Minnesota Department of Health
Health Partnerships Division – Public Health Practice Section
PO Box 64975 Saint Paul, MN 55164-0975
651-201-3880 | www.health.state.mn.us
2014 Local Public Health Act
Performance Measures
SEPTEMBER 2015 | DATA BOOK
2014 Local Public Health Act Performance Measures
CONTENTS
Background and Context ........................................................................................................................................................................................................................................................ 3
About the Data Book ........................................................................................................................................................................................................................................................... 3
Assure an Adequate Local Public Health Infrastructure: Capacity Measures from National Standards ....................................................................................................... 3
About the Standards............................................................................................................................................................................................................................................................ 3
100 National Public Health Measures ............................................................................................................................................................................................................................ 4
35 Key Measures ................................................................................................................................................................................................................................................................... 6
100 Measures by Domain .................................................................................................................................................................................................................................................. 7
Assure an Adequate Local Public Health Infrastructure: Minnesota-Specific Measures ................................................................................................................................. 28
Workforce Competency................................................................................................................................................................................................................................................... 28
School Health ...................................................................................................................................................................................................................................................................... 31
Health Equity ....................................................................................................................................................................................................................................................................... 32
Organizational Quality Improvement Maturity ........................................................................................................................................................................................................ 34
Health Information Technology .................................................................................................................................................................................................................................... 37
Statutory Requirements ................................................................................................................................................................................................................................................... 42
Public Health Accreditation ............................................................................................................................................................................................................................................ 44
Cross-Jurisdictional Sharing ........................................................................................................................................................................................................................................... 47
Promote Healthy Communities and Healthy Behaviors ............................................................................................................................................................................................ 49
Physical Activity .................................................................................................................................................................................................................................................................. 49
Nutrition ............................................................................................................................................................................................................................................................................... 50
Tobacco................................................................................................................................................................................................................................................................................. 52
Alcohol .................................................................................................................................................................................................................................................................................. 53
Maternal and Child Health.............................................................................................................................................................................................................................................. 55
Prevent the Spread of Infectious Diseases ..................................................................................................................................................................................................................... 56
Immunizations .................................................................................................................................................................................................................................................................... 56
Tuberculosis......................................................................................................................................................................................................................................................................... 59
Overall Infectious Diseases ............................................................................................................................................................................................................................................. 61
Protect Against Environmental Health Hazards ........................................................................................................................................................................................................... 62
Indoor Air: Radon .............................................................................................................................................................................................................................................................. 62
Indoor Air: Minnesota Clean Indoor Air Act .............................................................................................................................................................................................................. 63
Blood Lead ........................................................................................................................................................................................................................................................................... 64
Drinking Water Protection and Well Management ................................................................................................................................................................................................ 65
Environmental Surveillance and Assessment ............................................................................................................................................................................................................ 66
Nuisance Investigation..................................................................................................................................................................................................................................................... 67
Prepare for and Respond to Disaster, and Assist Communities in Recovery ...................................................................................................................................................... 68
Partner Engagement ......................................................................................................................................................................................................................................................... 68
Assure the Quality and Accessibility of Health Services ............................................................................................................................................................................................ 69
Clinic-Community Linkages ............................................................................................................................................................................................................................................ 69
Gaps in Services or Barriers to Access......................................................................................................................................................................................................................... 70
Service Provision and Health Insurance Strategies ................................................................................................................................................................................................. 73
Appendices............................................................................................................................................................................................................................................................................... 74
Minnesota Community Health Boards by Population ........................................................................................................................................................................................... 74
Minnesota Community Health Boards by Structure............................................................................................................................................................................................... 75
Areas of Public Health Responsibility.......................................................................................................................................................................................................................... 76
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2014 Local Public Health Act Performance Measures
BACKGROUND AND CONTEXT
ABOUT THE DATA BOOK
Minnesota community health boards (CHBs) report annually into the Planning and Performance
Measurement Reporting System (PPMRS), on Local Public Health Act (LPH Act) performance
measures that span six areas of public health responsibility (see appendices for six areas).
The purpose of this data book is to present state-level findings for each of the LPH Act
measures. This report communicates findings from the 2014 reporting period. For more
information on tailored reports specific to each community health board, contact:
MDH Health Partnership Division
Public Health Practice Section
PO Box 64975
Saint Paul, MN 55164-0975
Phone: 651-201-3880
Email: [email protected]
Online: www.health.state.mn.us
REPORTING INSTRUCTIONS AND GUIDANCE
Instructions for reporting on all six areas of public health responsibility can be found online:
www.health.state.mn.us/ppmrs/resources/performancemeasures/. Data reported was collected
between Jan. 1 and Dec. 31, 2014.
MDH Performance Management Framework
INTERPRETATION AND ASSISTANCE
In the interest of swift release and of transparency, the MDH Public Health Practice Section has released this data book. We understand that there are
data limitations and that measures are not fully described here. If there are measures that interest you, or you would like further assistance, we are happy
to discuss these with you. Please contact us using the information above. You can also find information on Minnesota’s accreditation efforts and Local
Public Health Assessment and Planning process online: www.health.state.mn.us/lphap.
The SCHSAC Performance Improvement Steering Committee has reviewed these findings and will release recommendations for system improvement later
this year. For more information, visit www.health.state.mn.us/schsac, and select “Workgroups,” then “Performance Improvement Steering Committee.”
CHB POPULATIONS AND SIZES
In this report, you will often data broken out by CHB population; for more information on how CHBs are divided, please refer to the appendices.
ASSURE AN ADEQUATE LOCAL PUBLIC HEALTH INFRASTRUCTURE: CAPACITY MEASURES FROM NATIONAL STANDARDS
ABOUT THE STANDARDS
In spring 2015, Minnesota CHBs reported on national public health measures,
rather than just a subset as in previous years. This is why trend data is included
for some measures and not others. You’ll see these key measures and the state’s
progress on them between 2012 and 2014 throughout this area of responsibility.
The Public Health Accreditation Board (PHAB) revised the national standards and
measures in 2014 (to version 1.5). Minnesota’s Local Public Health Act
performance measures—and guidance for reporting on them—were updated to
be consistent with this version. For more information on PHAB Standards and
Measures version 1.5, visit www.phaboard.org/.
Multi-county CHBs were asked to report on the lowest level of capacity of their
individual health departments for measures within “Capacity Measures from
National Standards” (see right). For a full list of single-county/city CHBs and
multi-county CHBs, please refer to the appendices.
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2014 Local Public Health Act Performance Measures
ASSURE AN ADEQUATE LOCAL PUBLIC HEALTH INFRASTRUCTURE: CAPACITY MEASURES FROM NATIONAL STANDARDS
100 NATIONAL PUBLIC HEALTH MEASURES
CAPACITY TO MEET 100 NATIONAL PUBLIC HEALTH MEASURES, MINNESOTA CHBS, 2014
Each horizontal bar of the tables below corresponds to an individual CHB. The shading within each bar reflects the number of measures that were
reported as either fully met (green), partially met (yellow), or not met (red) by each CHB. The CHBs grouped in the first quartile rank highest in the
number of measures they reported as fully met. The CHBs in the fourth quartile rank lowest in the number of measures they reported as fully met.
Capacity of Minnesota CHBs to meet 100 national public health measures, 2014
Fully Meet
Partially Meet
Cannot Meet
100
100
100
100
95
4
94
5
92
8
91
9
91
9
89
4
6
82
Minnesota CHBs (n=48)
80
67
67
65
22
65
19
63
34
63
23
63
22
62
22
62
22
60
25
59
35
57
27
56
24
54
26
40
39
39
27
MDH Health Partnerships Division
43
50
50
31
54
23
53
40
53
29
31
22
48
48
20
32
21
30
27
35
4
16
1
19
80
18
80
13
79
21
79
16
78
22
76
17
75
19
75
17
72
25
72
18
25
17
2
6
5
6
5
8
2
9
7
15
12
15
3
14
15
16
16
14
6
15
19
19
22
7
17
20
30
36
9
10
29
47
42
37
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2014 Local Public Health Act Performance Measures
CAPACITY TO MEET 100 NATIONAL PUBLIC HEALTH MEASURES, BY CHB POPULATION, 2014
The CHBs below are organized by population. Each horizontal bar of the tables below corresponds to an individual CHB. The shading within each bar
reflects the number of measures that were reported as either fully met (green), partially met (yellow), or not met (red) by each CHB.
Capacity of Minnesota CHBs to meet 100 national public health measures, by population and measures met, 2014
Partially Meet
Cannot Meet
Small CHBs
Fully Meet
50
Medium CHBs
39
48
48
54
20
56
23
24
63
62
72
72
25
67
22
22
76
75
25
18
Large CHBs
27
32
21
30
27
35
40
39
43
50
31
75
67
17
65
19
63
34
60
25
59
35
57
27
26
29
54
53
31
22
53
40
63
62
80
80
17
79
17
19
79
78
65
22
23
22
89
19
18
82
21
80
16
22
4
95
100
100
4
6
2
8
15
15
3
14
6
15
19
17
20
30
10
100
16
1
6
5
2
9
7
15
16
19
22
36
9
29
47
42
37
13
94
92
8
91
9
91
9
100
5
6
5
12
14
16
7
Range and median: National public health measures fully met, by population, Minnesota CHBs, 2014
0
10
20
30
40
50
60
70
80
Small CHBs
Median: 64 measures
Medium CHBs
Median: 62.5 measures
Large CHBs
100
Median: 79.5 measures
Minnesota
Median: 66 measures
Range: Measures fully met, by population, Minnesota CHBs, 2014
Minimum
Median
Maximum
MDH Health Partnerships Division
90
5
Small CHBs
(n=18)
Medium CHBs
(n=18)
Large CHBs
(n=12)
Minnesota
(n=48)
39 measures
64 measures
100 measures
27 measures
62.5 measures
100 measures
53 measures
79.5 measures
100 measures
27 measures
66 measures
100 measures
September 2014
2014 Local Public Health Act Performance Measures
MEASURES MET BY GREATEST AND FEWEST CHBS, MINNESOTA, 2014
Measures fully met by the greatest and fewest number of CHBs, Minnesota, 2014
Financial management systems - 11.2.3
Strategic planning process - 5.3.1
Adopted strategic plan - 5.3.2
Collaborations/relationships to develop future workforce - 8.1.1
Written agreements with entities with which CHB interacts - 11.2.2
Engagement with governing entities on promoting public's health - 4.2.2
Mandated operations, programs, and services are provided - 12.1.1
Info. provided to governing entity on important issues/actions - 12.3.1
100%
98%
98%
98%
98%
96%
96%
96%
Opportunities for staff involvement in performance mgmt. - 9.1.5
Monitor and revise CHIP as needed - 5.2.4
Procedures for external communication - 3.2.3
Coordinated notification/info.-sharing on enforcement of laws - 6.3.5
Ethical issues identified; ethical decisions made - 11.1.2
Culturally sensitive polices, processes, programs, interventions - 11.1.4
Implemented performance mgmt. system - 9.1.3
Workforce development plan/strategies - 8.2.1
40%
35%
33%
31%
31%
29%
23%
23%
% of CHBs that can
fully meet measure
ASSURE AN ADEQUATE LOCAL PUBLIC HEALTH INFRASTRUCTURE: CAPACITY MEASURES FROM NATIONAL STANDARDS
35 KEY MEASURES
Between 2012 and 2014, Minnesota CHBs reported on subset of 35 key public health national measures.* The SCHSAC Performance Improvement
Steering Committee monitors CHBs’ ability to achieve 35 national measures as an indicator of overall capacity of the state’s public health system. The
figure below illustrates the state’s collective progress toward meeting those key measures.
Key measures fully met by all Minnesota CHBs, 2012-2014
100%
90%
11%
80%
21%
70%
14%
60%
50%
40%
30%
68%
68%
51%
22%
37% 37%
51%
36%
41%
20%
10%
0%
2012
2013
2014*
In 2012-2013, MDH used 35 key measures from PHAB Standards and Measures v1.0 to assess CHB capacity. In 2014, MDH used the revised PHAB
Standards and Measures v1.5 to assess capacity; in v1.5, PHAB combined two measures into one, resulting in a total of 34 measures.
*
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ASSURE AN ADEQUATE LOCAL PUBLIC HEALTH INFRASTRUCTURE: CAPACITY MEASURES FROM NATIONAL STANDARDS
100 MEASURES BY DOMAIN
DOMAIN 1: ASSESS
Conduct and disseminate assessments focused on population health status and public health issues facing the community
ALL MEASURES IN DOMAIN 1, MINNESOTA CHBS, 2014
CHB capacity to meet measures in Domain 1, Minnesota, 2014
100%
80%
60%
Cannot Meet
40%
Partially Meet
Fully Meet
20%
0%
1.1.1
1.1.2
1.1.3
1.2.1
1.2.2
1.2.3
1.2.4
CHB capacity to meet measures in Domain 1, Minnesota, 2014 (n=48)
1.3.1
1.3.2
1.4.1
1.4.2
Fully Meet
Partially Meet
Cannot Meet
1.1
1.1.1
1.1.2
1.1.3
Community Health Assessment (CHA)
Partnership for CHA
CHA
Accessibility of CHA
79%
63%
69%
21%
35%
25%
0%
2%
6%
1.2
1.2.1
1.2.2
1.2.3
1.2.4
Data Collection and Maintenance
Surveillance system
Communication with surveillance sites
Primary data
Shared data with state, tribal health departments
50%
48%
60%
77%
48%
46%
29%
13%
2%
6%
10%
10%
1.3
1.3.1
1.3.2
Data Analysis
Data analysis and conclusions
Data to a variety of audiences
54%
81%
38%
10%
8%
8%
1.4
1.4.1
1.4.2
Data Use
Informing policy, processes, programs with data
Summaries, fact sheets to support planning
88%
71%
4%
17%
8%
13%
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KEY MEASURES IN DOMAIN 1, % FULLY MET, MINNESOTA CHBS, 2012-2014 *
1.1.3
CHA accessibility
60%
1.2.1
Data surveillance system
69%
56%
42%
38%
1.3.2
Data, variety of audiences
1.4.2
Fact sheets for planning
81%
50%
71%
60%
58%
40%
2012
2013
2014
2012
2013
2014
38%
2012
2013
2014
2012
2013
2014
STANDARDS IN DOMAIN 1, % FULLY MET BY POPULATION, MINNESOTA CHBS, 2014
86%
74%
70%
56%
CHB capacity to fully meet standards in Domain 1, by population, Minnesota, 2014
96%
88%
79%
78%
77%
69%
68%
67%
59%
56%
56%
50%
Small CHBs
Medium CHBs
Large CHBs
Minnesota
Standard 1.1
Standard 1.2
Standard 1.3
CHB capacity to meet measures in Domain 1, by population,
Minnesota, 2014
Standard 1.4
Small CHBs
(n=18)
Medium CHBs
(n=18)
Large CHBs
(n=12)
Minnesota
(n=48)
1.1
1.1.1
1.1.2
1.1.3
Community Health Assessment (CHA)
Partnership for CHA
CHA
Accessibility of CHA
83%
67%
72%
67%
44%
56%
92%
83%
83%
79%
63%
69%
1.2
1.2.1
1.2.2
1.2.3
1.2.4
Data Collection and Maintenance
Surveillance system
Communication with surveillance sites
Primary data
Shared data with state, tribal health departments
39%
50%
56%
78%
39%
39%
50%
72%
83%
58%
83%
83%
50%
48%
60%
77%
1.3
1.3.1
1.3.2
Data Analysis
Data analysis and conclusions
Data to a variety of audiences
50%
83%
44%
67%
75%
100%
54%
81%
1.4
1.4.1
1.4.2
Data Use
Informing policy, processes, programs with data
Summaries, fact sheets to support planning
83%
72%
83%
56%
100%
92%
88%
71%
2012-2014 trends for key measures show different background colors, depending on whether over 80 percent of CHBs can fully meet the measure
(green), 50 percent to 79 percent can fully meet the measure (yellow), or less than 50 percent can fully meet the measure (red).
*
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DOMAIN 2: INVESTIGATE
Investigate health problems and environmental public health hazards to protect the community
ALL MEASURES IN DOMAIN 2, MINNESOTA CHBS, 2014
CHB capacity to meet measures in Domain 2, Minnesota, 2014
100%
80%
60%
Cannot Meet
40%
Partially Meet
Fully Meet
20%
0%
2.1.1 2.1.2 2.1.3 2.1.4 2.1.5
2.2.1 2.2.2 2.2.3
2.3.1 2.3.2 2.3.3 2.3.4
CHB capacity to meet measures in Domain 2, Minnesota, 2014 (n=48)
2.4.1 2.4.2 2.4.3
Fully Meet
Partially Meet
Cannot Meet
2.1
2.1.1
2.1.2
2.1.3
2.1.4
2.1.5
Investigating Problems and Hazards
Protocols for investigation
Infectious disease investigation
Non-infectious investigation capacity
Partnerships for investigation
Timely reporting
83%
75%
79%
65%
60%
n/a*
19%
13%
33%
27%
17%
6%
8%
2%
13%
2.2
2.2.1
2.2.2
2.2.3
Containing/Mitigating Problems, Hazards
Protocols for containment, mitigation
Emergency operations plan (EOP)
After Action Reports (AAR)
77%
50%
60%
n/a
44%
29%
23%
6%
10%
2.3
2.3.1
2.3.2
2.3.3
2.3.4
Emergency Access to Expertise, Capacity
24/7 emergency access to epi, environmental resources
24/7 access to laboratory resources
Access to infrastructure capable of providing surge capacity
CHB-state-tribal collaboration to build capacity for crises
73%
71%
48%
79%
25%
19%
38%
19%
2%
10%
15%
2%
2.4
2.4.1
2.4.2
2.4.3
Emergency Communications
24/7 communications protocols
Health alerts
Timely communication during emergencies
67%
90%
75%
33%
10%
23%
0%
0%
2%
KEY MEASURES IN DOMAIN 2, % FULLY MET, MINNESOTA CHBS, 2012-2014
2.1.4
Partnerships: Investigation
2.2.3
After Action Reports
2.4.2
Emergency health alerts
84%
65%
54%
2012
*
2013
2014
58%
2012
68%
2013
92%
96%
2012
2013
90%
60%
2014
2014
Participants could only choose from “Fully Meet” and “Cannot Meet” in 2014.
