Continuous Quality Improvement and Accreditation



The 10 Essential Public Health Services

Continuous Quality Improvement and Accreditation Assessment

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Preliminary Report

for

Multi-State Learning Collaborative Site Visit

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This report was compiled by the

Office of Public Health and Medicine Partnerships.

Kathy Weaver, Director

Eric Jackson

Sue Hancock

Helen Schwartzel

TABLE OF CONTENTS

About the Assessment…………………………………………………………..4

Agency Essential Service Profile………………………………………………5

Assessment Summary Matrix………………………………………………….6

Surveys:

Essential Service #1……………………………………………………………..7

Essential Service #2……………………………………………………………..9

Essential Service #3…………………………………………………………….11

Essential Service #4…………………………………………………………….13

Essential Service #5…………………………………………………………….15

Essential Service #6…………………………………………………………….17

Essential Service #7…………………………………………………………….19

Essential Service #8.............................................................................................21

Essential Service #9…………………………………………………………….23

Essential Service #10…………………………………………………………...25

CQI Assessment Participants………………………………………………….27

About the Assessment

Assessment Goals:

• To provide programs an opportunity to examine their services through the lens of the 10 Essential Public Health Services.

• To compare program Essential Service delivery with that of other programs in the agency.

• To identify areas for improvement to elevate service quality and prepare for accreditation.

• To compare assessment results to results from the National Public Health Performance Standards Assessment conducted in 2007.

Assessment Process:

The Office of Public Health and Medicine Partnerships (OPHMP) administered ten surveys, one for each Essential Service, to a voluntary sample of 33 programs between March and December 2008. Each survey followed an educational session about the Essential Service provided by State Health Commissioner or her designees. In all, 266 surveys were submitted, an average of 27 surveys per Essential Service. Eight programs submitted all 10 surveys; 2 programs submitted 2 (lowest number returned).

The 10 surveys contained 142 stem questions, most of which could be answered YES or NO. Additional descriptive and informational sub-questions were included, usually multiple choice. Surveys contained a range of 1-10 stem questions for each Model Standard. Three surveys included screening questions to eliminate programs having no involvement with those services, Enforce Laws (6), Link to Health Care (7), and Research (10).

Survey Scoring:

Programs received one point for each YES response to stem questions and one point for any response to selected multiple choice questions. No points were given for responses to sub-questions, although the agency sample rate was included next to each response for comparison. Rates for each Model Standard were computed by dividing the number of YES responses by the number of possible YES responses. Rates for each Essential Service were computed by dividing the total number of YES responses to the total possible number of YES responses. These data were compiled into individual program reports.

Review of Results:

The OPHMP compiled survey data into ten aggregate agency sample reports which were reviewed by an Essential Service Review Team. This group was comprised of 7 members external to ISDH and 4 ISDH program staff. Different ISDH staff were recruited for each Review Team meeting; 26 staff participated. This group’s findings and recommendations will be published under separate cover.

What is included in this report?

• The agency’s Essential Service Profile, based on surveys submitted. The highest, mid-level and lowest Essential Service scores are noted.

• A matrix summarizing the rate of Essential Service delivery by Model Standard, compared to the state health system.

• Stem questions from all 10 surveys. Next to each response option is a percentage of the agency sample that selected that response. A table and graph summarizes agency and state system response by Model Standard.

Essential Service Profile

Indiana State Department of Health

This graph illustrates Essential Service delivery rates for Indiana State Department of Health agency sample* and the state public health system, as measured by the National Public Health Performance Standards Assessment (state health system) and an adaptation of the NPHPS tool (ISDH).

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Highest Level Essential Services:

• Mobilize Partnerships (ES 4)

• Develop Policy (ES 5)

• Link to Health Care (ES7)

Mid-level Essential Services:

• Monitor Health (ES 1)

• Evaluate (ES 9)

• Assure Competent Workforce (ES 8)

Lowest Level Essential Services:

• Enforce Laws (ES 6)

• Diagnose and Investigate (ES 2)

• Inform and Educate (ES 3)

• Research (ES 10)

*Agency sample represents the aggregate scores of all 33 programs that participated in the assessment.

Assessment Summary Matrix

ISDH and System Assessment Results by Model Standard

This matrix summarizes Essential Service delivery by model standard for Indiana State Department of Health and the state public health system. State system percentages were derived through the National Public Health Performance Standards (NPHPSP) assessment. Agency percentages were derived from a series of 10 surveys, one for each Essential Service, which were adapted from the NPHPS tool.

