riverside county local public health system assessment (lphsa) 2014 draft

Riverside County Local Public Health System Assessment 2014 DRAFT 7/14

Introduction

Improving the health of the community is inherently a team effort. The public health sys-

tem is comprised of partners coordinating their efforts to ensure that residents and visi-

tors of Riverside County have the opportunity to achieve optimal health. Until now our

system had not implemented a framework for evaluating how well the public health sys-

tem is meeting the needs of all it serves.

In April 2014, stakeholders from across the network of public health partners met to do

just that—to establish a baseline for how well the system is performing the Ten Essential

Services of Public Health using a nationally recognized tool. Perhaps even more important

than the results was the tremendous amount of sharing that took place among a diverse

group of attendees who had the opportunity to learn of the great work being done to sup-

port health in Riverside County.

Methods

The Local Public Health System Assessment is structured around the 10 Essential Public

Health Services which each consist of several Model Standards for a total of 30. On the

event day, these services were broken up into four sessions: ES 1-2, 3-5, 6-8 and 9-10.

Each session began with a speaker describing what the Essential Services are and how

they influence the community.

Rather than look at one specific organization, participants were encouraged to think about

the entire public health system as a whole. Stakeholders were urged to assign a score that

best represents the current level of activity within the system.

Tables then broke out into their own discussion groups that were led by a facilitator and

documented by a recorder. In total, participants discussed and voted on more than 100

actions relating to the 30 model standards. Each Essential Service section contained a one

page section where participants could write down their agency’s contributions and ex-

press strengths and challenges within the system.

After each breakout session was completed, the room answered the same questions using

the electronic voting system. Participants were able to see instant live results of all partic-

ipant votes. The assessment ended with a strengths and opportunities for improvement

round table.

Riverside County Local Public Health System Assessment 2014 DRAFT 7/14 2

Scoring

Participants were asked to evaluate each Essential Service by scoring the Model Standards

and their associated activities using the scale and point system displayed in the table be-

low. The scale consisted of a “Don’t know” option and five levels of activity from “no activi-

ty” to “optimal activity.” Each participant was instructed to score each item by assessing

the percent of each activity that is currently being completed by the public health system.

The scores of each participant were then compiled and averaged for each question, then

Standard, then Service to produce a final score. Final scores were calculated for East,

West, and Total to account for the diverse perspectives captured across the two day as-

sessment. It should be noted that by averaging the scores across all participants there is

little possibility that any measure will score 1 or 5 since either would require unanimous

agreement.


The results of the assessment are summarized below for each Essential Service and its component

Model Standards. Performance Scores are averaged based on the individual ratings of each LPHSA

participant. Overall, the system is perceived to be performing at a moderate level with a score of

3.10. In other words, participants felt the system is accomplishing 25-50% of the benchmark

activities.