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STANDARDS IN DOMAIN 2, % FULLY MET BY POPULATION, MINNESOTA CHBS, 2014
CHB capacity to fully meet standards in Domain 2, by population, Minnesota, 2014
82%
81%
86%
73%
58%
57%
52%
63%
63%
71% 71% 68%
70%
80% 83% 77%
Small CHBs
Medium CHBs
Large CHBs
Minnesota
Standard 2.1
Standard 2.2
Standard 2.3
CHB capacity to meet measures in Domain 2, by population,
Minnesota, 2014
Standard 2.4
Small CHBs
(n=18)
Medium CHBs
(n=18)
Large CHBs
(n=12)
Minnesota
(n=48)
2.1
2.1.1
2.1.2
2.1.3
2.1.4
2.1.5
Investigating Problems and Hazards
Protocols for investigation
Infectious disease investigation
Non-infectious investigation capacity
Partnerships for investigation
Timely reporting
83%
83%
89%
78%
72%
72%
56%
72%
44%
44%
100%
92%
75%
75%
67%
83%
75%
79%
65%
60%
2.2
2.2.1
2.2.2
2.2.3
Containing/Mitigating Problems, Hazards
Protocols for containment, mitigation
Emergency operations plan (EOP)
After Action Reports (AAR)
67%
44%
61%
78%
39%
39%
92%
75%
92%
77%
50%
60%
2.3
2.3.1
2.3.2
2.3.3
2.3.4
Emergency Access to Expertise, Capacity
24/7 emergency access to epi, environmental resources
24/7 access to laboratory resources
Access to infrastructure capable of providing surge capacity
CHB-state-tribal collaboration to build capacity for crises
67%
67%
39%
78%
78%
72%
50%
83%
75%
75%
58%
75%
73%
71%
48%
79%
2.4
2.4.1
2.4.2
2.4.3
Emergency Communications
24/7 communications protocols
Health alerts
Timely communication during emergencies
61%
83%
67%
72%
94%
72%
67%
92%
92%
67%
90%
75%
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2014 Local Public Health Act Performance Measures
DOMAIN 3: INFORM AND EDUCATE
Inform and educate about public health issues and functions
ALL MEASURES IN DOMAIN 3, MINNESOTA CHBS, 2014
CHB capacity to meet measures in Domain 3, Minnesota, 2014
100%
80%
60%
Cannot Meet
40%
Partially Meet
Fully Meet
20%
0%
3.1.1
3.1.2
3.1.3
3.2.1
3.2.2
3.2.3
CHB capacity to meet measures in Domain 3, Minnesota, 2014 (n=48)
3.2.4
3.2.5
3.2.6
Fully Meet
Partially Meet
Cannot Meet
3.1
3.1.1
3.1.2
3.1.3
Health Education and Promotion
Information for the public
Health promotion
Health equity
75%
85%
63%
25%
15%
25%
0%
0%
13%
3.2
3.2.1
3.2.2
3.2.3
3.2.4
3.2.5
3.2.6
Communications
Information for the public
Branding
External communications procedures
Risk communication plan
Variety of methods
Culturally sensitive formats
79%
37%
33%
77%
46%
60%
19%
33%
35%
n/a*
48%
38%
2%
27%
31%
23%
6%
2%
KEY MEASURES IN DOMAIN 3, % FULLY MET, MINNESOTA CHBS, 2012-2014
3.1.1
Information for the public
3.1.2
Health promotion
76%
80%
85%
2013
2014
75%
58%
2012
*
48%
2013
2014
2012
Participants could only choose from “Fully Meet” and “Cannot Meet” in 2014.
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2014 Local Public Health Act Performance Measures
STANDARDS IN DOMAIN 3, % FULLY MET BY POPULATION, MINNESOTA CHBS, 2014
CHB capacity to fully meet standards in Domain 3, by population, Minnesota, 2014
83%
83%
74%
72%
59%
56%
Small CHBs
56%
45%
Medium CHBs
Large CHBs
Minnesota
Standard 3.1
Standard 3.2
CHB capacity to meet measures in Domain 3, by population,
Minnesota, 2014
Small CHBs
(n=18)
Medium CHBs
(n=18)
Large CHBs
(n=12)
Minnesota
(n=48)
3.1
3.1.1
3.1.2
3.1.3
Health Education and Promotion
Information for the public
Health promotion
Health equity
94%
94%
61%
50%
72%
56%
83%
92%
75%
75%
85%
63%
3.2
3.2.1
3.2.2
3.2.3
3.2.4
3.2.5
3.2.6
Communications
Information for the public
Branding
External communications procedures
Risk communication plan
Variety of methods
Culturally sensitive formats
78%
50%
33%
67%
39%
67%
67%
22%
22%
78%
28%
56%
100%
50%
50%
92%
83%
58%
79%
40%
33%
77%
46%
60%
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2014 Local Public Health Act Performance Measures
DOMAIN 4: COMMUNITY ENGAGEMENT
Engage with the community to identify and address health problems
ALL MEASURES IN DOMAIN 4, MINNESOTA CHBS, 2014
CHB capacity to meet measures in Domain 4, Minnesota, 2014
100%
80%
60%
Cannot Meet
40%
Partially Meet
Fully Meet
20%
0%
4.1.1
4.1.2
4.2.1
CHB capacity to meet measures in Domain 4, Minnesota, 2014 (n=48)
4.2.2
Fully Meet
Partially Meet
Cannot Meet
4.1
4.1.1
4.1.2
Collaboration
Partnerships
Technical assistance
94%
75%
6%
10%
0%
15%
4.2
4.2.1
4.2.2
Policies and Strategies
Community engagement
Engagement with governance
90%
96%
8%
4%
2%
0%
KEY MEASURES IN DOMAIN 4, %
FULLY MET, MINN. CHBS, 2012-2014
STANDARDS IN DOMAIN 4, % FULLY MET BY POPULATION,
MINNESOTA CHBS, 2014
4.1.1
Partnerships
94%
CHB capacity to fully meet standards in Domain 4, by population,
Minnesota, 2014
94%
92%
92%
72%
92%
84%
89%
100%
93%
Small CHBs
73%
Medium CHBs
Large CHBs
Minnesota
2012
2013
2014
Standard 4.1
CHB capacity to meet measures in Domain 4, by population,
Minnesota, 2014
Standard 4.2
Small CHBs
(n=18)
Medium CHBs
(n=18)
Large CHBs
(n=12)
Minnesota
(n=48)
4.1
4.1.1
4.1.2
Collaboration
Partnerships
Technical assistance
100%
83%
83%
61%
100%
83%
94%
75%
4.2
4.2.1
4.2.2
Policies and Strategies
Community engagement
Engagement with governance
89%
94%
83%
94%
100%
100%
90%
96%
MDH Health Partnerships Division
13
September 2014
2014 Local Public Health Act Performance Measures
DOMAIN 5: POLICIES AND PLANS
Develop public health policies and plans
ALL MEASURES IN DOMAIN 5, MINNESOTA CHBS, 2014
CHB capacity to meet measures in Domain 5, Minnesota, 2014
100%
80%
60%
Cannot Meet
40%
Partially Meet
Fully Meet
20%
0%
5.1.1
5.1.2
5.1.3
5.2.1
5.2.2
5.2.3
5.2.4
5.3.1
5.3.2
CHB capacity to meet measures in Domain 5, Minnesota, 2014 (n=48)
5.3.3
5.4.1
5.4.2
Fully Meet
Partially Meet
Cannot Meet
5.1
5.1.1
5.1.2
5.1.3
Serving as Resource
Monitor and track issues
Engagement in policy development
Education
90%
75%
73%
8%
21%
19%
2%
4%
8%
5.2
5.2.1
5.2.2
5.2.3
5.2.4
Community Health Improvement Plan (CHIP)
Process for CHIP
CHIP
Collaborative implementation of CHIP
Monitor and revise CHIP
94%
92%
48%
35%
n/a*
n/a
33%
21%
6%
8%
19%
44%
5.3
5.3.1
5.3.2
5.3.3
Strategic Plan
Process for strategic plan
Strategic plan
Implement strategic plan
98%
98%
56%
n/a
n/a
23%
2%
2%
21%
5.4
5.4.1
5.4.2
Emergency Operations Plan
Develop emergency operations plan (EOP)
Emergency operations plan (EOP)
85%
79%
15%
21%
0%
0%
KEY MEASURES IN DOMAIN 5, % FULLY MET, MINNESOTA CHBS, 2012-2014
5.2.1
CHIP process
5.2.2
CHIP
94%
5.2.3
Collaborative CHIP impl.
92%
48%
56%
25%
33%
2012
*
23%
2013
2014
2012
35%
32%
8%
30%
2013
5.2.4
Monitor and revise CHIP
2014
2012
2013
2014
2012
16%
2013
2014
Participants could only choose from “Fully Meet” and “Cannot Meet” in 2014.
MDH Health Partnerships Division
14
September 2014
2014 Local Public Health Act Performance Measures
5.3.1
Strategic planning process
58%
5.3.2
Strategic plan
98%
5.3.3
Implement strategic plan
98%
56%
31%
24%
17%
12%
28%
2012
2013
2014
2012
2013
2014
2012
2013
2014
STANDARDS IN DOMAIN 5, % FULLY MET BY POPULATION, MINNESOTA CHBS, 2014
CHB capacity to fully meet standards in Domain 5, by population, Minnesota, 2014
80% 74%
86%
79%
69%
79%
57%
89%
67%
76%
89% 84%
96%
75%
81%
82%
Small CHBs
Medium CHBs
Large CHBs
Minnesota
Standard 5.1
Standard 5.2
Standard 5.3
CHB capacity to meet measures in Domain 5, by population,
Minnesota, 2014
Standard 5.4
Small CHBs
(n=18)
Medium CHBs
(n=18)
Large CHBs
(n=12)
Minnesota
(n=48)
5.1
5.1.1
5.1.2
5.1.3
Serving as Resource
Monitor and track issues
Engagement in policy development
Education
89%
72%
78%
89%
67%
67%
92%
92%
75%
90%
75%
73%
5.2
5.2.1
5.2.2
5.2.3
5.2.4
Community Health Improvement Plan (CHIP)
Process for CHIP
CHIP
Collaborative implementation of CHIP
Monitor and revise CHIP
94%
94%
44%
44%
89%
89%
33%
17%
100%
92%
75%
50%
94%
92%
48%
35%
5.3
5.3.1
5.3.2
5.3.3
Strategic Plan
Process for strategic plan
Strategic plan
Implement strategic plan
100%
100%
67%
94%
100%
33%
100%
92%
75%
98%
98%
56%
5.4
5.4.1
5.4.2
Emergency Operations Plan
Develop emergency operations plan (EOP)
Emergency operations plan (EOP)
78%
72%
83%
78%
100%
92%
85%
79%
MDH Health Partnerships Division
15
September 2014
2014 Local Public Health Act Performance Measures
DOMAIN 6: PUBLIC HEALTH LAWS
Enforce public health laws
ALL MEASURES IN DOMAIN 6, MINNESOTA CHBS, 2014
CHB capacity to meet measures in Domain 6, Minnesota, 2014
100%
80%
60%
Cannot Meet
40%
Partially Meet
Fully Meet
20%
0%
6.1.1
6.1.2
6.2.1
6.2.2
6.2.3
6.3.1
CHB capacity to meet measures in Domain 6, Minnesota, 2014 (n=48)
6.3.2
6.3.3
6.3.4
6.3.5
Fully Meet
Partially Meet
Cannot Meet
6.1
6.1.1
6.1.2
Review and Update
Review laws
Communication with governing bodies
60%
58%
27%
23%
13%
19%
6.2
6.2.1
6.2.2
6.2.3
Education
Consistency
Laws and licenses accessible to public
Education
63%
77%
83%
29%
n/a*
n/a
8%
23%
17%
6.3
6.3.1
6.3.2
6.3.3
6.3.4
6.3.5
Conduct and Monitor Activities
Enforcement procedures and protocols
Inspection schedule
Following procedures and protocols
Identifying compliance patterns
Coordinated notification
69%
56%
56%
42%
31%
25%
13%
23%
29%
29%
6%
31%
21%
29%
40%
KEY MEASURES IN DOMAIN 6, % FULLY MET, MINNESOTA CHBS, 2012-2014
6.3.4
Identifying compl. patterns
17%
2012
*
30%
2013
42%
2014
Participants could only choose from “Fully Meet” and “Cannot Meet” in 2014.
MDH Health Partnerships Division
16
September 2014
2014 Local Public Health Act Performance Measures
STANDARDS IN DOMAIN 6, % FULLY MET BY POPULATION, MINNESOTA CHBS, 2014
CHB ability to fully meet standards in Domain 6, by population, Minnesota, 2014
69%
67%
76%
59%
69%
81%
74%
67%
46%
44%
46%
Small CHBs
51%
Medium CHBs
Large CHBs
Minnesota
Standard 6.1
Standard 6.2
Standard 6.3
CHB capacity to meet measures in Domain 6, by population,
Minnesota, 2014
Small CHBs
(n=18)
Medium CHBs
(n=18)
Large CHBs
(n=12)
Minnesota
(n=48)
6.1
6.1.1
6.1.2
Review and Update
Review laws
Communication with governing bodies
61%
78%
50%
39%
75%
58%
60%
58%
6.2
6.2.1
6.2.2
6.2.3
Education
Consistency
Laws and licenses accessible to public
Education
56%
78%
94%
67%
72%
67%
67%
83%
92%
63%
77%
83%
6.3
6.3.1
6.3.2
6.3.3
6.3.4
6.3.5
Conduct and Monitor Activities
Enforcement procedures and protocols
Inspection schedule
Following procedures and protocols
Identifying compliance patterns
Coordinated notification
61%
44%
50%
39%
33%
72%
50%
50%
39%
17%
75%
83%
75%
50%
50%
69%
56%
56%
42%
31%
MDH Health Partnerships Division
17
September 2014
2014 Local Public Health Act Performance Measures
DOMAIN 7: ACCESS TO CARE
Promote strategies to improve access to health care
ALL MEASURES IN DOMAIN 7, MINNESOTA CHBS, 2014
CHB capacity to meet measures in Domain 7, Minnesota, 2014
100%
80%
60%
Cannot Meet
40%
Partially Meet
20%
Fully Meet
0%
7.1.1
7.1.2
7.1.3
7.2.1
7.2.2
CHB capacity to meet measures in Domain 7, Minnesota, 2014 (n=48)
7.2.3
Fully Meet
Partially Meet
Cannot Meet
7.1
7.1.1
7.1.2
7.1.3
Assess Capacity and Access
Assessing available health services
Identifying populations with barriers
Identifying gaps in access
58%
60%
42%
33%
29%
38%
8%
10%
21%
7.2
7.2.1
7.2.2
7.2.3
Strategies to Improve Access
Strategy development process
Implemented strategies
Culturally competent initiatives
60%
69%
65%
29%
25%
19%
10%
6%
17%
KEY MEASURES IN DOMAIN 7, % FULLY MET, MINNESOTA CHBS, 2012-2014
7.1.3
Identifying gaps in access
68%
30%
7.2.3
Culturally competent
initiatives to increase access
7.2.2
Strategies to increase access
42%
40%
2014
2012
69%
62%
65%
2013
2014
40%
17%
2012
2013
MDH Health Partnerships Division
2013
2014
2012
18
September 2014
2014 Local Public Health Act Performance Measures
STANDARDS IN DOMAIN 7, % FULLY MET BY POPULATION, MINNESOTA CHBS, 2014
CHB capacity to fully meet standards in Domain 7, by population, Minnesota, 2014
65%
65%
53%
61%
54%
69%
65%
Small CHBs
43%
Medium CHBs
Large CHBs
Minnesota
Standard 7.1
Standard 7.2
CHB capacity to meet measures in Domain 7, by population,
Minnesota, 2014
Small CHBs
(n=18)
Medium CHBs
(n=18)
Large CHBs
(n=12)
Minnesota
(n=48)
7.1
7.1.1
7.1.2
7.1.3
Assess Capacity and Access
Assessing available health services
Identifying populations with barriers
Identifying gaps in access
61%
83%
50%
56%
39%
33%
58%
58%
42%
58%
60%
42%
7.2
7.2.1
7.2.2
7.2.3
Strategies to Improve Access
Strategy development process
Implemented strategies
Culturally competent initiatives
56%
67%
72%
61%
72%
50%
67%
67%
75%
60%
69%
65%
MDH Health Partnerships Division
19
September 2014
2014 Local Public Health Act Performance Measures
DOMAIN 8: WORKFORCE
Maintain a competent public health workforce
ALL MEASURES IN DOMAIN 8, MINNESOTA CHBS, 2014
CHB capacity to meet measures in Domain 8, Minnesota, 2014
100%
80%
60%
Cannot Meet
40%
Partially Meet
20%
Fully Meet
0%
8.1.1
8.2.1
8.2.2
8.2.3
CHB capacity to meet measures in Domain 8, Minnesota, 2014 (n=48)
8.2.4
Fully Meet
Partially Meet
Cannot Meet
8.1
8.1.1
Sufficient Public Health Workforce
Collaboration to develop future workforce
98%
n/a*
2%
8.2
8.2.1
8.2.2
8.2.3
8.2.4
Competent Workforce
Workforce development plan
Competent workforce
Professional development
Work environment
23%
56%
77%
60%
33%
44%
23%
38%
44%
0%
0%
2%
KEY MEASURES IN DOMAIN 8, %
FULLY MET, MINN. CHBS, 2012-2014
STANDARDS IN DOMAIN 8, % FULLY MET BY POPULATION,
MINNESOTA CHBS, 2014
8.2.1
Workforce dev. plan
CHB capacity to fully meet standards in Domain 8, by population,
Minnesota, 2014
100% 94% 100% 98%
58%
13%
2012
23%
43%
Small CHBs
54%
Medium CHBs
Large CHBs
8%
2013
Minnesota
2014
Standard 8.1
CHB capacity to meet measures in Domain 8, by population,
Minnesota, 2014
*
65%
Standard 8.2
Small CHBs
(n=18)
Medium CHBs
(n=18)
Large CHBs
(n=12)
Minnesota
(n=48)
8.1
8.1.1
Sufficient Public Health Workforce
Collaboration to develop future workforce
100%
94%
100%
98%
8.2
8.2.1
8.2.2
8.2.3
8.2.4
Competent Workforce
Workforce development plan
Competent workforce
Professional development
Work environment
23%
67%
83%
61%
11%
39%
72%
50%
42%
67%
75%
75%
23%
56%
77%
60%
Participants could only choose from “Fully Meet” and “Cannot Meet” in 2014.
