By Lindsay Tiffany, Communications Specialist, NACCHO
NACCHO is pleased to recognize Joan Ellison, RN, MPH, as this year’s recipient of the Maurice “Mo” Mullet Lifetime of Service Award. This award honors current or former local health officials for noteworthy service to NACCHO that has reflected the commitment, vigor, and leadership exemplified by Mo’s distinguished career.
Ellison’s career in local public health spanned more than 43 years, including 34 years as Public Health Director of the Livingston County (NY) Department of Health. Throughout that time, she devoted herself to improving the health of the community and to working with colleagues at state and national levels to better the field of public health. Ellison exemplified continuous quality improvement, as evidenced by her work on APEX-PH, Mobilizing for Action through Planning and Partnerships (MAPP), and public health department accreditation.
NACCHO: How did you get involved with NACCHO?
Ellison: I joined NACCHO in 1990 when I read that NACCHO was accepting applications from LHDs to become demonstration sites for APEX-PH. I applied and had no idea what I committed the department to; however, we were accepted as a demonstration site. NACCHO broadened our public health world. Exposure to the broader scope of public health is difficult in a small health department; NACCHO brings the national level home. After APEX-PH, I volunteered to serve on the MAPP Committee and went on to serve on several other NACCHO committees, the NACCHO Board of Directors, and I chaired the Profile committee. It has been very rewarding and exciting for me to work with NACCHO and NACCHO staff and my experience has brought depth to the department.
NACCHO: In your nomination, your colleague noted that you and your staff wore buttons with the words “That’s the way we’ve always done it” crossed out with a large red “x.” How important was innovation for you in your career in local public health?
Ellison: Innovation and creativity are extremely important in public health. We are a small-to-medium county health department in upstate New York. Exposure to what larger counties were doing and being on the cutting edge of public health was elusive to us. Thinking outside of the box was critical. Innovation was the turning point for us because it allowed us to implement APEX-PH, starting with an internal assessment. We were then able to identify priorities. We simply weren’t allowed to say “That’s how we’ve always done it.” We needed new ways to address public health concern and to improve our internal structure.
NACCHO: From advocating for funding for LHD bioterrorism efforts to battling the West Nile Virus, you’ve faced all kinds of challenges. What has been the most challenging issue you faced and how did you deal with it?
Ellison: There were a number of challenges. More than any issue, funding was and remains the number one challenge for local health departments. It was challenging to think of different ways to explain what public health is and how it benefits the community. It’s not something you can explain in a few words and expect that they will immediately understand. There are so many other priorities in the community that it is overwhelming to fight for public health funding. We found that we really had to educate people in a grassroots way–from community members and local policymakers to state and federal legislators.
Unfortunately, to this day public health funding continues to get cut. This comes at a time when you read the public health journals and see that more and more problems are being identified as public health issues. In my opinion, public health is the health of public. People are not putting funding where it needs to be to address such a wide range of issues. Funding has been and will be a challenge and we’ll need to continue to work on it forever. We’re really past the phrase “Do more with less.” We’ve already done that. If you don’t have resources to be able to provide the infrastructure that is needed, there is really no other avenue for addressing these critical public health issues.
NACCHO: You were a big champion for the Mobilizing Action through Planning and Partnerships (MAPP) process. How did MAPP strengthen your LHD?
Ellison: The department has implemented the MAPP process several times. It was fantastic because it put the role of the LHD in the community into focus. Through the MAPP process, we became identified by the community as change agent, as a leader, and as a facilitator. It made us a partner in the community. Our partners were also facing financial challenges, similar to us. MAPP encouraged all of us as partners to address the health of community through the community public health system and that was advantageous for everyone. I think community agencies sometimes struggle with turf—“that’s my program” or “that’s not our issue.” MAPP relinquishes that hold and brings partners together.
NACCHO: What are you most proud of in your long tenure in local public health?
Ellison: Two things come to mind. The first is initiating a local law to ban smoking in public places in our county. In the mid 1990’s when we began working on the smoking ban, two counties in New York state already had bans in place. Our county was the third and, more notably, we were the first small county and our local law was stronger than any in the state. We put public health first and our community took action. The hearing for the ban was largest public hearing that our county board had ever had. While there were opponents and proponents, the majority of those that came out were in favor of it.
Recently, I couldn’t be more proud of our department for achieving accreditation. We were first of 11 health departments recognized. It was many, many years of excellence that prepared us for accreditation. Through continuous quality improvement efforts, the department was able to meet the PHAB Standards and Measures. To realize that we met national standards is awesome. It takes a long time for public health to be able to show its successes. The things we address—be it promoting the use of car seats or diet and exercise interventions or reducing chronic disease mortality—it takes years to see the results and it’s rarely one intervention that makes a difference. The staff worked tirelessly through various strategies and interventions with partner agencies to improve the health of the community. Through their efforts, Livingston County has been named the healthiest county in New York State for two years! Staff deserve the credit for accreditation.
NACCHO: What advice would you give to young professionals just starting their careers in local health departments?
Ellison: First, they need to think of public health as the health of the public. Oftentimes when you talk to community partners about a problem, they think it’s the LHD’s problem. By framing public health as the health of the public, it makes community partners see that it’s not just the LHD’s responsibility, but is the work of entire public health system. Partnering with other organizations in your community is critical. Learn how to work with your community. Every community and agency is different. It’s important for public health leaders to understand the focus of programs and to develop community goal through a community health improvement plan.
Second, I would tell them that this is the best career you could have. It’s tireless work. You have to work long and hard but if you do, you will see changes. It’s incredibly rewarding.