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Strengthening Public Health Workgroup
FINAL REPORT TO SCHSAC
STRENGTHENING PUBLIC HEALTH WORKGROUP FINAL REPORT
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Strengthening Public Health Workgroup Final Report
Draft: February 20, 2018
Minnesota Department of Health Center for Public Health Practice PO Box 64975 St. Paul, MN 55164-0975 651-201-5000 health.ophp@state.mn.us http://www.health.state.mn.us/divs/opi/pm/schsac/
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STRENGTHENING PUBLIC HEALTH WORKGROUP FINAL REPORT
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Table of Contents
Strengthening Public Health Workgroup ........................................................................................ 0
Executive Summary ..................................................................................................................... 3
Purpose ................................................................................................................................... 3
Overview of activities .............................................................................................................. 3
Observations ........................................................................................................................... 3
Prioritized actions ................................................................................................................... 4
Next steps ............................................................................................................................... 4
Background ................................................................................................................................. 5
Summary of observations ........................................................................................................... 5
Priorities for action and future directions .................................................................................. 6
Priorities for action ................................................................................................................. 6
Additional future directions .................................................................................................... 7
Conclusion ................................................................................................................................... 9
Appendix A: Workgroup membership and charge ................................................................... 10
Background ........................................................................................................................... 10
Meetings ............................................................................................................................... 10
Appendix B: Workgroup observations ...................................................................................... 13
Governmental Public Health Partnership ............................................................................. 13
Basic Public Health Responsibilities ...................................................................................... 13
Public Health Funding ........................................................................................................... 13
Effective Local Governance ................................................................................................... 14
Leadership ............................................................................................................................. 14
Public Health Workforce ....................................................................................................... 14
STRENGTHENING PUBLIC HEALTH WORKGROUP FINAL REPORT
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Executive Summary
Purpose
The Strengthening Public Health Workgroup was formed by SCHSAC in response to mounting concerns
about persistent resource constraints and wide variability among community health boards related to
performance. The workgroup was asked to identify, examine and recommend a set of promising
strategies to assure that: 1) basic local public health activities are in place in all parts of Minnesota; and
2) Minnesota’s public health system is evolving to meet modern community health issues. The
workgroup, which met three times between October 2017 and January 2018, included a broader
membership than is typical for a SCHSAC workgroup, drawing members from both inside and outside
public health (see membership list in Appendix A).
Overview of activities
Over the course of three full-day meetings members received a large volume of in-depth information on
the current state of Minnesota’s public health system, including information on organization,
governance, basic public health responsibilities, funding, leadership, and workforce issues. Through
discussions and group activities, the workgroup synthesized this information into a set of observations
about the system. They concluded by creating prioritized actions and future directions for consideration
by SCHSAC.
Observations
Each of these observations is complex and has a number of factors that contribute to fully
understanding the issues facing Minnesota’s public health system. An expanded list is in Appendix B.
▪ Minnesota’s governmental public health system has served us well, but much has changed since it
was established in 1976.
▪ The current partnership between MDH and local public health is a major strength of Minnesota’s
governmental public health system. SCHSAC is an integral aspect of the partnership.
▪ Tribal health departments are an important part of Minnesota’s governmental public health
system, but are not always considered or fully included.
▪ Basic public health responsibilities must be carried out in all parts of Minnesota in order to protect
and promote the health of the public and prevent disease an injury. However, a number of local
health departments do not and cannot realistically carry them out. Further clarification of those
responsibilities is both needed and desired.
▪ Funding for public health is largely categorical and has very limited flexibility.
▪ The community health board has responsibility for public health in their jurisdiction. To be
successful in governing, they must engage a diverse set of individuals and groups including
communities and elected officials at all levels.
STRENGTHENING PUBLIC HEALTH WORKGROUP FINAL REPORT
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▪ It is the role of the community health services (CHS) administrator to be the lead local public health
official. Currently, they face many challenges in carrying out this role successfully.
▪ Public health departments across the state face significant workforce challenges.
Prioritized actions
The workgroup recommended 11 future directions for Minnesota’s public health system (pages 6-9).
Their top three priorities for action are:
1. Clarify the basic public health responsibilities for Minnesota and identify new ways to carry them
out.
