Lead States in Public Health Quality Improvement - Collaborations with Tribal Health

1. Lead States in Public Health Quality Improvement -Collaborations with Tribal Health NIHB Public Health Summit May 22nd, 2008 Sarah Gillen, MPH Lead States in Public Health Quality Improvement, a multi-state learning collaborative (MLC)

2. Presentation Objectives • Provide an overview of the Lead States in Public Health Quality Improvement (MLC) • Highlight assessment/QI efforts in three states (WA, WI, MN) and describe how these states are collaborating with tribal governments and health departments Lead States in Public Health Quality Improvement, a multi-state learning collaborative (MLC)

3. Project Purpose • Prepare states/locals for accreditation by strengthening assessment and accreditation capacity • Incorporate quality improvement practice into public health systems • Inform the national accreditation program • Promote collaborative learning across states and partners • Expand the knowledge base for the broader public health community Lead States in Public Health Quality Improvement, a multi-state learning collaborative (MLC)

4. Project Support • Funded by RWJF • Managed by NNPHI and PHLS • The National Network of Public Health Institutes (NNPHI) is a membership organization that fosters networking and collaboration amongst public health institutes and multi-sector partners. • The Public Health Leadership Society is an alumni organization of graduates from national, state and local public health leadership development programs. • Collaboration with several national partners Lead States in Public Health Quality Improvement, a multi-state learning collaborative (MLC)

5. Project Overview • MLC 1 (5 states) • Focused on enhancing state based accreditation and assessment programs • Informed the Exploring Accreditation • MLC 2 (10 states) • Added quality improvement in the context of accreditation • Lead States in Public Health Quality Improvement, MLC 3 (16 states) • 3 years ($150K/year) • Preparation for accreditation • Inform the Public Health Accreditation Board • Conduct quality improvement projects via mini-collaboratives (IHI breakthrough series model) Lead States in Public Health Quality Improvement, a multi-state learning collaborative (MLC)

6. Participating States Lead States in Public Health Quality Improvement, a multi-state learning collaborative (MLC)

7. Washington • Program is “accreditation-like” - review against standards • Public Health Improvement Plan (PHIP) • Partnership effort involving 7 organizations • Legislative mandate to create improvement plan every two years • “The PHIP Partnership helps us set and accomplish goals that none of us could do alone.” • Starting in 1993, PHIP mandated standards and measures for the public health system (local and state) • Standards cover 5 areas Lead States in Public Health Quality Improvement, a multi-state learning collaborative (MLC)

8. Washington • Collaboration with tribes - American Indian Health Commission (AIHC) • Help the PHIP to develop the 3 legislatively mandated performance measures specific to communicable disease and chronic disease.  • Serve on the following committees: • Key Health Indicators Committee • Performance Management Committee • Workforce Development Committee • Public Health Information Technology Committee • Co-implement strategies based on public health systems that provide core government services.  • Will lead a policy discussion to determine how to include AIHC in the standards assessment process. Lead States in Public Health Quality Improvement, a multi-state learning collaborative (MLC)

9. Wisconsin • Certification program for local public health agencies mandated since 1993 • Program was refined in 2003-2004 and revised program was launched in 2005 • Process • 13 Sections - Explores the structure of health departments and boards of health and Wisconsin’s 12 Essential Public Health Services (EPHS) • Minimum standards must be met • Certification is awarded via 3 tiers • All LHDs are reviewed once every 5 years Lead States in Public Health Quality Improvement, a multi-state learning collaborative (MLC)

10. Wisconsin • Collaboration with tribes • The Wisconsin Division of Public Health has a formal consultation policy with all Wisconsin tribes. • The Division and tribes are exploring the identification of a tribal health department certification – similar to the process for LHDs – however separate • Focus on essential services, performance standards and examples in other states (ND) • Working with a few tribes on an inventory of services and communicable disease control and communication with local health departments.  • WI plans to host to meetings with tribes in years 2 and 3 of the project to discuss where the certification efforts intersect Lead States in Public Health Quality Improvement, a multi-state learning collaborative (MLC)

11. Minnesota • 2001 - State-local workgroup formed to create a strategic plan for strengthening the statewide PH infrastructure • 2004-2005 - Standards were developed and pilot tested • 2006 – Standards revised and accountability review process was finalized • Process covers six core areas • Added quality improvement collaborative • Partnership between MDOH, UMN-SPH, LPHA Lead States in Public Health Quality Improvement, a multi-state learning collaborative (MLC)

12. Elements of MN’s Assessment & QI Process Lead States in Public Health Quality Improvement, a multi-state learning collaborative (MLC)

13. Minnesota • Collaboration with Tribes • Tribes do not fall under the umbrella of the Local Public Health Act – thus they do not receive state/local funding • Representative from Fond du Lac Tribe serves on steering committee (brings QI expertise to the committee) • Tribes are invited to participate in RFP process, trainings and showcase Lead States in Public Health Quality Improvement, a multi-state learning collaborative (MLC)

14. Resources & Contact Information • Resources • Project description and links to state efforts available at: www.nnphi.org/mlc • Electronic file library with accreditation and QI documents www.nnphi.org/ecatalog • Contact Information • For questions – contact Liz Tagle at etagle@nnphi.org or 504-301-9847 Lead States in Public Health Quality Improvement, a multi-state learning collaborative (MLC)