Model Standard percentages for the agency survey were computed by dividing the number of YES responses by the number of possible YES responses for each Model Standard. The Essential Service overall rate was derived by dividing the total number of YES responses by the total possible number of YES responses for the entire Essential Service.

|  |  |Model |Model |Model |Model |  |

|  |  |Standard |Standard |Standard |Standard |Overall |

|  |  |1 |2 |3 |4 |  |

|Essential |Agency |48% |39% |69% |59% |53% |

|Essential |Agency |38% |41% |52% |37% |40% |

|Essential |Agency |49% |36% |32% |47% |41% |

|Essential |Agency |80% |71% |76% |60% |73% |

|Essential |Agency |81% |50% |83% |58% |66% |

|Essential |Agency |43% |41% |38% |30% |41% |

|Essential |Agency |57% |60% |65% |64% |61% |

|Essential |Agency |46% |44% |50% |81% |48% |

|Essential |Agency |62% |38% |65% |44% |51% |

|Essential |Agency |31% |25% |29% |29% |29% |

Model Standard 1: Planning and Implementation

Model Standard 2: Local and State Partnerships

Model Standard 3: Performance Management/Quality Improvement

Model Standard 4: Public Health Capacity and Resources

ESSENTIAL SERVICE #1: MONITOR HEALTH STATUS TO IDENTIFY COMMUNITY HEALTH PROBLEMS

ESSENTIAL SERVICE #1 SUMMARY:

|  |Agency Percent |State System Percent |

|Model Standard 1 |48% |58% |

|Model Standard 2 |39% |31% |

|Model Standard 3 |69% |28% |

|Model Standard 4 |59% |50% |

|Overall |53% |42% |

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Model Standard 1.1: Planning and Implementation

1. Does your program conduct active surveillance to measure the health status of Indiana’s population related to your public health specific issue? (Active surveillance means a system where your program collects the data.) YES (54%) NO (46%)

2. Does your program monitor the number in Indiana’s population who has the condition or disease related to your program? (Monitor means reviewing data collected by someone else, e.g., federal agencies or national groups.)

YES (68%) NO (29%) NR (No response) (3%)

3. Does your program compile your population specific health data into reports?

YES (68%) NO (32%)

4. Does your program collect data from diverse sources (e.g., hospitals, managed care

providers, local health departments)? YES (61%) NO (39%)

5. Is your program specific data geo-coded (use GIS mapping)?

YES (36%) NO (61%) NR (3%)

6. Does your program operate a registry? YES (25%) NO (75%)

7. How do you collect your program specific data?

Electronically per consumer/patient/incident (50%)

By paper reporting from providers per patient (46%)

NR (4%)

8. Does your program contribute to a data reporting system designed to identify potential threats to the public’s health? YES (21%) NO (54%)

NA (Not Applicable) (14%) NR (11%)

Model Standard 1.2: State-Local Partnerships

9. Does your program provide technical assistance (e.g., training, consultations) to local health departments to interpret and use your program specific data?

Yes (39%) No (57% nR (4%)

Model Standard 1.3: Performance Management and Quality Improvement

10. Does your program review/evaluate your efforts/procedures to monitor program specific health data? Yes (64%) No (32%) nR (4%)

11. If you answered yes to question 1 regarding active surveillance, does your program review/evaluate your efforts/procedures to conduct active surveillance of specific health data?

YES (73%) NO (27%)

Model Standard 1.4: Public Health Capacity and Resources

12. Does your program budget funds for health data monitoring efforts?

Yes (54%) No (43%) NR (3%)

13. If you answered YES to conducting active surveillance (question 1), does your program budget funds for active surveillance activities? YES (67%) NO (33%)

14. Does your program coordinate with other ISDH programs to monitor specific health factors?

YES (71%) NO (21%) NR (2%)

15. To conduct active surveillance of program specific health factors, my program staff is:

Highly competent (18%) Competent 29%)

Somewhat competent (18%) Not competent (6%) NR (29%)

16. To monitor program specific health factor data, my program staff is:

Highly competent (25%) Competent (29%)

Somewhat competent (21%) Not competent (14%) NR (11%)

ESSENTIAL SERVICE #2: DIAGNOSE AND INVESTIGATE HEALTH PROBLEMS AND HEALTH HAZARDS IN THE COMMUNITY.