MDH Health Partnerships Division
20
September 2014
2014 Local Public Health Act Performance Measures
DOMAIN 9: QUALITY IMPROVEMENT
Evaluate and continuously improve processes, programs, and interventions
ALL MEASURES IN DOMAIN 9, MINNESOTA CHBS, 2014
CHB capacity to meet measures in Domain 9, Minnesota, 2014
100%
80%
60%
Cannot Meet
40%
Partially Meet
20%
Fully Meet
0%
9.1.1
9.1.2
9.1.3
9.1.4
9.1.5
9.2.1
CHB capacity to meet measures in Domain 9, Minnesota, 2014 (n=48)
9.2.2
Fully Meet
Partially Meet
Cannot Meet
9.1
9.1.1
9.1.2
9.1.3
9.1.4
9.1.5
Performance Management System
Staff engagement in development
Performance management system
Implemented performance management system
Customer satisfaction
Opportunities for staff involvement
42%
48%
23%
44%
40%
27%
n/a*
38%
33%
27%
31%
52%
40%
23%
33%
9.2
9.2.1
9.2.2
Quality Improvement
Quality improvement plan/program
Implemented quality improvement activities
94%
50%
0%
25%
6%
25%
KEY MEASURES IN DOMAIN 9, % FULLY MET, MINNESOTA CHBS, 2012-2014
9.1.1
Staff engagement in
developing PM system
9.1.2
PM system
*
26%
2012
2013
2014
9.1.4
Customer satisf. process
48%
42%
21%
9.1.3
Implemented PM system
13%
12%
2012
2013
2014
12%
14%
2012
2013
23%
27%
2014
2012
42%
44%
2013
2014
Participants could only choose from “Fully Meet” and “Cannot Meet” in 2014.
MDH Health Partnerships Division
21
September 2014
2014 Local Public Health Act Performance Measures
9.1.5
Staff involvement in PM
9.2.1
QI plan/program
9.2.2
Implemented QI activities
94%
50%
40%
27%
26%
10%
2012
2013
2014
2012
2013
32%
23%
10%
2014
2012
2013
2014
STANDARDS IN DOMAIN 9, % FULLY MET BY POPULATION, MINNESOTA CHBS, 2014
CHB capacity to fully meet standards in Domain 9, by population, Minnesota, 2014
72%
70%
75%
72%
58%
Small CHBs
37%
39%
Medium CHBs
29%
Large CHBs
Minnesota
Standard 9.1
Standard 9.2
CHB capacity to meet measures in Domain 9, by population,
Minnesota, 2014
Small CHBs
(n=18)
Medium CHBs
(n=18)
Large CHBs
(n=12)
Minnesota
(n=48)
9.1
9.1.1
9.1.2
9.1.3
9.1.4
9.1.5
Performance Management System
Staff engagement in development
Performance management system
Implemented performance management system
Customer satisfaction
Opportunities for staff involvement
33%
50%
28%
33%
39%
33%
28%
6%
44%
33%
67%
75%
42%
58%
50%
42%
48%
23%
44%
40%
9.2
9.2.1
9.2.2
Quality Improvement
Quality improvement plan/program
Implemented quality improvement activities
94%
44%
100%
44%
83%
67%
94%
50%
MDH Health Partnerships Division
22
September 2014
2014 Local Public Health Act Performance Measures
DOMAIN 10: EVIDENCE-BASED PRACTICES
Contribute to and apply the evidence base of public health
ALL MEASURES IN DOMAIN 10, MINNESOTA CHBS, 2014
CHB capacity to meet measures in Domain 10, Minnesota, 2014
100%
80%
60%
Cannot Meet
40%
Partially Meet
20%
Fully Meet
0%
10.1.1
10.2.1 (n=21)
10.2.2
10.2.3
CHB capacity to meet measures in Domain 10, Minnesota, 2014 (n=48)
10.1
10.1.1
Identification and Use
Use of evidence-based/promising practices
10.2
10.2.1
10.2.2
10.2.3
Promotion
Human subject protection
Expert analysis
Communication
KEY MEASURES IN DOMAIN 10, %
FULLY MET, MINN. CHBS, 2012-2014
n=21
Fully Meet
Partially Meet
Cannot Meet
88%
8%
4%
76%
56%
63%
n/a*
17%
13%
24%
27%
25%
STANDARDS IN DOMAIN 10, % FULLY MET BY POPULATION,
MINNESOTA CHBS, 2014
10.1.1
Use of evidence-based/
promising practices
CHB capacity to fully meet standards in Domain 10, by population,
Minnesota, 2014
100%
88%
92%
72%
88%
82%
56%
68%
54%
Small CHBs
62%
Medium CHBs
Large CHBs
48%
Minnesota
2012
2013
2014
Standard 10.1
CHB capacity to meet measures in Domain 10, by population,
Minnesota, 2014
*
10.1
10.1.1
Identification and Use
Use of evidence-based/promising practices
10.2
10.2.1
10.2.2
10.2.3
Promotion
Human subject protection
Expert analysis
Communication
Standard 10.2
Small CHBs
(n=18)
Medium CHBs
(n=18)
Large CHBs
(n=12)
Minnesota
(n=48)
100%
72%
92%
88%
71% (n=7)
50%
56%
80% (n=5)
44%
56%
78% (n=9)
83%
83%
76% (n=21)
56%
63%
Participants could only choose from “Fully Meet” and “Cannot Meet” in 2014.
MDH Health Partnerships Division
23
September 2014
2014 Local Public Health Act Performance Measures
DOMAIN 11: ADMINISTRATION AND MANAGEMENT
Maintain administrative and management capacity
ALL MEASURES IN DOMAIN 11, MINNESOTA CHBS, 2014
CHB capacity to meet measures in Domain 11, Minnesota, 2014
100%
80%
60%
Cannot Meet
40%
Partially Meet
Fully Meet
20%
0%
11.1.1
11.1.2
11.1.3
11.1.4
11.1.5
11.1.6
11.1.7
CHB capacity to meet measures in Domain 11, Minnesota, 2014 (n=48)
11.2.1
11.2.2
11.2.3
11.2.4
Fully Meet
Partially Meet
Cannot Meet
11.1
11.1.1
11.1.2
11.1.3
11.1.4
11.1.5
11.1.6
11.1.7
Operational Infrastructure
CHB policies and procedures
Ethical issues and decisions
Confidentiality policies
Cultural sensitivity
Human resources
Information management
Clean, safe, accessible, and secure facilities
67%
31%
71%
29%
81%
69%
73%
33%
29%
27%
48%
17%
31%
25%
0%
40%
2%
23%
2%
0%
2%
11.2
11.2.1
11.2.2
11.2.3
11.2.4
Financial Management
Oversight of grants and contracts
Written agreements
Financial management systems
Additional resources to support CHB
94%
98%
100%
90%
4%
2%
0%
10%
2%
0%
0%
0%
KEY MEASURES IN DOMAIN 11, % FULLY MET, MINNESOTA CHBS, 2012-2014
11.1.4
Cultural sensitivity in
operations
21%
2012
28%
29%
2013
2014
MDH Health Partnerships Division
24
September 2014
2014 Local Public Health Act Performance Measures
STANDARDS IN DOMAIN 11, % FULLY MET BY POPULATION, MINNESOTA CHBS, 2014
CHB capacity to fully meet standards in Domain 11, by population, Minnesota, 2014
99%
90%
98%
95%
76%
56%
53%
Small CHBs
60%
Medium CHBs
Large CHBs
Minnesota
Standard 11.1
Standard 11.2
CHB capacity to meet measures in Domain 11, by population,
Minnesota, 2014
Small CHBs
(n=18)
Medium CHBs
(n=18)
Large CHBs
(n=12)
Minnesota
(n=48)
11.1
11.1.1
11.1.2
11.1.3
11.1.4
11.1.5
11.1.6
11.1.7
Operational Infrastructure
CHB policies and procedures
Ethical issues and decisions
Confidentiality policies
Cultural sensitivity
Human resources
Information management
Clean, safe, accessible, and secure facilities
56%
28%
67%
28%
78%
72%
67%
72%
17%
61%
11%
78%
61%
72%
75%
58%
92%
58%
92%
75%
83%
67%
31%
71%
29%
81%
69%
73%
11.2
11.2.1
11.2.2
11.2.3
11.2.4
Financial Management
Oversight of grants and contracts
Written agreements
Financial management systems
Additional resources to support CHB
100%
94%
100%
100%
83%
100%
100%
78%
100%
100%
100%
92%
94%
98%
100%
90%
MDH Health Partnerships Division
25
September 2014
2014 Local Public Health Act Performance Measures
DOMAIN 12: GOVERNANCE
Maintain capacity to engage the public health governing entity
ALL MEASURES IN DOMAIN 12, MINNESOTA CHBS, 2014
CHB capacity to meet measures in Domain 12, Minnesota, 2014
100%
80%
60%
Cannot Meet
40%
Partially Meet
Fully Meet
20%
0%
12.1.1
12.1.2
12.2.1
12.3.1
CHB capacity to meet measures in Domain 12, Minnesota, 2014 (n=48)
12.3.2
12.3.3
Fully Meet
Partially Meet
Cannot Meet
12.1
12.1.1
12.1.2
Roles, Responsibilities, and Authorities
Mandated operations, programs, and services provided
Operational definitions of governing entity’s roles/responsibilities
96%
94%
4%
6%
0%
0%
12.2
12.2.1
Communication
Communication with governing entity regarding responsibilities
71%
27%
2%
12.3
12.3.1
12.3.2
12.3.3
Engagement
Providing information to governing entity on important issues/actions
Tracking/reviewing governing entity actions
Communication with governing entity about performance
96%
73%
67%
4%
15%
23%
0%
13%
10%
KEY MEASURES * IN DOMAIN 12, % FULLY MET, MINNESOTA CHBS, 2012-2014
12.2.1*
Communication with
Governing Entity
83%
90%
71%
88%
71%
2012
*
2013
2014
This measure was previously listed as two separate measures in PHAB Standards and Measures v1.0: 12.2.1A and 12.2.2A.
MDH Health Partnerships Division
26
September 2014
2014 Local Public Health Act Performance Measures
STANDARDS IN DOMAIN 12, % FULLY MET BY POPULATION, MINNESOTA CHBS, 2014
CHB capacity to fully meet standards in Domain 12, by population, Minnesota, 2014
100%
89%
96%
95%
92%
72%
89%
85%
71%
65%
56%
79%
Small CHBs
Medium CHBs
Large CHBs
Minnesota
Standard 12.1
Standard 12.2
Standard 12.3
CHB capacity to meet measures in Domain 12, by population,
Minnesota, 2014
Small CHBs
(n=18)
Medium CHBs
(n=18)
Large CHBs
(n=12)
Minnesota
(n=48)
12.1
12.1.1
12.1.2
Roles, Responsibilities, and Authorities
Mandated operations, programs, and services provided
Operational definitions of governing entity’s roles/responsibilities
100%
100%
89%
90%
100%
92%
96%
94%
12.2
12.2.1
Communication
Communication with governing entity regarding responsibilities
72%
56%
92%
71%
12.3
12.3.1
Engagement
Providing information to governing entity on important
issues/actions
Tracking/reviewing governing entity actions
Communication with governing entity about performance
100%
89%
100%
96%
83%
72%
56%
50%
83%
83%
73%
67%
12.3.2
12.3.3
MDH Health Partnerships Division
27
September 2014
2014 Local Public Health Act Performance Measures
ASSURE AN ADEQUATE LOCAL PUBLIC HEALTH INFRASTRUCTURE: MINNESOTA-SPECIFIC MEASURES
WORKFORCE COMPETENCY
WORKFORCE STRENGTHS AND GAPS, MINNESOTA CHBS, 2014
CHB workforce strengths (top) and gaps (bottom), Minnesota, 2014
45%
Gaps
Strengths
41%
27%
25%
2%
4%
22%
Community
engagement
Leadership
Policy
development/
program
planning
20%
Cultural
competency
20%
20%
12%
Communication
10%
8%
20%
Financial
planning and
management
4%
31%
41%
Public
health
sciences
CHB workforce strengths and gaps, Minnesota, 2014 (n=50)
Analysis/assessment
Policy development/program planning
Communication
Cultural competency
Community engagement
Public health sciences
Financial planning and management
Leadership
Informatics
Analysis/
assessment
47%
Informatics
Strengths
Gaps
8%
27%
20%
25%
45%
10%
20%
41%
4%
31%
22%
12%
20%
4%
41%
20%
2%
47%
CHANGE IN WORKFORCE STRENGTHS AND GAPS, MINNESOTA CHBS, 2014
Strength: Cultural competency
8%
2012
18%
2013
25%
2014
Gap: Informatics
65%
2012
54%
2013
MDH Health Partnerships Division
Strength: Community engagement
54%
2012
48%
45%
2013
2014
Strength: Public health sciences
2%
2%
2012
2013
Gap: Financial planning and mgmt.
47%
12%
2014
2012
24%
2013
28
2014
Gap: Communication
20%
2014
10%
4%
8%
12%
2012
2013
2014
September 2014
2014 Local Public Health Act Performance Measures
5%
0%
45%
Analysis/
assessment
5%
0%
36%
11%
10%
25%
27%
0%
Public
health
sciences
32%
37%
36%
11%
Financial
planning and
management
40%
11%
25%
18%
16%
Communication
20%
9%
11%
15%
0%
32%
20%
27%
18%
37%
10%
5%
Cultural
competency
45%
Policy dev./
program
planning
Large CHBs
47%
Leadership
45%
Community
engagement
Small CHBs
Medium CHBs
35%
27%
35%
15%
37%
9%
16%
40%
64%
CHB workforce strengths (top) and gaps (bottom), Minnesota, 2014
0%
5%
26%
0%
55%
37%
36%
0%
0%
11%
Gaps
Strengths
WORKFORCE STRENGTHS AND GAPS, BY POPULATION, MINNESOTA CHBS, 2014
Informatics
Small CHBs
(n=19)
Medium CHBs
(n=20)
Large CHBs
(n=11)
Minnesota
(n=50)
Workforce Strengths
Analysis/assessment
Policy development/program planning
Communication
Cultural competency
Community engagement
Public health sciences
Financial planning and management
Leadership
Informatics
11%
16%
32%
37%
37%
11%
16%
26%
5%
10%
35%
20%
10%
55%
0%
25%
40%
5%
0%
27%
0%
27%
36%
27%
18%
64%
0%
8%
27%
20%
25%
45%
10%
20%
41%
4%
Workforce Gaps
Analysis/assessment
Policy development/program planning
Communication
Cultural competency
Community engagement
Public health sciences
Financial planning and management
Leadership
Informatics
32%
37%
11%
5%
11%
37%
11%
0%
47%
25%
15%
15%
35%
0%
40%
20%
5%
45%
36%
9%
9%
18%
0%
45%
36%
0%
45%
31%
22%
12%
20%
4%
41%
20%
2%
47%
CHB workforce strengths and gaps, by population, Minnesota, 2014
MDH Health Partnerships Division
29
September 2014
2014 Local Public Health Act Performance Measures
WORKFORCE STRENGTHS, RANKED, BY POPULATION, MINNESOTA CHBS, 2014
Small CHBs (n=19)
Medium CHBs (n=20)
Large CHBs (n=11)
Minnesota (n=50)
1
1
2
3
4
5
6
1
2
3
1
2
3
4
5
3
4
5
7
9
Community engagement
Cultural competency
Communication
Leadership
Policy dev./program planning
Financial planning/mgmt.
Analysis/assessment
Public health sciences
Informatics
Community engagement
Leadership
Policy dev./program planning
Financial planning/mgmt.
Communication
Analysis/assessment
Cultural competency
8
Informatics
n/r Public health sciences
Leadership
Community engagement
Policy dev./program planning
Cultural competency
Public health sciences
6
Financial planning/mgmt.
n/r Analysis
Communication
Informatics
7
8
9
Community engagement
Leadership
Policy dev./program planning
Cultural competency
Communication
Financial planning/mgmt.
Public health sciences
Analysis/assessment
Informatics
n/r: Not ranked
WORKFORCE GAPS, RANKED, BY POPULATION, MINNESOTA CHBS, 2014
Small CHBs (n=19)
Medium CHBs (n=20)
Large CHBs (n=11)
Minnesota (n=50)
1
2
1
2
3
4
5
6
1
1
2
3
4
5
Informatics
Public health sciences
Policy dev./program planning
4
Analysis/assessment
5
Financial planning/mgmt.
Communication
7
Community engagement
8
Cultural competency
n/r Leadership
Informatics
Public health sciences
Cultural competency
Analysis/assessment
Financial planning and mgmt.
Policy dev./program planning
Communication
8
Leadership
n/r Community engagement
Informatics
Public health sciences
3
Analysis/assessment
Financial planning and mgmt.
5
Cultural competency
6
Policy dev./program planning
7
Communication
n/r Leadership
Community engagement
7
8
9
Informatics
Public health sciences
Analysis/assessment
Policy dev./program planning
Cultural competency
Financial planning and mgmt.
Communication
Community engagement
Leadership
n/r: Not ranked
METHOD OF ASSESSING WORKFORCE STRENGTHS AND GAPS, MINNESOTA CHBS, 2014
Methods used to assess workforce, Minnesota CHBs, 2014
Used PHCC with MDH
28%
Used PHCC on own
None of the above
14%
Used tool instead of/with PHCC
Did not assess during 2014
Use of PHCC to assess
workforce
Assessed workforce in 2014
Assembled team to assess
Compiled/analyzed individuals
CHANGE IN METHOD OF
ASSESSING WORKFORCE *
Last assessed in 2012
4%
16%
10%
45%
Last assessed in 2011 or earlier
8%
19%
26%
Last assessed in 2013
4% 8%
2012
Method used to assess workforce strengths/gaps, Minnesota CHBs, 2014
2013
2014
Minnesota (n=50)
The CHB used the Public Health Core Competencies Tool (PHCC) on its own
The CHB used the Public Health Core Competencies Tool, with assistance from MDH
The CHB used an assessment tool instead of (or in addition to) the PH Core Competencies Tool
The CHB assembled a team knowledgeable of staff skills to conduct a workforce assessment
The CHB compiled and analyzed individual assessments to develop an overall workforce assessment
The CHB did not assess workforce strengths or gaps during this reporting cycle
Most recent CHB workforce assessment performed in 2013
Most recent CHB workforce assessment performed in 2012
Most recent CHB workforce assessment performed in 2011 or earlier
None of the above
14%
28%
8%
28%
4%
38%
8%
4%
10%
16%
2014: Includes CHBs that chose “The CHB used the Core Competencies for Public Health Professionals Tool on its own” and “The CHB used the Core
Competencies for Public Health Professionals Tool with assistance from MDH.” 2012-2013: Includes CHBs that chose “The CHB used the Public Health
Core Competencies Tool.”