Results

Performance Scores

Model Standards by Essential Service East West Total

ES 1: Monitor Health Status 3.06 2.85 2.94

1.1 Community Health Assessment 3.15 2.88 2.99

1.2 Current Technology 2.83 2.91 2.88

1.3 Registries 3.19 2.76 2.95

ES 2: Diagnose and Investigate 3.70 3.36 3.47

2.1 Identification/Surveillance 3.40 3.18 3.27

2.2 Emergency Response 3.83 3.48 3.57

2.3 Laboratories 3.86 3.43 3.58

ES 3: Educate/Empower 3.09 3.07 3.08

3.1 Health Education/Promotion 3.32 3.32 3.32

3.2 Health Communication 2.78 2.79 2.79

3.3 Risk Communication 3.17 3.10 3.12

ES 4: Mobilize Partnerships 3.20 3.16 3.17

4.1 Constituency Development 2.99 3.14 3.08

4.2 Community Partnerships 3.42 3.17 3.27

ES 5: Develop Policies/Plans 2.90 2.98 2.95

5.1 Governmental Presence 2.74 3.06 2.93

5.2 Policy Development 3.12 3.22 3.19

5.3 CHIP/ Strategic Planning 2.35 2.08 2.21

5.4 Emergency Plan 3.36 3.54 3.47

ES 6: Enforce Laws 3.56 3.34 3.43

6.1 Review Laws 3.81 3.49 3.63

6.2 Improve Laws 3.29 3.04 3.13

6.3 Enforce Laws 3.59 3.48 3.53

ES 7: Link to Health Services 3.41 3.01 3.18

7.1 Personal Health Services 3.43 3.02 3.19

7.2 Assure linkage 3.40 3.00 3.16

ES 8: Assure Workforce 3.11 2.87 2.98

8.1 Workforce Assessment 2.51 2.25 2.37

8.2 Workforce Standards 3.42 3.30 3.38

8.3 Continuing Education 3.33 3.15 3.22

8.4 Leadership Development 3.17 2.78 2.94

ES 9: Evaluate Services 3.10 2.65 2.83

9.1 Evaluation of population Health 3.14 2.66 2.86

9.2Evaluation of personal health 3.24 2.90 3.04

9.3 Evaluation of LPHS 2.92 2.38 2.58

ES 10: Research/Innovations 3.11 2.96 3.1

10.1 Foster Innovation 2.82 2.67 2.98

10.2 Academic Linkage 3.66 3.39 3.51

10.3 Research Capacity 2.84 2.82 2.82

Average Overall Score 3.20 3.01 3.10


Results (cont.)

While nearly all Essential Services received scores in the 2-3 point range, there were a few ser-

vices that ranked notably higher than others. The top 3 performance scores are identified in the

table above and indicate that the following services were perceived by participants as outperform-

ing the rest: 1) Essential Services 2: Diagnose and Investigate Community Health Problems and

Health Hazards; 2) Essential Service 6: Enforce Laws and Regulations that Protect Health and

Ensure Safety; and 3) Essential Service 7: Link people to Needed Personal Health Services and

Assure Safety Net Services. There was some slight discrepancy in scores between Eastern and

Western Riverside where the participants tended to view the system performance slightly more

favorably overall. Meanwhile, the participants at the West location ranked Essential Service 4:

Identifies local health system partners and stakeholders, more favorably than EPHS 7.

Top 3 Performance Scores East West Total

ES 2 3.70 ES 2 3.36 ES 2 3.47

ES 6 3.56 ES 6 3.34 ES 6 3.43

ES 7 3.41 ES 4 3.15 ES 7 3.18

The bottom 3 performance scores are identified in the table above and indicate that the following

services were perceived by participants as underperforming the rest: 1) Essential Service 9:

Evaluate Effectiveness, Accessibility and Quality of Personal and Population-Based health Ser-

vices; 2) Essential Service 1: Monitor and Health Status to Identify Community Health Problems;

3) Essential Service 5: Develop Policies and Plans That Support Individual and Community

Health Efforts.

Due to the variation in scoring from West to East, the following services also scored toward the

bottom and may be considered priority items for targeted improvement activities: 1) Essential

Service 10: Research New Insights and Innovative Solutions; and 2) Essential Service 8: Assure a

Competent Public and Personal Health Care Workforce,

Bottom 3 Performance Scores East West Total

ES 5 2.89 ES 8 2.87 ES 9 2.83

ES 1 3.05 ES 1 2.84 ES 1 2.94

ES 10 3.08 ES 9 2.64 ES 5 2.95


The following pages contain a summary sheet for each of the ten Essential Public Health Services

(EPHS). The steps below provide guidance on how to approach the results.

Essential Service Summary Sheets

How To Interpret Services and Results

1

2

3

Review the EPHS description to familiarize yourself with the

system activities associated with the Service.

Familiarize yourself with the partners who are expected to play a role in completing

the activities of the EPHS. What type of agency do you work for and what is the

agency’s role in this Service? What partners does your agency collaborate with in

performing these activities?

Examine the average scores for the Model Standards that comprise each

Service. A score is given for each Standard based on the combined rating

of all participants who attended the LPHSA. An overall EPHS score is given

based on the average of its component Standard scores. The results are

also given for both locations where the assessment was conducted.

4 Use the colored activity scale below the bar chart to gauge the level of per-

formance that corresponds to the numerical score for each standard and

service overall. How far is each measure from achieving the optimal level

of performance?

5 After reviewing the scores for the Model Standards on the bar chart, ex-

amine the tables containing the specific questions that were used to evalu-

ate the performance of each Standard. Each question was scored and the

activity level is given for each. See the Scoring section for more detail on

how activity levels are defined.

6 Finally, read over the summaries of the Strengths, Challenges, Agency

Contributions, and Table Discussions that took place during the assess-

ment. This qualitative data was taken from the written and verbal input

from participants and gathered by recorders who were assigned to each

table of participants.