ESSENTIAL SERVICE #2 SUMMARY:

|  |Agency Percent |State System |

| | |Percent |

|Model Standard 1 |38% |57% |

|Model Standard 2 |41% |81% |

|Model Standard 3 |52% |40% |

|Model Standard 4 |37% |43% |

|Overall |40% |55% |

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Model Standard 2.1: Planning and Implementation

1. Does your program have a process to identify and analyze causes of health problems or threats? YES (50%) NO (46%) NA (4%)

2. Does your program have the capability to rapidly enhance surveillance activities?

YES (19%) Not needed (65%) Needed, don’t have (8%) NR (8%)

3. Do you have a position within your program dedicated to surveillance and analysis of health problems and threats? YES (42%) No, need one (19%)

No, don’t need (35%) NR (4%)

4. Do you use surveillance data to make decisions about the services your program provides?

YES (54%) NO (39%) No, want to (4%) NR (4%)

5. Does your program have a plan to use defined roles and responsibilities when responding to public health problems with your state and local partners?     

YES (39%) NO (50%) NA (4%) NR (8%)

6. Does your program have a plan to communicate with policy/decision-makers about health problems or threats?

YES (46%) NO (42%) No, but should (4%) NR (4%) NA (4%)

7. Do your program plans assure that screening tests for health problems or threats are conducted?

YES (19%) No, but should (8%) NA (69%) NR (4%)

Model Standard 2.2:   State and Local Partnerships

8. Does your program consult with or train local partners on use of epidemiological data?  YES (31%) NO (62%) No, but plan to (4%) NR (4%)

9. Does your program provide state and local partners with information and guidance about public health problems or threats? YES (62%) NO (27%) No, but plan to (8%)

10. Does your program provide trained personnel to assist local communities in the investigation of public health problems? YES (31%) NO (69%)

Model Standard 2.3: Performance Management and Quality Improvement

11. Does your program periodically review the effectiveness of your surveillance and analysis activities? YES (58%) NO (42%)

12. Has your program made improvements to your surveillance and investigation methods as a result of the review process? YES (46%) NO (12%) NA (42%)

Model Standard 2.4: Public Health Capacity and Resources

13. Does your program have adequate financial resources to support surveillance and investigation of health problems? YES (19%) NO (77%) NA (4%)

14. Do you coordinate and align your data analysis efforts with other programs?

YES (65%) NO (27%) NA (4%) NR (4%) 

15. Does your program have sufficient numbers of staff to conduct quality surveillance activities?  YES (23%) NO (65%) NA (8%) NR (4%) 

16. Are your staff sufficiently skilled to conduct up-to-date surveillance activities?

YES (42%) NO (65%) NA (12%)

ESSENTIAL SERVICE #3: INFORM, EDUCATE, & EMPOWER PEOPLE ABOUT HEALTH ISSUES

ESSENTIAL SERVICE #3 SUMMARY:

|  |Agency Percent |State System Percent |

|Model Standard 1 |49% |71% |

|Model Standard 2 |36% |74% |

|Model Standard 3 |32% |28% |

|Model Standard 4 |47% |50% |

|Overall |41% |56% |

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Model Standard 3.1: Planning & Implementation

1. Does the program you manage design health education/promotion materials?

YES (67%) NO (33%)

2. Does your program have a written health education/health promotion plan?

YES (17%) NO (83%)

3. Does the program you manage develop health education interventions (exhibits, talks, public forums, media releases, etc)? YES (63%) NO (33%) NR (4%)

Model Standard 3.2: State-Local Relationships

4. Does your program provide technical assistance (consultation, training) to local public health systems (system includes more than the local health department) to develop health education materials? YES (33%) NO (67%)

5. Does your program provide technical assistance to local public health systems to develop their health communication skills? YES (29%) NO (71%)

6. Does your program provide technical assistance to local public health systems on how to target high risk populations with health promotion messages? YES (33%) NO (67%)

7. Does your program provide financial resources to local public health systems to disseminate their health education messaging? YES (50%) NO (50%)

Model Standard 3.3: Performance Management & Quality Improvement

8. Does your program regularly (at least yearly) evaluate the effectiveness of your health education materials? YES (28%) NO (72%)

9. Does your program regularly evaluate the accuracy of our health education materials?

YES (72%) NO (28%)