*
MDH Health Partnerships Division
30
September 2014
2014 Local Public Health Act Performance Measures
ASSURE AN ADEQUATE LOCAL PUBLIC HEALTH INFRASTRUCTURE: MINNESOTA-SPECIFIC MEASURES
SCHOOL HEALTH
CHB work with school health, Minnesota, 2014
Information and referral
94%
Wellness activities
94%
Partnership activities
92%
Provide public health updates/resources
92%
Consultations
88%
Community Crisis Management
84%
Facilitate or coordinate joint meetings
72%
Environmental
62%
Conduct trainings for staff
58%
Conduct trainings for students
50%
Provide health services in the schools
48%
Employ school nurses
CHB does not partner with school health
22%
0%
CHB work with school health, Minnesota, 2014
Minnesota (n=50)
Employ school nurses
Partnership activities
Provide health services in the schools
Conduct trainings for staff
Conduct trainings for students
Consultations
Facilitate or coordinate joint meetings
Provide public health updates/resources
Information and referral
Community Crisis Management (e.g., outbreaks)
Wellness activities (e.g., SHIP)
Environmental (e.g., mold, pesticides, lice)
CHB does not partner with school health
MDH Health Partnerships Division
22%
92%
48%
58%
50%
88%
72%
92%
94%
84%
94%
62%
0%
31
September 2014
2014 Local Public Health Act Performance Measures
ASSURE AN ADEQUATE LOCAL PUBLIC HEALTH INFRASTRUCTURE: MINNESOTA-SPECIFIC MEASURES
HEALTH EQUITY
WORK TOWARD HEALTH EQUITY, MINNESOTA CHBS, 2014
CHB work toward health equity, Minnesota, 2014
100%
80%
60%
Not true/I don't know
40%
Somewhat true
20%
Very true
0%
Health equity is Engaged with Esablished core
priority
external
contingency of
agencies/
staff
organizations
Increased
internal
resources
Built leadership Supported Built capacity to
capacity of
community achieve health
community
self-identified
equity
members
concerns
CHB work toward health equity, Minnesota, 2014 (n=50)
My CHB has identified health equity as a priority, with a specific intent to
address social determinants of health.
My CHB has built capacity (e.g., human resources, funding, training of
staff) to achieve health equity by addressing social determinants of health.
My CHB has established a core contingency of CHB staff who are poised to
advance a health equity agenda.
My CHB has increased the amount of internal resources directed to
addressing social determinants of health.
My CHB has engaged with local government agencies or other external
organizations to support policies and programs to achieve health equity.
My CHB has made deliberate efforts to build the leadership capacity of
community members to advocate on issues affecting social determinants
of health.
My CHB has provided resources to community groups to support their
self-identified concerns for achieving health equity in their community.
MDH Health Partnerships Division
32
Very true
Somewhat true
Not true
I don’t know
54%
42%
2%
2%
12%
70%
18%
0%
20%
56%
24%
0%
18%
52%
30%
0%
30%
60%
10%
0%
18%
60%
22%
0%
16%
58%
22%
0%
September 2014
2014 Local Public Health Act Performance Measures
AGREEMENT THAT WORK TOWARD HEALTH EQUITY IS “VERY TRUE” IN OWN CHB, BY POPULATION, MINNESOTA CHBS, 2014
CHB work toward health equity, by population, Minnesota, 2014
100%
80%
60%
40%
20%
0%
Health equity is Engaged with
priority
external
agencies/
organizations
Increased
internal
resources
Established core Built leadership Supported Built capacity to
contingency of capacity of community self- achieve health
staff
community
identified
equity
concerns
CHB work toward health equity, by population, Minnesota, 2014
My CHB has identified health equity as a priority, with a specific intent to
address social determinants of health.
My CHB has built capacity (e.g., human resources, funding, training of staff)
to achieve health equity by addressing social determinants of health.
My CHB has established a core contingency of CHB staff who are poised
to advance a health equity agenda.
My CHB has increased the amount of internal resources directed to
addressing social determinants of health.
My CHB has engaged with local government agencies or other external
organizations to support policies and programs to achieve health equity.
My CHB has made deliberate efforts to build the leadership capacity of
community members to advocate on issues affecting social determinants
of health.
My CHB has provided resources to community groups to support their
self-identified concerns for achieving health equity in their community.
MDH Health Partnerships Division
33
Small CHBs
(n=19)
Medium CHBs
(n=20)
Large CHBs
(n=11)
Minnesota
(n=50)
42%
50%
82%
54%
5%
15%
18%
12%
11%
20%
36%
20%
5%
10%
55%
18%
21%
25%
55%
30%
16%
15%
27%
18%
5%
25%
18%
16%
September 2014
2014 Local Public Health Act Performance Measures
ASSURE AN ADEQUATE LOCAL PUBLIC HEALTH INFRASTRUCTURE: MINNESOTA-SPECIFIC MEASURES
ORGANIZATIONAL QUALITY IMPROVEMENT MATURITY
WORK TOWARD ORGANIZATIONAL QUALITY IMPROVEMENT MATURITY, MINNESOTA CHBS, 2014
CHB work toward organizational QI maturity, Minnesota, 2014
100%
80%
60%
40%
20%
0%
Key
Staff
CHB has QI
decision- contribute to
plan
makers
decisions
support QI
Leaders
trained in
basic QI
Strongly agree, agree
Staff can
Most work
Customer
work across aligned with satisfaction
programs
QI
data used
Neutral
Job
CHB has CHB has high
descriptions pervasive QI level of QI
include QI
culture
capacity
Disagree, strongly disagree, I don't know
CHB work toward organizational QI maturity, Minnesota, 2014 (n=50)
Strongly
agree
Agree
Neutral
Disagree
Strongly
disagree
I don’t
know
24%
36%
68%
54%
6%
4%
0%
4%
2%
0%
0%
2%
8%
44%
28%
18%
2%
0%
66%
6%
26%
48%
6%
32%
2%
12%
0%
2%
0%
0%
28%
46%
26%
0%
0%
0%
56%
10%
12%
36%
38%
50%
8%
40%
30%
0%
10%
8%
0%
2%
0%
0%
0%
0%
6%
42%
28%
24%
0%
0%
Staff members are routinely asked to contribute to decisions at my CHB.
The leaders of the CHB are trained in basic methods for evaluating and
improving quality, such as Plan-Do-Study-Act.
Job descriptions for many individuals responsible for programs and
services in my CHB include specific responsibilities related to measuring
and improving quality.
My CHB has a quality improvement (QI) plan.
Customer satisfaction information is routinely used by many individuals
responsible for programs and services in my CHB.
When trying to facilitate change, staff has the authority to work within
and across program boundaries.
The key decision makers in my CHB believe QI is very important.
My CHB currently has a pervasive culture that focuses on continuous QI.
My CHB currently has aligned our commitment to quality with most of
our efforts, policies, and plans.
My CHB currently has a high level of capacity to engage in QI efforts.
GREATEST CHANGE IN ORGANIZATIONAL QI MATURITY (CHBS THAT AGREE/STRONGLY AGREE), MINNESOTA CHBS, 2014
CHB has QI plan
CHB has high level of QI capacity
Job descriptions include QI
92%
48%
36%
52%
2013
2014
33%
23%
42%
48%
29%
2012
2013
MDH Health Partnerships Division
2014
2012
2013
34
2014
2012
September 2014
2014 Local Public Health Act Performance Measures
WORK TOWARD ORGANIZATIONAL QI MATURITY (CHBS THAT STRONGLY AGREE/AGREE), BY POPULATION, MINNESOTA CHBS, 2014
CHB work toward organizational QI maturity, by population, Minnesota, 2014
100%
80%
60%
40%
20%
0%
Key
Staff
CHB has QI Leaders
Staff can Most work Customer
Job
CHB has
decision- contribute
plan
trained in work across aligned satisfaction descriptions pervasive
makers to decisions
basic QI programs
with QI
data used include QI QI culture
support QI
CHB work toward organizational QI maturity (CHBs that strongly
agree/agree), by population, Minnesota, 2014
Staff members are routinely asked to contribute to decisions at my CHB.
The leaders of the CHB are trained in basic methods for evaluating and
improving quality, such as Plan-Do-Study-Act.
Job descriptions for many individuals responsible for programs and
services in my CHB include specific responsibilities related to measuring
and improving quality.
My CHB has a quality improvement (QI) plan.
Customer satisfaction information is routinely used by many individuals
responsible for programs and services in my CHB.
When trying to facilitate change, staff has the authority to work within
and across program boundaries.
The key decision makers in my CHB believe QI is very important.
My CHB currently has a pervasive culture that focuses on continuous QI.
My CHB currently has aligned our commitment to quality with most of
our efforts, policies, and plans.
My CHB currently has a high level of capacity to engage in QI efforts.
CHB has
high level
of QI
capacity
Small CHBs
(n=19)
Medium CHBs
(n=20)
Large CHBs
(n=11)
Minnesota
(n=50)
95%
84%
85%
90%
100%
100%
92%
90%
47%
45%
73%
52%
95%
47%
90%
45%
91%
82%
92%
54%
58%
65%
100%
74%
84%
37%
37%
95%
65%
40%
100%
100%
82%
92%
48%
62%
37%
40%
82%
48%
METHOD OF ASSESSING ORGANIZATIONAL QI MATURITY, MINNESOTA CHBS, 2014
Method of assessing organizational quality
improvement maturity, Minnesota CHBs, 2014
Leadership
completed,
18%
Other, 6%
Survey to
core staff,
18%
MDH Health Partnerships Division
Survey to
entire staff,
30%
One
person
completed,
28%
Method used to assess organizational quality improvement
maturity (i.e., completing questions 13-22), Minn. CHBs, 2014
Minnesota
(n=50)
One person (e.g., the CHS administrator, public health director,
etc.) filled out Q13-22, based on their knowledge of the agency
The agency administered the QI maturity survey to a core group
of staff (e.g., leadership team, QI council, etc.), and used those
results for answering Q13-22
The agency administered the QI maturity survey to the entire
staff, and used those results for answering Q13-22
The agency used another assessment tool (instead of the QI
maturity survey) to answer Q13-22
Other
28%
35
18%
30%
0%
24%
September 2014
2014 Local Public Health Act Performance Measures
ORGANIZATIONAL QUALITY IMPROVEMENT MATURITY SCORE
The following CHBs are not included in rates below due to governance changes between 2012 and 2014: Horizon, Kandiyohi-Renville, Nobles, PolkNorman-Mahnomen, SWHHS (Southwest Health and Human Services).
MEDIAN QUALITY IMPROVEMENT MATURITY SCORE, MINNESOTA, 2012-2014
Quality improvement maturity scores can range from 0.0 to 5.0; for the sake of clarity, the full range of available scores is not shown on the vertical axis
of the figure below.
Median quality improvement maturity score, by population,
Minnesota, 2012-2014
4.5
Median QI
maturity score, by
pop., Minn.,
2012-2014
4.0
3.5
3.0
Small
CHBs
Med.
CHBs
Large
CHBs
Minn.
2011*
n/a
n/a
n/a
3.2
2012
3.1
3.5
3.8
3.5
2013
3.6
3.5
3.5
3.6
2014
3.8
3.6
4.4
3.9
2.5
2011
2012
2013
Small CHBs
Medium CHBs
Large CHBs
Minnesota
2014
CHANGE IN STATEWIDE QUALITY IMPROVEMENT MATURITY, MINNESOTA, 2012-2014
Statewide organizational QI maturity, Minnesota, 2011-2014
100%
80%
28%
60%
40%
60%
20%
0%
19%
2011
2012
Statewide organizational
QI maturity, Minnesota, 2011-2014
2011*
2012
2013
2014
50%
54%
64%
11%
4%
12%
17%
Minor involvement in QI
Informal or ad-hoc QI
46%
34%
2013
Formal, organization-wide QI
2014
Formal, organization-wide QI
(score of 4.0 or greater)
Informal or ad-hoc QI
(score of 3.0 to 3.9)
Minor involvement in QI
(score of 2.9 or less)
11%
19%
34%
46%
60%
64%
54%
50%
28%
17%
12%
4%
2011 data was obtained from the University of Southern Maine as part of the MLC (Multi-State Learning Collaborative) Survey. MDH was able to obtain
data for 56 respondents (80 percent response rate), representing a mix of CHBs and LHDs. Data for 2012-2014 was obtained from PPMRS and the
reporting entity was the CHB.
*
MDH Health Partnerships Division
36
September 2014
2014 Local Public Health Act Performance Measures
ASSURE AN ADEQUATE LOCAL PUBLIC HEALTH INFRASTRUCTURE: MINNESOTA-SPECIFIC MEASURES
HEALTH INFORMATION TECHNOLOGY
Software used for public health EHR,
Minnesota CHBs, 2014
Planned EHR system changes in next 18 months,
Minnesota CHBs, 2014
PH-Doc
Software by CHAMP
36%
Software by CareFacts
Decade
None
52%
Assess and plan for new system
8%
Select, implement new system
4%
10%
8%
No major changes
2%
Other
58%
Exchange w/ another system
12%
Custom-built local system
Digital Health Department
Increase funct. capabilities, use
56%
I don't know
10%
24%
2%
2%
Software applications used for the electronic public
health record, Minnesota CHBs, 2014
Minnesota
(n=50)
Planned electronic health record system changes in
the next 18 months, Minnesota CHBs, 2014
Minnesota
(n=50)
56%
Assess and plan for a new EHR system
Select and implement a new EHR system
Increase the functional capabilities or use of the
EHR system
Electronically exchange health information with
another system
No major changes planned to current EHR system
I don’t know
10%
8%
58%
PH-Doc (Public Health Documentation
System by MCCC)
Software by CareFacts Information Systems, Inc.
Software by CHAMP Software, Inc.
Digital Health Department (by Garrison Enterprises, Inc.)
Decade (by DECADE Software Company)
Custom-built local system
No electronic system in place
Other
12%
36%
4%
2%
8%
2%
10%
52%
24%
2%
CURRENT HIT/HIE ACTIVITIES, MINNESOTA CHBS, 2014
Current organizational activities related to informatics,
Minnesota CHBs, 2014
Review current system/needs
42%
Conduct readiness assessment
Project management process
24%
MDH Health Partnerships Division
24%
Other
10%
Do not exchange with other orgs
8%
I don't know
12%
Review current system and determine information
needs of your organization
Create a strategic direction or plan for public health EHR
Implement a formal project management process
(i.e., use of project charter)
Conduct or review security risk analysis information and
privacy/confidentiality control in regard to EHR system
Conduct a readiness assessment for exchange (e.g.,
Public Health Informatics Profile Toolkit)
Other
None
70%
Query securely
20%
Current organizational activities related to health
informatics, Minnesota CHBs, 2014
70%
Receive securely
30%
Conduct security risk analysis
None of the above
Send securely
66%
Create strategic direction/plan
Other
Current health information exchange activities,
Minnesota CHBs, 2014
Minnesota
(n=50)
16%
2%
Current activities related to health information
exchange, Minnesota CHBs, 2014
66%
Send secure messages or attachments to
providers/facilities/organizations (e.g., during
referrals, care transitions)
Receive secure messages or attachments from
providers/facilities/ organizations (e.g.,
information from specialists, hospitals to which
your patients were referred)
Securely query for patient records from
providers/facilities/organizations
I don’t know
Do not exchange with other organizations
Other
42%
20%
30%
24%
8%
12%
37
Minnesota
(n=50)
70%
70%
24%
2%
16%
10%
September 2014
2014 Local Public Health Act Performance Measures
EXCHANGING WITH PARTNERS, MINNESOTA CHBS, 2014
Current and most needed partners from which Minnesota CHBs need to electronically recieve health information, 2014
Minnesota Dept. of Health
58%
Health/county-based purchasing plans
58%
Hospitals
52%
LHDs/CHBs outside jurisdiction
88%
34%
Laboratories
44%
20%
Pharmacies
32%
16%
Home health agencies
Do not receive/need to receive
52%
36%
County/city dept/program outside LHD
Other
70%
38%
Primary care clinics
Jail/correctional health
82%
42%
Minnesota Dept. of Human Services
Long-term care facilities
84%
74%
Most need to receive
34%
12%
Currently receive
34%
10%
54%
10%
4%
22%
6%
18%
Current partners from which Minnesota CHBs electronically receive health information, and
partners from which Minnesota CHBs most need to electronically receive health information, 2014 (n=50)
Currently
receive
Most need to
receive
34%
58%
12%
52%
10%
20%
42%
10%
58%
38%
16%
36%
4%
18%
44%
74%
34%
82%
22%
32%
70%
54%
84%
52%
34%
88%
6%
0%
County/city department/program outside or inside jurisdiction but outside local health department
Health or county-based purchasing plans
Home health agencies
Hospitals
Jail/correctional health
Laboratories
Local health departments/CHBs outside jurisdiction
Long-term care facilities
Minnesota Dept. of Health
Minnesota Dept. of Human Services
Pharmacies
Primary care clinics
Other
Do not electronically receive/need to receive health information
Current and most needed partners from which Minnesota CHBs need to electronically recieve health information, 2014
Minnesota Dept. of Health
66%
Health/county-based purchasing plans
Primary care clinics
74%
40%
Hospitals
34%
County/city dept/program outside LHD
34%
Home health agencies
48%
80%
44%
20%
44%
18%
Long-term care facilities
16%
Laboratories
16%
10%
Other
4% 4%
Do not receive/need to receive
12%
MDH Health Partnerships Division
92%
44%
Minnesota Dept. of Human Services
Jail/correctional health
68%
44%
LHDs/CHBs outside jurisdiction
Pharmacies
80%
56%
Most need to send
26%
56%
Currently send
20%
16%
38
September 2014
2014 Local Public Health Act Performance Measures
Current partners from which Minnesota CHBs electronically send health information, and
partners from which Minnesota CHBs most need to electronically send health information, 2014 (n=50)
County/city department/program outside or inside jurisdiction but outside local health department
Health or county-based purchasing plans
Home health agencies
Hospitals
Jail/correctional health
Laboratories
Local health departments/CHBs outside jurisdiction
Long-term care facilities
Minnesota Dept. of Health
Minnesota Dept. of Human Services
Pharmacies
Primary care clinics
Other
Do not electronically receive/need to receive health information
Currently
send
Most need to
send
34%
56%
20%
34%
10%
16%
44%
16%
66%
40%
18%
44%
4%
12%
44%
68%
44%
80%
16%
20%
74%
56%
80%
48%
26%
92%
4%
0%
CHALLENGES RELATED TO ELECTRONIC EXCHANGE, MINNESOTA CHBS, 2014
Largest challenges related to health information exchange with external organizations, Minnesota CHBs, 2014
HIPAA, privacy, legal concerns
Do not know partners' ability to exchange
Partners do not have capacity to exchange
Lack of access to tech support
Competing priorities
Subscription rates too high
Cannot standardize messages/transactions
Unclear value on ROI
Insufficient info on available options
Limited broadband/internet access
CHB support
Other
54%
48%
36%
34%
20%
20%
14%
14%
12%
4%
2%
10%
Largest challenges related to health information exchange with external organizations, Minnesota CHBs, 2014
Minnesota (n=50)
CHB support
Competing priorities
Do not know exchange partners' ability to electronically exchange health information
Exchange partners do not have the ability to electronically exchange health information
HIPAA, privacy, or legal concerns
Inability of our organization's EHR system to generate/receive electronic messages/transactions in standardized format
Insufficient information on exchange options available
Lack of access to technical support or expertise
Limited broadband/Internet access
Subscription rates for exchange services are too high
Unclear value on return on investment (ROI)
Other
2%
20%
48%
36%
54%
14%
12%
34%
4%
20%
14%
10%
Largest challenges related to health information exchange with external organizations, by population, Minnesota CHBs, 2014
64%
58%
45%
42%
50% 55%
50%
37%
37%
30%
36%
9%
16% 20%
27%
26%
Small CHBs
15% 18%
Medium CHBs
Large CHBs
HIPAA/privacy/ legal
concerns
Partners' ability
unknown
MDH Health Partnerships Division
Partners have no
ability
Lack of access to
TA/expertise
39
Competing priorities Subscription rates
too high
September 2014
2014 Local Public Health Act Performance Measures
Largest challenges related to HIE with external organizations, by
population, Minnesota CHBs, 2014
CHB support
Competing priorities
Do not know partners' ability to electronically exchange health info.
