WELCOME Transforming the Future of Public Health in Missouri

Special thanks to:

TFPH Steering Committee • Formed in 2014 • Representatives from:

• Missouri Public Health Association • Missouri Association of Local Public Health Agencies • Missouri Institute for Community Health • Missouri Department of Health and Senior Services • local public health agencies, academic institutions, and

private public health organizations

Initial Planning Phase • Funded by MoDHSS:

• Online survey of 360 Missouri stakeholders • Key informant interviews of:

• Governmental Public Health Practitioners • Policymakers, Elected Officials and Funders • Academic Partners

• Identified priority issues

Initial Planning Phase Results • Results confirmed Missouri’s Public Health System:

• lacks a systematic, coordinated approach in structure, form, scope, and funding

• has great variance in how local public health agencies in Missouri are governed, financed, and supported by their communities

• will be further weakened, threatening the delivery of public health programs and services to our residents if Missouri’s public health system continues to see funding cuts

Initial Planning Phase Results (continued) • Themes permeating Key Informant Interviews:

• Agreement that the governmental public health system in Missouri is fragmented

• Lack of coordination and leadership among: • various levels of governmental public health • policymakers • academia

• Evident barriers to effective and efficient public health practice

• The current public health system was primarily described as a system of silos which lacks resources and is unknown to the public

Initial Planning Phase Results (continued) • Results also reported themes of optimism from

respondents: • believe now is the time for public health system

transformation • broad interest in engaging in system transformation if

it is led well and taken seriously • believe the leadership of the process will be a key

component of its success

Funding Sought • Submitted to Missouri Foundation for Health

• Substantial amount of funding requested • Too many deliverables • The Foundation saw the value of the project – not

funded • Suggested that we break our proposal into phases

• Re-Submitted to Missouri Foundation for Health and Health Care Foundation of Greater Kansas City • Smaller proposal for initial phase one • Success!!

TFPH Phase One

Goals for Phase One based on results from the Initial Planning Phase:

1. To identify public health system stakeholders, leaders and vision

2. To align Missouri’s public health professional organizations

TFPH Phase One (continued) Goal 2 – Align Public Health Professional Organizations • Public Health Professional Organizations have met

twice: • Missouri Public Health Association • Missouri Institute of Community Health • Missouri Association of Local Public Health Agencies • Missouri Center for Public Health Excellence • Missouri Milk, Food and Environmental Health Association • Missouri Environmental Health Association

• The group agreed on the value of aligning their voices for unified advocacy on key public health issues.

TFPH Phase One (continued) Goal 2 – Align Public Health Professional Organizations

• Developed a vision statement: “United for public health.”

• Adopted a mission statement: ”Leading public health system alignment through collaboration, communication, workforce development and advocacy.”

• Committed to meet regularly to continue working toward alignment.

TFPH Phase One (continued) Goal 1

• Identify public health system stakeholders, leaders and vision.

• Discuss the process and structure for forming an Advisory Council that will develop the vision for action planning to move the initiative forward.

• In order to be successful, this must be a collaborative effort with everyone having a voice in developing the transformation approach.

Guiding Principles for Today and Beyond

• Inclusive: open process • Participatory: stay engaged and be ready to shift quickly • Opportunity for every voice to be heard • Look at viable solutions for challenges • No ideas are set in stone yet • Seeking consensus, collaboration and cooperation

• Think BIG!

Consensus Decision-Making 6 guiding principles for today and beyond: • Agreement Seeking: maximize agreement

• Collaborative: participants contribute to a shared proposal

• Cooperative: participants strive for best possible decision for the group and members, rather than self

• Egalitarian: participants have equal opportunity to present and amend proposals

• Inclusive: As many stakeholders as possible involved

• Participatory: actively solicit the input and participation

Slido.com Event: D195

Transformation Efforts in Other States • Why look at other states?

