national trend toward performance and quality improvement in public health.

• Discuss the key public health elements included in the health reform discussions.

• Recognize the potential future scenarios for public health practice.

What Was Wrong with the Old Public Health?

• Public health in disarray—governmental only (Institute of Medicine Report,1988) • Public health in disarray—broader public health (Institute of Medicine Report, 2003) • Accountability and performance (Blueprint for a Healthier America, 2008) • Accountability, performance, and QI (Lessons Learned from the MLC Projects, 2007)

Poll Question Do you agree with the comments about the problems of the old public health?

A. Yes B. No

Click on the down arrow if you can’t see the response choices.

What’s Changed Over the Past Decade?

Increasing emphasis on performance and quality improvement Decreased funding and overall economic pressures More programs focused on health promotion Emergency preparedness

What’s next for public health?

Congressional Interest in Public Health Reform • Not health care reform • Not about funding streams • Prevention and wellness (focus of Senate and House bills) • Interested in prevention and wellness (Policy makers comments)

APHA’s Health Reform Suggestions Invest in population-based services Address chronic underfunding Have more fiscal accountability Require methods to study impact of federal policies & programs on public health

APHA’s Health Reform Suggestions Develop, expand, and monitor programs aimed at reducing health disparities Have the healthiest nation in one generation Provide health care coverage for all

Report of PHLS/NACCHO Session on Health Reform • What part of health reform should public health

not

be interested in?

• Some public health programs are best coordinated statewide.

• Population-focused public health programs increase the likelihood of success in clinical programs.

Report of PHLS/NACCHO Session on Health Reform • Public health programs can reach populations not covered in health care reform.

• The public health infrastructure has to also prepare itself for a new day in public health if health care reform occurs as planned.

PHAB Board of Directors Vision for the Future • High performing health departments contributing to a healthier nation!

• 60% of the population will be covered by accredited health departments by 2015.

PHAB’s Partners NACCHO APHA ASTHO NALBOH NIHB CDC PHF NNPHI RWJ Foundation

Developmental Work Standards development & vetting Assessment process Beta test Research & evaluation Fees & incentives Information systems development

Why Accreditation for Public Health? Baldrige for health systems and businesses Joint Commission for Health Systems PHAB is planning a system that blends the two

The Value of Accreditation: Agency Benefits & Public Benefits • Improved public health outcomes • A tool for quality and performance improvement • Accountability • Credibility • Recognition of excellence • Clarification of expectations • Increased visibility • Improved community health status

Which Public Health Departments Are Affected?

Organizational structure does not matter!

Three required components Community health assessment Community health improvement plan Agency strategic plan

Potential Vision for the New Public Health Department • No longer the safety net • Stronger links to the health care system for assuring the health of the public • Focus on high performance, accountability, and a culture of improvement • Increase visibility • Improved recruitment and retention

Poll Question This national picture that we’ve just discussed has a lot to do with the daily work of health departments.

A. Strongly agree B. Agree C. Disagree D. Strongly disagree

Click on the down arrow if you can’t see the response choices.