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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?