Lapeer County Health Department



Lapeer County Health Department

Strategic Plan

2011-2013

The Lapeer County Health Department develops three year strategic plans to establish priorities and guide decision making and quality improvement processes.

This document represents the 4th 3 year strategic planning document/cycle. Plans have been scaled down somewhat from cycle to cycle to create realistic goals given the reduction in resources that have occurred beginning in 2006.

The strategic planning process begins with an evaluation of the previous plan. The 2008-10 plan included three goals which were largely met. One of these goals was related to plans for the recruitment and retention of staff. Due to ongoing layoffs and hiring freezes during the duration of this plan, the goal was not fully met. However, plans to more comprehensively cross-train staff was very effectively implemented, and informed much of the reorganization of department and staff during this downsizing period.

The strategic planning process for 2011-2013 began in September of 2010. Administrative Team was asked to review current progress and issues with front line staff during staff meetings. During the October 13, 2010 Administrative Team Meeting the SWOT analysis was conducted and Mandates and Stakeholders documents were reviewed and updated. A list of possible strategic issues was created. These materials were reviewed and discussed at a Special Board of Health Meeting that was held November 19, 2010. The Board provided feedback on priorities, strategic issues and a draft plan.

The 2011-13 Strategic Plan was finalized at the January 12, 2011 Administrative Team Meeting.

LAPEER COUNTY HEALTH DEPARTMENT

STRATEGIC PLANNING 2011-13

SWOT ANALYSIS

Internal Strengths

Resources or capabilities that help an organization accomplish its mandates or mission (i.e. professional staff, adequate resources, leadership…)

• Staff expertise

• Experienced leadership

• Disciplinary diversity provides broad based support for service provision

• Staff commitment to provide services within the limitations of the resources available

• Staff willingness to collaborate

• Diversity of revenue sources

• Adequate facilities for most programs

• Progress toward technology and communications

• Board of Health committed to core public health services and supportive of health department staff and programs

Internal Weaknesses

Deficiencies in resources and capabilities that hinder an organization’s ability to accomplish its mandate or mission (i.e. lack of effective communications, absence of clear vision or mission, flawed organizational structure, noncompetitive pay structure).

• Inadequate animal control facilities

• Negative staff perception of working conditions

• Overall, staff perceive a lack of support from governing boards

• Some staff perceive a lack of internal communication

• Lack of opportunity for advancement/career tracks for staff

• Sustained demands on staff resulting in burn-out

• Loss of Environmental Health Back-up due to 50% staff reductions

• Administrators act as back-up, limiting time for administrative, quality assurance and other oversight responsibilities

External Opportunities

Outside factors or situations that can affect your organization in a favorable way (i.e. new funding from a federal program, political support for a potential project, a chance to modify an outdated mandate).

• Slow economy:

**Leads to an increased demand for some services and increased

Funding (i.e. WIC)

• Local climate encourages and promotes collaborative opportunities

• Affordable Care Act may include some funding for public health prevention

External Threats

Outside factors or situations that can affect your organization in a negative way (i.e. loss of state funding, increasing demand for a specific service, union/management conflicts).

• Economic changes lead to shifting funding levels/sources and threaten programs/overall departmental financial security

• Political climate trends toward smaller government, increased private sector involvement in traditional governmental services

• Changing political priorities for funding of public health programs

2011-2013 Stakeholder Identification

External Stakeholders

Mandate Detail 2011-2013

| |Source (Charter, Policy, | |Effects on | | |

|Mandate (Required) |Rules, Law, Norms, etc.) |Key Requirements |Organization |Current |Status |

|Disease prevention and health |MCLA* 333.2433 |“Continually and dliligently” seek to |Provides direction for agency mission, goals | ( |Still appropriate |

|promotion. |MSA** 14.15(2433j) |prevent disease, prolong life, and promote|and activities. | | |

| | |public health through organized programs | | |Out-of-Date |

| | |directed at environmental health hazards, | | | |

| | |specific diseases, and specially | | | |

| | |vulnerable population groups. | | | |

|Public Health Law enforcement |MCLA *333.2433 |Implement and enforce laws for which |Provides direction and authority for legal | ( |Still appropriate |

