Kane County MAPP Collaborative 2014 Local Public Health System Assessmentkanecounty.healthforecast.net/Local Public Health Syst… · · 2015-03-17Kane County Local Public Health

Kane County MAPP Collaborative

2014 Local Public Health System Assessment

Prepared by the Illinois Public Health Institute

Kane County Local Public Health System Assessment 2014 2

Table of Contents

Introduction ………………………………………………………………………………………………………………….. 3

Executive Summary ……………………………………………………………………………………………………….. 4

Assessment Instrument ………………………………………………………………………………………………….. 5

Assessment Methodology …………….………………………………………………………………………………….. 6

Assessment Participants ………………………………………………………………………………………………….. 7

Results of the LPHSA ……………………………………………………………………………………………………….. 8

Scores and Common Themes for Each Essential Public Health Service …………………………….. 10

EPHS 1: Monitor Health Status to Identify Community Health Problems ………………………..…11

EPHS 2: Diagnose and Investigate Health Problems and Health Hazards …………………………..14

EPHS 3: Inform, Education, and Empower People about Health Issues ……………………………. 17

EPHS 4: Mobilize Community Partnerships to Identify and Solve Health Problems …………..20

EPHS 5: Develop Policies and Plans that Support Individual and Community Health ……….. 23

EPHS 6: Enforce Laws and Regulations that Protect Health and Ensure Safety ………………….26

EPHS 7: Link People to Needed Personal Health Services and Assure the Provision of Health Care When Otherwise Unavailable …………………………………………………………………….. 29

EPHS 8: Assure a Competent Public Health and Personal Health Care Workforce ………….. 32

EPHS 9: Evaluate Effectiveness, Accessibility, and Quality of Personal and Population- Based Health Services ……………………………………………………………………………………………………… 35

EPHS 10: Research for New Insights and Innovative Solutions to Health Problems …………. 38

Conclusion ……………………………………………………………………………………….………………………………41 Appendix 1: List of Participating Agencies ………………………………………………………………………. 43 Appendix 2: Essential Public Health Service Score Charts ……………………………………………….. 45 Appendix 3: Kane County Health Department Contribution to Local Public Health System Performance …………………………………………………………………………………. 59


Introduction

The Kane County Local Public Health System Assessment (LPHSA) was conducted on September 26, 2014 as one of the four assessments in the Kane County Mobilizing for Action through Planning and Partnerships (MAPP) Collaborative process. MAPP is a community-driven strategic planning framework that assists communities in developing and implementing efforts around the prioritization of public health issues and identification of resources to address them as defined by the Ten Essential Public Health Services. The MAPP process includes four assessment tools, including the Local Public Health System Assessment.

The LPHSA, described in detail in the following section, is used to understand the overall strengths and weaknesses of the public health system based on the 10 Essential Public Health Services. Results from the LPHSA will be analyzed with the reports from the other three assessments in the MAPP process, which include the Community Health Status Assessment (CHSA), Community Themes and Strengths Assessment (CTSA), and the Forces of Change Assessment (FOCA). Strategic analysis of these assessment results will inform the identification of prevailing strategic issues, which will be prioritized. Goals and action plans will be developed for each of these priority issues. These action plans will be implemented and aligned to improve the local public health system and ultimately the health and wellbeing of the Kane County community.


Executive Summary: Cross-Cutting Themes from the Kane County Local Public Health System Assessment Throughout the discussions of the 10 Essential Public Health Services, a number of cross-cutting themes emerged in the dialogue among each group. Key strengths that were noted throughout the system include strong partnerships and collaboration across agencies, a strong commitment to innovation and best practice, and willingness to leverage collective resources and efforts to work toward common goals. Dialogue throughout the 10 Essential Services revealed that while the Kane County LPHS has a strong spirit of collaboration in place, the next step to improving collective performance as a system is to go beyond sharing resources and work toward building an infrastructure of shared priorities, goals and objectives that can be achieved through strategic alignment of efforts across the system. Embarking on the Mobilizing Action through Planning and Partnerships (MAPP) process will help the Kane County LPHS improve collective performance as a cohesive system by engaging partners across the spectrum of the public health system to develop a comprehensive Community Health Improvement Plan with shared ownership and shared priorities that all partners can work together to address through alignment of individual and collective efforts.


The Assessment Instrument The National Public Health Performance Standards (NPHPS) Assessment measures the performance of the local public health system -- defined as the collective efforts of public, private and voluntary entities, as well as individuals and informal associations that contribute to the public’s health within a jurisdiction. This may include organizations and entities such as the local health department, other governmental agencies, healthcare providers, human service organizations, schools and universities, faith institutions, youth development organizations, economic and philanthropic organizations, and many others. Any organization or entity that contributes to the health or wellbeing of a community is considered part of the public health system. Ideally, a group that is broadly representative of these public health system partners will participate in the assessment process. By sharing their diverse perspectives, all participants will gain a better understanding of each organization’s contributions, the interconnectedness of activities, and how the public health system can be strengthened. The NPHPS does not focus specifically on the capacity or performance of any single agency or organization.

The instrument is framed around the 10 Essential Public Health Services (EPHS) that are utilized in the field to describe the scope of public health. For each essential service in the local instrument, the model standards describe or correspond to the primary activities conducted at the local level. The number of model standards varies across the essential services; while some essential services include only two model standards, others include up to four. There are a total of 30 model standards in this instrument. For each standard in each essential service, there are a series of questions that break down the standard into its component parts.

Each EPHS model standard is scored by participants to assess system performance on the following scale:


Optimal Activity (76-100%)

The public health system is doing absolutely everything possible for this activity and there is no room for improvement.

Significant Activity (51-75%)

The public health system participates a great deal in this activity and there is opportunity for minor improvement.

Moderate Activity (26-50%)

The public health system somewhat participates in this activity and there is opportunity for greater improvement.

Minimal Activity (1-25%)

The public health system provides limited activity and there is opportunity for substantial improvement.

No Activity (0%)

The public health system does not participate in this activity at all.

NPHPS results are intended to be used for quality improvement purposes for the public health system and to guide the development of the overall public health infrastructure. Analysis and interpretation of data should also take into account variation in knowledge about the public health system among assessment participants: this variation may introduce a degree of random non-sampling error.

The Assessment Methodology The assessment retreat was held on September 26 and began with a 60-minute plenary presentation to welcome participants, provide an overview of the process, introduce the staff and answer questions. Participants were then broken into five groups; each breakout group was responsible for conducting the assessment for two essential public health services, as follows:

LPHSA Breakout Groups Group LPHSA Group Responsibilities E EPHS 1 – Monitor health status to identify community health problems.

EPHS 2 – Diagnose and investigate health problems and health hazards in the community.

D EPHS 3 – Inform, educate, and empower people about health issues. EPHS 4 – Mobilize community partnerships to identify and solve health problems.

C EPHS 5 – Develop policies and plans that support individual and community health efforts. EPHS 6 – Enforce laws and regulations that protect health and ensure safety.

B EPHS 7 – Link people to needed personal health services and assure the provision of health services. EPHS 9 – Evaluate effectiveness, accessibility and quality of


personal/population-based health services. A EPHS 8 – Assure a competent public and personal health care workforce.

EPHS 10 – Research for new insights and innovative solutions to health problems.

Each group was professionally facilitated, recorded, and staffed by a note taker. The program ended with a plenary session where highlights were reported by members of each group. Event organizers facilitated the end-of-day dialogue, outlined next steps to enter, analyze and report assessment findings to the Kane County MAPP Collaborative and retreat participants.

Assessment Participants The Kane County MAPP Collaborative developed a list of agencies to be invited to participate in a full day assessment retreat. The event organizers carefully considered how to balance participation across sectors and agencies and how to ensure that diverse perspectives as well as adequate expertise were represented in each breakout group. The event drew 62 public health system partners that included public, private and voluntary sectors. The composition of attendees reflected a diverse representation of partners that was apportioned as follows:

Constituency Represented Total Attended Businesses 2 Coalitions 2* Colleges and Universities 7 Community-Based Organizations and Non Profits 12 Hospitals, Health Systems and Clinics 10 Local Health Department 11 Local Government 18 State Government 1 *Coalition representatives also represented hospital constituencies.


Results of the Kane County Local Public Health System Assessment

The table and graph below together provide an overview of the local public health system’s performance in each of the 10 EPHS.

Summary Essential Public Health Service Scores

EPHS EPHS Description 2014 Score

Overall Ranking

1 Monitor health status to identify community health problems.

70 6th

2 Diagnose and investigate health problems and health hazards in the community.

81 1st

3 Inform, educate, and empower people about health issues.

75 3rd

4 Mobilize community partnerships to identify and solve health problems.

74 4th

5 Develop policies and plans that support individual and community health efforts.

65 8th

6 Enforce laws and regulations that protect health and ensure safety.

59 9th

7 Link people to needed personal health services and assure the provision of health services.

69 7th

8 Assure a competent public and personal health care workforce.

71 5th

9 Evaluate effectiveness, accessibility, and quality of personal/population-based health services.

78 2nd

10 Research for new insights and innovative solutions to health problems.

45 10th

Overall LPHS Performance Score 69

The table above provides a quick overview of the system’s performance in each of the 10 Essential Public Health Services. Each EPHS score is a composite value determined by the scores given to those activities that contribute to each essential service. The scores range from a minimum value of 0% (no activity is performed pursuant to the standards) to maximum of 100% (all activities associated with the standards are performed at optimal levels).


The chart below provides a graphic representation of Essential Public Health Service scores based on the scoring options: Optimal Activity (76-100%)

The public health system is doing absolutely everything possible for this activity and there is no room for improvement.

Significant Activity (51-75%)

The public health system participates a great deal in this activity and there is opportunity for minor improvement.

Moderate Activity (26-50%)

The public health system somewhat participates in this activity and there is opportunity for greater improvement.

Minimal Activity (1-25%)

The public health system provides limited activity and there is opportunity for substantial improvement.

No Activity (0%)

The public health system does not participate in this activity at all.

Highest Ranked: EPHS 2, Diagnose and Investigate Health Problems and Health Hazards in the Community, received a cumulative score of optimal activity (81).

Lowest Ranked: EPHS 10, Research for New Insights and Innovative Solutions to Health Problems, received a cumulative score of moderate activity (45).

Overall Performance: The average of all EPHS scores resulted in a cumulative score of significant activity (69).

69

45

78

71

69

59

65

74

75

81

70

0 20 40 60 80 100

Overall Cumulative System Performance Score

Essential Service 10 Research/Innovations

Essential Service 9 Evaluate Services

Essential Service 8 Assure Workforce

Essential Service 7 Link to Health Services

Essential Service 6 Enforce Laws

Essential Service 5 Develop Policies/Plans

Essential Service 4 Mobilize Partnerships

Essential Service 3 Educate/Empower

Essential Service 2 Diagnose and Investigate

Essential Service 1 Monitor Health Status


Scores and Common Themes for each Essential Public Health Service The following graphs and scores are intended to help the Kane County Local Public Health System gain a better understanding of its collective performance and work toward strengthening areas for improvement. For each Essential Service and Model Standard there is a bar graph depicting each Model Standard average and a cumulative rating score, discussion themes, and a summary of strengths, weaknesses, and opportunities for immediate and long term improvement. Refer to Appendix 2 for the specific performance measure scoring for each Essential Service and Model Standard.