Partners do not have the ability to electronically exchange health info.
HIPAA, privacy, or legal concerns
Inability of our organization's EHR system to generate/receive electronic
messages/transactions in standardized format
Insufficient information on exchange options available
Lack of access to technical support or expertise
Limited broadband/internet access
Subscription rates for exchange services are too high
Unclear value on return on investment (ROI)
Other
Small CHBs
(n=19)
Medium CHBs
(n=20)
Large CHBs
(n=11)
Minnesota
(n=50)
5%
16%
42%
37%
58%
0%
0%
20%
50%
50%
45%
20%
0%
27%
55%
9%
64%
27%
2%
20%
48%
36%
54%
14%
11%
37%
5%
26%
16%
5%
10%
30%
5%
15%
15%
10%
18%
36%
0%
18%
9%
18%
12%
34%
4%
20%
14%
10%
WRITTEN ELECTRONIC HEALTH INFORMATION EXCHANGE PLANS, MINNESOTA CHBS, 2014
Electronic HIE plans, Minnesota CHBs, 2014
Electronic HIE plans, by population, Minnesota CHBs, 2014
36%
32%
CHB has
written plan,
26%
15%
CHB does
not have
written plan,
74%
Small CHBs
with written plans
CHB has written plan
CHB does not have written plan
Medium CHBs
with written plans
Large CHBs
with written plans
Small CHBs
(n=19)
Medium CHBs
(n=20)
Large CHBs
(n=11)
Minnesota
(n=50)
32%
68%
15%
85%
36%
64%
26%
74%
SKILLS AND ROLES NEEDED RELATED TO ELECTRONIC HEALTH RECORDS, MINNESOTA CHBS, 2014
Most needed skills and roles related to electronic health records, Minnesota CHBs, 2014
People to manage/process data
60%
Person to lead implementation
46%
People to help design/maintain/customize EHR
46%
People to train staff
36%
People to develop/write reports
People to get EHR ready for use
Other
28%
8%
14%
Most needed skills and roles related to electronic health records, Minnesota CHBs, 2014
A person to lead the implementation of an EHR
People to develop and write reports from an EHR
People to help design, maintain and customize an EHR for use in our facility
People to get the EHR ready for use (e.g., entering orders, patient information, etc.)
People to manage and process the data, information, and knowledge (e.g., informatics nurse or public
health professional)
People to train staff on how to use the EHR
Other
MDH Health Partnerships Division
40
Minnesota (n=50)
46%
28%
46%
8%
60%
36%
14%
September 2014
2014 Local Public Health Act Performance Measures
MOST NEEDED EHR-RELATED SKILLS AND ROLES, BY POPULATION, MINNESOTA CHBS, 2014
Most needed skills and roles related to electronic health records, by population, Minnesota CHBs, 2014
68%
65%
55% 55%
37%
65%
27%
32%
64%
36%
47%
46%
35%
Small CHBs
20%
16%
0%
People to
manage/process
data
Person to lead
implementation
People to help
design/maintain/
customize EHR
0%
People to train staff People to develop/
write reports
A person to lead the implementation of an EHR
People to develop and write reports from an EHR
People to help design, maintain and customize an EHR for use in our facility
People to get the EHR ready for use (e.g., entering orders, patient
information, etc.)
People to manage and process the data, information, and knowledge
(e.g., informatics nurse or public health professional)
People to train staff on how to use the EHR
Other
9%
Medium CHBs
Large CHBs
People to get EHR
ready for use
Small CHBs
(n=19)
Medium CHBs
(n=20)
Large CHBs
(n=11)
Minnesota
(n=50)
37%
0%
32%
16%
65%
35%
65%
0%
27%
64%
36%
9%
46%
28%
46%
8%
68%
55%
55%
60%
47%
10%
20%
25%
46%
0%
36%
14%
MOST NEEDED EHR-RELATED SKILLS AND ROLES, RANKED, BY POPULATION, MINNESOTA CHBS, 2014
Small CHBs (n=19)
Medium CHBs (n=20)
Large CHBs (n=11)
Minnesota (n=50)
1
1
1
People to develop/write
reports
People to manage/process
data
People to train staff
1
People to help design/
maintain/customize EHR
Person to lead
implementation
People to get EHR ready for
use
4
2
People to manage/process
data
People to train staff
3
Person to lead
implementation
4
People to help design/
maintain/customize EHR
5
People to get EHR ready for
use
n/r People to develop/write
reports
3
4
5
Person to lead
implementation
People to help design/
maintain/customize EHR
People to manage/process
data
People to develop/write
reports
People to train staff
2
3
4
5
n/r People to get EHR ready for
use
6
2
3
5
6
People to manage/process
data
Person to lead
implementation
People to help design/
maintain/customize EHR
People to train staff
People to develop/write
reports
People to get EHR ready for
use
n/r: Not ranked
MDH Health Partnerships Division
41
September 2014
2014 Local Public Health Act Performance Measures
ASSURE AN ADEQUATE LOCAL PUBLIC HEALTH INFRASTRUCTURE: MINNESOTA-SPECIFIC MEASURES
STATUTORY REQUIREMENTS
Meeting state statutory requirements, Minnesota CHBs, 2014
100%
80%
60%
Does not meet statutory requirements
40%
Meets statutory requirements
20%
0%
CHB composition
Business
transactions
CHS administrator Medical consultant
Nusiance
procedures
Meeting state statutory requirements, Minnesota CHBs, 2014
Minnesota (n=50)
The composition of the CHB meets the requirements required by Minn. Stat. § 145A.03, subd. 1.
The CHB has in place written procedures for transacting business and has kept a public record of its transactions,
findings, and determinations, as required by Minn. Stat. § 145A.03, subd. 5.
The CHB has a CHS administrator who meets the requirements of Minn. Rule 4736.0110.
The CHB has a medical consultant in accordance with Minn. Stat. § 145A.04, subd. 2a.
The CHB has written policies and procedures for implementing the removal and abatement of public health
nuisances specified in Minn. Stat. § 145A.04, subd. 8.
The CHS administrator reviewed and assured the accuracy of all reporting related to the Local Public Health Act,
Title V, and TANF, prior to submission.
100%
98%
98%
100%
84%
98%
BOARD MEETINGS IN 2014, MINNESOTA CHBS
Review of annual reporting by CHS admnistrator, Minnesota CHBs, 2014
CHS administrator did not
review reporting, 2%
CHS adminstrator reviewed
reporting, 98%
Meeting state statutory requirements, Minnesota CHBs, 2014
Minnesota (n=50)
The CHS administrator reviewed and assured the accuracy of all reporting related to the Local Public Health
Act, Title V, and TANF, prior to submission.
The CHS administrator did not review and assure the accuracy of all reporting related to the Local Public Health Act,
Title V, and TANF, prior to submission.
MDH Health Partnerships Division
42
98%
2%
September 2014
2014 Local Public Health Act Performance Measures
COMMUNITY HEALTH BOARD MEETINGS, MINNESOTA, 2014
Community health board meetings in 2014, Minnesota
At least twice per
month, 12%
Median number of board meetings/
year, Minnesota CHBs, 2012-2014
At least once
during year, 10%
11
10
At least quarterly,
22%
At least once per
month, 36%
7.5
At least every
other month, 20%
2012
2013
2014
Community health board meetings in 2014, Minnesota
Minnesota (n=50)
1 to 3 meetings in 2014 (at least once during year)
4 to 5 meetings in 2014 (at least quarterly)
6 to 11 meetings in 2014 (at least every other month)
12 to 25 meetings in 2014 (at once per month)
26 to 52 meetings in 2014 (at least twice per month)
10%
22%
20%
36%
12%
Number of meetings
MDH Health Partnerships Division
Minimum
Median
Maximum
2
11
52
43
September 2014
2014 Local Public Health Act Performance Measures
ASSURE AN ADEQUATE LOCAL PUBLIC HEALTH INFRASTRUCTURE: MINNESOTA-SPECIFIC MEASURES
PUBLIC HEALTH ACCREDITATION
Participation in public health accreditation, Minnesota CHBs, 2014
Not applying at this time,
21%
Planning to apply in 2015,
2%
Planning to apply in 2016,
6%
Planning to apply in 2017,
21%
Undecided, 29%
In process of applying, 19%
Achieved accreditation, 2%
Participation in national voluntary public health accreditation, Minnesota CHBs, 2014
Minnesota (n=48)
My CHB has achieved accreditation
My CHB is in the process of accreditation (e.g., has submitted a statement of intent)
My CHB is planning to apply (but is not in the process of accreditation)
My CHB is undecided about whether to apply for accreditation
My CHB has decided not to apply at this time
Individual jurisdictions within my CHB are participating in accreditation differently
2%
19%
29%
29%
21%
0%
Participation in public health accreditation, Minnesota CHBs,
2013-3014
45%
Participation in national voluntary
public health accreditation, Minnesota
CHBs, 2014
40%
35%
My CHB has achieved accreditation
My CHB is in the process of
accreditation (e.g., has submitted a
statement of intent)
My CHB is planning to apply (but is
not in the process of accreditation)
My CHB is undecided about whether
to apply for accreditation
My CHB has decided not to apply at
this time
Individual jurisdictions within my CHB
are participating in accreditation
differently
30%
25%
20%
15%
10%
5%
0%
2013
2014
Achieved accreditation
In process of applying
Planning to apply
Undecided
2013
2014
2%
8%
2%
19%
41%
29%
37%
29%
12%
21%
0%
0%
Not applying at this time
MDH Health Partnerships Division
44
September 2014
2014 Local Public Health Act Performance Measures
GEOGRAPHIC SPREAD OF CHBS PARTICIPATING IN PUBLIC HEALTH ACCREDITATION, MINNESOTA CHBS, 2014
Participation in national voluntary public health accreditation,
Minnesota CHBs, 2014
■
■
■
■
CHB has achieved accreditation (1)
Hennepin
CHB is in the process of accreditation (9)
Bloomington
Olmsted
Dakota
Richfield
Edina
St. Paul-Ramsey
Meeker-McLeod-Sibley
Washington
Minneapolis
CHB is planning to apply (14)
Carver
Morrison-Todd-Wadena
Chisago
Partnership4Health
Fillmore-Houston
Polk-Norman-Mahnomen
Goodhue
Scott
Horizon
Stearns
Kanabec-Pine
SWHHS
Kandiyohi-Renville
Wright
CHB is undecided about whether to apply for accreditation
CHB has decided not to apply at this time
PARTICIPATION IN PUBLIC HEALTH ACCREDITATION, BY POPULATION,
MINNESOTA CHBS, 2014
Small CHBs
Medium CHBs
Large CHBs
17%
17%
■ Not applying at
this time
39%
■ Undecided
33%
39%
■ Planning to apply
■ In the process of
applying
28%
22%
11%
33%
42%
11%
8%
My CHB has achieved accreditation
My CHB is in the process of accreditation (e.g., has submitted a statement
of intent)
My CHB is planning to apply (but is not in the process of accreditation)
My CHB is undecided about whether to apply for accreditation
My CHB has decided not to apply at this time
Individual jurisdictions within my CHB are participating in accreditation
differently
MDH Health Partnerships Division
45
■ Achieved
accreditation
Small CHBs
(n=18)
Medium CHBs
(n=18)
Large CHBs
(n=12)
Minnesota
(n=48)
0%
11%
0%
11%
8%
42%
2%
19%
22%
28%
39%
0%
33%
39%
17%
0%
33%
17%
0%
0%
29%
29%
21%
0%
September 2014
2014 Local Public Health Act Performance Measures
REASON(S) FOR NOT PARTICIPATING IN PUBLIC HEALTH ACCREDITATION AT THIS TIME, BY POPULATION, MINNESOTA CHBS, 2014
Reasons CHBs are undecided or will not apply for accreditation at this time, Minnesota, 2014
80%
67% 70%
47%
33%
20%
10%
Time/effort exceeds
benefits
Standards exceed
capacity
Interest/capacity
varies within CHB
Undecided
20% 20%
10%
0%
Fees too high
No support from
governing body
Standards not
appopriate
Undecided (n=15)
Reason(s) CHBs are undecided or will not apply for accreditation at this
time, Minnesota, 2014
Time and effort for accreditation application exceed the benefits of
accreditation
Accreditation standards exceed the capacity of my CHB
Interest/capacity varies within the jurisdictions of my CHB
Fees for accreditation are too high
No support from governing body for accreditation
Accreditation standards are not appropriate for my CHB
Not Applying
10%
Not applying at this time (n=10)
1° reason
2° reason
1° reason
2° reason
33%
33%
10%
60%
13%
27%
13%
7%
0%
20%
20%
7%
13%
0%
50%
0%
10%
20%
10%
40%
10%
0%
0%
0%
CHANGE IN PRIMARY REASON(S) FOR NOT PARTICIPATING IN ACCREDITATION AT THIS TIME, MINNESOTA CHBS, 2014
Time/effort exceed benefits
60%
39%
33%
Standards exceed capacity
Interest/capacity varies in jurisdictions
67%
33%
30%
21%
7%
2013
2014
2013
2014
19%
10%
5%
0%
2013
2014
Among undecided CHBs
Among undecided CHBs
Among undecided CHBs
Among CHBs not applying at this time
Among CHBs not applying at this time
Among CHBs not applying at this time
MDH Health Partnerships Division
46
September 2014
2014 Local Public Health Act Performance Measures
ASSURE AN ADEQUATE LOCAL PUBLIC HEALTH INFRASTRUCTURE: MINNESOTA-SPECIFIC MEASURES
CROSS-JURISDICTIONAL SHARING
Participation in cross-jurisdictional sharing, Minnesota CHBs, 2014
No participation
42%
Between CHBs
12%
16%
30%
Participated in cross-jurisdictional sharing
Did not participate in cross-jurisdictional
sharing
Participation in cross-jurisdictional sharing, Minnesota CHBs, 2014
Between CHBs AND among counties within a
multi-county CHB
Minnesota (n=50)
Between CHBs [only]
Among counties within a multi-county CHB [only]
Between CHBs AND counties within a multi-county CHB
Did not participate in cross-jurisdictional sharing
MDH Health Partnerships Division
Among counties within a multi-county CHB
42%
12%
30%
16%
47
September 2014
2014 Local Public Health Act Performance Measures
FUNCTIONS PERFORMED WITH CROSS-JURISDICTIONAL SHARING, MINNESOTA CHBS, 2041
Cross-jurisdictional sharing of rganizational and
administrative functions, Minnesota CHBs, 2014
Cross-jurisdictional sharing of programmatic functions,
Minnesota CHBs, 2014
Emergency prep.