EPHS 1 – Monitor Health Status, Identify Community Health Needs

Essential Public Health Service (EPHS 1) aims to provide accurate and periodic assessments of the com-

munity’s health status. Monitoring health registries, identifying health risks, vital statistics and identifi-

cation of resources play major roles of this service.

LPHSA 2014 FINDINGS

Results Summary

MINIMAL approaching MODERATE activity level

EPHS 1: Expected System Partners

Community health planners Community-based organizations Emergency preparedness teams Environmental health data experts Epidemiologists General public Healthcare systems Hospitals and clinics Local Board of Health or other local

governing entity

Local chapter of national health-related group

Local Health Department or other government public health agency

Managed care organizations Public Health laboratories State health department University or academic institutions

Activity Level Minimal Moderate Significant

Optimal

None


STRENGTHS CHALLENGES

Collaborations with other agencies in working and sharing of data between different organizations.

Technology improvements and access to organiza-tions, universities and government data.

The size of the county can result in disconnect be-tween agencies and partners who can provide ser-vices and resources.

Although there is a great amount of data provided, the navigation process is difficult due to a lack of effective distribution.

AGENCY CONTRIBUTIONS

Across the county, annual data is collected on pre-term birth rates at the State and County level.

Participants indicated that Needs Assessments were conducted in the areas of LGBT, healthcare, workforce and child obesity.

Health portals and surveys are also being devel-oped in Coachella Valley to assess health status throughout the community.


Strengths Challenges





Agency Contributions Table Discussion Summary




Health concerns are being identified but there is confusion about what is being maintained in the community. Sharing and attaining health infor-mation is an area that Riverside County aims to continually improve.

At what level does the Local Public Health System:

1.1 Model Standard: Population-Based Community Health Assessment (CHA) Minimal

1.1.1 Conduct regular community health assessments? Moderate

1.1.2 Continuously update the community health assessment with current information? Minimal

1.1.3 Promote the use of the community health assessment among community members and partners?

Minimal


1.2 Model Standard: Current Technology to Manage and Communicate Population Health Data

Minimal

1.2.1 Use the best available technology and methods to display data on the public’s health? Minimal

1.2.2 Analyze health data, including geographic information, to see where health problems exist?

Moderate

1.2.3 Use computer software to create charts, graphs, and maps to display complex public health data (trends over time, sub-population analyses, etc.)?

Minimal


1.3 Model Standard: Maintenance of Population Health Registries Minimal

1.3.1 Collect data on specific health concerns to provide the data to population health regis-tries in a timely manner, consistent with current standards?

Minimal

1.3.2 Use information from population health registries in community health assessments or other analyses?

Minimal


EPHS 2 – Diagnose and Investigate Health problems and Health Hazards

Essential Public Health Service (EPHS 2) Timely identify and investigate health threats in the

community. Availability of diagnostic services is examined as well as response plans to address major

health threats.

LPHSA 2014 FINDINGS

Results Summary

MODERATE activity level


Colleges and universities Employers Hospitals and clinics Local Board of Health or other local

governing entity Local Health Department or other

government public health agency Long-term care facilities Managed care organizations

Physicians Pre-school and daycare programs Primary care clinics, including Federally

Qualified Health Centers (FQHCs) and community health centers

Public and private schools Public Health laboratories Public safety and emergency response

organizations


Optimal

None









2.1 Model Standard: Identification and Surveillance of Health Threats Moderate

2.1.1

Participate in a comprehensive surveillance system with national, state and local part-ners to identify, monitor, share information, and understand emerging health problems and threats?

Moderate

2.1.2 Provide and collect timely and complete information on reportable diseases and poten-tial disasters, emergencies and emerging threats (natural and manmade)?

Moderate

2.1.3

Assure that the best available resources are used to support surveillance systems and activities, including information technology, communication systems, and professional expertise?

Moderate


2.2 Model Standard: Investigation and Response to Public Health Threats and Emer-gencies

Moderate

2.2.1

Maintain written instructions on how to handle communicable disease outbreaks and toxic exposure incidents, including details about case finding, contact tracing, and source identification and containment?

Moderate

2.2.2 Develop written rules to follow in the immediate investigation of public health threats and emergencies, including natural and intentional disasters?