Essential Service 1: Monitor Health Status to Identify Community Health Problems To assess performance for Essential Public Health Service 1, participants were asked to address two key questions:

What’s going on in our community? Do we know how healthy we are?

Monitoring health status to identify community health problems encompasses the following:

• Accurate, ongoing assessment of the community’s health status. • Identification of threats to health. • Determination of health service needs. • Attention to the health needs of groups that are at higher risk than the total

population. • Identification of community assets and resources that support the public health

system in promoting health and improving quality of life. • Use of appropriate methods and technology to interpret and communicate data to

diverse audiences. • Collaboration with other stakeholders, including private providers and health benefit

plans, to manage multi-sectorial integrated information systems.

Overall performance for Essential Service 1 was scored as significant, with each of the three

70

75

67

67

0 20 40 60 80 100

Essential Service 1 Overall Score

1.3 Maintaining Population HealthRegistries

1.2 Current Technology to Manageand Communicate Population Health

Data

1.1 Population-Based CommunityHealth Assessment


model standards ranking in the significant range. Performance for Essential Service 1 was ranked sixth out of the 10 Essential Services.

Essential Service 1 Summary

Dialogue in Essential Service 1 explored LPHS performance in monitoring community health status through community health assessment, using technology to manage and analyze population health data, and maintaining population health registries. Discussions of this essential service described a robust collaborative community health assessment process that uses both qualitative and quantitative data to drive public health interventions and local public health system priority setting. Participants shared many examples of data sources that they use to assess health in Kane County, including both secondary and primary data sources. Participants reported that the local public health system seeks to make community health data accessible and available to the public, though it can be a challenge to present the data in user-friendly formats that community members can understand. Model Standard 1.1, Population-Based Community Health Assessment, explores the extent to which Kane County regularly assesses community health and uses the findings to inform the community and to drive future policy and planning. Participants described a well-structured and formalized integration and collaboration among health department, hospitals, and other community partners to create a cohesive community health assessment and community health Improvement planning process. The community health assessment is conducted every three years so the health department can partner and align timelines with the 5 hospitals in the area. This collaborative approach to the community health assessment and improvement plan allows partners to leverage shared data and resources, as well as coordinate implementation of interventions based on shared priorities by leveraging partners’ collective resources. Participants reported a perception that much of the public is unaware of the community health assessment, but noted that significant effort is being made to engage the community in the assessment process and communicate its findings with the public. Results of the most recent assessment were shared through press releases, social media outlets including Facebook and Twitter, and through the public libraries. Model Standard 1.2, Current Technology to Manage and Communicate Population Health Data, explores the extent to which the local public health system uses the best technology and methods to combine, analyze, and communicate data on the public’s health. Participants perceived that while the Kane County LPHS has a lot of data and some partners have relatively sophisticated technology to analyze the data, making the data accessible and digestible to the public is a challenge. Model Standard 1.3, Maintenance of Population Health Registries, explores the extent to which data are regularly collected to update population health registries and the extent to which data from these health registries is used to inform the community health assessment and other health analyses. Registries identified by participants include flu, sentinel events, infectious diseases, chronic diseases, water and air quality, West Nile Virus, smoking, and foodborne


illness. Participants reported that the health department, hospitals, and schools are some of the key partners contributing to population health registries in Kane County. Participants highlighted the state’s cancer registry as a particular strength for the system, which is very complete and can be leveraged for grants and decision-making. Strengths

• Strong, formalized integration and collaboration among health department, hospitals, and other community partners to create a cohesive community health assessment and community health improvement planning process.

• Local public health system uses community health assessment to drive interventions. • A lot of data is shared through health department and other community partners including the

police department, FQHCs, hospitals, and schools. • Kane County compares health indicators to other counties, to the state, and to national

benchmarks. • Strong, nationally-recognized cancer registry that can be used by local public health system

partners to apply for grants. • Strong tracking of communicable disease. • Good use of mixed methods for seeking community input into the community health

assessment (asset mapping, photo voice, focus groups, surveys, town hall meetings). Weaknesses

• Data may not be accessible or user-friendly for community members. • Lack of databases tracking mental health issues. • Immunization and death registries are not updated in a timely manner.

Opportunities for Short Term Improvement

• Increase engagement of elected officials in community health assessment process. • Increase grassroots-level community input. • Improve accessibility and user-friendliness of data for community members.

Opportunities for Long Term Improvement

• Seek grant funding to support work to make community health status data more user-friendly

and digestible for lay people. • Continue to build partnerships with local businesses, employers, and other nontraditional

partners to engage in the MAPP process.


• Improve collection of data from a broader array of community groups and agencies and put in a unified location in accessible, user-friendly formats like infographics.

• Improve timeliness of immunization and death data. Essential Service 2: Diagnose and Investigate Health Problems and Health Hazards To assess performance for Essential Public Health Service 1, participants were asked to address three key questions:

Are we ready to respond to health problems or health hazards in our county? How quickly do we find out about problems? How effective is our response?

Diagnosing and investigating health problems and health hazards in the community encompasses the following:

• Access to public health laboratory capable of conducting rapid screening and high-volume testing.

• Active infectious disease epidemiology programs • Technical capacity for epidemiologic investigation of disease outbreaks and patterns of

infectious and chronic diseases and injuries and other adverse health behaviors and conditions.

Overall performance for Essential Service 2 was scored as optimal, with Model Standard 2.1 (Identifying and Monitoring Health Threats) and Model Standard 2.3 (Laboratory Support for Investigating Health Threats) scoring significant, and Model Standard 2.3 (Investigating and

81

68

100

75

0 20 40 60 80 100


2.3 Laboratory Support for InvestigatingHealth Threats

2.2 Investigating and Responding toPublic Health Threats and Emergencies

2.1 Identifying and Monitoring HealthThreats


Responding to Public Health Threats and Emergencies) scoring as optimal. Performance for Essential Service 2 was ranked the highest out of the 10 Essential Services.


Participants in Essential Service 2 explored LPHS readiness to diagnose and effectively respond to health problems and health hazards, which received the highest overall performance score of the 10 Essential Public Health Services. Participants described strong partnerships, clear lines of communication, robust data, and systematized protocols as major strengths in this essential service. One asset that was frequently referenced was the Regional Medical Disaster Preparedness Coalition, which brings together fire departments, police departments, emergency management, health departments, and hospitals from five counties to coordinate emergency planning and response activities. Participants also reported very robust localized partnerships and communication as well, describing frequent meetings, communication, emergency planning activities, and information sharing between the Kane County Health Department and the five hospitals in Kane County. When health hazards and emergencies occur, the Kane County Health Department responds quickly by convening the five hospitals together to share information about the health threat and to coordinate an appropriate and timely response. Model Standard 2.1, Identification and Surveillance of Health Threats, explores LPHS performance to monitor and identify outbreaks, disasters, emergencies, and other emerging threats to public health. This model standard received a significant score. Participants described a robust surveillance process, with strong, immediate, and systematized communication between the health department and community hospitals to diagnose and respond to health hazards. Participants described established procedures for identifying and responding to health hazards such as infectious diseases, substance abuse, and bioterrorism incidents. Partners in the LPHS use sophisticated data mining program to track and monitor potential threats to public health. Many partners contribute to the surveillance data, including hospitals, hazmat teams, pharmacists, and local law enforcement. One example of a robust surveillance system described by participants is the Illinois Prescription Monitoring Program, which helps healthcare professionals track and recognize drug seeking behavior in patients who may be abusing pain medications. Another example of successful identification and response to a health hazard described by participants was the abuse of a particular prescription cough medicine in the community. Surveillance data helped the health department recognize a trend in abuse of the medication, which has informed the creation of a policy to reduce the drug’s street value. Participants reported strong linkages between the Kane County LPHS and state national surveillance systems. Participants identified the need to create tracking and surveillance systems for social and mental health conditions, as they were unaware of surveillance of this kind of data. Model Standard 2.2, Investigation and Response to Public Health Threats and Emergencies, explores LPHS performance in collecting and analyzing data on public health threats and


responding to emergencies. Performance for this model standard was scored as optimal. Participants reported that the LPHS ensures timely response to health threats and emergencies through an incident command system aligned with national guidelines and described written protocols and standards case finding, contact tracing, and containment for threats including infectious disease outbreaks, bioterrorist threats, and environmental health hazards. Participants described a very robust Regional Medical Disaster Preparedness Coalition that meets quarterly to coordinate emergency planning activities, share information and resources, and discuss emergent threats. Participants also shared that a wide array of partners throughout the LPHS are engaged in emergency planning and response, including epidemiologists, law enforcement, hazmat teams, emergency management, medical examiners, and chaplains. They noted that further engagement of mental health professionals is a needed area for improvement. Model Standard 2.3, Laboratory Support for Investigation of Health Threats, was also scored at a significant level of performance. Participants reported that while the Illinois Department of Public Health has traditionally been the source for laboratory testing for communicable disease threats, the capacity and timeliness of the state lab has been substantially reduced as a result of funding cuts, leading the LPHS to increasingly rely on hospital laboratories to fill this gap.

Strengths

• Strong emergency preparedness system. • Established system of communication across the LPHS to diagnose and investigate health

hazards. • Robust data mining IT systems shared between the hospitals and health department. • Health department collects data about potential health hazards and brings the five local

hospitals together to discuss emergent issues and how to coordinate an appropriate response. • Strong surveillance of many health hazards. • Strong linkages with state and national surveillance systems. • Kane County Health Department does a good job of passing information about health hazards

on to partners like hospitals and schools.

Weaknesses

• State laboratory capacity and timeliness have diminished greatly in recent years due to lack of funding and resources, so the LPHS increasingly must rely on hospital labs for testing.

• Lack of mental health surveillance data. • Mental health professionals are not sufficiently engaged in community emergency planning

activities.



• Reach out to mental health professionals to engage them in emergency planning activities.


• Create surveillance systems for tracking social and mental health issues like depression and domestic violence.

• Continue to improve health hazard messaging to the public through dissemination of understandable, actionable information that elicits an appropriate response from the public.

Essential Service 3: Inform, Educate, and Empower People about Health Issues To assess performance for Essential Public Health Service 3, participants were asked to address the key question:

How well do we keep all segments of our community informed about health issues? Informing, educating, and empowering people about health issues encompasses the following:

• Community development activities. • Social marketing and targeted media public communication. • Provision of accessible health information resources at community levels. • Active collaboration with personal healthcare providers to reinforce health promotion

messages and programs. • Joint health education programs with schools, churches, worksites, and others.

75

100

58

67

0 20 40 60 80 100


3.3 Risk Communication

3.2 Health Communication

3.1 Health Education and Promotion


Overall performance for Essential Service 3 was scored as significant with Model Standards 3.1 (Health Education and Promotion) and 3.2 (Health Communication) receiving a significant score, and Model Standard 3.3 (Risk Communication) receiving an optimal score. Performance for Essential Service 3 was ranked third out of the 10 Essential Services. This overall ranking should be interpreted with caution, however, as the cumulative score was inflated by Model Standard 3.3’s outlying optimal score.