SHIP
Community engagement
Maternal and child health
Population-based prevention
Health equity activities
C&TC outreach
Env health programs
WIC services and outreach
Communicable diseases
Chronic diseases
Direct clinical services
Oral health
Other
55%
48%
41%
37%
36%
36%
31%
24%
19%
19%
5%
26%
Programmatic functions for which CHBs shared
services across jurisdictions, Minnesota, 2014
Child and Teen Checkups (C&TC) outreach
Chronic disease screening or treatment
Communicable disease screening or treatment
Community engagement
Direct clinical services
Emergency preparedness planning, reporting,
or other ongoing activities
Environmental health programs (other than
inspection or licensing)
Health equity activities
Maternal and child health services (e.g., family
home visiting, early hearing detection and
intervention, birth defects)
Oral health
SHIP (Statewide Health Improvement Program
Population-based prevention programs other
than SHIP
WIC services and outreach
Other
None of the above
MDH Health Partnerships Division
Assessment and planning
Staff training
Strategic planning
Performance mgmt, QI
Communications
Financial management
CHS administration
Org structure and governance
Epidemiology or surveillance
HIT or management
Inspection, permit, or licensing
Workforce assessment, planning
Purchasing
Lab services
Human resources
Other
None of the above
83%
79%
Minnesota
(n=42)
36%
19%
24%
55%
19%
83%
36%
38%
48%
5%
79%
41%
31%
26%
0%
48
74%
62%
52%
50%
48%
43%
43%
36%
29%
29%
26%
26%
17%
10%
7%
17%
10%
Organizational and administrative functions for
which CHBs shared services across jurisdictions,
Minnesota, 2014
Minnesota
(n=42)
Assessment and planning
Communications or public information
Epidemiology or surveillance
Financial management
CHS administration
Human resources
Health information technology or management
Inspection, permit or licensing
Laboratory services
Organizational structure and governance
Performance management/quality improvement
Purchasing
Staff training
Strategic planning
Workforce assessment and planning
Other
None of the above
74%
47%
29%
43%
43%
7%
29%
26%
10%
38%
50%
17%
62%
52%
26%
17%
10%
September 2014
2014 Local Public Health Act Performance Measures
PROMOTE HEALTHY COMMUNITIES AND HEALTHY BEHAVIORS
PHYSICAL ACTIVITY
PHYSICAL ACTIVITY STRATEGIES AND FUNDING SOURCES, MINNESOTA CHBS, 2014
Physical activity strategies and funding sources, Minnesota CHBs, 2014
96%
96%
92%
88%
88%
Used SHIP funding for strategy
48%
36%
2%
Active Living for
Communities
36%
28%
2%
Active Schools
18%
2%
Worksite Wellness
8%
Used other funding for strategy
8%
Child Care
Was not involved in strategy
Health Care
Strategies (below) and funding sources (at right) used to promote physical activity,
Minnesota CHBs, 2014
Used SHIP
funding
Used other
(non-SHIP)
funding
No
involvement
96%
92%
96%
88%
88%
48%
36%
28%
18%
36%
2%
2%
2%
8%
8%
Active Living for Communities
Active Schools
Worksite Wellness
Child Care
Health Care
ACTIVITES RELATED TO PHYSICAL ACTIVITY STRATEGIES, MINNESOTA CHBS, 2014
Activities (below) related to strategies used (right) to promote physical
activity, Minnesota CHBs, 2014
Active Living
for Communities (n=49)
Active
Schools
(n=49)
Worksite
Wellness
(n=49)
Child Care
(n=46)
Health Care
(n=46)
90%
82%
98%
94%
80%
55%
29%
29%
27%
0%
92%
88%
96%
76%
69%
61%
43%
35%
33%
0%
94%
96%
94%
80%
74%
61%
47%
27%
27%
0%
96%
96%
85%
83%
52%
52%
33%
20%
20%
0%
85%
65%
89%
61%
54%
35%
24%
17%
15%
4%
Attended trainings
Conducted assessments
Convened partners or participated in coalitions
Involved with community outreach and education
Educated policymakers
Developed proposal or policy
Implemented policy
Maintained policy
Evaluated policy
None of the above
MDH Health Partnerships Division
49
September 2014
2014 Local Public Health Act Performance Measures
FUNDING SOURCES SUPPORTING PHYSICAL ACTIVITY STRATEGIES, MINNESOTA CHBS, 2014
Top funding sources supporting physical activity strategies, Minnesota CHBs,
2014
SHIP
45
Local tax levy
Grants/ foundation funds
State general fund
14
1
Federal program-specific funding
Fees/ reimbursements
6
Does
not
exceed
state
match
50%
10
3
Other state funds
3 1
8
10
1 4
CHBs in which local tax levy
investment in physical activity exceeds
required state match, Minnesota, 2014
(n=22)
7
1° Funding Source
2
2° Funding Source
3 2
3° Funding Source
1
Exceeds
required
state
match
50%
Title V Block Grant 0
Top funding sources used to support physical activity strategies, Minnesota CHBs, 2014
Local tax levy
State general fund
SHIP
Other state funds
Federal program-specific funding
Title V Block Grant
Grants/foundation funds
Fees/reimbursements
1° funding
source
2° funding
source
3° funding
source
0
1
45
0
3
0
1
0
14
4
3
3
7
0
10
0
8
10
1
2
2
0
6
1
PROMOTE HEALTHY COMMUNITIES AND HEALTHY BEHAVIORS
NUTRITION
NUTRITION STRATEGIES AND FUNDING SOURCES, MINNESOTA CHBS, 2014
Nutrition strategies and funding sources, Minnesota CHBs, 2014
98%
98%
92%
86%
80%
50%
Used SHIP funding for strategy
32%
0%
Healthy Eating in
Communities
32%
0%
Healthy School
Foods
28%
26%
4%
Worksite Wellness
8%
Child Care
Strategies (below) and funding sources (at right) used to promote nutrition,
Minnesota CHBs, 2014
Healthy Eating in Communities
Healthy School Foods
Worksite Wellness
Child Care
Health Care
MDH Health Partnerships Division
50
16%
Used other (non-SHIP) funding for strategy
Was not involved in strategy
Health Care
Used SHIP
funding
Used other
(non-SHIP)
funding
No
involvement
98%
98%
92%
86%
80%
50%
32%
32%
26%
28%
0%
0%
4%
8%
16%
September 2014
2014 Local Public Health Act Performance Measures
ACTIVITES RELATED TO NUTRITION STRATEGIES, MINNESOTA CHBS, 2014
Activities (below) related to strategies used (right) to promote
nutrition, Minnesota CHBs, 2014
Healthy
Eating in
Communities (n=50)
Healthy
School
Foods
(n=50)
Worksite
Wellness
(n=48)
Child Care
(n=46)
Health Care
(n=42)
92%
90%
96%
98%
68%
52%
44%
20%
20%
0%
92%
88%
98%
88%
76%
62%
52%
38%
36%
0%
90%
94%
96%
77%
67%
46%
33%
25%
27%
0%
96%
96%
85%
80%
54%
50%
41%
15%
17%
0%
88%
74%
83%
64%
57%
38%
33%
19%
14%
2%
Attended trainings
Conducted assessments
Convened partners or participated in coalitions
Involved with community outreach and education
Educated policymakers
Developed proposal or policy
Implemented policy
Maintained policy
Evaluated policy
None of the above
FUNDING SOURCES SUPPORTING NUTRITION STRATEGIES, MINNESOTA CHBS, 2014
Top funding sources supporting nutrition strategies, Minnesota CHBs, 2014
SHIP
45
Local tax levy
11
Grants/ foundation funds
State general fund
5
1
4
Other state funds
5
Fees/ reimbursements 0
Title V Block Grant
4
9
4
5
Federal program-specific funding
11
10
1
4
1° Funding Source
2° Funding Source
3° Funding Source
Does
not
exceed
state
match
50%
Exceeds
required
state
match
50%
1
Top funding sources used to support nutrition strategies, Minnesota CHBs, 2014
Local tax levy
State general fund
SHIP
Other state funds
Federal program-specific funding
Title V Block Grant
Grants/foundation funds
Fees/reimbursements
MDH Health Partnerships Division
CHBs in which local tax levy
investment in nutrition exceeds
required state match, Minnesota, 2014
(n=20)
51
1° funding
source
2° funding
source
3° funding
source
0
1
45
0
4
0
0
0
11
5
4
5
10
0
5
0
9
11
0
1
4
1
4
0
September 2014
2014 Local Public Health Act Performance Measures
PROMOTE HEALTHY COMMUNITIES AND HEALTHY BEHAVIORS
TOBACCO
TOBACCO STRATEGIES AND FUNDING SOURCES, MINNESOTA CHBS, 2014
Tobacco prevention and control strategies and funding sources, Minnesota CHBs, 2014
86%
76%
52%
52%
32%
22%
12%
2%
Tobacco-Free Living/Tobacco
Control
Used SHIP funding for strategy
34%
Used other (non-SHIP) funding for strategy
Was not involved in strategy
Worksite Wellness
Health Care
Strategies (below) and funding sources (at right) used to promote tobacco prevention and
control, Minnesota CHBs, 2014
Tobacco-Free Living/Tobacco Control
Worksite Wellness
Health Care
Used SHIP
funding
Used other
(non-SHIP)
funding
No
involvement
86%
76%
52%
52%
32%
22%
2%
12%
34%
Tobacco-Free
Living/Tobacco
Control (n=49)
Worksite
Wellness
(n=44)
Health Care
(n=33)
88%
94%
90%
90%
76%
80%
63%
51%
35%
0%
86%
84%
84%
71%
71%
55%
36%
32%
18%
0%
76%
73%
67%
70%
49%
42%
33%
27%
12%
3%
ACTIVITES RELATED TO TOBACCO STRATEGIES, MINNESOTA CHBS, 2014
Activities (below) related to strategies used (right) to promote tobacco prevention and
control, Minnesota CHBs, 2014
Attended trainings
Conducted assessments
Convened partners or participated in coalitions
Involved with community outreach and education
Educated policymakers
Developed proposal or policy
Implemented policy
Maintained policy
Evaluated policy
None of the above
FUNDING SOURCES SUPPORTING TOBACCO STRATEGIES, MINNESOTA CHBS, 2014
Top funding sources supporting tobacco prevention and control strategies,
Minnesota CHBs, 2014
SHIP
Local tax levy
35
1
Grants/ foundation funds
State general fund
12
4
4 1
1 4
7
4
5
Other state funds
4
4 1
Title V Block Grant
MDH Health Partnerships Division
2 2
1
8
Federal program-specific funding
Fees/ reimbursements
9
CHBs in which local tax levy
investment in tobacco prevention and
control exceeds required state match,
Minnesota, 2014 (n=21)
4
1° Funding Source
2° Funding Source
3° Funding Source
1
52
Does
not
exceed
state
match
57%
Exceeds
required
state
match
43%
September 2014
2014 Local Public Health Act Performance Measures
Top funding sources used to support tobacco prevention and control strategies,
Minnesota CHBs, 2014
1° funding
source
2° funding
source
3° funding
source
1
1
35
4
4
0
4
0
12
4
9
4
5
0
4
2
8
7
1
1
4
1
1
2
Local tax levy
State general fund
SHIP
Other state funds
Federal program-specific funding
Title V Block Grant
Grants/foundation funds
Fees/reimbursements
PROMOTE HEALTHY COMMUNITIES AND HEALTHY BEHAVIORS
ALCOHOL
ALCOHOL STRATEGIES AND FUNDING SOURCES, MINNESOTA CHBS, 2014
Strategies used related to alcohol use, Minnesota CHBs, 2014
Working on barriers faced by underserved populations
12%
Drinking and driving
36%
Beverage server training
34%
Health education messages
58%
None of the above
20%
Alcohol compliance checks
36%
Social host ordinances
34%
Alcohol use at community festivals and county fairs
30%
Policy advocacy
34%
Policies to reduce drink specials in bars and restaurants
8%
Alcohol outlet density in the community
8%
Screening, counseling, referral in health care settings*
Other*
28%
6%
* not asked in 2013.
Strategies used related to alcohol use, Minnesota CHBs, 2014
Minnesota (n=50)
Policy advocacy (strengthening local ordinances)
Policies to reduce drink specials in bars and restaurants
Alcohol compliance checks
Beverage server training
Alcohol outlet density in the community
Social host ordinances
Alcohol use at community festivals and county fairs
Drinking and driving
Health education messages
Working on barriers faced by underserved populations to reduce disparities in alcohol use
Screening, counseling, and/or referral in health care settings
Other
None of the above
MDH Health Partnerships Division
53
34%
8%
36%
34%
8%
34%
30%
36%
58%
12%
28%
6%
20%
September 2014
2014 Local Public Health Act Performance Measures
GREATEST CHANGE IN STRATEGIES RELATED TO ALCOHOL USE, MINNESOTA CHBS, 2013-2014
Policies to reduce
drink specials
Alcohol oulet density
Working on barriers for
underserved populations
Drinking and driving
42%
36%
8%
4%
8%
4%
2013
2014
2013
2014
12%
14%
2013
2014
2013
2014
ACTIVITES RELATED TO ALCOHOL STRATEGIES, MINNESOTA CHBS, 2014
Activities related to most frequently used strategies related to
alcohol use, Minnesota CHBs, 2014
Health
education
messages
(n=29)
Alcohol
compliance
checks
(n=18)
Drinking
and
driving
(n=18)
Policy
advocacy
(n=17)
Beverage
server
training
(n=17)
Social host
ordinances
(n=17)
62%
55%
66%
86%
41%
14%
7%
14%
7%
3%
56%
50%
67%
56%
50%
17%
17%
39%
11%
6%
61%
50%
89%
94%
61%
11%
0%
17%
11%
0%
82%
47%
82%
88%
82%
53%
29%
53%
29%
0%
76%
47%
82%
82%
76%
35%
41%
41%
18%
0%
41%
35%
76%
65%
59%
41%
18%
53%
24%
6%
Attended trainings
Conducted assessments
Convened partners or participated in coalitions
Involved with community outreach and education
Educated policymakers
Developed proposal or policy
Implemented policy
Maintained policy
Evaluated policy
None of the above
FUNDING SOURCES SUPPORTING ALCOHOL STRATEGIES, MINNESOTA CHBS, 2014
Top funding sources supporting alcohol use strategies, Minnesota CHBs, 2014
Local tax levy
17
State general fund
6
Federal program-specific funding
6
Other state funds
Grants/foundation funds
Fees/reimbursements
Title V Block Grant
SHIP
7
5
1° Funding Source
3
1 2
2° Funding Source
3
3° Funding Source
3
2 1
2
Top funding sources used related to alcohol use strategies, Minnesota CHBs, 2014
Local tax levy
State general fund
SHIP
Other state funds
Federal program-specific funding
Title V Block Grant
Grants/foundation funds
Fees/reimbursements
MDH Health Partnerships Division
5
3
5
1 1
11
54
1° funding
source
2° funding
source
3° funding
source
17
6
2
5
6
2
1
1
11
7
0
3
3
1
2
1
5
5
0
0
0
0
3
3
September 2014
2014 Local Public Health Act Performance Measures
PROMOTE HEALTHY COMMUNITIES AND HEALTHY BEHAVIORS
MATERNAL AND CHILD HEALTH
Total women, infants, and children served by the WIC program, by population Minnesota CHBs, 2014
0
10,000
20,000
Total women served (unduplicated)
8,432
16,489
Total infants served (unduplicated)
8,643
16,888
Total children served (unduplicated)
12,859
30,000
50,000
60,000
70,000
80,000
90,000
31,287
31,844
24,594
Small CHBs
45,918
Medium CHBs
Total women, infants, and children served by the WIC program,
Minnesota CHBs, 2014
Large CHBs
Small CHBs
(n=19)
Women served (unduplicated)
Infants served (unduplicated)
Children served (unduplicated)
MDH Health Partnerships Division
40,000
8,432
8,643
12,859
55
Medium CHBs
(n=20)
16,489
16,888
24,594
Large CHBs
(n=11)
31,287
31,844
45,918
Total: MN
(n=50)
56,208
57,375
83,371
September 2014
2014 Local Public Health Act Performance Measures
PREVENT THE SPREAD OF INFECTIOUS DISEASES
IMMUNIZATIONS
RANGE OF VACCINATED CHILDREN, MINNESOTA CHBS, 2014
% children 24-35 months with full vaccine series
completed, Minnesota CHBs, 2014
20%
40%
60%
80%
100%
Each Bar = One Minnesota CHB
0%
RANGE OF VACCINATED CHILDREN, BY POPULATION, MINNESOTA CHBS, 2014
Range and median: Children 24-35 months with full vaccine series completed, by population, Minnesota CHBs, 2014
0%
10%
20%
30%
40%
50%
60%
70%
80%
Small CHBs
Median: 72%
Medium CHBs
Median: 72%
Large CHBs
Median: 68%
Minnesota
Median: 70%
Range: Children 24-35 months with full vaccine series completed, by
population, Minnesota CHBs, 2014
Minimum
Median
Maximum
MDH Health Partnerships Division
90%
56
Small CHBs
(n=19)
Medium CHBs
(n=20)
Large CHBs
(n=11)
Minnesota
(n=50)
55%
72%
85%
41%
72%
85%
59%
68%
75%
41%
70%
85%
September 2014
2014 Local Public Health Act Performance Measures
STRATEGIES TO INCREASE IMMUNIZATION RATES, MINNESOTA CHBS, 2014
Strategies used to increase immunization rates, Minnesota CHBs, 2014
Provided direct services
98%
Worked with MIIC regional coord.
90%
Provided education
90%
Increased MIIC enrollment
76%
Monitored MIIC rates
72%
Increased use of MIIC functions
66%
School imm. clinics
62%
Convened partners
58%
Reminder/ recall: clinic patients
42%
Reminder/ recall: county residents
42%
Used QI tools
20%
Mentored other CHBs
8%
Strategies used to increase immunization rates, Minnesota CHBs, 2014
Minnesota (n=50)
Participated in or convened school-located immunization clinics
Convened partners in both public and private sectors to discuss immunization status and strategies
Engaged health care providers to increase Minnesota Immunization Information Connection (MIIC) enrollment and reporting
Engaged health care providers to increase use of MIIC functions (e.g., assessment, client follow-up)
Worked with CHB’s corresponding MIIC Regional Coordinator
Actively monitored and tracked MIIC immunization assessment rates over time
Conducted reminder/recall outreach for clinic patients
Conducted reminder/recall for county residents
Provided direct services (gave immunizations)
Provided education to the community
Mentored one or more CHBs to help them improve immunization rates
Used QI tools and processes to improve CHB immunization rates
None of the above
62%
58%
76%
66%
90%
72%
42%
42%
98%
90%
8%
20%
0%
STRATEGIES TO INCREASE IMMUNIZATION RATES, BY POPULATION, MINNESOTA CHBS, 2014
Monitored MIIC
rates
Increased use of
MIIC functions
MDH Health Partnerships Division
School imm. clinics
Reminder/ recall:
clinic patients
57
Used QI tools
0%
18%
10%
Small CHBs
27%
25%
11%
35%
37%
27%
64%
65%
79%
73%
70%
58%
82%
75%
63%
Selected strategies used to increase immunization rates, by population, Minnesota CHBs, 2014
Medium CHBs
Large CHBs
Mentored other
CHBs
September 2014
2014 Local Public Health Act Performance Measures
Strategies used to increase immunization rates, by population,
Minnesota CHBs, 2014
Participated in or convened school-located immunization clinics
Convened partners in both public and private sectors to discuss
immunization status and strategies
Engaged health care providers to increase Minnesota Immunization
Information Connection (MIIC) enrollment and reporting
Engaged health care providers to increase use of MIIC functions (e.g.,
assessment, client follow-up)
Worked with CHB’s corresponding MIIC Regional Coordinator
Actively monitored and tracked MIIC immunization assessment rates over
time
Conducted reminder/recall outreach for clinic patients
Conducted reminder/recall for county residents
Provided direct services (gave immunizations)
Provided education to the community
Mentored one or more CHBs to help them improve immunization rates
Used QI tools and processes to improve CHB immunization rates
None of the above
Small CHBs
(n=19)
Medium CHBs
(n=20)
Large CHBs
(n=11)
Minnesota
(n=50)
79%
53%
65%
65%
27%
55%
62%
58%
74%
80%
73%
76%
58%
70%
73%
66%
95%
63%
90%
75%
82%
82%
90%
72%
37%
47%
100%
84%
0%
11%
0%
35%
40%
95%
95%
10%
25%
0%
64%
36%
100%
91%
18%
27%
0%
42%
42%
98%
90%
8%
20%
0%
COIMMUNITY EDUCATION RELATED TO IMMUNIZATIONS, SELECTED MINNESOTA CHBS, 2014
96%
Adolescent
Influenza
Childhood immunizations
Adolescent immunizations
Adult immunizations
Influenza immunizations
None of the above
0%
96%
Childhood
Focus of education provided by those CHBs
engaged in immunization-related community
education, Minnesota, 2014 (n=45)
78%
98%
Focus of education provided by those CHBs engaged in
immunization-related community education,
Minnesota, 2014 (n=45)
MDH Health Partnerships Division
Adult
Minnesota
(n=45)
98%
96%
78%
96%
0%
None of the
above
58
September 2014
2014 Local Public Health Act Performance Measures
PREVENT THE SPREAD OF INFECTIOUS DISEASES
TUBERCULOSIS
TUBERCULOSIS AMONG CONTACTS IN MINNESOTA, 2012
Latent TB Infections (LTBI) among contacts in Minnesota, 2012*
150
100
50
147 new diagnoses
92% of those diagnosed
started tx
Persons with new LTBI diagnoses identified
from TB contact investigations
Persons who started treatment
[of contacts with new LTBI]
64% of those who
started tx
completed it
0
Persons who completed treatment
[of contacts with new LTBI who started
treatment]
Latent TB Infections (LTBI) among contacts in Minnesota, 2012*
Count
Persons with new LTBI diagnoses identified from contact investigations of TB cases in 2012
Started treatment [of contacts with new LTBI]
Completed treatment [of contacts with new LTBI who started treatment]
147
135
87
TUBERCULOSIS AMONG REFUGEES AND IMMIGRANTS IN MINNESOTA, 2012
The Centers for Disease Control and Prevention (CDC) recommends that immigrants with TB Class conditions identified overseas and all new refugees are
offered a comprehensive screening for TB shortly after arrival. The Minnesota Department of Health works closely with local public health to coordinate
these screenings and facilitate treatment for those diagnosed with latent TB infection (LTBI). This partnership is crucial to preventing future cases of TB
disease. Minnesota is one of the national leaders in successful LTBI treatment for immigrants and refugees.