2. Take steps to align public health funding and resources with local needs.
3. Take a comprehensive and multisectoral approach to public health workforce development.
Next steps
While the workgroup recognizes that there are many other areas where important work should be
undertaken to strengthen, and “future proof” Minnesota’s public health system, they respectfully
request that SCHSAC focus all available energy on addressing the three priorities first. It is the
workgroup’s belief that in doing so, the foundation for other future improvements will have been laid.
The SCHSAC executive committee and MDH will continue to refine the priorities into short and long-
term action steps over the next few years; they will be included in the annual SCHSAC work plan.
Other next steps include:
▪ Approval and acceptance of this report by SCHSAC and the commissioner of health;
▪ SCHSAC executive committee will provide leadership for implementation and ensure the annual
SCHSAC work plan is updated to reflect the future directions and;
▪ MDH will work with local and tribal public health to identify tasks and activities that can be
undertaken in the next year; and
▪ MDH will work with local public health to undertake an analysis of the future directions, in order to
identify any needed statute, rule or policy changes.
STRENGTHENING PUBLIC HEALTH WORKGROUP FINAL REPORT
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Background
The SCHSAC Strengthening Public Health Workgroup was convened in response to mounting concerns
about persistent resource constraints that prevent effective responses to current public health threats
and challenges and wide variability among community health boards related to performance and
resources. They were given the following charge:
Convene a broad set of stakeholders of governmental public health to identify, examine, and
recommend a set of promising strategies to assure that: (1) required local public health activities are in
place in all parts of Minnesota; and (2) Minnesota’s public health system is evolving to meet modern
community health issues.
The workgroup met three times between October 2017 and January 2018. The membership of the
workgroup was purposely broad in order to include perspectives of multiple stakeholders who are
interested in protecting and improving the health of Minnesota residents. Members included county
commissioners, state legislators, community health services administrators, health and human services
directors, county administrators, tribal health directors, healthcare providers, and community
organizations. A full list of members can be found in Appendix B.
At the first meeting, members received information on Minnesota’s governmental public health system,
including: how public health is organized in Minnesota; the role of state and local public health agencies;
the public health partnership; and the capacity of local public health departments to carry out a set of
basic public health activities.
At the second meeting, members received more in-depth information regarding the differences in the
capacity of local public health departments to meet basic public health activities and met in small groups
to further discuss decision-making; leadership; state and local roles; and resources.
At the third and final meeting, members refined their observations regarding the current state of
Minnesota’s public health system. They developed and prioritized a set of directions for strengthening
public health in Minnesota. A high-level overview of their observations and priorities for action is below.
Summary of observations
Workgroup members had several observations regarding the current state of Minnesota’s public health
system, summarized in the bullets below. Each of these observations is complex and has a number of
factors that contribute to fully understanding the issues facing local public health in Minnesota. These
observations formed the basis for the workgroup’s recommended actions and future directions to
SCHSAC. The full text version of their observations from meeting 3 is in Appendix A.
▪ Minnesota’s governmental public health system has served us well, but much has changed since it
was established in 1976.
▪ The current partnership between MDH and local public health is a major strength of Minnesota’s
governmental public health system. SCHSAC is an integral aspect of the partnership.
▪ Tribal health departments are an important part of Minnesota’s governmental public health
system, but are not always considered or fully included.
STRENGTHENING PUBLIC HEALTH WORKGROUP FINAL REPORT
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▪ Basic public health responsibilities must be carried out in all parts of Minnesota in order to protect
and promote the health of the public and prevent disease an injury. However, a number of local
health departments do not, and cannot, realistically carry them out. Further clarification of these
responsibilities is both needed and desired.
▪ Funding for public health is largely categorical and has very limited flexibility.
▪ The community health board has responsibility for public health in their jurisdiction. To be
successful in governing, they must engage a diverse set of individuals and groups including
communities and elected officials at all levels.
▪ It is the role of the community health services (CHS) administrator to be the lead local public health
official. Currently, they face many challenges to carrying out this role successfully.
▪ Public health departments across the state face significant workforce challenges.
Priorities for action and future directions
Workgroup discussions over the course of three meetings resulted in the members recommending
actions needed to strengthen public health in Minnesota. While all the actions were deemed important,
members were asked to select their top three priorities (see items 1-3 below). All the recommended
actions are listed below and are in the order of priority identified by the workgroup. The SCHSAC
executive committee and MDH will continue to refine these into short and long-term action steps over
the next few years; they will be included in the annual SCHSAC work plan.
Priorities for action
Priority 1: Clarify the basic public health responsibilities for Minnesota and identify new ways
to carry them out.