• identify best practices • review evidence-based work • learn from their experiences • generate new ideas for Missouri

• The Public Health National Center for Innovations sponsoring pieces of transformation process in 4 states (WA, OR, OH, KS)

• Texas’ transformation led by Department of Health and Human Services

Ohio Ohio Public Health Partnership • Adopt one definition of population health across all state programs • Validate methodology for determining the cost to local

health departments for delivery of foundational public health services

• Maximize the use of shared services through cross-jurisdictional sharing

• Explore pathways to PHAB accreditation for small LPHAs • Align hospital and state and local public health agency

assessments and improvement planning timelines and priorities

Washington Washington State Association of Local Public Health Associations • Define a limited set of core (foundational) public health

services that should be in every community • Adequate funding; estimated cost of providing core

services statewide; local funding mechanisms to fund specific priorities

• New multi-jurisdictional service delivery model to maximize efficiency and effectiveness and enhance capacity

• Set of principles to guide vision implementation

Kansas

Kansas Public Health System Groups • Conduct a capacity assessment of all 100 local public

health agencies • Engage stakeholders to identify foundational public

health services • Develop foundational public health services performance

measures • Form sub-committees to develop and implement

Foundational Public Health Services

Oregon Oregon Coalition of Local Health Officials, Inc. • House Bill 3100 (2015) established Public Health Modernization as the new model for public health • A system-wide assessment identified public health

programs are limited or minimal in over 1/3 of Oregon communities

• Adopt the foundational public health services as a roadmap for rebuilding and modernizing the public health system

• Critical first step investment of $15M of the $105M per year identified needed

Texas Texas Dept of Health and Human Services • Restructure statewide public health services to create an accountable, organized system public health system that is easier to navigate, • Promote a culture of shared responsibility for success

through teamwork, effective communication, and support of HHS staff

• Create clear lines of accountability for decision making • Use data to measure outcomes more clearly • Clearly define performance metrics

Commonalities • Focus on Foundational Public Health Services and

performance metrics • Seeking additional funding for public health • Committed to long-term transformational process;

invested time, money and energy into research and preparation before taking any action

• Defining and promoting public health for themselves, the general population and legislators

• Making changes based on the specific needs of their state • Embracing big ideas/big change, such as structure,

funding, accountability, culture, etc.

Differences • Prompted to pursue change by different catalysts

(funding, workforce, data, disease, isolation, etc.) • Grassroots vs. grasstops approach • Seeking a variety of state policy changes

Show Me State • Missouri has identified the public health system

challenges. Now we have many ideas to draw from and build upon as we begin to think about solutions.

• We should not limit our thinking to what has been done before.

• Missouri has many unique assets and challenges, but the TFPH is committed to this transformational process long-term.

What will make the TFPH coalition powerful?

If you were ten times bolder, what big idea would you recommend?

What topics/issues must be explored by TFPH to drive transformative change?

Which three are the most important?

Group A

What will make the TFPH coalition powerful?

Group B

What is needed to rebuild, modernize and fund a 21st century public health system in Missouri?

Group C

Communicating the Case for Change

Communication Strategies • Open, transparent, two-way communication • Effective outreach efforts • Input valued and integrated

Get Engaged in the Initiative • Sign up for weekly email updates

• Text HealthierMO to 345345 • www.HealthierMO.org

• Follow initiative progress at www.HealthierMO.org • Follow Facebook @HealthierMO – like, share and comment • Use #HealthierMO • Submit nominations for Advisory Council and

Communications Committee • Volunteer to help test new materials and messages • Share information with your audiences • Talk about #HealthierMO in your communities

Share Your Input • Comment or message us on Facebook • Contact Us form on our website

• Share your public health stories • Share photos of people working toward a #HealthierMO • Share ways you are advancing the initiative locally • Share your concerns, your hopes and potential solutions

Jaci McReynolds, Communications Coordinator jmcreynolds@healthiermo.org * (417) 839-3579

Reflection

• What could derail or delay this transformation

movement?

• What can mitigate the risk?

• What ways can you and other leaders be part of the

movement?

Summary • Created and agreed upon a plan for the formation of the

Advisory Council

• Identified some priority issues for the Advisory Council to address

• Committed to the success of the project and identified ways for everyone to stay involved

Success • Disciplined process (long-term and evidence-based)

• Inclusive (representative of diverse communities)

• Commitment to action (big steps already underway)

• Organized as a movement (grassroots)

• Transparent (give and take of information)

Transforming the Future of Public Health in Missouri

#HealthierMO

www.HealthierMO.org @HealthierMO