| | |responsibility is vested in the local |enforcement. | |Out-of-Date |

| | |health department | | | |

|Investigation and control of |MCLA*333.2433 |Make investigations and inquiries as to: |Provides direction for agency mission, goals | ( |Still appropriate |

|disease | |the causes of disease and especially of |and activities | |Out-of-Date |

| | |epidemics; the causes of morbidity and | | | |

| | |mortality; and the causes, prevention and | | | |

| | |control of environmental health hazards, | | | |

| | |nuisances, and sources of illness | | | |

|Health education and nutrition |MCLA*333.2433 |Plan, implement and evaluate health |Provides direction for agency mission, goals | ( |Still appropriate |

|services | |education and nutrition services |and activities | |Out-of-Date |

|Authority to enter into contracts |MCLA*333.243 |Enter into an agreement…to assist the |Provides ability to apply for State and grant| ( |Still appropriate |

| | |local health department in carrying out |funding for programs consistent with agency | |Out-of-Date |

| | |its duties and functions unless otherwise |mission, goals and objectives | | |

| | |prohibited by law | | | |

|Adopt public health regulations |MCLA*333.243 |Adopt regulations to properly safeguard |Provides regulatory authority and affects | ( |Still appropriate |

| | |the public health and to prevent the |development and implementation of | |Out-of-Date |

| | |spread of diseases and sources of |communicable disease, environmental health | | |

| | |contamination. |and animal control programs. | | |

|Authority to accept grants and |MCLA*333.243 |Accept gifts, grants…for use in performing|Provides ability to apply for grant funding | ( |Still appropriate |

|other sources of funding | |the local health department’s functions |for programs consistent with agency mission, | |Out-of-Date |

| | | |goals and objectives | | |

|Other authority |MCLA*333.243 |Provide services not inconsistent with |Allows Agency to provide other services | ( |Still appropriate |

| | |this code. |needed within the community based on Agency | |Out-of-Date |

| | | |mission, goals & objectives and Public Health| | |

| | | |Code. | | |

|Authority for the Board of |287.276 Section 29a** |The board of county commissioners by |Provides authority for local establishment of| ( |Still appropriate |

|Commissioners to establish an | |ordinance may establish an animal control |an animal control agency | |Out-of-Date |

|animal control agency by ordinance | |agency which shall employ at least 1 | | | |

| | |animal control officer | | | |

|Local authority to establish and |Lapeer County Animal Control | |Provides shelter operation, dog licensing, | ( |Still appropriate |

|implement a program for the |Ordinance, | |and ordinance violation penalties | |Out-of-Date |

|licensing and regulation of dogs |October 1, 2008 | | | | |

|and other animals and facilities | | | | | |

|that house them | | | | | |

|Local authority to implement |Soil & Sedimentation Ordinance | |Provides authority for local enforcement and |( |Still appropriate (New|

|program and collect fees for the |November, 2009 | |fee collection | |program 7/09) |

|Soil & Sedimentation Erosion | | | | | |

|Program | | | | | |

* Michigan Compiled Laws (Michigan Public Health Code Act 369 of the Public Acts of 1978, as last amended by Act No. 196 of 1998).** Medical Services Administration (Michigan Department of Community Health)

** Michigan Penal Code (Act 328, Public Acts of 1931, as amended)

3/04; 8/07; 10/08; 10/10 SS

LAPEER COUNTY HEALTH DEPARTMENT

PRIORITY NEEDS

2011-13

|Priority |Program |Mandate Status |

|1 |Communicable Disease Surveillance, Investigation and follow-up (Rabies, |Mandated |

| |meningitis, tuberculosis, hepatitis, etc) | |

|1 |STD |Mandated |

|4 |Nutrition Services |Mandated |

| |Health Education |Mandated |

|1 |Immunization |Mandated |

|4 |Hearing |Mandated |

|4 |Vision |Mandated |

|2 |Public/Private Sewer |Mandated |

| |Public Swimming Pool Inspection |Mandated |

|1 |Food Protection |Mandated |

|2, 4 |Public/Private Water Supply |Mandated |

|3 |Medical Examiner |Mandate to County |

| |Jail Health |Mandate to County Jail |

|3 |Emergency Preparedness (Community Health Annex) |Mandated under Emergency Management Act |