Moderate

2.2.3 Designate a jurisdictional Emergency Response Coordinator? Moderate

2.2.4 Prepare to rapidly respond to public health emergencies according to emergency opera-tions coordination guidelines?

Moderate

2.2.5 Identify personnel with the technical expertise to rapidly respond to possible biological, chemical, or and nuclear public health emergencies?

Moderate

2.2.6 Evaluate incidents for effectiveness and opportunities for improvement? Moderate


2.3 Model Standard: Laboratory Support for Investigation of Health Threats Moderate

2.3.1 Have ready access to laboratories that can meet routine public health needs for finding out what health problems are occurring?

Moderate

2.3.2 Maintain constant (24/7) access to laboratories that can meet public health needs dur-ing emergencies, threats, and other hazards?

Moderate

2.3.3 Use only licensed or credentialed laboratories? Moderate

2.3.4 Maintain a written list of rules related to laboratories, for handling samples (collecting, labeling, storing, transporting, and delivering), for determining who is in charge of the samples at what point, and for reporting the results?

Moderate








Across the county, agency contributions consisted of collaborating in hazard preparedness training and protocols.

Also, diagnosing community health problems based on information provided by community members and assessments through events and outreach programs.

It is vital to make sure that the LPHS is reaching all populations in the community more effectively es-pecially those with language and cultural barriers.


The County has a strong disaster planning and emergency response system.

Rapid response to infectious diseases such as TB, West Nile, and Meningitis .

Riverside County is ahead of the curve when com-pared to other counties or entities.

Need for more detailed information on disease hazards that may be a problem or are on the in-crease

Poor communication throughout the county



EPHS 3 – Inform, Educate and Empower People About Health Issues

Essential Public Health Service (EPHS 3) Use health education and health promotion partnerships with-

in the community to support and develop skills and behaviors for health living.

LPHSA 2014 FINDINGS

Results Summary



Civic organizations Colleges and universities Faith-based organizations Health educators Hospitals and clinics Local Board of Health or other local

governing entity Local businesses and employers Local Health Department or other

government public health agency

Managed care organizations Media Neighborhood organizations Non-profit organizations/Advocacy

organizations Other community/grassroots

organizations Public and private schools Public Information Officers


Optimal

None











EPHS 3 – Inform, Educate and Empower People About Health Issues


The County has a knowledgeable workforce that collaborates through building healthy communi-ties and creating impactful messages that edu-cates the public

Local health systems throughout Riverside County are working to create culturally competent infor-mation to smaller sectors in the community.

Limited staffing and resources throughout the county

Use of media is minimal and could be used more thoroughly to reach rural and diverse populations

Not enough communication between organizations


Across the county, agency contributions consist of working with disadvantaged and vulnerable pop-ulations in Eastern Coachella. Agencies through-out the county organize communities to inform policy advocacy, and engage with community members towards health promotion and positive health outcomes.

Leadership in the HEAL Zone and participation in the Riverside County Health Coalition is also tak-ing place in the community.

Increasing distribution and access of resources equally between eastern and western regions of the county.


3.1 Model Standard: Health Education and Promotion Moderate

3.1.1 Provide policymakers, stakeholders, and the public with ongoing analyses of community health status and related recommendations for health promotion policies?

Moderate

3.1.2 Coordinate health promotion and health education activities to reach individual, inter-personal, community, and societal levels?

Moderate

3.1.3 Engage the community throughout the process of setting priorities, developing plans and implementing health education and health promotion activities?

Moderate


3.2 Model Standard: Health Communication Minimal

3.2.1 Develop health communication plans for relating to media and the public and for shar-ing information among LPHS organizations?

Minimal

3.2.2 Use relationships with different media providers (e.g. print, radio, television, and the internet) to share health information, matching the message with the target audience?

Minimal

3.2.3 Identify and train spokespersons on public health issues? Minimal


3.3 Model Standard: Risk Communication Moderate

3.3.1 Develop an emergency communications plan for each stage of an emergency to allow for the effective dissemination of information?