The workgroup agreed that public health’s upstream approach is vitally important protect and promote
the health of the public and prevent disease an injury. The workgroup also agreed that there are certain,
basic, public health responsibilities that must be carried out statewide. These responsibilities must be
understood by local elected officials and public health leaders who govern and carryout public health
locally. While a number of documents and definitions currently exist, they are not well understood or
clearly communicated. MDH and SCHSAC should work together to clarify and increase understanding of
the basic public health responsibilities including the scope and scale of those responsibilities.
Community health boards and local health departments, in consultation with MDH, should locally
determine the best way to carry out these responsibilities. While some jurisdictions may be already
adequately carrying out the basic responsibilities, others may need to explore new and innovative ways
of meeting their responsibilities (e.g. models for cross-jurisdictional sharing).
Priority 2: Take steps to align public health funding and resources with local needs.
The workgroup felt strongly that public health funding should be aligned to meet the needs of local
communities in a way that balances flexibility and accountability. Currently, resources for public health
are primarily driven by categorical grants, not by community priorities. CHBs have limited capacity to
STRENGTHENING PUBLIC HEALTH WORKGROUP FINAL REPORT
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address health needs identified by the community, or emerging and unexpected situations (i.e.,
outbreaks, disasters). A vision for public health funding should be set and stakeholders, including those
in the position to fund public health, should be engaged to achieve the vision.
Priority 3: Take a comprehensive and multisectoral approach to public health workforce
development.
Workgroup members recommended the creation of a public health workforce development plan. They
felt that to be sufficiently broad and future oriented, it should be created by MDH and local public
health in partnership with higher education programs, and other public health organizations (e.g., Local
Public Health Association, Minnesota Public Health Association).
Public health departments across the state are facing workforce challenges. Challenges include
competition with other sectors for staff, lack of ongoing skill development opportunities, and a
mismatch in existing hiring practices and necessary emerging skills and professions. The field of public
health is evolving and the skills and composition of the workforce must evolve with it. The plan should
include strategies to address workforce training and development for leadership and staff. It should
include expansion of the types of professionals in the public health workforce; an emphasis on
increasing the racial and ethnic diversity of professionals in the field; ongoing leadership development;
and creation of a “pipeline” of future public health workers.
Additional future directions
The workgroup made additional recommendations for future action to strengthen Minnesota’s public
health system. While these actions did not rise to the level of the top three priority actions, the
workgroup felt they were important and agreed to forward them to SCHSAC for consideration.
Align MDH regional resources to meet local needs.
Local health departments value the MDH regional resources available to them, like the public health
nurse consultants, regional epidemiologists, and public health preparedness consultants. While the roles
of these staff have evolved over time, a comprehensive evaluation of the alignment of these resources
with local needs has not occurred.
The workgroup agreed that MDH and local public health should work together to examine the roles of
the MDH regional staff. This examination should include determining activities that could be done more
efficiently at the regional or state level, versus activities best carried out at the local level. Differences
between regions and new approaches to working together, such as co-locating regional MDH staff
within a local health department and cross-jurisdictional sharing, should be considered.
Increase local capacity to identify and address community health issues.
According to a recent survey of local capacity, many CHBs are not adequately equipped to identify and
address local needs in a way that engages the community, uses a variety of sources of data, and works in
partnership with diverse community stakeholders. The workgroup suggested leveraging additional
support and resources to build the capacity (i.e., time, expertise and staffing) of CHBs to do community
health assessment, and community health improvement planning. Additional support could include
technical assistance from MDH, alignment with federally required local hospital-based community
assessments, regional approaches, or partnerships with higher education. It bears mentioning that
some, but not all, CHBs need help in developing, implementing and monitoring those plans to address
community needs.
STRENGTHENING PUBLIC HEALTH WORKGROUP FINAL REPORT
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Increase engagement with local and state policymakers.
Local and state elected officials (policymakers) have an important role in advancing the health of their
communities. It is critical that they understand the relationship between policies and health, and are
equipped to consider health in decision-making. In addition, local community health board members
need to understand their responsibility for assuring that basic public health responsibilities are carried
out, and that local health needs are addressed. In order to ensure well-informed public health policy and
decision making the workgroup recommended increasing efforts to engage community health board
members and local and state policy makers.
Strengthen and support the role of the CHS Administrator.