| |Animal Control |Basic |

| |General Environmental health Programs: Campgrounds, FIA Inspections |Basic |

| |Children’s Special Health Services (CSHCS) |Basic |

| |Maternal Child Health |Basic |

| |Family Planning |Basic |

|5 |WIC |Basic |

| |Smoking Enforcement |Basic |

| |Tatoo Parlor Control |Basic |

| |Substance Abuse Treatment |Allowable |

| |Senior Programs |Allowable |

|5 |Maternal Infant Health Program (Maternal Support Services/Infant Support |Allowable |

| |Services) | |

| |Population based child-family home visitation (First Steps to Success) |Allowable |

| |Soil Erosion and Sedimentation Control Program |Mandate to County |

PRIORITIES

1: Top 3

CD

Immunization

Food

2: TB

Sewage

3: M.E.

Emergency Preparedness

4: Nutrition

Hearing

Vision

Public/Private Water Supply

5: Maternal Child Health

WIC

LAPEER COUNTY HEALTH DEPARTMENT

STRATEGIC PLANNING

KEY STRATEGIC ISSUES

WORKSHEET 2011-2013

What is the issue? Phrase the issue as a question that has more than one answer. The issue should be one the organization can do something about.

Issue #1: How will the health department maintain the ability to provide health department services in light of changing resources?

Why is this an issue?

Providing quality public health services has been shown to be an efficient, cost-effective way of doing business. Preventive services can be difficult to measure in terms of outcomes since it can be difficult to quantify the value of preventing costly health events such as the transmission of disease, food/water contamination, health conditions secondary to poor nutrition or tobacco/alcohol abuse. While quality is measured in some cases in some programs, and quality is addressed on an ad hoc, problem-driven basis in all programs, a more comprehensive quality-driven process could reduce costs through greater emphasis on best practices.

Incoming State of Michigan leadership has indicated an intention to engage in outcome-based funding. The ability of public health as a whole and Lapeer County Health Department to establish and measure health outcomes is likely to have an impact on funding in the future.

How is it related to the agency’s mission, mandates, internal strengths and weaknesses or external opportunities and threats? Public health is preventive by definition. However, in most cases we have not adequately defined or measured outcomes in a way that provides a strong case for outcome-based, value-added funding for the future.

What are the consequences of not addressing this issue? The likely result of not addressing this issue will be a continued erosion of public health preventive dollars.

What should our goals be in addressing this issue?

Maintain an adequate funding base for the highest priority, results-based programs.

Identify desirable health outcomes

Determine method(s) to best measure outcomes

Conduct periodic measurement of outcomes

Evaluate outcomes and revise policies/procedures to improve outcomes

Issue #2: How can Lapeer County Health Department support and encourage staff during times of economic challenges?

Why is this an issue?

The vast majority of outcomes accomplished by the Health Department are done so through front line staff work. Staff burn out can compromise the quality of efforts directed toward health efforts in this county. Lack of employee engagement can lead to sub-standard work and can compromise customer service.

How is it related to the agency’s mission, mandates, internal strengths and

weaknesses or external opportunities and threats?

Increased staff engagement often allows for an enhanced customer experience. The majority of public health prevention work is educational in nature. Having engaged, supported staff serve the public improves the message the client receives and may lead to improved health outcomes.

What are the consequences of not addressing this issue?

Having a large proportion of unengaged staff can affect the morale of the entire workforce and lead to a negative, less productive customer educational experience.

What should our goals be in addressing this issue?

Goal: Improved staff engagement leading to improved work climate and improved customer relations

Identify markers and measurement for staff engagement

Identify current levels of staff engagement.

Determine factors that contribute to staff disengagement

Identify policies, activities, etc. that could improve staff engagement

Implement policies/activities, etc.