10. Does your program regularly include the targeted population to assist with the evaluation of your health education materials? YES (22%) NO (78%)

11. Does your program regularly evaluate the effectiveness of your media strategies?

YES (8%) NO (79%) NR (13%)

12. Does your program conduct ongoing quality improvement activities (QI activities include setting priorities; updating policies; applying new knowledge; updating your health education plan) related to your health education materials? YES (29%) NO (67%) NR (4%)

Model Standard 3.4: Public Health Capacity and Resources

13. Does your program regularly budget for your health education plan?

YES (42%) NO (54%) NA (4%)

14. Does your program partner with other ISDH departments to support your health education plan? YES (42%) NO (54%) NA (4%)

15. Does your program use on-line messaging to disseminate your health information messages?

YES (67%) NO (29%) NA (4%)

16. Does your program have employees who are trained in the development of health education materials? YES (38%) NO (58%) NA (4%)

17. Does your program have employees who have experience in carrying out health promotion services? YES (67%) NO (29%) NA (4%)

18. Does your program have employees who are skilled in social marketing?

YES (42%) NO (50%) NA (4%) NR (4%)

19. Does your program have employees who are skilled in media relations?

YES (33%) NO (59%) NA (4%) NR (4%)

20. Does your program have employees who are skilled in program evaluation?

YES (63%) NO (33%) NR (4%)

21. Does your program have a sufficient number of trained employees to carry out Essential Service # 3 in order to inform, educate, and empower the public about health issues?

YES (25%) NO (67%) NA (4%) NR (4%)

ESSENTIAL SERVICE #4: MOBILIZE PARTNERSHIPS TO IDENTIFY AND SOLVE HEALTH PROBLEMS

ESSENTIAL SERVICE #4 SUMMARY:

|  |Agency Percent |State System |

| | |Percent |

|Model Standard 1 |80% |53% |

|Model Standard 2 |71% |38% |

|Model Standard 3 |76% |25% |

|Model Standard 4 |60% |32% |

|Overall |73% |37% |

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Model Standard 4.1: Planning and Implementation

1. Does your program have external partners with whom you work to address your program’s health concerns? YES (93%) NO (7%)

2. Does your program make joint planning decisions with your external partners?

YES (86%) NO (7%) NA (7%)

3. Does your program implement joint projects with your external partners?

YES (89%) NO (4%) NA (7%)

4. Does your program have plans to approach any new external partners to address health issues related to your program area? YES (56%) NO (44%)

5. Please list any new partners you plan to contact: (44%-New partners; 56% no new partners)

6. Has your program partnered with other ISDH programs to plan and implement joint activities?

YES (89%) NO (11%)

7. What types of publications does your program produce to communicate information to decision-makers and the public? (Please check all that apply)

Annual reports (18%)

Fact sheets (44%)

Burden report (19%)

State plan (48%)

Executive summary of state plan (26%)

Other (39%) (Please describe)

Model Standard 4.2: State-Local Relationships

8. Does your program provide technical assistance on partnership development to external partners (in the form of consultation or training)?

YES (40%) NO (52%) Plan to (4%) NR (4%)

9. Does your program provide financial support (in the form of grants, contracts, staffing, other resources) to external partners? YES (78%) NO (22%)

10. Does your program receive financial support (in the form of grants, contracts, staffing, other resources) from external partners? YES (67%) NO (33%)

11. Which of the following Essential Services does your program share responsibilities with your statewide and local partners? (Please check all that apply)

Monitor health (74%)

Diagnosis/investigate (44%)

Inform and educate (93%)

Develop policies (67%)

Enforce laws/regulations (33%)

Link to health care (59%)

Workforce development (22%)

Evaluation (70%)

Research (22%)

Model Standard 4.3: Performance Management and Quality Improvement

12. Does your program review its external partnership activities?

YES (63%) NO (33%) Plan to ((4%)

13. Does your program conduct ongoing quality improvement activities with your external partners? YES (89%) NO (11%)

Model Standard 4.4: Public Health Capacity and Resources

14. Does your program annually budget financial resources to sustain partnerships?

YES (63%) NO (37%)

15. Do you align and coordinate your partnership efforts with other internal or external partners?

YES (74%) NO (26%)

16. Does your program utilize the unique aspects of ISDH as a state-level agency to (check all that apply): (67% do at least one; 33% do not do any)

Provide leadership in establishing policy to promote partnerships (52%)