Participants in Essential Service 3 explored LPHS performance in keeping the Kane County community informed and empowered about public health issues. Strong collaboration among partners across the LPHS was a theme referenced throughout the dialogue of this Essential Service. Participants noted that partners communicate frequently and pool resources to educate and empower the public about health and other community issues. Improvement is needed, however, in outreach to vulnerable populations, who are not being effectively reached by current messaging efforts. While the cumulative score for Essential Service 3 was a high significant, it should be noted that this score was impacted by the scoring of Model Standard 3.3 (Risk Communication), which received optimal scores in all performance measures. Model Standard 3.1, Health Education and Promotion, explores the extent to which the LPHS successfully provides policy makers, stakeholders, and the public with health information and related recommendations for health promotion policies, coordinates health promotion and education activities, and engages the community in setting priorities and implementing health education and promotion activities. Participants assessed the LPHS’s performance of this model standard as significant. They reported that there is substantial effort among partners to coordinate health education efforts throughout the community, but there may be gaps in effectively getting information to the people who need it most and in effectively implementing health education activities. Participants reported a lack of understanding about how to best reach out to the public and low-income families in particular. Participants highlighted the need for more collaborative evaluation of their efforts to be able to improve their collective health education strategies. Model Standard 3.2, Health Communication, explores the extent to which the LPHS uses health communication strategies to increase awareness of health risk factors, promote healthy behaviors, advocate for organizational and community changes to support health living, build a culture of health, and create support for health policies and programs through development of relationships with the media, information sharing among LPHS partners, and identification and training of spokespersons on public health issues. Participants scored the LPHS performance for this model standard as a low significant, with the major weakness being the lack of a collective, coordinated county wide health communication plan that is effective at targeting specific community groups. There is particular room for improvement in communicating non-emergency health information to the public.


Model Standard 3.3, Risk Communication, specifically explores LPHS performance in communicating health information in emergencies. This model standard received an optimal score. There is wide involvement of partners in emergency communication plans, and emergency communication planning is well-coordinated and based on best practices. Participants reported that emergency communication efforts in Kane County are well-funded and resources are available to rapidly distribute emergency information to partners and to the public.

Strengths

• Strong cross-sector collaboration and coordination, strong spirit of partnership across agencies in the LPHS.

• Partners throughout the LPHS willing to pool resources to achieve goals. • Strong coordination of messaging among LPHS partners. • LPHS has leveraged the farmer’s market as a resource to provide health information to

empower low income residents to purchase healthy food through allowing SNAP (food stamp) purchases at the market.

• Emergency preparedness health communication to the public is very strong. • Overlapping 911 and Code Red are strong emergency communication resources.

Weaknesses

• Despite willingness to partner and pool resources to educate and empower the community, it

has proven difficult to get resources and information to the right places to help vulnerable community members.

• Low income families in Kane County experience barriers to accessing health information. The information is being distributed, but there is a gap in properly reaching vulnerable community members that is not well-understood.

• Digital divide exists for distributing health information. LPHS relies too heavily on the internet to communicate with the public.


• Diversity of Kane County can make it challenging to appropriately serve all community

members. • Evaluate how community members access health information to understand the best outreach

methods. • Leverage the media more frequently to reach out to community members. • Educate community members about how to register for Code Red (Emergency Communication

system). • Create a group for local and regional Public Information Officers (PIOs).



• Continue to improve health hazard messaging to the public through dissemination of understandable, actionable information that elicits an appropriate response from the public Coordinate evaluation activities and share evaluation data to better understand how to most effectively inform and engage the public.

• Increase effective implementation of health promotion activities so we can help community members act on health information to improve their health.

Essential Service 4: Mobilize Community Partnerships to Identify and Solve Health Problems To assess performance for Essential Public Health Service 4, participants were asked to address the key question:

How well do we truly engage people in local health issues? Mobilizing community partnerships to identify and solve health problems encompasses the following:

• Convening and facilitating partnerships among groups and associations (including those not typically considered to be health related).

• Undertaking defined health improvement planning process and health projects, including preventive, screening, rehabilitation, and support programs.

• Building a coalition to draw on the full range of potential human and material resources to improve community health.

Overall performance for Essential Service 4 was scored as significant with Model Standard 4.1

74

67

81

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4.2 Community Partnerships

4.1 Constitutency Development


(Constituency Development) receiving an optimal score and Model Standard 4.2 (Community Partnerships) receiving a significant score. Performance for Essential Service 4 was ranked fourth out of the 10 Essential Services.


Participants in Essential Service 4 explored LPHS performance in engaging the community in local health issues through partnerships. Key themes throughout the Essential Service included acknowledgement of the strong culture of partnership and collaboration, the wide engagement of LPHS agencies in cross-sector partnerships, and the strong directory of community resources as significant assets in the Kane County LPHS. While many strengths were described in this Essential Service, participants also noted that an opportunity for growth within this realm is the formalization and assessment of partnership activities. Model Standard 4.1, Constituency Development, examines LPHS performance in identifying and involving a wide range of community partners and providing opportunities to contribute to community health. Participants scored LPHS performance of the model standard as optimal, noting that Kane County has been nationally recognized for its collaborative community health assessment and community health improvement planning. Participants reported that the county’s community health assessment and improvement plan leverages collective resources from local hospitals, the United Way, the health department, and a local mental health board. A particular strength within the area of constituency development is the Kane County Guide, which is an online directory of community resources in the county, and includes profiles for each agency within the LPHS with contact information and service descriptions. Opportunities for growth to strengthen this community resource even further include translating the guide into Spanish and creating a Kane County Guide app so community members can access information about community resources from their phones, and formalizing a process for identifying new constituents and stakeholders within the LPHS to ensure that they are included in partnership opportunities. Model Standard 4.2, Community Partnerships, explores LPHS performance in encouraging and mobilizing collaboration across the Kane County community, establishing a broad-based community health improvement committee, and assessing the impact and effectiveness of community partnerships in improving community health. Participants scored performance of this model standard as significant, noting that establishing strategic partnerships and alliances to provide a comprehensive approach to improving community health is a great strength of the LPHS, but acknowledging that assessment of these efforts is an area for growth. Strengths

• Kane County Guide serves as a comprehensive online community resource directory that profiles agencies within the LPHS.


• Mobilizing Action through Planning and Partnerships engages partners throughout the LPHS in a collective, collaborative, and ongoing health assessment and improvement process.

• Kane County LPHS has a strong culture of partnerships and can leverage existing engagement to further coordinate health improvement activities.

Weaknesses

• No formalized point of entry or process for identifying new LPHS constituents and stakeholders. • Need for greater public voice and community member involvement within LPHS. • Measuring and evaluating collaborative relationships has been difficult.


• Engage college and university students in community health activities. • Engage the community at large to ensure broad representation of public voices within the

LPHS. • Engage new organizations and key constituents and formalize the process for identifying new

constituents and stakeholders within the LPHS to ensure that they are included in partnership opportunities.

• Advertise Kane County Guide in the local newspaper so community members know about this resource.

• LPHS organizations should like each other on Facebook so they can stay connected and informed about each other’s activities and recognize opportunities for partnership when they arise.

• Formalize community health improvement steering committee.


• Translate the Kane County Guide into Spanish and other predominant languages in the community.

• Create a Kane County Guide app so community members can access information about community resources from their phones.


Essential Service 5: Develop Policies and Plans that Support Individual and Community Health Efforts To assess performance for Essential Public Health Service 5, participants were asked to address two key questions:

What local policies in both the government and private sector promote health in our community? How well are we setting healthy local policies?

Developing policies and plans that support individual and community health efforts encompasses the following:

• Leadership development at all levels of public health. • Systematic community-level and state-level planning for health improvement in all

jurisdictions. • Development and tracking of measurable health objectives from the community health

plan as a part of continuous quality improvement strategy plan. • Joint evaluation with the medical healthcare system to define consistent policy regarding

prevention and treatment services. • Development of policy and legislation to guide the practice of public health.

Overall performance for Essential Service 5 was scored as significant with all model standards scoring in the significant range. Performance for Essential Service 5 was ranked 8th out of the 10 Essential Services.

65

75

58

67

58

0 20 40 60 80 100


5.4 Planning for Public HealthEmergencies

5.3 Community Health ImprovementProcess and Strategic Planning

5.2 Public Health Policy Development

5.1 Governmental Presence at the LocalLevel



Participants in Essential Service 5 explored public health planning and policy development in Kane County. Participants reported that there has been substantial progress within this essential service in recent years as the LPHS has become more involved in advocating for viewing policy through the lens of public health. The LPHS has done a good job of engaging the public in this area, but could strengthen relationships with policymakers themselves to ensure that health impact is a consideration whenever a new policy is being developed. Kane County has a strong vision for improving community health, but further effort should be made to formalize evaluation of community health improvement planning efforts. Emergency planning is robust, with strong partnerships and plans in place. Model Standard 5.1, Governmental Presence at the local level, received an average score of significant. Participants reported strong engagement across government departments in county planning efforts, and identified strong partnerships as an asset in this area. Participants reported that the county is increasingly seeking input from other partners in decision-making, leading to the development of more robust and informed policies. While strong partnerships were identified as a strength for this model standard, participants reported that increased collaboration and alignment can continue to be improved through enhanced communication and outreach efforts. Model Standard 5.2, Public Health Policy Development, also received a significant overall score. Participants reported that a strength of the LPHS in this area is strong advocacy for public health in policymaking, leading to increasing emphasis and public awareness of a Health in All Policies framework as well as emerging community consciousness of public health policy. Kane County has been an early adopter of evidence-based policies, such as complete streets, and best practices to inform decision-making, such as Health Impact Assessment. Areas for growth identified within this model standard including formalizing Kane County’s commitment to the Health in All Policies approach through developing a model policies guide to inform all future policymaking in Kane County. Model Standard 5.3., Community Health Improvement Process and Strategic Planning, looks at the LPHS’s actions to improve community health. Participants scored performance of this model standard as significant. Participants cited the Kane County 2040 Plan, which aligns transportation, land use, and public health efforts toward a common vision of a healthy community as a strong example of strategic planning among LPHS partners. To improve performance within this model standards, participants suggested that the LPHS should improve monitoring and evaluation of implementation of these plans. Model Standard 5.4, Planning for Public Health Emergencies, was identified as strength for the local public health system and received a high significant score. Emergency planning is an area of strength for Kane County. Emergency preparedness is very robust, though some participants reported the need to further clarify partner roles and responsibilities in emergencies, as well as the need to build public awareness of the county’s emergency planning efforts.


Strengths

• Kane County residents have an emerging consciousness of public health policy. • Strong complete streets plan. • Strong 2040 community plan for Kane County. • Increasing emphasis and public awareness of Health in All Policies approach to decision making. • Kane County considers many partners’ voices in decision-making and policymaking. • Healthy Places Coalition does great work to address radon in the community. • LPHS does a good job advocating for public health in policymaking. • Many agencies across the LPHS are engaged in collaborative emergency preparedness work. • Robust emergency preparedness plans.