Latent TB Infections (LTBI) among refugees,
Minnesota, 2012*†
Latent TB Infections (LTBI) among immigrants,
Minnesota, 2012*†
500
80
70
400
300
200
60
50
92% of those
diagnosed
started tx
472 new
diagnoses
100
40
81% of those
who started
tx completed
it
30
66 new
diagnoses
79% of those
diagnosed
started tx
20
10
0
83% of those
who started tx
completed it
0
Diagnosed
Initiated treatment Completed treatment
Diagnosed
Latent TB Infections (LTBI) among refugees and immigrants, Minnesota, 2012*†
Diagnosed with LTBI
Initiated LTBI treatment [among those diagnosed with LTBI]
Completed LTBI treatment [among those who initiated LTBI treatment]
Initiated treatment Completed treatment
Visa Status:
Refugee
Visa Status:
Immigrant
Both
472
432
352
66
52
43
538
484
395
Most recent finalized data available is from 2012; lag in finalizing is due to the long nature of LTBI treatment (3-9 months, depending on the drug[s]
used).
†
Data only includes immigrants (with a TB Class designation on their pre-immigration exam) and/or refugees who were admitted to the US in 2012, and
whose original destination was Minnesota.
*
MDH Health Partnerships Division
59
September 2014
2014 Local Public Health Act Performance Measures
ACTIVITIES RELATED TO TUBERCULOSIS, MINNESOTA CHBS, 2014
Methods used to address active TB,
Minnesota CHBs, 2014
Attended trainings
Methods used to address latent TB infections (LTBI),
Minnesota CHBs, 2014
Provided direct services
None of the above
Contact investigation/follow-up
46%
26%
n/a
n/a
Provided essential services
n/a
Developed after action report
n/a
13%
7%
None of the above
26%
Attended trainings
Convened partners or participated in coalitions
Provided direct services
Directly Observed Therapy (DOT)
Conducted community outreach and education
Educated policymakers
Educated providers
Contracted with other entities to provide services
Contact investigation/follow-up
Coordinated TB care
Voluntary quarantine/isolation
Provided essential services
Developed after action report
None of the above
60
67%
Voluntary quarantine/isolation
Methods used to address tuberculosis (active and latent), Minnesota CHBs, 2014
MDH Health Partnerships Division
20%
Coordinated TB care
52%
Voluntary quarantine/isolation
48%
Contracted to provide services
22%
Coordinated TB care
26%
Educated providers
39%
Contact investigation/follow-up
30%
Educated policymakers
22%
Contracted to provide services
85%
n/a
Outreach, education
20%
Educated providers
Provided essential services
Directly Observed Therapy (DOT)
61%
Outreach, education
26%
Provided direct services
59%
Educated policymakers
57%
Partners, coalitions
26%
Directly Observed Therapy (DOT)
Developed after action report
Attended trainings
48%
Partners, coalitions
15%
Active TB
Minnesota (n=50)
LTBI
Minnesota (n=50)
48%
26%
59%
61%
20%
22%
39%
22%
46%
52%
26%
13%
7%
26%
57%
26%
85%
n/a
30%
26%
48%
20%
n/a
67%
n/a
n/a
n/a
15%
September 2014
2014 Local Public Health Act Performance Measures
PREVENT THE SPREAD OF INFECTIOUS DISEASES
OVERALL INFECTIOUS DISEASES
OTHER INFECTIOUS DISEASES, MINNESOTA CHBS, 2014
Involvement in other infectious disease-related
prevention, activities, or services; Minnesota CHBs, 2014
Pertussis
Ebola (write-in)
Tick-borne illness
Chlamydia
Animal bites
HIV/AIDS
Influenza (write-in)
Other
None of the above
Involvement in other infectious disease-related
prevention, activities, or services, Minn. CHBs, 2014
Minnesota
(n=50)
Chlamydia
Tick-borne illness
Animal bites
Pertussis
HIV/AIDS
Write In: Ebola
Write In: Influenza
Other
None of the above
50%
36%
28%
24%
20%
10%
10%
22%
22%
24%
28%
20%
50%
10%
36%
10%
22%
22%
ACTIVITIES RELATED TO OTHER INFECTIOUS DISEASES, MINNESOTA CHBS, 2014
Attended trainings
Conducted assessments
Convened partners or participated in coalitions
Provided referrals
Educated policymakers
Educated providers
Conducted community outreach and education
Provided direct services
Reported cases
Contracted with other entities to provide services
Conducted contact/follow-up investigations
Educated school staff
Partnered with schools
Voluntary quarantine/isolation
Collaborated with Animal Control
Pertussis
(n=25)
Ebola
(n=18)
Tick-borne
illness
(n=14)
Chlamydia
(n=12)
Animal
bites
(n=10)
HIV/AIDS
(n=5)
Influenza
(n=5)
64%
24%
28%
48%
24%
52%
80%
n/a
n/a
0%
44%
64%
52%
n/a
n/a
83%
22%
100%
11%
72%
72%
78%
11%
6%
n/a
11%
67%
28%
6%
n/a
14%
7%
14%
29%
21%
21%
79%
n/a
n/a
n/a
n/a
n/a
n/a
n/a
n/a
58%
50%
33%
50%
17%
25%
92%
58%
25%
17%
25%
n/a
n/a
n/a
n/a
20%
20%
10%
40%
10%
30%
50%
n/a
n/a
n/a
70%
n/a
n/a
n/a
60%
60%
40%
40%
60%
20%
60%
80%
40%
40%
40%
n/a
n/a
n/a
n/a
n/a
80%
0%
40%
60%
20%
80%
80%
40%
20%
n/a
0%
80%
40%
0%
n/a
INFECTIOUS DISEASE SURVEILLANCE, PREVENTION, AND CONTROL FOR SPECIFIC POPULATIONS; MINNESOTA CHBS, 2014
Involvement in other infectious disease surveillance,
prevention, and control for specific populations;
Minnesota CHBs, 2014
Refugee/immigrant health
46%
Correctional health
Other
None of the above
MDH Health Partnerships Division
Refugee/immigrant health
Correctional health
Urban American Indian/tribal health
College students
Other
None of the above
20%
College students
Urban AI/tribal health
Involvement in other infectious disease
surveillance, prevention, and control for specific
populations; Minnesota CHBs, 2014
16%
2%
8%
Minnesota
(n=50)
46%
20%
2%
16%
8%
40%
40%
61
September 2014
2014 Local Public Health Act Performance Measures
PROTECT AGAINST ENVIRONMENTAL HEALTH HAZARDS
INDOOR AIR: RADON
Promotion of radon testing, Minnesota CHBs, 2014
Does not promote radon
testing, 10%
Promotes radon testing,
90%
Promotion of radon testing
Minnesota (n=50)
CHB promotes radon testing
CHB does not promote radon testing
90%
10%
METHOD OF PROMOTING/RATIONALE FOR NOT PROMOTING RADON TESTING, MINNESOTA CHBS, 2014
Methods of promoting radon testing,
Minnesota CHBs, 2014 (n=45)
93%
Rationale for not promoting radon testing,
Minnesota CHBs, 2014 (n=5)
89%
40%
Distribute
test kits
Community
education
9%
7%
Conduct
assessments
Other
Methods of promoting radon testing,
Minnesota CHBs, 2014
Distribute test kits
Provide community education to promote testing
Conduct assessments
Other
MDH Health Partnerships Division
60%
40%
0%
Lack of $
resources
Minnesota
(n=45)
Lack of
staffing
Low levels Low priority
Rationale for not promoting radon testing,
Minnesota CHBs, 2014
93%
89%
9%
7%
Lack of financial resources
Lack of staffing
Low radon levels in jurisdiction
Low organizational priority
Other
62
20%
Other
Minnesota
(n=5)
40%
40%
0%
20%
60%
September 2014
2014 Local Public Health Act Performance Measures
PROTECT AGAINST ENVIRONMENTAL HEALTH HAZARDS
INDOOR AIR: MINNESOTA CLEAN INDOOR AIR ACT
Minnesota Clean Indoor Air Act (MCIAA) support, Minnesota CHBs, 2014
No work to support MCIAA,
22%
Works to support MCIAA,
78%
MCIAA support, Minnesota CHBs, 2014
Minnesota (n=50)
CHB works to support MCIAA
CHB does not work to support MCIAA
78%
22%
ADDRESSING AND ENFORCING MCIAA, MINNESOTA CHBS, 2014
Methods used to address MCIAA complaints,
Minnesota CHBs, 2014 (n=39)
72%
62%
Methods used to address MCIAA complaints,
Minnesota CHBs, 2014
56%
Refer to MDH Indoor Air Unit
Investigate complaints
Administer enforcement, as necessary
Community education
Other
36%
10%
Refer to
Investigate Community Administer
MDH Indoor complaints education enforcement,
Air Unit
as necessary
Other
Minnesota
(n=39)
72%
62%
36%
56%
10%
Facilities in which MCIAA is enforced,
Minnesota CHBs, 2014 (n=39)
No answer,
3%
Food,
beverage,
and lodging
establishments only,
28%
MDH Health Partnerships Division
All public
places and
places of
employment,
69%
63
Facilities in which MICAA is enforced, Minnesota
CHBs, 2014
Minnesota
(n=39)
All public places and places of employment
Food, beverage and lodging establishments only
No answer
69%
28%
3%
September 2014
2014 Local Public Health Act Performance Measures
PROTECT AGAINST ENVIRONMENTAL HEALTH HAZARDS
BLOOD LEAD
Response to elevated blood lead, Minnesota CHBs, 2014
CHB responds to all blood
lead test results, regardless
of level, 18%
CHB only responds to results
above 5 µg/dL, 82%
Response to elevated blood lead, Minnesota CHBs, 2014
Minnesota (n=50)
CHB responds to all blood lead test results, regardless of level
CHB only responds to results above 5 µg/dL
CHB does not respond to elevated blood lead test results
Not applicable: CHB did not receive blood lead test results during reporting period
18%
82%
0%
0%
RESPONDING TO ELEVATED BLOOD LEAD, MINNESOTA CHBS, 2014
Method of response to elevated blood lead for CHBs that
respond to all levels, Minnesota, 2014 (n=9)
Referrals and/or contact provider
Method of response to elevated blood lead for CHBs that
respond only to above 5 μg/dL, Minnesota, 2014 (n=41)
100%
Referrals and/or contact provider
Call family to discuss
100%
Call family to discuss
Send family a letter
100%
Send family a letter
Track/assure follow-up testing
Do follow-up visit
Other
Do follow-up visit
67%
Review housing-based threats
56%
Other
33%
Send family a letter
Call family to discuss
Schedule home visit and provide educational materials
Track/assure follow-up blood lead testing
Provide public health referrals (e.g., WIC, MA, follow-up testing) and/or contact
medical provider
Review additional housing-based health threats (e.g., Healthy Homes)
Do follow-up visit
Other
MDH Health Partnerships Division
90%
Home visit, educational materials
89%
Review housing-based threats
93%
90%
Track/assure follow-up testing
100%
Home visit, educational materials
95%
64
83%
42%
39%
34%
CHBs responding to
all levels (n=9)
CHBs responding only to
above 5 μg/dL (n=41)
100%
100%
89%
100%
100%
90%
93%
83%
90%
95%
56%
67%
33%
39%
42%
34%
September 2014
2014 Local Public Health Act Performance Measures
PROTECT AGAINST ENVIRONMENTAL HEALTH HAZARDS
DRINKING WATER PROTECTION AND WELL MANAGEMENT
PROMOTING WATER QUALITY, MINNESOTA CHBS, 2014
Methods used to promote water quality, Minnesota CHBs, 2014
Provide or facilitate water testing services for residents
60%
Provide technical assistance on drinking water issues
46%
Attend water quality trainings
42%
Educate policymakers or the public on drinking water quality
32%
Other
28%
CHB has not considered water quality promotion
20%
Methods used to promote water quality, Minnesota CHBs, 2014
Minnesota (n=50)
Attend water quality trainings
Educate policymakers or the public on drinking water quality
Provide technical assistance on drinking water issues
Provide or facilitate water testing services for residents
Other
CHB has not considered water quality promotion
42%
32%
46%
60%
28%
20%
SERVICES PROVIDED TO PRIVATE WELL OWNERS, MINNESOTA CHBS, 2014
Service provider(s) for private well owners, Minnesota CHBs, 2014
54%
48%
12%
The CHB provides services
Another local department provides services
Neither the CHB nor a local department provides
services to private well owners
Service provider(s) for private well owners, Minnesota CHBs, 2014
Minnesota (n=50)
The CHB provides services
Another local department provides services
Neither the CHB nor a local department provides services to private well owners
Services provided to private well owners by
Minnesota CHBs, 2014 (n=24)
Services provided to private well owners by
Minnesota CHBs, 2014
Promote well water testing
Info. to private owners
79%
54%
Education materials
46%
Well Sealing Cost Share
None of the above
MDH Health Partnerships Division
Collect well water samples for testing
Promote well water testing
Well information provided to private well
owners
Well management education materials broadly
provided
Well Sealing Cost Share
None of the above
100%
Collect samples for testing
48%
54%
12%
25%
0%
65
Minnesota (n=24)
54%
100%
79%
45%
25%
0%
September 2014
2014 Local Public Health Act Performance Measures
PROTECT AGAINST ENVIRONMENTAL HEALTH HAZARDS
ENVIRONMENTAL SURVEILLANCE AND ASSESSMENT
ADDRESSING CLIMATE CHANGE, MINNESOTA CHBS, 2014
Methods used to consider climate change, Minnesota CHBs, 2014
Attend trainings
52%
Educate policymakers or the public on the health impacts
26%
Convene partners or participate in coalitions
14%
Develop or implement a plan or policy
14%
Conduct assessments on vulnerability
8%
Pursue funding
4%
Other
14%
CHB has not considered climate change
38%
Methods used to consider climate change, Minnesota CHBs, 2014
Minnesota (n=50)
Attend climate change trainings
Educate policymakers or the public on the health impacts of climate change
Convene partners or participate in coalitions or mitigate or adapt to climate change
Develop or implement a plan or policy to mitigate or adapt to climate change (e.g., heat response plan or policy to
turn vacant lots into community gardens)
Conduct assessments on climate change vulnerability
Pursue funding to address climate change (e.g., grants)
Other
CHB has not considered climate change
52%
26%
14%
14%
8%
4%
14%
38%
CHANGE IN ADDRESSING CLIMATE CHANGE, MINNESOTA CHBS, 2013-2014
CHBs developing a plan or
implementing a policy to consider
climate change, Minnesota, 2013-2014
CHBs educating policymakers as a
means of considering climate change,
Minnesota, 2013-2014
CHBs that have not considered climate
change, Minnesota, 2013-2014
44%
24%
2013
MDH Health Partnerships Division
14%
2014
26%
20%
2013
2014
66
2013
38%
2014
September 2014
2014 Local Public Health Act Performance Measures
PROTECT AGAINST ENVIRONMENTAL HEALTH HAZARDS
NUISANCE INVESTIGATION
Environmental health complaints most frequently
addressed by Minnesota CHBs, 2014
Mold
62%
Garbage/junk house
56%
Accumulation of rubbish or junk
42%
Vermin or vector infestations
30%
Improper sewage disposal
24%
Hazardous building
16%
Elevated radon
12%
Failure to keep waste properly
10%
Accumulation of decaying matter
4%
Clandestine drug labs
4%
Hazardous waste
4%
Unsecured hole or opening
4%
Chemical spill
4%
Other
16%
Environmental health complaints most commonly
addressed by Minnesota CHBs, 2014
Minnesota
(n=50)
Garbage/junk house
Mold
Improper sewage disposal, discharging to
surface/groundwater/into structure
Accumulation of rubbish or junk
Accumulation of decaying animal or vegetable
matter
Hazardous building or unsanitary dwelling
Vermin or vector infestations
Clandestine drug labs
Failure to keep waste, refuse, or garbage properly
Contaminated drinking water
Elevated radon
Contaminated surface water
Hazardous waste
Unsecured hole or opening (abandoned well, well
pit, sewage treatment system, non-maintained
swimming pool, mine shaft, tunnel)
Accumulation of carcasses of animals or failure to
dispose of carcasses in sanitary manner
Chemical spill
Contaminated ground water
Other
56%
62%
24%
42%
4%
16%
30%
4%
10%
0%
12%
0%
4%
4%
0%
4%
0%
16%
ADDRESSING MOST COMMON NUISANCE COMPLAINTS, MINNESOTA CHBS, 2014
Methods used to address most common nuisance complaints, Minnesota CHBs, 2014
71%
53%
19%
10%
0%
Garbage/junk house
(n=28)
Methods used to address most common nuisance
complaints, Minnesota CHBs, 2014
Partnered with other agencies to address
Evidence-based strategies on prevention
Removal, abatement, or resolution
None of the above
MDH Health Partnerships Division
Partnered with
other agencies
50%
40%
32%
Mold (n=31)
83%
73%
48%
42%
16%
90%
82%
79%
Evidence-based
strategies
17%
0%
0%
Accumulation of rubbish
or junk (n=21)
Vermin or vector
infestations (n=15)
Removal, abatement,
or resolution
0%
None of the above
Improper sewage
disposal (n=12)
Mold (n=31)
Garbage/junk
house (n=28)
Accumulation
of rubbish/junk
(n=21)
Vermin or
vector infestations (n=15)
Improper
sewage
disposal (n=12)
16%
42%
71%
10%
79%
32%
82%
0%
48%
19%
90%
0%
53%
40%
73%
0%
50%
17%
83%
0%
67
September 2014
2014 Local Public Health Act Performance Measures
PREPARE FOR AND RESPOND TO DISASTER, AND ASSIST COMMUNITIES IN RECOVERY
PARTNER ENGAGEMENT
ENGAGEMENT WITH CDC EMERGENCY PREPAREDNESS SECTORS, MINNESOTA CHBS, 2014
CDC emergency preparedness sectors engaged (out of 12*) by Minnesota CHBs, 2014
12
9
6
3
0
Each Bar = One Minnesota CHB
CDC emergency preparedness sectors engaged (out of 12*) by Minnesota CHBs, 2014
Minnesota (n=50)
Social services
Cultural and faith-based groups and organizations
Health care
Business
Community leadership
Housing and sheltering
Emergency management
State Office on Aging (or equivalent)
Media
Mental and behavioral health
Education and childcare settings
Other
86%
84%
84%
68%
68%
68%
60%
60%
52%
44%
22%
82%
RANGE OF ENGAGEMENT WITH CDC EMERGENCY PREPAREDNESS SECTORS, MINNESOTA CHBS, 2014
Range and median: CDC emergency preparedness sectors engaged, by population, Minnesota CHBs, 2014
12
11
9
6
8.5
8
6
3
0
Small CHBs
Medium CHBs
Large CHBs
Range: CDC emergency preparedness sectors engaged, by population,
Minnesota CHBs, 2014
Minimum
Median
Maximum
*
Minnesota
Small CHBs
(n=19)
Medium CHBs
(n=20)
Large CHBs
(n=11)
Minnesota
(n=50)
3
6
11
1
8.5
12
5
11
12
1
8
12
Includes 11 sectors noted in table, and “other.”
