Essential Service #6 :

Refresher: Why learn about Essential Services? Improve quality and performance. Achieve better outcomes – improved health,

less preventable death and disease. Be more efficient with time and money. Receive national accreditation.

Refresher: Why pursue accreditation?

Documents accountability

Encourages continuous Quality Improvement

Sets benchmarks on services

Leads to best practice sharing

Helps to identify gaps in performance

Essential Service #6: In “plain English”

Enforce public health laws and regulations.

(Or “When we enforce health regulations, are we up-to-date, technically competent, fair and effective?”)

What does ES #6 include?

Review, evaluation, and revision of legal authority, laws and regulations

Education about laws and regulations Advocacy for regulations needed to protect and

promote health Support of compliance efforts and enforcement

ES# 6: In the Assurance Core Function

Examples of ES #6

Communicable disease statute and regulations

Food protection laws, inspection processes Hospital/long term care statute & regulations Housing codes, e.g., Lead Poisoning

Prevention; Radon; septic systems Indiana Code Title 16-Health More examples?

How do we assess our performance?

Four Model Standards: Planning and Implementation State and Local Partnerships Performance Management/Quality

Improvement Public Health Capacity and Resources

ES#6 - Planning and Implementation

We should ask ourselves, do we: Review existing and proposed laws?

What is current scientific knowledge? Are there new Best Practices?

Solicit input on laws from stakeholders? Legislators Legal advisors General public Persons/entities in the regulated environment.

Planning and Implementation, cont

Do we: Review/update state laws to assure appropriate

emergency powers? [e.g., isolation & quarantine]

Support compliance among persons/entities in regulated environment? [e.g., food handlers]

Provide written guidelines related to new regulations? [e.g., swimming pool inspections; camp ground inspections; HPV education materials]

State and Local Partnerships

Do we: Offer technical assistance to local communities

on newly enacted laws and regulations?

Assist local health departments to develop local laws/ordinances?

Performance Management/Quality Improvement

Do we: Review whether PH laws are on target & meeting

the needs to keep the public healthy & safe? Make sure enforcement activities effective? Assure ongoing Quality Improvement by

managing the overall performance of enforcement activities?

Public Health Capacity and Resources

Do we: Commit adequate financial resources for the

enforcement of laws? Rely on PH system partners to focus their assets

on enforcement activities? Use workforce expertise to effectively review,

develop, and enforce public health laws? [e.g., changes in immunization laws; new sanitary systems]

How did we do?

Results by Model Standard

Keys to improvement: Competencies

Analytic/Assessment Skills Define a public health problem that needs a new

law or regulation Collect data to justify the need for new laws

Policy Development/Program Planning Skills Identify, interpret, implement PH laws,

regulations, policies Decide on appropriate course of action

Keys to Improvement: Competencies

Communication Skills Communicate new laws and regulations Solicit input from individuals, organizations Lead/participate in groups to address new laws Listen in an unbiased manner; respect points of

view of others; promote expression of diverse opinions, perspectives

Keys to Improvement: Competencies

Cultural Competency Skills Understand how laws and regulations may affect

various cultures [e.g., immunizations; disease registries; food preparation]

Understand forces contributing to cultural diversity, importance of a diverse PH workforce

Interact effectively with persons from diverse backgrounds

Keys to Improvement: Competencies

Basic Public Health Sciences Skills Understand how laws and regulations impact

determinants of health and illness* [e.g., access to care; genetic screening; setting poverty level]*Biologic, Behavioral, Environmental, Socio/Economic, Access to Care

Leadership and Systems Thinking Skills Use legal and political system to affect change

Keys to Improvement: Competencies

Financial Planning and Management Skills Develop and present budgets to implement

regulations Follow laws and manage programs within budget

constraints Monitor program performance in implementing

regulations

References CDC National Public Health Performance

Standards Program Website: http://www.cdc.gov/od/ocphp/nphpsp/EssentialPublicHealthServices.htm#es2

Council on Linkages Training Project Website: http://www.trainingfinder.org/competencies/list_ephs.htm#2

Indiana Public Health System Quality Improvement Report (2007).

Discussion:

What does your program do to implement Essential Service #6?