Weaknesses

• Need for increased collaboration between health department and municipalities. • Policymaking and regulation are a challenge for unincorporated areas of the county- they do

not benefit from things like complete streets, and there are no regulations to enforce. • At times, state and county policies do not align, which causes confusion. • Old policies are not reviewed on a regular basis to determine whether they are still appropriate. • Need for better outreach to policymakers. • Need for improved communication between partners in emergency preparedness work to

clarify agency roles in an emergency situation. • Partners do not always trust each other to appropriately implement emergency response plans.


• Increase communication and partnerships between Kane County Health Department and

municipalities. • Increase collaboration between government entities. • Reach out to partners across the county to learn what their priorities are. • Improve provision of health data to stakeholders in the community to inform decision-making. • Increase use of best practices to inform decision-making. • Educate partners about their role within the LPHS so they understand the impact of their work

on the public’s health. • Determine how to implement follow up evaluation and annual feedback for the Community

Health Improvement Plan and LPHS strategic plans. • Increase public awareness of the county’s emergency planning efforts.



• Develop a model policies guide to help incorporate a Health in All Policies framework into all future policymaking in Kane County.

• Develop and strengthen the volunteer force in the future.

Essential Service 6: Enforce Laws and Regulations that Protect Health and Ensure Safety To assess performance for Essential Public Health Service 6, participants were asked to address the key question:

When we enforce health regulations are we technically competent, fair, and effective? Enforcing laws and regulations that protect health and ensure safety encompasses the following:

• Enforcement of sanitary codes, especially in the food industry. • Protection of drinking water supplies. • Enforcement of clean air standards. • Animal control activities. • Follow up of hazards, preventable injuries, and explores regulated disease identified in

occupational and community settings. • Monitoring quality of medical services (e.g. laboratories, nursing homes, and home

healthcare providers.). • Review of new drug, biologic, and medical device applications.

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6.3 Enforcing Laws, Regulations, andOrdinances

6.2 Involvement in Improving Laws,Regulations, and Ordinances

6.1 Reviewing and Evaluating Laws,Regulations, and Ordinances


Overall performance for Essential Service 6 was scored as significant with all model standards scoring in the significant range. Performance for Essential Service 6 was ranked 9th out of the 10 Essential Services.


Essential Service 6 examines the LPHS’s performance in enforcing health and safety laws and regulations. Participants explores different examples of laws and ordinances in Kane County that protect the health of public, including water restrictions to protect against water shortages, air quality regulations, building codes, and food safety and sanitation regulations. Model Standard 6.1, Reviewing and Evaluating Laws, Regulations and Ordinances, emphasizes the impact of policies on the health of the public, and issues of compliance among community members. This model standard received a significant overall score. Participants reported that partners within the Kane County LPHS review best practices and pay attention to what laws are passing in other communities and states to compare how local laws, regulations and ordinances measure up and to identify areas for improving policies. However, there is no formal tracking process for regular review of policies in Kane County, so staying current on best practices across all areas of laws, regulations and ordinances that affect the health of the public is a challenge and occurs on an ad hoc basis. Participants suggested that an area for growth is the creation of a systematized and formalized review process for policies to determine if changes or updates are needed. Model Standard 6.2, Involvement in Improving Laws, Regulations, and Ordinances, explores the extent to which the LPHS participates in advocating for the improvement or creation of policies that affect public health. Participants reported referring to best practice evidence as well as case studies from other communities to encourage improvements to local decision-making. Representatives from the health department described public meetings as a method for getting community input that informs KCHD’s advocacy for improving existing policies or creating new policies. Participants reported that the LPHS is responsive to changing needs and evidence on best practices, though the process of changing or creating policies is very slow. Model Standard 6.3, Enforcing Laws, Regulations, and Ordinances, explores LPHS performance in enforcing policies, including making sure community members are aware of relevant laws, regulation, and ordinances. Participants described efforts by municipalities to be transparent with the public about current policies. For example, the City of Aurora has information about ordinances on its website and distributes informational pamphlets on regulations targeted to specific audiences. Aurora also operates a call center for questions about local ordinances and regulations, which receives 50,000 calls a year. This allows the public to stay informed about policies that affect them. The county also uses the press and social media to educate community members about policies that affect them. Participants reported that enforcement entities are well-trained, and enforcement roles are generally understood throughout the LPHS, though sometimes cross-over in certain areas of enforcement can cause confusion, which highlights the


need for further clarification of roles. An area for growth is the evaluation of enforcement to create data to track compliance with local laws, regulations, and ordinances.

Strengths

• LPHS is responsive to changing evidence and best practices. • Local municipalities are willing to work to make improvements to existing laws, regulations, and

ordinances. • LPHS does a good job of informing the public of laws, regulations, and ordinances that affect

them through a variety of methods, including social media, municipal websites, pamphlets, press releases, and call centers so community members understand how to comply with local policies.

• Enforcement workforce is well-trained. Weaknesses

• Review of laws, regulations, and ordinances is informal and occurs on an ad hoc basis. • Process of improving or creating new laws is very slow. • LPHS has very few technical or legal experts that have the capacity to inform needed policy

change or policy creation. • Cross over and overlap in some areas of enforcement causes confusion over enforcement roles

and responsibilities among LPHS partners. • Need for more robust evaluation of compliance with laws, regulations, and ordinances.


• Look for model ordinances from other communities that are clear and easily explainable that

Kane County can adopt or adapt. • Create an evaluation process for tracking compliance with policies to identify where further

public education or potential clarification or changes to policies are needed.


• Create a systematized, regular review process for laws, regulations, and ordnances. • Continue to advocate for Health in All Policies approach so laws, regulations and ordinances can

be written with a public health lens in mind.


Essential Service 7: Link People to Needed Personal Health Services and Assure the Provision of Healthcare When Otherwise Unavailable To assess performance for Essential Public Health Service 7, participants were asked to address the key question:

Are people in our community receiving the health services they need? Linking people to needed personal health services and ensuring the provision of health care when otherwise unavailable (sometimes referred to as outreach or enabling services) encompasses the following:

• Assurance of effective entry for socially disadvantaged people into a coordinated system of clinical care.

• Culturally and linguistically appropriate materials and staff to ensure linkage to services for special population groups.

• Ongoing “care management” • Transportation services. • Targeted health education/promotion/disease prevention to high-risk population groups.

Overall performance for Essential Service 7 was scored as significant with all model standards scoring in the significant range. Performance for Essential Service 7 was ranked seventh out of the 10 Essential Services.

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7.2 Ensuring People are Linked toPersonal Health Services

7.1 Identifying Personal Health ServiceNeeds of Populations



Participants in Essential Service 7 explored LPHS performance in connecting community members to the health services they need. Participants in Essential Service 7 discussed the challenges of creating a sustainable infrastructure to meet the increasing service needs of vulnerable residents of Kane County. Participants reported that basic provision of primary care in the county is fairly good, though thousands of people in the community still lack any access to primary care services. Care management through the Affordable Care Act has been effective in reducing improper ER use through the creation of medical homes. Kane County has been a leader in care management throughout the state, and participants noted that the first certified medical home in Illinois was located in Kane County. Despite the signs of success of care management efforts, participants cautioned that this work is still in the beginning stages and continued work and improvement is needed. Participants contrasted the relative success of the provision of basic primary care to Kane County residents with the challenge of providing other types of health-related services, including enabling, wrap around, and mental health and substance abuse services. Participants stated that while the county has a broad range of services, the depth of services is not significant. Many individual agencies try to provide a wide range of services to a wide range of people, but do not have the capacity to meet the depth and volume of the increasing needs of vulnerable populations in the county. While some agencies are working well together, coordination and collaboration to best meet the needs of community members is an area for substantial improvement. One specific need is to coordinate and disseminate information about services among providers so they can track delivery of availability of services across the county to appropriately refer and partner with other agencies. Participants highlighted the need for a database or central repository where service providers could access this information. An additional concern raised by partners in this essential service is the lack of sustainability of services that are grant-driven. Agency representatives explained that they frequently rely on grants to fund programs that work well, but stop when the grant period is over, leading to very inconsistent services for community members. They also raised concerns because grant providers increasingly require sustainability plans to continue work after the grant period, agencies may not qualify for grants unless they can demonstrate support from the county tax base. Model standard 7.1, Identifying Personal Health Service Needs of Populations, received a significant overall score. Participants noted that homeless individuals, disabled individuals, and individuals with mental health and substance abuse issues, and youth have been identified as vulnerable populations that the Kane County LPHS tries to serve. Participants reported that the Community Health Assessment that takes place every three years helps to inform service providers about the needs of community members, and the Community Health Improvement Plan provides an excellent structure to coordinate work to meet the emerging needs of community members, but they also highlighted the need for a system that will allow providers to share information to understand what services are available to meet different community needs.


Model Standard 7.2, Ensuring People are Linked to Personal Health Services, also received a significant overall score. Participants identified several areas where linkages to care fall short, including specialty care, dental care, and women’s health services. Participants described that a strong effort is being made on the part of the LPHS to link vulnerable individuals to services, but large gaps still remain for specific populations, and follow through after linkages are made which has room for substantial improvement. Strengths

• A broad range of personal health services exist for Kane County residents. • Kane County generally provides good access to primary care. • Implementation of care management and medical homes have reduced improper ER usage and

increased navigation and coordination of care for patients. • Agencies do a good job of partnering with each other to coordinate services when possible, and

these relationships can be leveraged to further increase coordination of care. • Service providers use the Community Health Assessment data to inform service needs.

Weaknesses

• While Kane County has a broad range of services for vulnerable residents, depth of services is

not significant to meet the increasing volume of needs. • Many service providers in the community try to provide a wide range of services to a wide

range of people rather than coordinating services across the community. • Many agencies lack capacity to meet the growing needs in the county. • Transportation is a substantial barrier to accessing services, particularly transportation between

northern and southern regions of the county. • Enabling services and wraparound services have substantial room for improvement are in need

of better funding. • Need for mental health and substance abuse services currently exceed service capacity in the

county. • Services are heavily grant-driven, making them inconsistent and unsustainable over the long

term. • Substantial shortage of affordable and accessible housing for individuals with disabilities • Kane County does not currently have the capacity to address the growing heroin epidemic in

the community.



• Leverage advocacy organizations and engage with lawmakers to support funding for needed services.

• Improve provision of culturally competent services to subpopulations within the community, including the Spanish-speaking population and the Laotian population.


• Improve coordination of service provision across the county. • Coordinate and disseminate information about services through creation of a central repository

that allows providers to track availability/delivery of services to appropriately refer and collaborate with other agencies.

• Advocate for more support of services through tax base rather than relying on unsustainable grants to sustain long-term, consistent services.

• Work to improve behavioral health and dental services.

Essential Service 8: Assure a Competent Public Health and Personal Healthcare Workforce To assess performance for Essential Public Health Service 8, participants were asked to address two key questions:

Do we have a competent public health staff? Ensuring a competent public and personal health care workforce encompasses the following:

• Education, training, and assessment of personnel (including volunteers and other lay community health workers) to meet community needs for public and personal health services.

• Efficient processes for licensure of professionals. • Adoption of continuous quality improvement and lifelong learning programs. • Active partnerships with professional training programs to ensure community-relevant

learning experiences for all students. • Continuing education in management and leadership development programs for those

charged with administrative/executive roles.