Invest in professional expertise to improve partnerships (48%)

Promote evidence-based solutions for partnership issues (41%)

Provide leadership in convening a multi-sectoral partnership effort (52%)

17. Is your program sufficiently staffed to carry out partnership development activities?

YES (37%) NO (59%) Sometimes (4%)

ESSENTIAL SERVICE #5: DEVELOP POLICIES AND PLANS THAT SUPPORT INDIVIDUAL AND STATEWIDE HEALTH EFFORTS

ESSENTIAL SERVICE #5 SUMMARY:

|  |Agency Percent |State System |

| | |Percent |

|Model Standard 1 |81% |64% |

|Model Standard 2 |50% |36% |

|Model Standard 3 |83% |34% |

|Model Standard 4 |58% |32% |

|Overall |66% |42% |

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Model Standard 5.1: Planning and Implementation

1. Does your program convene statewide partners and facilitate collaboration to advance your program goals? YES (96%) NO (4%)

2. Does your program develop a statewide improvement plan? YES (69%) NO (31%)

3. Does your program conduct policy development activities? YES (77%) NO (23%)

Model Standard 5.2: State-Local Relationships

4. Does your program provide technical assistance and training to local public health systems for developing local plans related to your health area?

YES (61%) NO (35%) NR (4%)

5. Does your program provide support and assistance to counties in the development of community health improvement plans that are integrated with your program’s statewide health improvement strategies? YES (38%) NO (62%)

6. Does your program provide technical assistance in local policy development?

YES (50%) NO (50%)

Model Standard 5.3: Performance Management and Quality Improvement

7. Does your program periodically review progress on your state plan objectives?

YES (73%) NO (27%)

8. Does your program review new and existing policies for health impacts related to your program area? YES (88%) NO (12%)

9. Does your program actively manage and work to improve the overall performance of your program’s planning and policy development activities? YES (88%) NO (12%)

Model Standard 5.4: Public Health Capacity and Resources

10. Does your program commit financial resources to health planning and policy development efforts? YES (50%) NO (50%)

11. Does your program align and coordinate efforts with other ISDH programs to implement planning and policy development? YES (81%) NO (19%)

12. Does your program use the ISDH’s public health leadership role to facilitate planning and policy development? YES (58%) NO (38%) NR (4%)

13. Does your program have the sufficient professional competency to carry out planning activities? YES (58%) NO (42%)

14. Does your program have the professional expertise to carry out health policy development?

YES (42%) NO (39%) Not needed (19%)

ESSENTIAL SERVICE #6: ENFORCE LAWS AND RULES THAT PROTECT HEALTH AND ENSURE SAFETY.

ESSENTIAL SERVICE #6 SUMMARY:

|  |Agency Percent |State System Percent|

|Model Standard 1 |43% |57% |

|Model Standard 2 |41% |45% |

|Model Standard 3 |38% |44% |

|Model Standard 4 |30% |40% |

|Overall |41% |47% |

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Screening Questions:

1. Does your program review, evaluate, and recommend revision of laws, rules or regulations to assure that they reflect current scientific knowledge and best practices for achieving compliance?

YES (56%) NO (44%)

2. Does your program educate persons and entities who are regulated (e.g., restaurants; health care facilities) and/or those that enforce laws (local health departments) designed to protect health and safety? YES (56%) NO (44%)

3. Does your program conduct enforcement activities for public health concerns (some examples include enforcement of regulations of health care facilities; enforcement of food safety laws; enforcement activities occurring during emergency situations; environmental health laws; vital records; WIC)?

YES (33%) NO (67%)

Program completed survey (63%) Program screened out (37%)

Model Standard 6.1: Planning and Implementation

6) Does your program annually review the state statute that directs your enforcement activities?

YES (47%) NO (53%)

7) If your program has applicable rules that direct your enforcement activities, do you annually review them? YES (35%) NO (6%) NA (59%)

8) If your program has an applicable federal law, does your program annually review the federal statute that directs your program activities?

YES (18%) NO (18%) NA (52%) NR (12%)

9) In your annual program planning, do you determine whether any NEW state law or rule needs to be considered? YES (70%) NO (18%) NR (12%)

Model Standard 6.2: State-Local Relationships

10) For local partners who assist your program to implement enforcement activities, do you provide information on the state law or rules related to those enforcement activities?

