NACCHO launched its newly designed website to make its rich array of resources and information more accessible to its members, partners, and visitors in enhancing population health. The new site’s functionality will also allow NACCHO to drive member engagement, maximize retention rates, and increase organizational relevancy. Continue reading
Interview by Ian Goldstein, Web and New Media Specialist, NACCHO
NACCHO’s LHD of the Year Award recognizes and honors outstanding accomplishments of local health departments (LHDs) across the country for their innovation, creativity, and impact on communities. Whatcom County (WA) Health Department is the winner of NACCHO’s 2014 Local Health Department of the Year Award in the medium-sized jurisdiction category for its initiative to house and expand services for homeless veterans. The following is an excerpt from a recent podcast in which NACCHO interviewed Regina Delahunt, MS, REHS, Director, Whatcom County Health Department.
NACCHO: Tell us about your policy and why you wanted to apply for NACCHO’s LHD of the Year Award.
Delahunt: We applied because the award’s focus was on policy development. About five years ago, we made conscious decision in our health jurisdiction to focus on more upstream policy-level change, especially policies that affect the social determinants of health. We applied because we have had quite a bit of success with the policy-level change. We wanted to showcase one of our biggest successes and recognize all of our partners because we could not do this on our own. We also wanted to share our experience with other health jurisdictions so that maybe their road to policy development would be a little bit easier. Continue reading
Winifred M. Holland, MPH, MA, LMHC, Health Officer, Florida Department of Health in Clay County, has spent more than 30 years in public health. In this interview, Holland discusses her career path, the challenges of maintaining the fiscal viability of her LHD, and the rewards of working on teen pregnancy prevention programs.
- Please tell us about your professional background and how you got to where you are today.
I have been a public health professional for over 30 years. My initial degree is in secondary education but once I was exposed to public health, it became my passion. Continue reading
The following story was submitted to NACCHO’s Stories from the Field website by Robert Cohen from Maine Township (IL) Regional Medical Reserve Corp on July 3. NACCHO’s Stories from the Field website provides a means for local health departments (LHDs) to share their experiences and demonstrate the value of public health. Stories from the Field can be used to support advocacy, peer learning, and collaboration with state and federal partners. Share your story at http://nacchostories.org.
Throughout the country, there are hundreds of small, low-powered radio stations that provide information about an area’s attractions, special road conditions, fire hazards, and so much more. These little gems can be of significant use during public health emergencies or area disasters.
During public health and safety emergencies, a low-powered portable emergency advisory radio station can directly reach citizens via standard radio receivers. It can be a lifesaver, allowing the broadcast of critical instructions and information regarding disasters/evacuations, medical emergencies (hospital surge, points-of-distribution field information, quarantine isolation, decontamination), terrorist/shooter incidents, HAZMAT and traffic information, and critical public safety instructions. Low-powered broadcasts may be received on standard vehicle radios or portable radios over a three- to five-mile range (25–75 square miles). Systems today are so advanced that several can be linked together for greater coverage.
Low-powered AM radio stations can provide an additional tool during non-emergency times for broadcasting helpful public health information, developing community awareness for your programs, and also as a recruiting tool that does not have to be paid for each time it is utilized. The system we have can be run from a fixed location as we do most of the time or can be loaded into the back of a car and taken anywhere in our area and setup to broadcast pertinent information regarding a public health emergency or disaster related information. Portability also makes a low-powered radio station especially useful at large public gatherings for broadcasting key information, such as schedules, traffic, parking, safety, and critical instructions for patrons approaching or exiting.
Messaging can be controlled using flash drives […] and may also be uploaded via ethernet from a network or a laptop computer. If you need to “break in” to your messaging, you may do so live with a microphone. When you lose power in your area due to storm damage, you can still broadcast by connecting your unit to a generator.
Getting the word out to hundreds or thousands of residents on an ongoing basis can be a costly venture. Having your own low-powered AM radio station and some strategically placed signage telling people how to access your station can accomplish community outreach by continuously broadcasting your message with all of the pertinent information. We broadcast information regarding West Nile Virus, whenever there is a food recall in our area, storm-related information, flooding information, location of mass care or shelter facilities, and general community events information. Just think about an available 24/7 recruiting drive for your medical reserve corps or other programs. Look at what you might accomplish if thousands of people knew about a blood drive. Consider all of the information you could get out regarding point-of-distribution sites.
Since the inception of our station, we have increased volunteer enrollment in three of our programs. When flooding was a potential threat, those in prone areas were grateful for the extra warning we were able to give them. Our community events have been better attended as well. Most importantly, when we had to shut down our radio to change our antenna location, we got phone calls wondering what happened and why was our station off the air. This told us that our residents have embraced the system.