Community health services (CHS) administrators play an important role acting on behalf of their CHB
and providing leadership for public health in their jurisdiction. Many factors contribute to the wide
variation in the level of authority, role and skillset possessed by CHS administrators around the state.
The workgroup recommended taking steps to clarify and standardize expectations for the CHS
administrator role. Additionally they recommended providing more training and ongoing professional
development opportunities to better support leaders currently who are serving as CHS administrators.
Some workgroup members expressed interest in renaming this important position to be more
descriptive and consistent with the role of a local health official.
Strengthen SCHSAC through continuous improvement.
The State Community Health Services Advisory Committee (SCHSAC) is an important component of the
state-local public health partnership. SCHSAC should continue to celebrate its strengths, partnerships
and successes while recognizing and adapting to the changing public health landscape. In the spirit of
continuous improvement, the following areas should be reviewed: the level of engagement of current
members; effectiveness of the SCHSAC meeting structure; engagement of tribal partners; multi-county
CHB membership; promotion/marketing of SCHSAC to county commissioners who are not members,
and engagement of state and local elected officials.
Engage tribal governments in local public health governance.
Each of the 11 tribal nations in Minnesota have their own sovereign governments, cultures and
community health priorities. Local health departments and community health boards must be
knowledgeable about the unique role and sovereignty of tribal governments and should engage with
tribes appropriately. CHBs should involve tribes who reside within the borders of their jurisdictions in
public health decision-making. This could involve having tribal governments represented on the
community health board, as well as engaging them in the planning and delivery of activities and services
that affect their community.
Increase consistency across MDH programs to reduce administrative burden for local and
tribal health departments.
Many programs across MDH interact with and provide funding to local and tribal health departments.
Duplicative requests for documentation, cumbersome reporting requirements, and lack of consistency
across MDH programs place undue administrative burdens on local and tribal public health. MDH should
streamline their grant management processes. Efforts should be made to increase consistency in how
grants are administered (i.e., use consistent management processes throughout the grant cycle).
Additionally, MDH should work to increase the flexibility of categorical grants, so those funds can be
used to address local needs and support local public health infrastructure activities.
STRENGTHENING PUBLIC HEALTH WORKGROUP FINAL REPORT
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Review and clarify the role of the CHB medical consultant.
The Local Public Health Act (MN Statute 145a) requires CHBs to appoint a medical consultant to “ensure
appropriate medical advice and direction for the community health board and assist the board and its
staff in the coordination of community health services with local medical care and other health
services.” The role and qualifications of the medical consultant should be updated to reflect the current
interplay of healthcare and public health, and the needs of local health departments and CHBs.
Conclusion
An engaged and forward-thinking group of leaders, with a shared interest in ensuring the strength of
Minnesota’s public health system, came together for three productive meetings at the end of 2017. In
their brief time together, these members – local public health directors, human services directors, county
commissioners, county administrators, state legislators, tribal health, academics, healthcare
professionals, and community partners – learned a great deal about the current state of Minnesota’s
public health system. They asked difficult questions, and had frank conversations about the challenges
facing the system. They engaged in robust, creative and future-oriented discussions, which led them to
develop priorities for action and future directions.
The workgroup’s top three priorities for action were:
▪ Priority 1: Clarify the basic public health responsibilities for Minnesota and identify new ways to
carry them out.
▪ Priority 2: Take steps to align public health funding and resources with local needs.
▪ Priority 3: Take a comprehensive and multisectoral approach to public health workforce
development.
While the workgroup recognizes that there are many other areas where important work should be
undertaken to strengthen, and “future proof” Minnesota’s public health system, they respectfully
request that SCHSAC focus all available energy on addressing these first three priorities. It is the
workgroup’s belief that in doing so, the foundation for other future improvements will have been laid.
Finally, despite the significant challenges currently facing the system, the workgroup members were
very impressed by the breadth of issues addressed by Minnesota’s public health professionals. They
extend their thanks and appreciation for the work done, every day, to protect and improve the health of
Minnesotans.
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Appendix A: Workgroup membership and
charge
SCHSAC will convene a broad set of stakeholders of governmental public health to identify, examine,
and recommend a set of promising strategies to assure that: 1) required local public health activities are
in place in all parts of Minnesota; and 2) Minnesota’s public health system is evolving to meet modern
community health issues.
Background
The Community Health Services Act (now the Local Public Health Act) passed in 1976 laid out a vision for
a public health system in Minnesota. The Local Public Health Act has been updated several times with
relatively minor changes, and SCHSAC has produced a number of reports with recommendations for
strengthening the system. Some of those recommendations have been implemented, and others have
not.