MDH Health Partnerships Division
68
September 2014
2014 Local Public Health Act Performance Measures
ASSURE THE QUALITY AND ACCESSIBILITY OF HEALTH SERVICES
CLINIC-COMMUNITY LINKAGES
Methods used to promote clinic-community linkages for prevention, Minnesota CHBs, 2014
88%
74%
Community-clinical linkages
State and federal health reform
initiatives
14%
6%
Other
None of the above
Methods used to promote clinic-community linkages for prevention, Minnesota CHBs, 2014
Minnesota (n=50)
Community-clinical linkages
Advancing public health, health care, and community linkages with state and federal health reform initiatives
Other
None of the above
Actions taken to use community-clinical linkages to
promote clinic-community linkages for prevention,
Minnesota CHBs, 2014 (n=44)
Partners, coalitions
Assessments
Evaluated policy
81%
Assessments
68%
62%
Educated policymakers
21%
11%
14%
9%
Actions taken to promote clinic-community linkages for prevention,
Minnesota CHBs, 2014
Attended trainings
Conducted assessments
Convened partners or participated in coalitions
Developed policy proposal
Engaged stakeholders
Educated policymakers
Implemented policy
Maintained policy
Evaluated policy
None of the above
MDH Health Partnerships Division
73%
Trainings
41%
Developed policy proposal
81%
Engaged stakeholders
75%
Educated policymakers
Maintained policy
Partners, coalitions
86%
Trainings
Implemented policy
Actions taken to use state/federal health reform initiatives
to promote clinic-community linkages for prevention,
Minnesota CHBs, 2014 (n=37)
98%
Engaged stakeholders
88%
74%
14%
6%
69
32%
Developed policy proposal
11%
Implemented policy
11%
Evaluated policy
8%
Maintained policy
8%
Among CHBs using
community-clinical linkages
(n=44)
Among CHBs using state/
federal health reform initiatives
(n=37)
75%
68%
98%
21%
86%
41%
11%
9%
14%
0%
81%
62%
81%
11%
73%
32%
11%
8%
8%
0%
September 2014
2014 Local Public Health Act Performance Measures
Top funding sources used to promote clinic-community linkages for prevention, Minnesota CHBs, 2014
SHIP
26
Local tax levy
8
State general fund
4
Grants/foundation funds
7
3
5
Other state funds
Fees/reimbursements
1° Funding Source
9
6
Title V Block Grant
4
7
5
2
Federal program-specific funding
10
15
5
2° Funding Source
2
3° Funding Source
2
3
1
Top funding sources used to promote clinic-community linkages for prevention, Minnesota
CHBs, 2014
Local tax levy
State general fund
SHIP
Other state funds
Federal program-specific funding
Title V Block Grant
Grants/foundation funds
Fees/reimbursements
1° funding
source
2° funding
source
3° funding
source
8
4
26
0
6
0
3
0
15
7
10
0
5
5
2
0
7
5
4
3
2
2
9
1
ASSURE THE QUALITY AND ACCESSIBILITY OF HEALTH SERVICES
GAPS IN SERVICES OR BARRIERS TO ACCESS
BASIC NEEDS
GAPS IN BASIC NEEDS, MINNESOTA CHBS, 2014
Gaps in basic needs in communities served by Minnesota CHBs, 2014
Transportation
Income
64%
92%
Lack of insurance
Cultural competency of providers
Basic life needs
62%
30%
66%
46%
Gap exists
Gap addressed
56%
54%
Gaps in basic needs related to health care/services, in communities served by
Minnesota CHBs, 2014
Transportation
Lack of insurance
Income
Cultural competency of providers
Basic life needs
None of the above
MDH Health Partnerships Division
100%
28%
70
Gap exists in CHB
Minnesota (n=50)
Gaps addressed in CHB
Minnesota (n=50)
100%
66%
92%
56%
54%
0%
64%
62%
28%
30%
46%
8%
September 2014
2014 Local Public Health Act Performance Measures
ACTIVITIES CONDUCTED TO ADDRESS GAPS IN BASIC NEEDS, MINNESOTA CHBS, 2014
Activities conducted to address gaps in basic needs
related to health care/services, Minnesota CHBs, 2014
Transportation
(n=32)
Lack of
insurance
(n=31)
31%
47%
31%
50%
53%
53%
53%
0%
29%
68%
42%
39%
35%
90%
45%
0%
Provided or contracted for services
Outreach
Health education
Case management
Transportation Assistance
Assistance with insurance enrollment/referrals
Partnered in community efforts to reduce barriers
None of the above
Income (n=14)
Cultural
competency of
providers
(n=15)
Basic life needs
(n=23)
29%
57%
36%
43%
43%
86%
64%
0%
73%
20%
40%
20%
13%
33%
53%
0%
35%
57%
61%
65%
35%
65%
70%
0%
HEALTH CARE PROVISION
GAPS IN HEALTH CARE PROVISION, MINNESOTA CHBS, 2014
Gaps in health care provision (i.e., lack of providers) in communities served by Minnesota CHBs, 2014
MA dental providers
80%
Pediatric/adolescent mental health providers
52%
Adult mental health providers
Other nurses
Dental providers: Privately insured population
90%
18%
64%
Public health nurses
Specialists
94%
48%
Chemical health providers
Primary care providers
44%
12%
Gap addressed
36%
6%
8%
Gap exists
52%
26%
16%
12%
Gaps in health care provision (i.e., lack of providers) in communities served by Minnesota
CHBs, 2014
Adult mental health providers
Pediatric/adolescent mental health providers
Chemical health providers
MA dental providers
Dental providers: Privately insured population
Primary care providers
Specialists
Public health nurses
Other nurses
None of the above
MDH Health Partnerships Division
98%
71
Gap exists in CHB
Minnesota (n=50)
Gaps addressed in CHB
Minnesota (n=50)
90%
94%
64%
98%
12%
36%
26%
52%
16%
2%
48%
52%
18%
80%
0%
12%
6%
44%
8%
6%
September 2014
2014 Local Public Health Act Performance Measures
ACTIVITIES CONDUCTED TO ADDRESS GAPS IN HEALTH CARE PROVISION, MINNESOTA CHBS, 2014
Activities conducted to address largest gaps in health care provision,
Minnesota CHBs, 2014
MA dental
providers
(n=40)
Pediatric/
adolescent
mental health
providers
(n=26)
Adult mental
health
providers
(n=24)
Public health
nurses (n=22)
23%
75%
45%
25%
23%
45%
70%
0%
46%
42%
23%
35%
31%
54%
65%
0%
33%
33%
25%
38%
25%
54%
66%
0%
36%
55%
23%
14%
14%
5%
27%
18%
Provided or contracted for services
Outreach
Health education
Case management
Transportation Assistance
Assistance with insurance enrollment/referrals
Partnered in community efforts to reduce barriers
None of the above
HEALTH CARE SERVICES
GAPS IN HEALTH CARE SERVICES, MINNESOTA CHBS, 2014
Gaps in health care services in communities served by Minnesota CHBs, 2014
MA dental services
76%
Pediatric/adolescent mental health services
54%
Adult mental health services
52%
Chemical health
20%
Supportive home services
EMS/urgent care
Jail/ correctional health
Dental services: Privately insured population
24%
14%
30%
Gap addressed
16%
12%
8%
Gaps in health care services in communities served by Minnesota CHBs, 2014
Adult mental health services
Pediatric/adolescent mental health services
Family planning/STI
MA dental services
Dental services: Privately insured population
EMS/urgent care
Chemical health
Supportive home services
Jail/correctional health
Nursing home/assisted living
None of the above
MDH Health Partnerships Division
Gap exists
32%
24%
2%
12%
90%
64%
22%
Family planning/STI
Nursing home/ assisted living
100%
94%
72
Gap exists in CHB
Minnesota (n=50)
Gaps addressed in CHB
Minnesota (n=50)
90%
94%
30%
100%
8%
16%
64%
32%
12%
24%
0%
52%
54%
24%
76%
0%
2%
20%
22%
12%
14%
6%
September 2014
2014 Local Public Health Act Performance Measures
ACTIVITIES CONDUCTED TO ADDRESS GAPS IN HEALTH CARE SERVICES, MINNESOTA CHBS, 2014
Activities conducted to address largest gaps in health care services,
Minnesota CHBs, 2014
MA dental
services (n=38)
Pediatric/
adolescent
mental health
services (n=27)
Adult mental
health services
(n=26)
Family
planning/STI
(n=12)
26%
68%
47%
26%
21%
58%
63%
0%
33%
52%
22%
41%
22%
48%
70%
4%
31%
42%
23%
42%
19%
42%
62%
8%
92%
75%
75%
42%
0%
50%
50%
0%
Provided or contracted for services
Outreach
Health education
Case management
Transportation Assistance
Assistance with insurance enrollment/referrals
Partnered in community efforts to reduce barriers
None of the above
ASSURE THE QUALITY AND ACCESSIBILITY OF HEALTH SERVICES
SERVICE PROVISION AND HEALTH INSURANCE STRATEGIES
Activities performed related to service provision, Minnesota CHBs, 2014
Primary Care: Medical
Primary Care: Dental
Licensed Home Care
Correctional Health
Provided/contracted for
services
30%
26%
30%
38%
Assessed clients without
insurance
66%
56%
42%
20%
Referred clients without
insurance
72%
68%
42%
18%
Able to report insurance
status
36%
22%
30%
8%
22%
24%
50%
58%
None of these
Activities performed related to service provision, Minnesota CHBs, 2014
Provided/contracted for services
Assessed insurance status
Referred clients without insurance
Able to report insurance status
None of these
MDH Health Partnerships Division
73
Primary Care:
Medical
Primary Care:
Dental
Licensed
Home Care
Correctional
Health
30%
66%
72%
36%
22%
26%
56%
68%
22%
24%
30%
42%
42%
30%
50%
38%
20%
18%
8%
58%
September 2014
2014 Local Public Health Act Performance Measures
APPENDICES
MINNESOTA COMMUNITY HEALTH BOARDS BY POPULATION
Contact information on community health boards in Minnesota can be found online: www.health.state.mn.us/divs/opi/gov/find/.
Small CHBs (n=18)
Benton
Cass
Countryside
Des Moines Valley
Edina
Faribault-Martin
Fillmore-Houston
Freeborn
Goodhue
Medium CHBs (n=18)
Aitkin-Itasca-Koochiching
Bloomington
Blue Earth
Brown-Nicollet
Carver
Chisago
Crow Wing
Dodge-Steele
Horizon
Large CHBs (n=12)
Anoka
Carlton-Cook-Lake-St. Louis
Dakota
Hennepin
Minneapolis
Olmsted
Population of less than 50,000
Kanabec-Pine
Le Sueur-Waseca
Mower
Nobles
Polk-Norman-Mahnomen
Quin County
Richfield
Wabasha
Watonwan
Population between 50,000 and 100,000
Isanti-Mille Lacs
Kandiyohi-Renville
Meeker-McLeod-Sibley
Morrison-Todd-Wadena
North Country
Rice
Sherburne
SWHHS
Winona
Population of greater than 100,000
Partnership4Health*
St. Paul-Ramsey
Scott
Stearns
Washington
Wright
* Throughout this report, you may note differences in the count of small, medium, and large CHBs. This is because Partnership4Health chose to begin
reporting as a combined CHB for certain measures during its merger process, which became effective January 1, 2015. Where reporting as separate CHBs
on data prior to the merge, Clay-Wilkin and Otter Tail reported as medium CHBs, and Becker as a small CHB (see map, above).
*
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APPENDICES
MINNESOTA COMMUNITY HEALTH BOARDS BY STRUCTURE
Contact information on community health boards in Minnesota can be found online: www.health.state.mn.us/divs/opi/gov/find/.
Single-County CHBs (n=28)
Anoka
Benton
Bloomington
Blue Earth
Carver
Cass
Chisago
Crow Wing
Dakota
Edina
Freeborn
Goodhue
Hennepin
Minneapolis
Mower
Nobles
Olmsted
Rice
Richfield
St. Paul-Ramsey
Scott
Sherburne
Stearns
Wabasha
Washington
Watonwan
Winona
Wright
Multi-County CHBs (n=20)
Aitkin-Itasca-Koochiching
Brown-Nicollet
Carlton-Cook-Lake-St. Louis
Countryside
Des Moines Valley
Dodge-Steele
Faribault-Martin
Fillmore-Houston
Horizon
Isanti-Mille Lacs
Kanabec-Pine
Kandiyohi-Renville
Le Sueur-Waseca
Meeker-McLeod-Sibley
Morrison-Todd-Wadena
North Country
Partnership4Health*
Polk-Norman-Mahnomen
Quin County
SWHHS
Partnership4Health chose to begin reporting as a combined CHB for certain measures during its merger process, which became effective January 1,
2015. Where reporting as separate CHBs on data prior to the merge, Becker and Otter Tail reported as single-county CHBs, and Clay-Wilkin as a multicounty CHB (see map, above).
*
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APPENDICES
AREAS OF PUBLIC HEALTH RESPONSIBILITY
Information on the areas of public health responsibility can be found online: www.health.state.mn.us/divs/opi/gov/lphact/.
ASSURE AN ADEQUATE LOCAL PUBLIC HEALTH INFRASTRUCTURE
This area of public health responsibility describes aspects of the public health infrastructure that are essential to a well-functioning public health
system—including assessment, planning, and policy development. This includes those components of the infrastructure that are required by law for
community health boards. It also includes activities that assure the diversity of public health services and prevents the deterioration of the public health
system.
In PPMRS reporting, this area of responsibility is split into: Capacity Measures from National Standards, and Minnesota-Specific Measures.
PROMOTE HEALTHY COMMUNITIES AND HEALTHY BEHAVIORS
This area of public health responsibility includes activities to promote positive health behaviors and the prevention of adverse health behaviors – in all
populations across the lifespan in the areas of alcohol, arthritis, asthma, cancer, cardiovascular/stroke, diabetes, health aging, HIV/AIDS, Infant, child, and
adolescent growth and development, injury, mental health, nutrition, oral/dental health, drug use, physical activity, pregnancy and birth, STDs/STIs,
tobacco, unintended pregnancies, and violence. It also includes activities that enhance the overall health of communities.
PREVENT THE SPREAD OF INFECTIOUS DISEASE
This area of responsibility focuses on infectious diseases that are spread person to person, as opposed to diseases that are initially transmitted through
the environment (e.g., through food, water, vectors and/or animals). It also includes the public health department activities to detect acute and
communicable diseases, assure the reporting of communicable diseases, prevent the transmission of disease (including immunizations), and implement
control measures during communicable disease outbreaks.
PROTECT AGAINST ENVIRONMENTAL HEALTH HAZARDS
This area of responsibility includes aspects of the environment that pose risks to human health (broadly defined as any risk emerging from the
environment), but does not include injuries. This area also summarizes activities that identify and mitigate environmental risks, including foodborne and
waterborne diseases and public health nuisances.
PREPARE FOR AND RESPOND TO DISASTERS,
AND ASSIST COMMUNITIES IN RECOVERY
This area of responsibility includes activities that prepare public health to respond to disasters and assist communities in responding to and recovering
from disasters.
ASSURE THE QUALITY AND ACCESSIBILITY OF HEALTH SERVICES
This area of responsibility includes activities to assess health care capacity and assure access to health care. It also includes activities relate to the
identification and reduction of barriers to health services. It describes public health activities to fill health care gaps, reduce barriers and link people to
needed services.
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