Evaluate

LAPEER COUNTY HEALTH DEPARTMENT STRATEGIC PLAN 2011-2013

|Strategy |Responsible |Projected |Progress |

| |Person/Entity |Completion Date | |

| | | | |

|Develop an outcomes-based structure for a minimum of one |Health Officer | | 2/9/11: Administrative Team review of Quality Assurance/Improvement process. “Embracing Quality in |

|program/division that includes front line staff input |Division Administrators| |Local Public Health” materials provided for each administrator to use to train and work with staff. |

|Provide staff training if indicated | | |Request that administrators submit plans that are developed and status to the Health Officer |

|Identify desirable health outcome(s) for program | |June, 2011 |periodically . |

|Determine method(s) to best measure outcomes | |August, 2011 | |

|Conduct periodic measurement of outcomes | |August, 2011 | |

|Evaluate outcomes and revise policies/procedures to improve outcomes | |September/October,| |

|Provide outcomes-based data to local and state partners as | |2012 | |

|appropriate | |November, 2012 | |

| | | | |

| | |TBA | |

GOAL 1: TO ASSURE THAT THE HEALTH DEPARTMENT MAINTAINS THE ABILITY TO PROVIDE PRIORITY HEALTH DEPARTMENT SERVICES IN LIGHT OF CHANGING RESOURCES

|Strategy |Responsible |Projected |Progress |

| |Entity |Completion Date |C= Completed, OS= on schedule, D= delayed |

| | | | |

GOAL 2: Improved staff engagement leading to improved work climate, improved customer relations and increased efficiencies

The Gallup Q12

(From the Gallup Management Journal, “Feedback for Real”

Author: John Thackray)

The Gallup Q12 is a survey designed to measure employee engagement.

The instrument was the result of hundreds of focus groups and interviews.

Researchers found that there were 12 key expectations, that when satisfied, form

the foundation of strong feelings of engagement. So far 87,000 work units and

1.5 million employees have participated in the Q12 instrument.

Comparisons of engagement scores reveal that those with high Q12 scores

exhibit lower turnover, higher sales growth, better productivity, better customer

loyalty and other manifestations of superior performance.

The Gallup organization also uses the Q12 as a semi-annual employee

engagement Index – a random sampling of employee across the country.

The engagement index slots people into one of three categories.

• Engaged employees work with passion and feel a profound connection to

their company. They drive innovation and move the organization forward.

• Not-Engaged employees are essentially “checked out.” They are

sleepwalking through their workday. They are putting in time, but not

enough energy or passion into their work.

• Actively Disengaged employees aren’t just unhappy at work; they’re

busy acting out their unhappiness. Every day, these workers undermine

what their engaged co-workers accomplish.

The results of the latest engagement index:

Engaged employees – 28 %

Not-engaged employees – 54%

Actively Disengaged – 17%

In other words, 71% of the workforce is either under performing or actively

undermining their work.

2

The Q12 Index

1) Do you know what is expected of you at work?

2) Do you have the materials and equipment to do your work

right?

3) At work, do you have the opportunity to do what you do best

every day?

4) In the last seven days, have you received recognition or praise

for doing good work?

5) Does your supervisor, or someone at work, seem to care about

you as a person?

6) Is there someone at work who encourages your development?

7) At work, do your opinions seem to count?

8) Does the mission/purpose of your company make you feel your

job is important?

9) Are your associates (fellow employees) committed to doing

quality work?

10) Do you have a best friend at work?

11) In the last six months, has someone at work talked to you

about your progress?

12) In the last year, have you had opportunities to learn and grow?

-----------------------

Schools/Daycare

Veterinarians

Media

City &Township Governments

Excavators/

Contractors/

Well Drillers

Accrediting Agencies

(CARF, MDCH)

Lapeer County Emergency Management

Engineering Firms

Hospitals and Health Care Providers

Builders and Realtors

Restaurants

Community Agencies

Michigan Department of Agriculture

Michigan Department of Community Health

Internal

Stakeholders

Residents of Lapeer County

LCHD Staff

Lapeer County Board of

Commissioners

Lapeer County Board of

Health

AFSCME/Teamsters Volunteers

Other County Depts.

________ ________

__

Grant funding Agencies

Michigan Department of Natural Resources and Environment (DNRE)

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