Currently, CHBs in Minnesota are struggling against persistent resource constraints that prevent
effective responses to current public health threats and challenges. Additionally, there is wide variability
among community health boards related to performance and resources. This means that where a
person lives may have a significant impact on the level, range and quality of public health services
available in their community.
To put it in the words of practitioners in the system, there is concern that Minnesota’s public health
infrastructure is crumbling and it is an imminent threat both to the integrity of our public health system
and ultimately the health of all Minnesotans. The long-term public health focus on prevention is often
lost in the many pressing, near-term issues and mandated services counties must prioritize.
To date, the concerns and potential solutions have been discussed primarily by public health
practitioners, through workgroups of the State Community Health Advisory; committees of the Local
Public Health Association; and the Minnesota Department of Health. Those conversations need to
broaden to include perspectives of other stakeholders interested in protecting and improving the health
of Minnesota residents.
Meetings
During three meeting between October and January the workgroup will:
▪ Develop a common understanding of Minnesota’s governmental public health system.
▪ Identify strengths and challenges of current system.
▪ Brainstorm potential strategies for strengthening Minnesota’s governmental public health system.
▪ Explore and refine potential strategies for strengthening Minnesota’s governmental public health
system.
▪ Continue to explore potential strategies and select the most promising strategies for SCHSAC and
MDH to investigate further.
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Membership (as of 10/12/17)
Name Title/Role Organization
Ed Ehlinger (Co-chair) Commissioner of Health MDH
Susan Morris (Co-chair) Isanti County Commissioner/ SCHSAC
Member Isanti County CHB
Richard Anderson Beltrami County Commissioner Beltrami County CHB
Steven Belton Community Partner Minneapolis Urban League
Michelle Benson State Senator, District 31 Chair, HHS Finance and Policy
Committee, Republican
Kodjo Bossou* Medical Consultant Goodhue County CHB
Patrick Boyle* St. Louis County Commissioner Carlton-Cook-Lake-St. Louis CHB
Charles Bransford Medical Consultant Washington County CHB
Drew Campbell Blue Earth County Commissioner/
SCHSAC Member Blue Earth County CHB
Jill DeBoer Community Partner U of M, Center for Infectious
Disease Research and Policy
Renee Frauendienst CHS Administrator Stearns County CHB
Mike Freiberg State Representative, District 45B Member, HHS Reform Committee,
DFL
Rachel Hardeman Community Partner U of M, School of Public Health
Kelly Harder Health & Human Services Director Dakota County
Doug Huebsch* Otter Tail County Commissioner/ SCHSAC
Member Partnership4Health CHB
Mónica Hurtado Community Partner Voices for Racial Justice
Lowell Johnson CHS Administrator Washington County CHB
Sheila Kiscaden Olmsted County Commissioner/ SCHSAC
Member Olmsted County CHB
Deatrick LaPointe Community Partner St Paul-Ramsey Co CHB Advisory
Committee member
Warren Larson Community Partner Sanford Health
Harlan Madsen Kandiyohi County Commissioner/ SCHSAC
Member Kandiyohi-Renville CHB
Todd Patzer Lac qui Parle County Commissioner Countryside CHB
Nels Pierson State Representative, District 26B Member, HHS Finance Committee,
Republican
Michael Plante County Administrator Wabasha County
Cyndy Rastedt* Tribal Health White Earth Nation
Sarah Reese CHS Administrator Polk-Norman-Mahnomen CHB
Nate Sandman Tribal Health Fond du Lac Band of Lake Superior
Chippewa
Chera Sevcik CHS Administrator Faribault-Martin CHB
Ann Stehn Health & Human Services Director Kandiyohi County
STRENGTHENING PUBLIC HEALTH WORKGROUP FINAL REPORT
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Name Title/Role Organization
Sandy Tubbs CHS Administrator Horizon CHB
Wendy Underwood Director of County Relations MN Department of Human Services
PaHoua Vang Community Partner Minnesota Public Health
Association
Melissa Wiklund State Senator, District 50 Member, HHS Finance and Policy
Committee, DFL
Michael Williams County Administrator Stearns County
*Indicates members who were unable to attend meetings.