Overall performance for Essential Service 8 was scored as significant with Model Standard 8.1 (workforce Assessment, Planning and Development) scoring in the moderate range, Model Standard 8.2 (Public Health Workforce Standards) scoring as optimal, and Model Standard 8.3 (Life-long Learning through Continuing Education, Training, and Mentoring) and 8.4 (Public Health Leadership Development) scoring as significant. Performance for Essential Service 8 was ranked fifth out of the 10 Essential Services.


Participants in Essential Service 8 discussed public health workforce development in Kane County. While the LPHS effectively leverages partnerships and shared resources in many aspects of workforce development, including sharing of training and leadership development opportunities and preparing the future public health workforce through provision of internships, the system needs to do a better job of collectively assessing its workforce capacity to ensure that future capacity will be adequate. Participants also emphasized that securing more funding for the public health system is critical to growing and strengthening Kane County’s public health workforce capacity. Model Standard 8.1, Workforce Assessment, Planning, and Development, explores how well the Kane County LPHS is assessing its workforce as a system. Participants scored overall performance as moderate because while a lot of good activity is occurring at individual agencies, partners were not aware of each other’s workforce assessment activities, and no collective workforce assessment is taking place across the LPHS as a whole. The health department shared an example of how a comprehensive workforce assessment tool they use has helped them to identify gaps in training and threats and opportunities to prepare for. For example, the assessment results alerted them to the average age of their staff and showed that many are approaching retirement age. The health department plans to act on this data through succession planning and cross-training to ensure that gaps are filled and work can continue

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8.4 Public Health LeadershipDevelopment

8.3 Life-long Learning throughContinuing Education, Training, and…

8.2 Public Health Workforce Standards

8.1 Workforce Assessment, Planning,and Development


when staff retire. This is a good model that the LPHS as a whole may be able to replicate to conduct a collective comprehensive workforce assessment. Model Standard 8.2, Public Health Workforce Standards, received an overall score of optimal performance. Participants reported that the LPHS does a good job of ensuring that the workforce is appropriately certified and licensed, and job descriptions and standards are based on the skills and abilities need to provide the 10 Essential Public Health Services. One potential area for quality improvement is better integration of public health competencies in staff performance reviews throughout LPHS agencies to ensure that organizations are continually linking work back to the essential public health services. Model Standard 8.3, Life-long Learning Through Continuing Education, Training, and Mentoring, received a significant overall performance score. Participants reported good overall support for professional development among the LPHS, and noted that the two area universities are key partners in not only preparing and educating the public health workforce, but are also good partners for collaborative training efforts with LPHS organizations. Participants reported ample training opportunities across the LPHS and good sharing of training opportunities across partner organizations, making continuing education and professional development widely available to the LPHS workforce. An area for growth is to improve LPHS training on cultural competency and to ensure that the workforce understands and can relate their work to the social determinants of health. Model Standard 8.4, Public Health Leadership Development, scored as significant. Participants reported that the LPHS does a good job of providing access to leadership development opportunities, but many within the workforce may not be aware of these opportunities so further marketing of these opportunities is needed. A further area for growth for the LPHS is ensuring that there are ample opportunities for leadership development among members of the LPHS workforce that represent the diversity within the community, though substantial progress has been made in this area in recent years. Strengths

• Many agencies throughout the LPHS are doing organization-level workforce assessments. • LPHS is supportive of staff seeking continuing education opportunities and frequently

reimburses training and conference costs to support professional development. • Many employers in the LPHS reimburse staff for licensure and certification fees. • Good training of law enforcement to identify mental illnesses so they can help connect people

with mental health issues to treatment rather than incarcerating them. • Robust training opportunities across the LPHS and good sharing of training opportunities across

partner organizations. • Some students receive tuition waivers for completing internships.


Weaknesses

• Workforce assessments are usually done by occupation or organization rather than looking comprehensively at the LPHS workforce.

• Partners are not aware of each other’s workforce assessment and workforce development activities

• Local public health workforce not adequately trained in the social determinants of health framework.


• Encourage organizations to post annual reports on their webpages to increase communication

and availability of information between partners. • Need to improve succession planning as much of the public health workforce is nearing

retirement. • Identify the emerging skills needed for LPHS workforce. • Organizations can start to build workforce assessment questions into annual staff surveys and

performance reviews to identify training needs. • Leverage tools like the Workforce Assessment template developed by Ohio State University.


• Conduct a comprehensive, collaborative workforce assessment of the Kane County LPHS as a whole.

• Form data sharing agreement. • Formally build in succession planning and staff cross-training into organizational development

plans across the LPHS. • Improve LPHS training on cultural competency and to ensure that the workforce understands

and relate their work to the social determinants of health. Essential Service 9: Evaluate Effectiveness, Accessibility, and Quality of Personal and Population-Based Health Services

To assess performance for Essential Public Health Service 9, participants were asked to address three key questions:

Are we meeting the needs of the population we serve? Are we doing things right?


Are we doing the right thing? Evaluating effectiveness, accessibility, and quality of personal and population-based health services encompasses the following:

• Assessing program effectiveness through monitoring and evaluating implementation outcomes and impact.

• Providing information necessary for allocating resources and reshaping programs.

Overall performance for Essential Service 9 was scored as significant with Model Standard 9.1 (Evaluating Population-Based Health Services) receiving a significant score, and Model Standards 9.2 (Evaluating Personal Health Services) and 9.3 (Evaluating the Local Public Health System) receiving optimal scores. Performance for Essential Service 9 was ranked second out of the 10 Essential Services.


Participants in Essential Service 9 explored how the Kane County LPHS evaluates the effectiveness of personal and population-based services, and the LPHS itself. Participants reported that individually, agencies do fairly well in evaluating their services, particularly for personal health services. One cross-cutting weakness throughout this essential service was a lack of data sharing between agencies so partners can leverage each other’s data for collective, systemic quality improvement.

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9.3 Evaluating the Local Public HealthSystem

9.2 Evaluating Personal Health Services

9.1 Evaluating Population-Based HealthServices


Model Standard 9.1, Evaluation of Population-Based Health Services, explores whether population-based services are being adequately evaluated by the LPHS, whether community feedback is sought, and whether gaps in service provision have been identified. Overall performance for this model standard was scored as significant. Participants reported that population-based service data is not as robust as personal health service data, and there is a lack of system coordination at population-based service evaluation. Assessing public satisfaction with community approaches to health promotion and disease prevention is done individually and is beginning to be done collectively through the Community Health Assessment and Community Health Improvement Plan, but there is room for growth in this area because it has been a challenge to get community members to complete satisfaction surveys. Some partners within the LPHS do a good job of using evaluation findings to improve population-based services, but there is need for improvement system-wide. Model Standard 9.2, Evaluation of Personal Health Services, examines the extent to which health care providers are evaluating personal health care services. Participants scored performance of this model standard as optimal, and reported robust and frequent evaluation of the accessibility, quality and effectiveness of health care and frequent evaluation of patient satisfaction. The data from these evaluations is used to inform service and program improvements. Model Standard 9.3, Evaluation of the Local Public Health System, explores LPHS performance in evaluating its effectiveness as a system. Participants scored this model standard as optimal. Participants reported that while the LPHS has only recently started to engage in formal, systematic evaluation of local public health system capacity, they feel confident that this work will be ongoing and increasingly robust in the future.

Strengths

• Many health care providers collect customer feedback and use data to drive quality improvement.

• Robust assessment process for linkages and referral services among healthcare providers.

Weaknesses

• Evaluation results are not frequently disseminated to the public or shared between partners. • Lack of integration of quality improvement models across the LPHS. • Evaluation tools are not always accessible for people with special needs. • Evaluation of population-based health services is not as robust as evaluation efforts for

personal healthcare services. • LPHS is lacking a comprehensive plan for overall population health evaluation.



• Encourage LPHS agencies to share evaluation results to better inform system-wide quality improvement efforts.

• Work to ensure that customer satisfaction surveys are appropriate for the patient population (linguistically appropriate, accessible for individuals with disabilities, etc.).


• Include questions about accessibility in LPHS client satisfaction surveys. • Create a comprehensive system-wide approach to evaluation of population-based health

services.

Essential Service 10: Research for New Insights and Innovative Solutions to Health Problems

To assess performance for Essential Public Health Service 10, participants were asked to address the key question:

Are we discovering and using new ways to get the job done? Researching for new insights and innovative solutions to health problems encompasses the following:

• Full continuum of innovation, ranging from practical field-based efforts to fostering change in public health practice to more academic efforts to encourage new directions in scientific research.

• Continuous linkage with institutions of higher learning and research. • Internal capacity to mount timely epidemiologic and economic analyses and conduct

health services research.

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10.3 Capacity to Intitiate orParticipate in Research

10.2 Linking with Institutions ofHigher Learning and/or Research

10.1 Fostering Innovation


Overall performance for Essential Service 10 was scored as moderate, with Model Standard 10.1 (Fostering Innovation) and Model Standard 10.2 (Linking with Institutions of Higher Learning and/or Research) scoring moderate, and Model Standard 10.3 (Capacity to Initiate or Participate in Research) scoring as significant Performance for Essential Service 2 was ranked the lowest out of the 10 Essential Services.


Participants in Essential Service 10 discussed LPHS performance in research and innovation. This essential service received the lowest cumulative score in the assessment. Participants explained that while the Kane County LPHS is very interested in driving innovation and conducting research, they are currently lacking the capacity to do this on the scale that they aspire to. Lack of funding is a particular barrier to higher performance within this area. While the lack of research infrastructure present in the Kane County LPHS has also been a barrier, participants predict that the imminent arrival of a research hospital with expand capacity to engage in this work in the future. Model Standard 10.1, Fostering Innovation, explores LPHS performance in finding new ways to improve public health practice, and received a moderate overall score. While partners in the LPHS have an interest fostering innovation and identifying and testing potential new solutions to public health problems, capacity to do so is limited given insufficient funding and expertise in this area. Participants noted that a research hospital, Northwestern, will be coming to the county soon, which will increase Kane County’s capacity to drive innovation and pilot test new approaches. An area for improvement is to build and strengthen LPHS infrastructure to drive innovation and research, which could be supported through leadership from Northwestern. An area of strength within this model standard is Kane County’s early adoption of best practices, including Health Impact Assessment (HIA), strengthening local food systems, and tobacco policies. Kane County serves as a model for other communities interested in implementing these best practices. Model Standard 10.2, Linkage with Institutions of Higher Learning and Research, examines the extent to which the LPHS engages in relationships with universities and other research institutions to collaborate and share data and best practices. Model Standard 10.2 received a moderate score. Participants reported that the local universities are great partners that have established relationships with many LPHS organizations. A particular strength is this model standard is the contribution of interns from these universities. Facilitating internship opportunities is a good example of a mutually beneficial relationship between universities and other LPHS partners, because the students benefit from real-world experience while building LPHS capacity to deliver public health services. While there is currently limited capacity to partner with universities on research due to a lack of funding, the LPHS is building the infrastructure to facilitate future collaborative research through the formation of strong partnerships.


Model Standard 10.3, Capacity to Initiate or Participate in Research, received a significant overall score. Funding was identified as the key barrier limiting more robust research activity in the Kane County LPHS, but the LPHS is interested in continuing to pursue research opportunities and strengthen its capacity in this area. Strengths

• Kane County has been recognized as a national model for early adoption of evidence-based practice.