Moderate

3.3.2 Make sure resources are available for a rapid emergency communication response? Moderate

3.3.3 Provide risk communication training for employees and volunteers? Minimal



City and county governmental agencies Civic organizations Colleges and universities Community members Faith-based organizations Health educators Health-related coalition leaders Hospitals and clinics Local Board of Health or other local

governing entity Local businesses and employers Local chambers of commerce Local Health Department or other

government public health agency Managed care organizations

Media Ministerial alliances Neighborhood organizations Non-profit organizations/Advocacy


organizations Public and private schools Public Information Officers State and Federal programs Substance abuse or mental health

organizations United Way Worksite wellness councils

EPHS 4– Mobilize Community Partnerships to Identify and Solve Health Problems

Essential Public Health Service (EPHS 4) Identifies local health system partners and stakeholders.

Creating formal and informal partnerships to promote health improvement are vial through the

community.

LPHSA 2014 FINDINGS

Results Summary



Optimal

None











EPHS 4– Mobilize Community Partnerships to Identify and Solve Health Problems


211 Directory Participation of constituents is improving There are numerous coalitions in Riverside Coun-

ty and ongoing efforts toward mobilizing partner-ships

There is strong community support Healthy Riverside County Coalition has done

great work

Partners need to work outside of silos, developing more collaborations around grants.

Community partnerships may not be assessing goals and moving toward progress, just discussing the topics

Lag in shifting focus– stop what you’ve been doing to re-prioritize on other issues that need to be completed


Currently, agencies throughout the county are monitoring solutions to environmental health concerns as well as participating in forums and community action groups that support health ini-tiatives; they are establishing new partnerships and bringing out resources to establish communi-ty partnerships to increase knowledge on the health of the community.

Creating a complete and current directory of com-munity organizations and stakeholders to collabo-rate with and involving all of eastern and western regions of the county.


4.1 Model Standard: Constituency Development Moderate

4.1.1 Maintain a complete and current directory of community organizations? Moderate

4.1.2 Follow an established process for identifying key constituents related to overall public health interests and particular health concerns?

Minimal

4.1.3 Encourage constituents to participate in activities to improve community health? Moderate

4.1.4 Create forums for communication of public health issues? Moderate


4.2 Model Standard: Community Partnerships Moderate

4.2.1 Establish community partnerships and strategic alliances to provide a comprehensive approach to improving health in the community?

Moderate

4.2.2 Establish a broad-based community health improvement committee? Moderate

4.2.3 Assess how well community partnerships and strategic alliances are working to im-prove community health?

Moderate


EPHS 5 – Develop Policies and Plans that Support Individual and Community Health Efforts

Essential Public Health Service (EPHS 5) Works toward policy development to protect health and guide

public health practice. This service includes community and state improvement planning as well as

emergency response planning.


City planners Civic organizations Colleges and universities Community development organizations Community health planners Community residents Department of Transportation and other

transportation services Departments of Parks and Recreation Elected officials and policymakers Faith-based organizations Health officer/Public Health director Healthcare providers Hospitals and clinics Indian Health Service Law enforcement agencies and

emergency services personnel

Local Board of Health or other local governing entity

Local businesses and employers Local foundations Local Health Department or other

government public health agency Managed care organizations Media Neighborhood organizations Non-profit organizations/Advocacy


organizations Professional associations Public Health attorneys Public interest law groups Substance abuse or mental health

organizations

LPHSA 2014 FINDINGS

Results Summary

MINIMAL activity level


Optimal

None









5.1 Model Standard: Governmental Presence at the Local Level Minimal

5.1.1 Support the work of a local health department dedicated to the public health to make sure the essential public health services are provided?

Moderate

5.1.2 See that the local health department is accredited through the national voluntary ac-creditation program?

Minimal

5.1.3 Assure that the local health department has enough resources to do its part in provid-ing essential public health services?

Minimal


5.2 Model Standard: Public Health Policy Development Moderate

5.2.1 Contribute to public health policies by engaging in activities that inform the policy development process?

Moderate

5.2.2 Alert policymakers and the community of the possible public health impacts (both intended and unintended) from current and/or proposed policies?

Moderate

5.2.3 Review existing policies at least every three to five years? Moderate


5.3 Model Standard: Community Health Improvement Process and Strategic Planning

Minimal

5.3.1 Establish a community health improvement process, with broad- based diverse par-ticipation, that uses information from both the community health assessment and the perceptions of community members?

Minimal

5.3.2 Develop strategies to achieve community health improvement objectives, including a description of organizations accountable for specific steps?