STRENGTHENING PUBLIC HEALTH WORKGROUP FINAL REPORT
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Appendix B: Workgroup observations
▪ While Minnesota’s governmental public health system has served us well, much has changed since
it was first established in 1976. Periodic, regular review of the public health system is important for
ensuring that it meets the needs of today and is flexible enough to meet the needs of the future.
Governmental Public Health Partnership
▪ The current partnership between MDH and local public health is a major strength of Minnesota’s
governmental public health system.
▪ The State Community Health Services Advisory Committee (SCHSAC) is an important and integral
component of the state-local partnership. It is also an important mechanism for communicating
with local policy makers. However, the work and role of SCHSAC is not well known among those not
involved.
▪ MDH technical expertise is important to many local health departments and some rely on having
access to this expertise. Likewise, MDH relies on local public health for their community expertise
and action locally.
▪ Tribal health departments are an important component of Minnesota’s governmental public health
system that are not always considered and/or included. State and local health departments and
community health boards must be knowledgeable about the unique role and sovereignty of tribal
governments and engage with tribes appropriately.
Basic Public Health Responsibilities
▪ In order to protect and promote the health of the public and prevent disease an injury, basic public
health responsibilities must be carried out in all parts of Minnesota. Examples of basic
responsibilities include: looking at data and engaging the community to understand what health
issues exist in the community; working with others to plan for and respond to emergencies that
may impact the health of the community; working with MDH to detect and respond to disease
outbreaks.
▪ A number of sources of information indicate that many local health departments across the state
do not and cannot realistically carry out basic public health responsibilities. Contributing factors
include resource limitations (funding and workforce), unanticipated events, and locally-driven
decisions.
▪ Clarity is needed on what is considered a basic public health responsibility. Once defined, local
jurisdictions are in the best position to determine how basic public health responsibilities are
carried out. For example, another health department, regional entity or local organization might be
best equipped to carry out the responsibilities.
Public Health Funding
▪ Funding for public health is largely categorical and has very limited flexibility. This is problematic
because in many cases:
▪ Local activities are driven by grant obligations instead of community priorities;
▪ Community health boards’ ability to address new and emerging issues is limited; and
▪ The amount of funding available for basic public health responsibilities like community health
assessment, partnership development, and control of tuberculosis or other infectious diseases
is limited.
STRENGTHENING PUBLIC HEALTH WORKGROUP FINAL REPORT
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▪ Funding mechanisms, timeframes and priorities at the federal, state and local levels (e.g. 2-year
biennium) are not structured to fund long-term prevention activities.
Effective Local Governance
▪ The community health board has responsibility for public health in their jurisdiction.
▪ To be successful in governing public health, community health boards need to:
▪ Assure members of the community health board (local elected officials, community
representative, etc.) understand their role in governing public health;
▪ Engage with the various communities in their jurisdiction, particularly marginalized groups like
people of color, American Indians and the elderly; and
▪ Have access to public health expertise.
Leadership
▪ The role of the community health services (CHS) administrator is to be the lead local public health
official, providing public health expertise in the community and the community health board.
▪ While every CHB has a CHS administrator, the role is not being fulfilled as intended everywhere due
to a number of challenges including overwhelming responsibilities; lack of skillsets; lack of local
support for them to serve as the local public health official; and a misunderstanding of the role.
▪ As the issues that public health must address have become more complex, the skill sets of health
department leaders has needed to evolve and include skills needed for population based practice.
Public Health Workforce
▪ Public health departments across the state face workforce challenges including recruitment of
qualified staff, retaining staff, and providing ongoing skill development. These challenges are
exacerbated in, but not limited to, greater Minnesota health departments.
▪ As the field of public health continues to move from a more clinical focus to a focus on the social
determinants of health, there is a greater need for a workforce that mirrors the population in the
community and has skills in community engagement, planning, data analysis, communications and
engaging with multiple sectors.
▪ New pipelines to careers in public health are needed to assure the future public health workforce
reflects the general population and has the needed skills.
Strategic Planning-Strengths, Opportunities, Weaknesses, Threats
Strengths
Ability to attract additional funding for the four-county area.
SHIP model of staffing for Health Promotion work-national attention.
Opportunities
Staff embracing transition to specialized work across the CHB.
Weaknesses
Balancing cost of travel time with staffing for specialized work.
Threats
Personnel recruitment due to job market salaries.
Retirements of staff in key positions.