• Kane County Health Department has completed a Health Impact Assessment (HIA) and now has the capacity and expertise to conduct future HIAs if funding is available.

• Strong partnerships exist between local universities and other LPHS organizations. • Universities facilitate internship programs that boost organizational capacity of LPHS agencies

and help to train the future public health workforce.

Weaknesses

• Capacity for pilot testing new interventions is limited due to insufficient infrastructure, funding and expertise.

• Limited capacity and infrastructure for research due to lack of funding. Opportunities for Short Term Improvement

• Continue to stay abreast of best practices and implement innovative interventions when

possible.


• Leverage arrival of Northwestern University hospital as an opportunity to build research infrastructure and capacity in the Kane County LPHS.

• As research capacity increases, develop a research agenda outlining priority areas to study. • Continue to seek funding and opportunities to build LPHS research capacity.


Conclusion: Key Findings from the Kane County Local Public Health System Assessment Kane County’s first Local Public Health System Assessment revealed a number of key areas of excellence for the public health system, including strong health hazard surveillance and emergency preparedness, commitment to quality improvement and best practice, robust partnerships, and strong public support for policies that support community health. Areas for improvement identified through the assessment cut across three major categories, relating to effective communication of data, addressing the needs of vulnerable populations, and strengthening public health system infrastructure. The Kane County local public health system has strong data collection systems in place for surveillance and monitoring of health status, but this information needs to be translated into a format that is easily understandable and actionable for lay audiences so it can be effectively shared with the public. Health surveillance can also be strengthened through collecting and monitoring mental health data, given the growing concerns about this issue both locally and nationally. While LPHS agencies do a good job of collecting and sharing data, the LPHS can improve performance by strengthening efforts to collect system-level data that LPHS partners can all contribute to and collectively use for system-wide improvement. For example, partners do well at evaluating their services on an agency level, particularly for personal health care services, but LPHSA participants reported little collection of evaluation data on population health services, and very little sharing of evaluation data among system partners. Greater transparency of evaluation data and greater emphasis on evaluating population-based public health services will help to inform strategies to advance performance across the public health system and improve the health and wellbeing of Kane County residents. Discussions throughout the Local Public Health System Assessment also revealed areas for improvement related to serving growing vulnerable populations in Kane County, including immigrant and refugee groups, individuals with disabilities, low-income families, youth, homeless individuals, and individuals with mental health or substance abuse issues. The LPHS needs to better understand how to serve these vulnerable populations effectively. A specific area identified for improvement is public health messaging. While the LPHS excels in the area of risk communication with the public, the system has room for growth in informing and educating the public about non-emergency health issues, with particularly need for improvement in targeting communication to vulnerable populations. Much of the health messaging to the public is disseminated through web-based media, so individuals lacking access to internet are likely not sufficiently reached. Low health literacy is also a concern for ensuring that health messaging is effective in regards to informing and educating the public. A specific population that is underserved by the LPHS in this area is low income families. While LPHSA participants reported that system partners disseminate a lot of health information to this population, these efforts have largely been unsuccessful at linking families to needed resources and fostering behavior change and health improvement. This underscores the importance of understanding the needs of vulnerable populations so these needs can be appropriately addressed. The LPHSA also


revealed a larger concern that there is growing depth and volume of needs among vulnerable populations that service providers do not have the capacity or resources to meet. Individuals with mental health and substance abuse issues are particularly underserved by Kane County service providers, largely due to a lack of resources available to meet increasing demands. The assessment also identified some infrastructure improvement opportunities to strengthen overall system capacity and functioning. While partners across the LPHS conduct agency-level workforce assessments to identify gaps and training needs, there is a need for these agencies to come together to conduct a comprehensive, collaborative LPHS workforce assessment, which will provide a holistic picture of workforce capacity and needs. Strengthening workforce capacity also necessitates working to secure more funding across the LPHS, with a particular emphasis on sustainability, as many services and programs are heavily reliant on grants, making them inconsistent and unsustainable over the long term. Research is also an area where LPHS capacity is currently low, highlighting the need to build a research infrastructure in the area so the Kane County LPHS can not only be an early adopter of best practices, but can also contribute to the public health evidence base and drive public health innovation. Improvements in the areas discussed above will help the Kane County LPHS enhance its collective performance and effectiveness as a system to better serve the community and to ensure greater health and quality of life for all Kane County residents. The strengths that surfaced throughout the assessment, including robust inter-agency relationships, established collaborative efforts, and commitment to quality and best practice, can be leveraged to help partners across the LPHS come together to collectively advance system-wide improvements.


Appendices Appendix 1: List of Participating Organizations

Constituency Represented Organization Businesses • Walgreens

• McCloud Pest Services Coalitions • Activate Elgin

• Elgin Hispanic Network • Healthy Places Coalition

Colleges and Universities • University of Illinois Extension • Northern Illinois University • Benedictine University • Aurora University School of

Nursing Community-Based Organizations and Non Profits

• Northern Illinois Food Bank • EPEL • AIM-CIL • Lazarus House • LIC/CFC/One Day Network • AID • Senior Services • TriCity Family Services • Kane County Medical Society • INC Board, NFP

Hospitals, Health Systems and Clinics • Presence St. Joseph Hospital • Presence Mercy Medical Center • Advocate Sherman Hospital • Greater Elgin Family Care Center • Northwestern Medicine Delnor

Hospital • Rush-Copley Medical Center • VNA Healthcare • Aunt Martha’s

Local Health Department • Kane County Health Department Local Government • City of Elgin

• Kane County Human Resources • Kane County Office of Emergency

Management


• St. Charles Park District • City of Montgomery • Regional Office of Education • Gail Borden Library • Regional Transit Authority • East Aurora High School District

131 • Geneva Police Department • Sugar Grove Police Department • City of Batavia • Elgin City Council • Kane County Department of

Transportation • South Elgin Park District • City of Aurora • CMAP

State Government • Illinois Department of Public Health


Appendix 2: Essential Public Health Service Scoring Charts

EPHS 1. Monitor Health Status To Identify Community Health Problems Model Standard Scores

1.1 Population-Based Community Health Assessment (CHA) SIGNIFICANT 67 The local public health system (LPHS) develops a community health profile (CHP) using data from a detailed community health assessment (CHA) to give an overall look at the community’s health. The CHA includes information on health status, quality of life, risk factors, social determinants of health, and strengths of the community at least every 3 years. Data included in the community health profile are accurate, reliable, and interpreted according to the evidence base for public health practice. CHP data and information are displayed and updated according to the needs of the community.

With a CHA, a community receives an in-depth picture or understanding of the health of the community. From the CHA and CHP, the community can identify the most vulnerable populations and related health inequities, prioritize health issues, identify best practices to address health issues and put resources where they are most needed. The CHP also tracks the health of a community over time and compares local measures to other local, state, and national benchmarks.

1.1.1 Community Health Assessment 75 1.1.2 Continuously update CHA with current information 75 1.1.3 Community-wide use of community health assessment or CHP data 50 1.2 Current Technology to Manage and Communicate Population Health Data SIGNIFICANT 67 The local public health system (LPHS) provides the public with a clear picture of the current health of the community. Health problems are looked at over time and trends related to age, gender, race, ethnicity, and geographic distribution are examined. Data are shown in clear ways, including graphs, charts, and maps while the confidential health information of individuals is protected. Software tools are used to understand where health problems occur, allowing the community to plan efforts to lessen the problems and to target resources where they are most needed. The Community Health Profile (CHP) is available in both hard copy and online formats, and is regularly updated. Links to other sources of information are provided on websites.

1.2.1 Best available technology and methods to display data 50 1.2.2 Analyze health data to see where health problems exist 75 1.2.3 Use computer software to create chart, graphs, and maps to display complex data 75 1.3 Maintenance of Population Health Registries SIGNIFICANT 75


The local public health system (LPHS) collects data on health-related events for use in population health registries. These registries allow more understanding of major health concerns, such as birth defects and cancer, and tracking of some healthcare delivery services, such as vaccination records. Registries also allow the LPHS to give timely information to at-risk persons. The LPHS assures accurate and timely reporting of all the information needed for health registries. Population health registry data are collected by the LPHS according to standards, so that they can be compared with other data from private, local, state, regional, and national sources. With many partners working together to contribute complete data, population registries provide information for policy decisions, program implementation, and population research.

1.3.1 Collect timely data consistent with current standards on specific health concerns 75 1.3.2 Use information from population health registries in CHAs 75


EPHS 2. Diagnose and Investigate Health Problems and Health Hazards Model Standard Scores

2.1 Identification and Surveillance of Health Threats SIGNIFICANT 75 The local public health system (LPHS) conducts surveillance to watch for outbreaks of disease, disasters and emergencies (both natural and manmade), and other emerging threats to public health. Surveillance data includes information on reportable diseases and potential disasters, emergencies or emerging threats. The LPHS uses surveillance data to notice changes or patterns right away, determine the factors that influence these patterns, investigate the potential dangers, and find ways to lessen the impact on public health. The best available science and technologies are used to understand the problems, determine the most appropriate solutions, and prepare for and respond to identified public health threats. To ensure the most effective and efficient surveillance, the LPHS connects it surveillance systems with state and national systems. To provide a complete monitoring of health events, all parts of the system work together to collect data and report findings.

2.1.1 Comprehensive surveillance system to identify, monitor and share information 75 2.1.2 Provide and collect information on reportable disease and potential disasters and threats 75 2.1.3 Best available resources to support surveillance systems and activities 75 2.2 Investigation and Response to Public Health Threats and Emergencies OPTIMAL 100 The local public health system (LPHS) stays ready to handle possible threats to the public health. As a threat develops – such as an outbreak of a communicable disease, a natural disaster, or a chemical, radiological, nuclear, explosive, or other environmental event – a team of LPHS professionals works closely together to collect and understand related data. Many partners support the response with communication networks already in place among health related organizations, public safety, rapid response teams, the media, and the public. In a public health emergency, a jurisdictional Emergency Response Coordinator leads LPHS partners in the local investigation and response. The response to an emergent event is in accordance with current emergency operations coordination guidelines.

2.2.1 Maintain instructions on how to handle communicable disease outbreaks 100 2.2.2 Written protocols for investigation of public health threats 100 2.2.3 Designated emergency response coordinator 100 2.2.4 Rapid response of personnel in emergency/ disasters 100 2.2.5 Identification of technical expertise 100 2.2.6 Evaluation of public health emergency response 100 2.3 Laboratory Support for Investigation of Health Threats SIGNIFICANT 69 The local public health system (LPHS) has the ability to produce timely and accurate laboratory results for public health concerns. Whether a laboratory is public or private, the LPHS sees that the correct testing is done and that the results are made available on time. Any laboratory used by public health meets all licensing and credentialing standards.

