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Considerations for Shared Governance Structureswww.health.state.mn.us/sslc Minnesota Department of Health
Public Health in Minnesota
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“Humankind has not woven the web of life. WE are but one thread within it. Whatever we do to the web, we do to ourselves. All things are bound together. All things connect.”
Chief Seattle
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Today’s Agenda
•Minnesota Public Health Structure• Statutory Responsibilities• Challenges and Opportunities
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Definitions of Public Health
“Public health is what we, as a society, do to collectively assure the conditions in which people can be healthy.”
Institute of Medicine
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Definitions of Public Health
“Public health is the science and art of disease prevention, prolonging life, and promoting health and well-being through organized community effort.”
CEA Winslow (1877-1957)
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Public Health Impact
25 of the 30 years of life gained in the 20th century resulted from public health accomplishments!
19001903
19061909
19121915
19181921
19241927
19301933
19361939
19421945
19481951
19541957
19601963
19661969
19721975
19781981
19841987
19901993
199630
40
50
60
70
80
90
Life expectancy at birth, United States, 1900-1998
FemaleMale
Age
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Ten Greatest Public Health AchievementsUnited States, 1900-1999• Vaccinations•Motor vehicle safety• Safer workplaces• Control of infectious diseases• Fluoridation of drinking water• Safer and healthier
foods•Healthier mothers and babies• Family planning•Decline in deaths from heart disease and stroke• Recognition of tobacco use as health hazard
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Levels of Government
US Capitol Building Minnesota StateCapitol Building
Label
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Public Health and the Supreme Court
“The preservation of the public health is one of the duties devolving upon the state as a sovereign power, and cannot be successfully controverted or delegated. In fact, among all the objects to be secured by government laws, none is more important than the preservation of the public health.”Schulte v. Fitch, NW 717, 1925
Protecting the public’s health is so basic, and the consequences of not protecting the public’s health are so serious, that both the state and federal constitution contain provisions to ensure this protection.
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Minnesota Department of Health
Protecting, maintaining, and improving the health of all Minnesotans.
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Federally Recognized Tribes in Minnesota
■ AnishinaabeBois ForteFond du LacGrand PortageLeech LakeMille LacsRed LakeWhite Earth
■ DakotaLower SiouxPrairie IslandShakopee MdewakantonUpper Sioux
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Origins of County Public Health Nursing
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State Boards of Health (c. 1950)
1. Creation of the boards was encouraged
2. Purpose: • Assess health• Create policies to prevent
communicable diseases• Assure sanitary conditions
Boards of HealthBefore 1976
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Community Health Act (1976)
Community Health Services System (CHS System)• Community involvement• Local control• Integrated statewide system• Adequate population base / economies of scale• Funding, with multi-county incentive
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Purpose of CHS System
“’Community health services’ [denotes] activities designed to protect and promote the health of the general population within a community health service area by emphasizing the prevention of disease, injury, disability, and preventable death through the promotion of effective coordination and use of community resources, and by extending health services into the community.”
Minn. Stat. § 145A.02, subd. 6(Local Public Health Act)
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Considerations for Shared Governance Structureswww.health.state.mn.us/sslc Minnesota Department of Health
Minnesota’s State-Local Partnership
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State Community Health Services Advisory Committee (SCHSAC)
STATECOMMUNITYHEALTHSERVICESADVISORYCOMMITTEE
• Hallmark of Local Public Health Act• Advise Commissioner of
Health• Representatives from
each community health board• Work performed by
workgroups
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Local Public Health Act of 1987
•Minnesota Legislature further clarified roles and responsibilities of the state and local public health system• Replaced the Community Health Services Act with the Local Public Health Act, also known as Minnesota Statute § 145A• Focuses accountability for funding on set of statewide outcomes
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Local Public Health Act of 2014
• Again modified to clarify public health responsibilities and accountability• Eliminate unnecessary and obsolete language• Align statute with current public health practices• Require community health boards to engage in performance management
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Elected Official’s Public Health Responsibilities
• Policy development• Resource stewardship• Legal authorization• Partner engagement• Continuous improvement•Oversight
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Considerations for Shared Governance Structureswww.health.state.mn.us/sslc Minnesota Department of Health
Local Public Health Assessment and
Planning
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Minnesota Local Public Health Assessment and Planning Process
Implement Plans ■ Monitor Progress ■ Revise Plans as Needed
Quality Improvement
Planning Process
Community Health Improvement
Planning Process
Organizational Strategic Planning
Process
Organizational Self-Assessment
Community Health Assessment
Ten Most Important Community Health
IssuesDELI
VER
AB
LE
Three Standards Most in Need of ImprovementD
ELI
VER
AB
LE
QI Plan DELIVERABLE
DELIVERABLE
Strategic Plan
CHIPDELIVERABLE
Implement
Plan
Prioritize
Assess
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Areas of Public Health Responsibility
in Minnesota• Assure an adequate local public health infrastructure• Promote healthy communities and healthy behaviors• Prevent the spread of communicable disease• Protect against environmental health hazards• Prepare for and respond to emergencies• Assure health services
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Essential Public Health Services
In Minnesota, these services refer to activities that are conducted to accomplish the areas of public health responsibility.
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Examples: Assure an Adequate Local Public Health Infrastructure
• These planning meetings• Agency strategic planning process• Recruiting and retaining staff with appropriate expertise
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Examples: Promote Healthy Communities and Healthy Behaviors
• Statewide Health Improvement Program (SHIP)•Healthy Families America• Chronic disease management• Asthma programs
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Examples: Prevent the Spread of Communicable Disease
•H7N9 (avian influenza)• Pertussis reemergence•Norovirus• Enterovirus D68
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Examples: Protect Against Environmental Health Hazards
• Regional mold plan• Food, beverage, and lodging delegation• Radon identification and mitigation• Public health nuisance
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Examples: Prepare for and Respond
to Emergencies
• Community planning for flu centers and ILI local surveillance•Mass dispensing clinics• Vaccination promotion campaign
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Examples: Assure Health Services
•MN CHOICES• Family planning• Early Childhood Dental Network• Fluoride varnish•Mental health initiatives for children and adults
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Public Health Challenges & Opportunities
Challenge is a dragon with a gift in its mouth. Tame the dragon, and the gift is yours.
Noela Evans