YES (53%) NO (6%) NA (41%)

11) If your program has state rules, does your program provide consultation or training to the persons/entities in the regulated environment to encourage compliance with the rules?

YES (65%) NO (6%) NA (23%) NR (6%)

12) Does your program provide consultation to local public health departments on developing local ordinances? YES (29%) NO (24%) NA (47%)

13) If your program has state law or rules that are relevant to other state agencies, do you meet at least annually with the agencies to assure collaborative compliance with the law or rules?

YES (17%) NO (12%) NA (59%) NR (12%)

Model Standard 6.3: Performance Management/Quality Improvement

14) Does your program annually review the overall performance of your enforcement/ regulatory activities? YES (47%) NO (53%)

15) Does your program annually develop an overall performance plan of its regulatory/enforcement activities and programs? YES (29%) NO (71%)

Model Standard 6.4: Public Health Capacity and Resources

16) Does your program budget financial resources for the enforcement of laws and rules that protect health and ensure safety? YES (35%) NO (65%)

17) Is your program sufficiently staffed to conduct enforcement activities?

YES (24%) NO (47%) NA (29%)

ESSENTIAL SERVICE #7: LINK PEOPLE TO NEEDED PERSONAL HEALTH SERVICES AND ASSURE THE PROVISION OF HEALTH CARE WHEN OTHERWISE UNAVAILABLE

|  |Agency Percent |State System Percent|

|Model Standard 1 |57% |41% |

|Model Standard 2 |60% |36% |

|Model Standard 3 |65% |25% |

|Model Standard 4 |64% |25% |

|Overall |61% |32% |

ESSENTIAL SERVICE #7 SIMMARY: [pic]

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Screening Questions:

A. Does your program fund personal health care services? [Personal health care services are defined as services provided on an individual basis, under the oversight of a licensed clinician (MD, DO, NP or dentist) for the purpose of treating or preventing illness.]

YES (22%) NO (78%)

B. Does your program work with hospitals, community health centers, Maternal / Child health clinics, WIC services or health care providers (e.g., physicians, nurses, social workers, nutritionists, psychologists, dentists ) to assure access to health care services?

YES (52%) NO (48%)

C. Does your program have other initiatives focused on increasing access to personal health care services? YES (33%) NO (67%)

Program completed survey: (56%) Program screened out: (44%)

Model Standard 7.1: Planning and Implementation

1) Does your program assess the availability of personal health care services to the state’s population? YES (73%) NO (27%)

2) Does your program work with local health systems to eliminate barriers to health care?

YES (73%) NO (27%)

3) Does your program work to improve personal health care service delivery by:

Assuring policymakers are informed of barriers to personal health care services (40%)

Informing ISDH leadership of state policy changes needed to increase access (47%)

Improving relationships between local/state health systems and health care providers (80%)

Other (please explain) (13%) None of the above (13%)

4) Does your program work directly with hospitals or health care providers to assess and plan for surge capacity in the event of an emergency?

YES (13%) NO (87%)

5) Does your program use its statewide perspective to facilitate reduction of disparities in accessing health care? YES (60%) NO (40%)

6) What other initiatives does your program conduct to increase access to health care? (33%)

Model Standard 7.2: State-Local Relationships

7) Does your program provide technical assistance to local health departments to assess and meet the health care needs of underserved populations in their communities?

YES (47%) NO (53%)

8) Does your program offer technical assistance to health care providers/clinics that provide services to underserved populations? YES (73%) NO (27%)

Model Standard 7.3: Performance Management and Quality Improvement

9) Does your program regularly review its strategies for increasing personal health care accessibility, affordability and acceptability? YES (73%) NO (27%)

10) Does your program have a written plan to manage and improve access to health care services?

YES (56%) NO (44%)

Model Standard 7.4: Public Health Capacity and Resources

11) Does your program commit financial resources to assure increased access to health care services? YES (73%) NO (27%)

12) Does your program seek new or additional sources of funding to assure increased access to health care services? YES (53%) NO (47%)

13) Does your program align and coordinate its efforts with other ISDH programs and/or state agencies to assure increased access to health care services?

YES (67%) NO (26%) NR (7%)

14) Does your program use the ISDH’s leadership role to:

Forge partnerships with health care services (53%)

Partner with experts to improve health care (80%)

Promote evidence-based solutions (53%)

Promote state policy that addresses barriers (53%)

None of the above (13%)

16) Is your program sufficiently staffed to improve access to health care services?