We found that instead of solely relying on public resources of newsprint and general radio, we are able to communicate specifically what we need to in order to keep our residents officially informed. By utilizing your own radio station, you are not limited to [whatever] time space a local television station may have to give you to get a condensed message out. Further, by having your own low-powered station, you can keep your message out there 24/7 for as long as needed, for mere pennies of electricity use.
Read more LHD stories from the field at http://nacchostories.org.
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.
Judy Monroe, MD, FAAFP, is the deputy director for state, tribal, local and territorial support efforts at CDC and director of the Office for State, Tribal, Local and Territorial Support (OSTLTS). In her role, Dr. Monroe provides critical leadership for supporting and revitalizing the public health system. Her efforts focus on establishing a systems approach that supports integration and collaboration among public health professionals and translating science to practice to increase the capacity and performance of public health agencies. The following is an excerpt from a recent podcast interview with Dr. Monroe.
NACCHO: How are you able to translate science into practice in order to increase the capacity and performance of governmental public health departments?
JM: Great question. We’ve actually used a logic model framework where you have to be aware of the science, accept it, adopt it, implement it, and then evaluate and sustain it. With each one of those steps, from awareness to adoption, we’ve got things—for example, CDC puts out Vital Signs every month, which talks about really timely topics using the best and latest science. We make sure that we’re using those to raise awareness of the latest science. We have some tools called “Did You Know?” that is a weekly publication that goes out to the field. We try to make it user-friendly. We have health officer orientation and welcomes. Partners like NACCHO help raise awareness. Meetings like the NACCHO Annual meeting help raise that awareness.
To me, that’s sort of the “what,” the science. But the “how” is where the nitty gritty comes from. How do you actually put this into practice? To me, the way to really make that happen is through conversation with folks in the field. We have something once a month called a Vital Signs Town Hall Meeting where we get folks that are in practice talking with the scientists at CDC and then folks in the field who get examples of how they’ve translated that [science] so others can learn from them. It’s a great way to cross-fertilize.
NACCHO: How do you bring these folks together?
JM: [The town hall meeting] is actually a phone call. It is a national town hall conference call. Anyone is welcome to join and there is information on our website about that. If you go to the OSTLTS webpage on the CDC website, there is lots of information there for health departments.
NACCHO: Much of the Affordable Care Act (ACA) is already in effect and many important provisions are set to take effect in January 2014. How is OSTLTS supporting local health departments with the ACA implementation?
JM: [OSTLTS is doing so] in a number of ways. It started with a workgroup that we have that is led by David Fleming, who is a NACCHO member, which looks at the health department of the future. We’ve been focusing on workforce, electronic health records, public health and healthcare integration, shared services, and so forth.
Listen to the rest of Dr. Monroe’s response at www.naccho.org/podcasts.
NACCHO periodically surveys a representative sample of America’s 2,800 local health departments (LHDs) to measure the impact of the economic recession on LHDs. This year, we included questions regarding budget cuts, job losses, and program reductions as a part of the 2013 National Profile of Local Health Departments (Profile) Study conducted from January to March. We are pleased to release findings on the impact of the economic recession on LHD jobs, budgets, and programs.
While the country as a whole shows signs of economic recovery, survey findings show that LHDs remain challenged to recover from the recession. Job losses and program cuts are beginning to taper, but LHDs are not rebounding yet.
Almost half of all LHDs (48%) reduced or eliminated services in at least one program area in 2012. Certain programs have been consistently impacted each year since 2009. Specifically, maternal and child health (MCH) and emergency preparedness (EP) services are among the most frequently affected: MCH services have been among the top three most frequently reduced programs in all six economic surveillance surveys NACCHO has conducted since 2009, and EP services have been among the top three most frequently reduced programs in four of the six surveys.
For every program except immunization, the percentage of LHDs reporting a reduction in program services they provided was smaller in 2012 than in 2011. But many programs are operating at diminished capacity, and LHDs will only be able to serve their communities by expanding programs, not by merely avoiding further cuts.
Since 2008, LHDs have shed nearly 44,000 jobs. In 2012, job losses and gains were roughly equal, with LHDs adding 4,000 positions and reducing 4,300 positions. But almost half of all LHDs (41%) experienced some type of reduction in workforce capacity.
A similar story emerges when we look at LHD budget cuts. More than a quarter (27%) of LHDs reported budget cuts in 2012. This represents a sizeable drop compared to the percentage of LHDs reporting cuts in previous years, and reflects cuts observed in December 2008. But while budget cuts are beginning to taper, LHDs are a long way from returning to the capacity at which they were operating before the recession began. LHDs are still more likely to report budgets cuts than budget increases (23%).
While job, budget, and program cuts were not as severe in 2012 as we have seen in the previous years NACCHO has conducted this study, economic growth at LHDs is still stagnant. As federal policymakers weigh further cuts, these data can be used to paint a picture of the challenges LHDs face in keeping their communities healthy and safe. Read the summary report for more details.
Have you shared the results from the job losses and program cuts survey? Tell us about it in the comments section.