2.3.1 Ready access to laboratories for routine diagnostic and surveillance needs 50 2.3.2 Ready access to laboratories for public health threats, hazards, and emergencies 25 2.3.3 Licenses and/or credentialed laboratories 100 2.3.4 Written protocols for laboratories for handling samples 100


EPHS 3. Inform, Educate and Empower People about Health Issues Model Standard Scores

3.1 Health Education and Promotion SIGNIFICANT 67 The local public health system (LPHS) designs and puts in place health promotion and health education activities to enable and support efforts to exert control over the determinants of health and to create environments that support health. These promotional and educational activities are coordinated throughout the LPHS to address risk and protective factors at the individual, interpersonal, community, and societal levels. The LPHS includes the community in identifying needs, setting priorities and planning health promotional and educational activities. The LPHS plans for different reading abilities, language skills, and access to materials.

3.1.1 Provision of community health information 75 3.1.2 Health education and/or health promotion activities 75 3.1.3 Collaboration on health communication plans 50 3.2 Health Communication SIGNIFICANT 58 The local public health system (LPHS) uses health communication strategies to contribute to healthy living and healthy communities, including: increasing awareness of risks to health; ways to reduce health risk factors and increase health protective factors; promoting healthy behaviors; advocating organizational and community changes to support healthy living; increasing demand and support for health services; building a culture where health is valued; and creating support for health policies, programs and practices. Health communication uses a broad range of strategies, including print, radio, television, the internet, media campaigns, social marketing, entertainment education, and interactive media. The LPHS reaches out to the community through efforts ranging from one-on-one conversations to small group communication, to communications within organizations and the community, to mass media approaches. The LPHS works with many groups to understand the best ways to present health messages in each community setting and to find ways to cover the costs.

3.2.1 Development of health communication plans 50 3.2.2 Relationships with media 75 3.2.3 Designation of public information officers 50 3.3 Risk Communication OPTIMAL 100 The local public health system (LPHS) uses health risk communications strategies to allow individuals, groups and organizations, or an entire community to make optimal decisions about their health and well-being in emergency events. The LPHS recognizes a designated Public Information Officer for emergency public information and warning. The LPHS organizations work together to identify potential risks (crisis or emergency) that may affect the community and develop plans to effectively and efficiently communicate information about these risks. The plans include pre-event, event, and post-event communication strategies for different types of emergencies.

3.3.1 Emergency communication plans 100 3.3.2 Resources for rapid communications response 100 3.3.3 Risk communication training 100


EPHS 4. Mobilize Community Partnerships to Identify and Solve Health Problems

Model Standard Scores 4.1 Constituency Development OPTIMAL 81 The local public health system (LPHS) actively identifies and involves community partners -- the individuals and organizations (constituents) with opportunities to contribute to the health of communities. These stakeholders may include health; transportation, housing, environmental, and non-health related groups, as well as community members. The LPHS manages the process of establishing collaborative relationships among these and other potential partners. Groups within the LPHS communicate well with one another, resulting in a coordinated, effective approach to public health so that the benefits of public health are understood and shared throughout the community.

4.1.1 Directory of organizations that comprise the LPHS 100 4.1.2 Identification of key constituents and stakeholders 75 4.1.3 Participation of constituents in improving community health 75 4.1.4 Communications strategies to build awareness of public health 75 4.2 Community Partnerships SIGNIFICANT 67 The local public health system (LPHS) encourages individuals and groups to work together so that community health may be improved. Public, private, and voluntary groups – through many different levels of information sharing, activity coordination, resource sharing, and in-depth collaborations – strategically align their interests to achieve a common purpose. By sharing responsibilities, resources, and rewards, community partnerships allow each member to share its expertise with others and strengthen the LPHS as a whole. A community group follows a collaborative, dynamic, and inclusive approach to community health improvement; it may exist as a formal partnership, such as a community health planning council, or as a less formal community group.

4.2.1 Partnerships for public health improvement activities 100 4.2.2 Community health improvement committee 50 4.2.3 Review of community partnerships and strategic alliances 50


EPHS 5. Develop Policies and Plans that Support Individual and Community Health Efforts

Model Standard Scores 5.1 Governmental Presence at the Local Level SIGNIFICANT 58 The local public health system (LPHS) includes a governmental public health entity dedicated to the public health. The LPHS works with the community to make sure a strong local health department (or other governmental public health entity) exists and that it is doing its part in providing essential public health services. The governmental public health entity can be a regional health agency with more than one local area under its jurisdiction. The local health department (or other governmental public health entity) is accredited through the national voluntary accreditation program.

5.1.1 Governmental local public health presence 75 5.1.2 Local health department accreditation 50 5.1.3 Resources for the local health department 50 5.2 Public Health Policy Development SIGNIFICANT 67 The local public health system (LPHS) develops policies that will prevent, protect or promote the public health. Public health problems, possible solutions, and community values are used to inform the policies and any proposed actions, which may include new laws or changes to existing laws. Additionally, current or proposed policies that have the potential to affect the public health are carefully reviewed for consistency with public health policy through health impact assessments. The LPHS and its ability to make informed decisions are strengthened by community member input. The LPHS, together with the community, works to identify gaps in current policies and needs for new policies to improve the public health. The LPHS educates the community about policies to improve the public health and serves as a resource to elected officials who establish and maintain public health policies.

5.2.1 Contribution to development of public health policies 75 5.2.2 Alert policymakers/public of public health impacts from policies 50 5.2.3 Review of public health policies 75 5.3 Community Health Improvement Process and Strategic Planning SIGNIFICANT 58 The local public health system (LPHS) seeks to improve community health by looking at it from many sides, such as environmental health, healthcare services, business, economic, housing, land use, health equity, and other concerns that impact the public health. The LPHS leads a community-wide effort to improve community health by gathering information on health problems, identifying the community’s strengths and weaknesses, setting goals, and increasing overall awareness of and interest in improving the health of the community. This community health improvement process provides ways to develop a community-owned plan that will lead to a healthier community. With the community health improvement effort in mind, each organization in the LPHS makes an effort to include strategies related to community health improvement goals in their own strategic plans.

5.3.1 Community health improvement process 75 5.3.2 Strategies to address community health objectives 50 5.3.3 Organizational strategic planning alignment with community health improvement plan 50 5.4 Plan for Public Health Emergencies SIGNIFICANT 75


The local public health system (LPHS) adopts an emergency preparedness and response plan which describes what each organization in the LPHS should be ready to do in a public health emergency. The plan describes community interventions necessary to prevent, monitor, and manage all types of emergencies, including both natural and intentional disasters. The plan also looks at challenges of possible events, such as nuclear, biological, or terrorist events. Practicing for possible events takes place through regular exercises or drills. A task force sees that the necessary organizations and resources are included in the planning and practicing for all types of emergencies.

5.4.1 Community task force or coalition for emergency preparedness and response plans 75 5.4.2 Emergency preparedness and response plan 75 5.4.3 Review and revision of the emergency preparedness and response plan 75


EPHS 6. Enforce Laws and Regulations that Protect Health and Ensure Safety

Model Standard Scores 6.1 Review and Evaluation of Laws, Regulations and Ordinances SIGNIFICANT 63 The local public health system (LPHS) reviews existing laws, regulations, and ordinances related to public health, including laws that prevent health problems, promote, or protect public health. The LPHS looks at federal, state, and local laws to understand the authority provided to the LPHS and the potential impact of laws, regulations, and ordinances on the health of the community. The LPHS also looks at any challenges involved in complying with laws, regulations, or ordinances, whether community members have any opinions or concerns, and whether any laws, regulations, or ordinances need to be updated.

6.1.1 Provision of community health information 75 6.1.2 Knowledge of laws, regulations, and ordinances 50 6.1.3 Review of laws, regulations and ordinances 25 6.1.4 Access to legal counsel 100 6.2 Involvement in the Improvement of Laws, Regulations, and Ordinances SIGNIFICANT 58 The local public health system (LPHS) works to change existing laws, regulations, or ordinances – or to create new ones – when they have determined that changes or additions would better prevent, protect or promote public health. To advocate for public health, the LPHS helps to draft the new or revised legislation, regulations, or ordinances, takes part in public hearings, and talks with lawmakers and regulatory officials.

6.2.1 Identification of public health issues not addressed through existing laws 50 6.2.2 Development or modification of laws or public health issues 50 6.2.3 Technical assistance for drafting proposed legislation, regulations, or ordinances 75 6.3 Enforcement of Laws, Regulations, and Ordinances MODERATE 35 The local public health system (LPHS) sees that public health laws, regulations, and ordinances are followed. The LPHS knows which governmental agency or other organization has the authority to enforce any given public health related requirement within its community, supports all organizations tasked with enforcement responsibilities, and assures that the enforcement is conducted within the law. The LPHS has sufficient authority to respond in an emergency event; and makes sure that individuals and organizations understand the requirements of relevant laws, regulation, and ordinances. The LPHS communicates the reasons for legislation and the importance of compliance.

6.3.1 Authority to enforce laws, regulations, and ordinances 75 6.3.2 Public health emergency powers 50 6.3.3 Enforcement in accordance with applicable laws, regulations, and ordinances 75 6.3.4 Provision of information about compliance 50 6.3.5 Assessment of compliance 25


EPHS 7. Link People to Needed Personal Health Services and Assure the Provision of Health Care When Otherwise Unavailable

Model Standard Scores 7.1 Identification of Personal Health Service Needs of Populations SIGNIFICANT 69 The local public health system (LPHS) identifies the personal health service needs of the community and identifies the barriers to receiving these services, especially among particular groups that may have difficulty accessing personal health services. The LPHS has defined roles and responsibilities for the local health department (or other governmental public health entity) and other partners (e.g. hospitals, managed care providers, and other community health agencies) in relation to overcoming these barriers and providing services.

7.1.1 Identification of populations who experience barriers to care 50 7.1.2 Identification of personal health service needs of populations 75 7.1.3 Develop partnerships to respond to unmet needs of the community 50 7.1.4 Understand barriers to care 100 7.2 Assuring the Linkage of People to Personal Health Services SIGNIFICANT 69 The local public health system (LPHS) partners work together to meet the diverse needs of all populations. Partners see that persons are signed up for all benefits available to them and know where to refer people with unmet personal health service needs. The LPHS develops working relationships between public health, primary care, oral health, social services, and mental health systems as well as organizations that are not traditionally part of the personal health service system, such as housing, transportation, and grassroots organizations.

7.2.1 Link populations to needed personal health services 75 7.2.2 Assistance to vulnerable populations in accessing needed health services 75 7.2.3 Initiatives for enrolling eligible individuals in public benefit programs 75 7.2.4 Coordination of personal health and social service 50


EPHS 8. Assure a Competent Public Health and Personal Health Care Workforce Model Standard Scores

8.1 Workforce Assessment, Planning and Development MODERATE 42 The local public health system (LPHS) assesses the local public health workforce – all who contribute to providing essential public health services for the community. Workforce assessment looks at what knowledge, skills, and abilities the local public health workforce needs and the numbers and kinds of jobs the system should have to adequately prevent, protect and promote health in the community. The LPHS also looks at the training that the workforce needs to keep its knowledge, skills, and abilities up to date. After the workforce assessment determines the number and types of positions the local public health workforce should include, the LPHS identifies gaps and works on plans to fill the gaps.