YES (40%) NO (53%) NR (7%)

ESSENTIAL SERVICE # 8: ASSURE A COMPETENT PUBLIC HEALTH AND PERSONAL HEALTH CARE WORKFORCE

|  |Agency Percent |State System Percent |

|Model Standard 1 |46% |41% |

|Model Standard 2 |44% |36% |

|Model Standard 3 |50% |25% |

|Model Standard 4 |81% |25% |

|Overall |48% |20% |

ESSENTIAL SERVICE # 8 SUMMARY: [pic]

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Model Standard 8.1: Planning & Implementation

1. Does your department have a written plan or strategy identifying the number of workforce needed to complete the work of the department? YES (46%) NO (54%)

2. Does your department have a written plan or strategy identifying the type of workforce needed to complete the work of the department? YES (46%) NO (54%)

3. Do you have a written assessment of each employee in your department for his/her

3a. Skills and competency YES (38%) NO (62%)

3b. Desire to gain additional education YES (31%) NO (69%)

4. Are any of your staff members certified in their professions or work skills?

YES (81%) NO (15%) NR (4%)

5. Do you have a written workforce education plan for all the staff in the department?

YES (23%) NO (77%)

6. Do you allocate funding each year for staff to attend continuing education opportunities (conferences, seminars) related to their position responsibilities?

YES (85%) NO (15%)

7. Have any of your staff members ever used the ISDH – Learning Management System (LMS)?

YES (74%) NO (26%)

8. Do any of your staff members use the ISDH – Learning Management System (LMS) on a regular basis? YES (4%) NO (92%) NR (4%)

9. Have you ever discussed and encouraged staff to enroll in the Mid-America Regional Public Health Leadership Institute (MARPHLI)? YES (35%) NO (65%)

Model Standard 8.2: State-Local Relationships

10. Does your department provide continuing education programs to local health department (LHD) staff or local public/community health services staff to improve local staff’s competencies?

YES (73%) NO (23%) NR (4%)

11. Does your department assist LHDs or local public/community health services to recruit staff?

YES (12%) NO (88%)

12. Does your department assist LHDs or local public/community health services to develop performance improvement strategies of their workforce? YES (23%) NO (77%)

13. Does your department have an on-going working relationship with any academic institution?

YES (69%) NO (31%)

Model Standard 8.3: Performance Management & Quality Improvement

14. Do you annually review your department’s written workforce education plan?

YES (50%) NO (33%) NR (17%)

Model Standard 8.4: Public Health Capacity & Resources

15. Are you willing to seek new financial resources for your department to support continuing education workforce development? YES (81%) NO (19%)

EVALUATE EFFECTIVENESS, ACCESSIBILITY, AND QUALITY OF PERSONAL AND POPULATION-BASED HEALTH SERVICES

ESSENTIAL SERVICE #9 SUMMARY:

|  |Agency Percent |State System Percent |

|Model Standard 1 |62% |45% |

|Model Standard 2 |38% |25% |

|Model Standard 3 |65% |8% |

|Model Standard 4 |44% |25% |

|Overall |51% |26% |

[pic]

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Model Standard 9.1: Planning and Implementation

1. Do your program plans include processes to evaluate your program services?

YES (88%) NO (12%)

2. Does your program evaluate personal health care services?

YES (27%) NO (73%)

3. If you conduct program evaluation, do you use the findings to develop an improvement plan?

YES (65%) NO (31%) NR (4%)

4. Does your program establish or use recognized performance standards to assess the performance of your program’s services?

YES (69%) No, program standards don’t exist. (23%)

No, standards exist, but we don’t use them. (8%),

Model Standard 9.2: State-Local Relationships

5. Does your program provide technical assistance on evaluation (e.g., consultations, training) to local public health system partners? YES (38%) NO (62%)

6. Does your program share results of state-level performance evaluations with local public health partners for use in planning processes? YES (38%) NO (62%)

Model Standard 9.3: Performance Management and Quality Improvement

7. Do you regularly review the processes you use to evaluate your program?

YES (65%) NO (35%)

Model Standard 9.4: Public Health Capacity and Resources

8. Does your program commit financial resources for evaluation? YES (62%) NO (38%)

9. Does your program work with other ISDH programs to conduct evaluations?

YES (31%) NO (65%) NR (4%)