Partnership4Heatlh Community Health Board March 3, 2018
Grant Funding Source Actual
2015 Actual 2016 Actual
2017
Budget
2018
Local Public Health - LPHA State 698,418.00 732,957.00 733,154.00 733,154.00
Shared Services Learning Collaborative - SSLC State 8,378.00 Grant ended
Healthy Homes State 2,000.00 Grant ended
Kansas Health Other 7,000.00 3,000.00 Grant ended
One Vegetable One Community - OVOC Other 600.00 Grant ended
Health Information Exchange - HIE Federal 166,481.92 75,259.83 20,207.01 Grant ended
Immunization Practices - IPI State 8,150.00 5,200.00 Fee for Services
Perinatal Hep B State 7,120.00 560.00 3,050.00 Fee for Services
Public Health Emergency Preparedness - PHEP Federal 112,288.03 125,424.35 97,827.53 122,746.00
City Readiness Initiative - CRI Federal 12,831.51 8,595.90 10,349.18 12,000.00
Ebola Federal 3,233.27 4,841.26 1,925.47 Grant ended
Community Paramedic Federal 16,967.00 Grant ended
Maternal Child Health - MCH 1/2 State & Federal 205,335.00 205,335.00 190,560.00 190,560.00
Temporary Assistance for Need Families - TANF Federal 226,861.06 201,059.17 245,075.00 220,314.00
Follow-Allong - FAP Federal 9,968.40 7,732.00 7,732.00 7,732.00
Women, Infant & Children - WIC Federal 822,197.00 805,339.00 669,084.00 645,814.00
Statewide Health Improvement Project - SHIP Innovation State 71,663.60 Grant ended
Statewide Health Improvement Project - SHIP State 596,264.38 357,539.48 387,571.70 393,531.00
Clearway Minnesota - CWM Other - 80,000.00 80,000.00
Community Wellness Grant - CWG Federal 140,735.68 441,802.30 494,794.81 435,360.00
Health Disparities Federal 10,712.16 101,142.37 82,024.00
Family Planning Special Projects - FPSP Federal 26,880.00 73,500.00 20,000.00 55,190.00
Maternal, Infant & Early Childhood Home Visiting - MIECHV I Federal 107,019.20 122,862.19 90,787.80 Grant ended
Maternal, Infant & Early Childhood Home Visiting - MIECHV II Federal 427,927.08 276,872.45 36,180.39 Grant ended
Accountable Communities for Health - ACH Extension Federal 54,943.65 224,846.13 90,209.04 Grant ended
Accountable Communities for Health - ACH Expansion Federal 74,999.60 Grant ended
Child & Teen Checkup Outreach - CTC 1/2 State & Federal 434,675.62 474,111.51 472,150.29 555,175.00
Early Hearing Detectiion/Birth Defects - EHDI/BDS Federal 7,675.00 9,950.00 4,075.00 Fee for Services
Refugee Health Federal 2,902.00 2,902.00 2,831.00 2,831.00
Totals 4,160,765.40 4,179,351.73 3,842,506.19 3,536,431.00
MIECHV Grant replacement funding - thru PNM CHB $380,296
Partnership4Health Community Health Board
Financial recap 15-18 03.02.18
CHB - Revenue recap - 2017
LPHA MCH Federal TANF Medicaid Medicare Private Insurance Local Tax Client Fees Other Fees Other Local Funds Other State Funds Other Federal Funds Total
Clay 300705.38 71986.89 98125.96 544563.26 597759.53 8466.21 661572.99 737900.99 1029160.77 212964.12 863676.74 1348252.03 6475134.87Wilkin 32000 11277.16 5595.74 182259.1 107386.33 16865 331650.72 5922.62 4686.24 64913.54 9541.22 125475.81 897573.48
Otter Tail 215025.88 54502 77778.34 671238.27 185689.64 45419.9 708030.94 306262.8 40976.8 20168.1 348879.63 1554840.21 4228812.51
Becker 151690 104698.14 62542.26 809216.84 1293.11 -82860.39 571.89 12394.92 7545.25 135458.55 569043.74 1771594.31
Totals 699421.26 242464.19 244042.3 2207277.47 890835.5 72044.22 1618394.26 1050658.3 1087218.73 305591.01 1357556.14 3597611.79 13373115.17
LPHA
5%
MCH
2%
Federal TANF2%
Medicaid
16%
Medicare7%
Private Insurance1%Local Tax
12%
Client Fees
8%
Other Fees8%
Other Local Funds2%
Other State Funds
10%
Other Federal Funds
27%
P4H CHB -2017 Revenue Sources