8.1.1 Assessment of the LPHS workforce 50 8.1.2 Identification of shortfalls and/or gaps within the LPHS workforce 50 8.1.3 Dissemination of results of the workforce assessment/gap analysis 25 8.2 Public Health Workforce Standards OPTIMAL 100 The local public health system (LPHS) maintains standards to see that workforce members are qualified to do their jobs, with the certificates, licenses, and education that are required by law or in local, state, or federal guidance. Information about the knowledge, skills, and abilities that are needed to provide essential public health services are used in personnel systems, so that position descriptions, hiring, and performance evaluations of workers are based on public health competencies.

8.2.1 Awareness of guidelines and/or licensure/certification requirements 100 8.2.2 Written job standards and/or position descriptions 100 8.2.3 Performance evaluations 100 8.3 Life-Long Learning Through Continuing Education, Training, and Mentoring SIGNIFICANT 75 The local public health system (LPHS) encourages lifelong learning for the public health workforce. Both formal and informal opportunities in education and training are available to the workforce, including workshops, seminars, conferences, and online learning. Experienced staff persons are available to coach and advise newer employees. Interested workforce members have the chance to work with academic and research institutions, particularly those connected with schools of public health, public administration, and population health. As the academic community and the local public health workforce collaborate, the LPHS is strengthened. The LPHS trains its workforce to recognize and address the unique culture, language and health literacy of diverse consumers and communities and to respect all members of the public. The LPHS also educates its workforce about the many factors that can influence health, including interpersonal relationships, social surroundings, physical environment, and individual characteristics (such as economic status, genetics, behavioral risk factors, and health care).

8.3.1 Identification of education and training needs for workforce development 75 8.3.2 Opportunities for developing core public health competencies 75 8.3.3 Educational and training incentives 100 8.3.4 Collaboration between organizations and the LPHS for training and education 75 8.3.5 Education and training on cultural competency and social determinants of health 50 8.4 Public Health Leadership Development MODERATE 63 Leadership within the local public health system (LPHS) is demonstrated by organizations and individuals that


are committed to improving the health of the community. Leaders work to continually develop the local public health system, create a shared vision of community health, find ways to make the vision happen, and to make sure that public health services are delivered. Leadership may come from the health department, from other governmental agencies, nonprofits, the private sector, or from several partners. The LPHS encourages the development of leaders that represent different groups of people in the community and respect community values.

8.4.1 Development of leadership skills 75 8.4.2 Collaborative leadership 50 8.4.3 Leadership opportunities for individuals and/or organizations 75 8.4.4 Recruitment and retention of new and diverse leaders 50


EPHS 9. Evaluate Effectiveness, Accessibility, and Quality of Personal and Population-Based Health Services

Model Standard Scores 9.1 Evaluation of Population-Based Health Services SIGNIFICANT 69 The local public health system (LPHS) evaluates population based health services, which are aimed at disease prevention and health promotion for the entire community. Many different types of population-based health services are evaluated for their quality and effectiveness in targeting underlying risks. The LPHS uses nationally recognized resources to set goals for their work and identify best practices for specific types of preventive services (e.g. Healthy People 2020 or the Guide to Community Preventive Services). The LPHS uses data to evaluate whether population-based services are meeting the needs of the community and the satisfaction of those they are serving. Based on the evaluation, the LPHS may make changes and may reallocate resources to improve population-based health services.

9.1.1 Evaluation of population-based health services 50 9.1.2 Assessment of community satisfaction with population-based health services 75 9.1.3 Identification of gaps in the provision of population-based health services 75 9.1.4 Use of population-based health services evaluation 75 9.2 Evaluation of Personal Health Services OPTIMAL 80 The local public health system (LPHS) regularly evaluates the accessibility, quality, and effectiveness of personal health services. These services range from preventive care, such as mammograms or other preventive screenings or tests, to hospital care to care at the end of life. The LPHS sees that the personal health services in the area match the needs of the community, with available and effective care for all ages and groups of people. The LPHS works with communities to measure satisfaction with personal health services through multiple methods, including a survey that includes people who have received care and others who might have needed care or who may need care in the future. The LPHS uses findings from the evaluation to improve services and program delivery, using technological solutions such as electronic health records when indicated, and modifying organizational strategic plans as needed.

9.2.1 Personal health services evaluation 75 9.2.2 Evaluation of personal health services against established standards 100 9.2.3 Assessment of client satisfaction with personal health services 100 9.2.4 Information technology to assure quality of personal health services 50 9.2.5 Use of personal health services evaluation 75 9.3 Evaluation of the Local Public Health System OPTIMAL 88 The local public health system (LPHS) evaluates itself to see how well it is working as a whole. Representatives from all groups (public, private, and voluntary) that provide essential public health services gather to conduct a systems evaluation. Together, using guidelines (such as this tool) that describe a model LPHS, participants evaluate LPHS activities and identify areas of the LPHS that need improvement. The results of the evaluation are also used during a community health improvement process.

9.3.1 Identification of community organizations or entities that contribute to the EPHS 100 9.3.2 Periodic evaluation of LPHS 100


9.3.3 Evaluation of partnership within the LPHS 75 9.3.4 Use of evaluation to guide improvements to the LPHS 75


EPHS 10. Research for New Insights and Innovative Solutions to Health Problems Model Standard Scores

10.1 Fostering Innovation MODERATE 38 Local public health system (LPHS) organizations try new and creative ways to improve public health practice. In both academic and practice settings, such as universities and local health departments, new approaches are studied to see how well they work.

10.1.1 Encouragement of new solutions to health problems 25 10.1.2 Proposal of public health issues for inclusion in research agenda 25 10.1.3 Identification and monitoring of best practices 75 10.1.4 Encouragement of community participation in research 25 10.2 Linkage with Institutions of Higher Learning and/or Research MODERATE 42 The local public health system (LPHS) establishes relationships with colleges, universities, and other research organizations. The LPHS is strengthened by ongoing communication between academics and LPHS organizations. They freely share information and best practices, and setting up formal or informal arrangements to work together. The LPHS connects with other research organizations, such as federal and state agencies, associations, private research organizations, and research departments or divisions of business firms. The LPHS does community-based participatory research, including the community as full partners from selection of the topic of study to design to sharing of findings. The LPHS works with one or more colleges, universities, or other research organizations to co-sponsor continuing education programs.

10.2.1 Relationships with institutions of higher learning and/or research organizations 25 10.2.2 Partnerships to conduct research 25 10.2.3 Collaboration between the academic and practice communities 75 10.3 Capacity to Initiate or Participate in Research SIGNFICANT 56 The local public health system (LPHS) takes part in research to help improve the performance of the LPHS. This research includes the examination of how well LPHS members provide the Essential Public Health Services in the community (public health systems and services research) as well as studying what influences health care quality and service delivery in the community (health services research). The LPHS has access to researchers with the knowledge and skills to design and conduct health-related studies, supports their work with funding and data systems, and provides ways to share findings. Research capacity includes access to libraries and information technology, the ability to analyze complex data, and ways to share research findings with the community and use them to improve public health practice.

10.3.1 Collaboration with researchers 75 10.3.2 Access to resources to facilitate research 25 10.3.3 Dissemination of research findings 50 10.3.4 Evaluation of research activities 75


Appendix 3: Kane County Health Department Contribution to Local Public Health System Performance In addition to measuring overall system performance, the LPHSA assesses the contribution of the local public health agency to the total system effort for each essential public health service. Participants indicated the contribution of the Kane County Health Department using the numeric voting scale below: • Agency contribution of 0 % • Agency contribution of 1-25 % • Agency contribution of 26-50 % • Agency contribution of 51-75 % • Agency contribution of 76-100 % The agency contribution results are presented at the end of each EPHS section, following the model standard scores and summary of strengths, weaknesses, and opportunities for improvement. The agency contribution scores represent participant perceptions regarding how much of the activity related to the model standards is directly attributed to the Kane County Health Department. There is no right or wrong answer as some EPHS and Model Standards require more or less health department involvement than others depending on the system. These contribution scores do not represent an evaluation of either the Kane County Health Department or the performance of the local public health system.

Readers should only consider whether the agency is contributing an appropriate level of service and whether any change in that contribution would influence system performance. The agency contribution should not be treated as a stand-alone indicator, but should be taken into consideration with the measures of performance for each model standard.


Kane County Health Department Contribution ESPH 1 Monitor Health Status to Identify Community Health Problems Model Standard 1.1 Population-Based Community Health Assessment 76-100% Model Standard 1.2 Current Technology to Manage and Communicate Population Health Data 76-100% Model Standard 1.3 Maintaining Population Health Registries 26-50% EPHS 2 Diagnose and Investigate Health Problems and Health Hazards Model Standard 2.1 Identifying and Monitoring Health Threats 51-75% Model Standard 2.2 Investigating and Responding to Public Health Threats and Emergencies 51-75% Model Standard 2.3 Laboratory Support for Investigating Health Threats 26-50% EPHS 3 Inform, Educate, and Empower People about Health Issues Model Standard 3.1 Health Education and Promotion 51-75% Model Standard 3.2 Health Communication 51-75% Model Standard 3.3 Risk Communication 76-100% EPHS 4 Mobilize Community Partnerships to Identify and Solve Health Problems Model Standard 4.1 Constituency Development 76-100% Model Standard 4.2 Community Partnerships 76-100% EPHS 5 Develop Policies and Plans that Support Individual and Community Health Efforts Model Standard 5.1 Governmental Presence at the Local Level 51-75% Model Standard 5.2 Public Health Policy Development 26-50% Model Standard 5.3 Community Health Improvement Process and Strategic Planning 51-75% Model Standard 5.4 Planning for Public Health Emergencies 26-50% EPHS 6 Enforce Laws and Regulations that Protect Health and Ensure Safety Model Standard 6.1 Reviewing and Evaluating Laws, Regulations, and Ordinances 1-25% Model Standard 6.2 Involvement in Improving Laws, Regulations, and Ordinances 1-25% Model Standard 6.3 Enforcing Laws, Regulations, and Ordinances 1-25% EPHS 7 Link People to Needed Personal Health Services and Assure the Provision of Healthcare When Otherwise Unavailable Model Standard 7.1 Identifying Personal Health Service Needs of Populations 76-100% Model Standard 7.2 Ensuring People are Linked to Personal Health Services 26-50% EPHS 8 Assure a Competent Public Health and Personal Healthcare Workforce Model Standard 8.1 Workforce Assessment, Planning, and Development 51-75% Model Standard 8.2 Public Health Workforce Standards 76-100% Model Standard 8.3 Life-long Learning through Continuing Education, Training, and Mentoring 51-75% Model Standard 8.4 Public Health Leadership Development 51-75% EPHS 9 Evaluate Effectiveness, Accessibility, and Quality of Personal and Population-Based Health Services Model Standard 9.1 Evaluating Population-Based Health Services 51-75% Model Standard 9.2 Evaluating Personal Health Services 51-75% Model Standard 9.3 Evaluating the Local Public Health System 1-25% EPHS 10 Research for New Insights and Innovative Solutions to Health Problems Model Standard 10.1 Fostering Innovation 26-50% Model Standard 10.2 Linking with Institutions of Higher Learning and/or Research 26-50% Model Standard 10.3 Capacity to Initiate or Participate in Research 26-50%

Documents

Kane County MAPP Collaborative 2014 Local Public Health System Assessmentkanecounty.healthforecast.net/Local Public Health Syst… · · 2015-03-17Kane County Local Public Health