10. Does your program use ISDH’s leadership role to conduct evaluation of local programs, services and systems? YES (27%) NO (65%) NR (8%)

11. Does your program have the professional expertise to conduct evaluation?

YES (65%) NO (23%) NR (12%)

12. Does your program have sufficient numbers of staff to conduct evaluation?

YES (34%) NO (58%) NR (8%)

ESSENTIAL SERVICE #10: RESEARCH FOR NEW INSIGHTS AND INNOVATIVE SOLUTIONS TO HEALTH PROBLEMS

|  |Agency Percent |State System Percent |

|Model Standard 1 |31% |6% |

|Model Standard 2 |25% |0% |

|Model Standard 3 |29% |0% |

|Model Standard 4 |29% |6% |

|Overall |29% |3% |

ESSENTIAL SERVICE #10 SUMMARY: [pic]

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Screening Questions:

A. In the past five years, has your program funded research activities?

YES (23%) NO (77%)

B. In the past five years, has your program conducted, participated in, or provided data for a research study? YES (35%) NO (65%)

C. In the past five years, has your program disseminated research findings (regardless of whether you participated in the study or not) to state or local PH system partners?

YES (35%) NO (65%)

Program completed survey (52%) Program screened out (48%)

Model Standard 10.1: Planning and Implementation

1. Does your program have active academic-practice collaborations to promote and organize research activities and/or disseminate and use research findings? YES (43%) NO (57%)

2. Does your program have a research agenda? YES (7%) NO (93%)

3. Does your program participate in research? YES (43%) NO (57%)

Model Standard 10.2: State-Local Relationships

4. Does your program provide technical assistance on research projects to local PH systems?

YES (14%) NO (86%)

5. Does your program assist local PH systems in the use of research findings?

YES (36%) NO (57%) NR (7%)

Model Standard 10.3: Performance Management and Quality Improvement

5. Does your program regularly review its research-related activities?

YES (36%) NO (64%)

6. Does your program manage and improve the performance of its research activities (e.g., use standards or benchmarks as targets, measure performance milestones, report progress to partners, conduct ongoing quality improvement activities)?

YES (21%) NO (71%) NR (8%)

Model Standard 10.4: Public Health Capacity and Resources

7. Does your program commit financial resources to research? YES (50%) NO (50%)

8. Does your program align and coordinate research efforts with other ISDH programs or state and local partners? YES (29%) NO (57%) NR (14%)

9. Does your program use the leadership role of ISDH to initiate research projects and put findings into practice? YES (29%) NO (64%) NR (7%)

10. Is your program sufficiently staffed to participate in research activities?

YES (8%) NO (71%) NR (21%)

CQI Assessment Participants

Acute Care- Mary Azbill

Adolescent Health-Stephanie Woodcox

Asthma Program – Marcie Memmer

Breast and Cervical Cancer Program – Marjori Allen

Comprehensive Cancer Control – Keylee Wright

Cancer Registry – Martha Graves

Diabetes – Laura Heinrich

Early Childhood – Andrea Wilkes

Environmental Health – Howard Cundiff, Tom Reel

Epidemiology – Jim Howell, Pam Pontones, Shawn Richards

Food Protection – Scott Gilliam

Genomics – Bob Bowman

HIPAA – Chris Mickens

HIV/STD – Jerry Burkman, Shawn Carney

Hospital Preparedness – John Braeckel

Immunization – Amanda Mizell, Kristin Ryker

Indiana Tobacco Prevention and Control – Karla Sneegas, Miranda Spitznagle

Laboratories – Judith Lovchik

Lead Program – Dave McCormick

Legal Department – Morgan McGill*

Long Term Care – Sue Hornstein

Maternal and Child Health – Nancy Meade

Nutrition and Physical Activity – Joey Vrazel

Office of Minority Health – Antoinette Holt

Office of Women’s Health – Tanya Parrish

Oral Health – Kent Smith

Perinatal Program – Beth Johnson

Primary Care – Ann Alley, Beth Hampshire, Mary Ann Hurrle

Prenatal Substance Use Prevention Program - Marcia Glass

Sexual Violence Prevention Program – Abby Kelly-Smith

Rural Health – Tammy Chadd

Tuberculosis Control – Sarah Burkholder, Tina Feaster

Vital Records – Corey Ealy

Women, Infants and Children – Patrice Wolfla, Brandi Jones

*Participated in review process, but not the assessment

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