Minimal

5.3.3 Connect organizational strategic plans with the Community Health Improvement Plan?

Minimal


5.4 Model Standard: Plan for Public Health Emergencies Moderate

5.4.1 Support a workgroup to develop and maintain preparedness and response plans? Moderate

5.4.2 Develop a plan that defines when it would be used, who would do what tasks, what standard operating procedures would be put in place, and what alert and evacuation protocols would be followed?

Moderate

5.4.3 Test the plan through regular drills and revise the plan as needed, at least every two years?

Moderate












Community support Coordination is getting better so services are not

duplicated Hospitals have policies that are put into place Healthy Resolution Toolkit was developed that

cities can adopt

Lack of collaboration throughout the county DOPH acts independently in their planning and

policy development efforts


Across the county, contributions consist of con-tinuous monitoring of local policies and statewide legislation to informs and improve health outcomes.

Stakeholders work with government agencies and NGO in the community to determine what policies and plans are most effective at promoting health.

Policy development and implementation is ongo-ing while working with the Healthy Communities Committee, Health Coalition and Thriving Schools Campaign.

Improving disconnect between private and public agencies as well as increasing funding for local public health efforts.



EPHS 6 – Enforce Laws and Regulations that Protect Health and Ensure Safety

Essential Public Health Service (EPHS 6) aims review, evaluate and revise laws and regulations.

Education and advocating for regulations that protects and promotes health within Riverside County.


Animal control authorities City planners Civic organizations Civil and human rights groups Corrections facilities Department of Transportation and other

transportation services District attorney and public defender Economists Elected officials and policymakers Environmental health agencies Fire department Health officer/Public Health director Healthcare providers Hospitals and clinics Law enforcement agencies and

emergency services personnel Local Board of Health or other local

governing entity

Local businesses and employers Local Health Department or other

government public health agency Long-term care facilities Media Neighborhood organizations Non-profit organizations/Advocacy

organizations Oil and gas industry representatives Other community/grassroots

organizations Public and private schools Public Health attorneys Public Housing State licensing boards Waste management facilities

LPHSA 2014 FINDINGS

Results Summary



Optimal

None









6.1 Model Standard: Review and Evaluation of Laws, Regulations, and Ordinances Moderate

6.1.1 Identify local public health issues that are inadequately addressed in existing laws, reg-ulations, and ordinances?

Moderate

6.1.2 Participate in changing existing laws, regulations, and ordinances, and/or creating new laws, regulations, and ordinances to protect and promote the public health?

Moderate

6.1.3 Provide technical assistance in drafting the language for proposed changes or new laws, regulations, and ordinances?

Moderate

6.1.4 Have access to legal counsel for technical assistance when reviewing laws, regulations, or ordinances?

Moderate


6.2 Model Standard: Involvement in the Improvement of Laws, Regulations, and Ordinances

Moderate

6.2.1 Identify local public health issues that are inadequately addressed in existing laws, reg-ulations, and ordinances?

Moderate

6.2.2 Participate in changing existing laws, regulations, and ordinances, and/or creating new laws, regulations, and ordinances to protect and promote the public health?

Moderate

6.2.3 Provide technical assistance in drafting the language for proposed changes or new laws, regulations, and ordinances?

Moderate


6.3 Model Standard: Enforcement of Laws, Regulations, and Ordinances Moderate

6.3.1 Identify organizations that have the authority to enforce public health laws, regulations, and ordinances?

Moderate

6.3.2 Assure that a local health department (or other governmental public health entity) has the authority to act in public health emergencies?

Moderate

6.3.3 Assure that all enforcement activities related to public health codes are done within the law?

Moderate

6.3.4 Educate individuals and organizations about relevant laws, regulations, and ordinanc-es?

Moderate

6.3.5 Evaluate how well local organizations comply with public health laws? Moderate













Policy work in Jurupa Valley regarding Livable Communities

Work with Health it All Cities Policy Environmental Health work in enforcing tobacco

laws Building Healthy Communities work on making

changes through policy

The need for public health policy in areas who don’t identify as part of the Local Public Health System

Lack of enforcement/authority/jurisdiction Need better communication with the public; they

don’t know laws are passed until they are impact-ed by them


Across the county, agencies participate in policy and development by enforcing environmental laws, regulations and ordinances.

Making sure agencies are in compliance with rules and regulations is a major influence from stakeholders throughout the county.

Local health system is good at enforcing laws, but not strong in identifying and changing laws it is imperative to ensure that the public is informed and aware of policies and laws before it affects them.



Essential Public Health Service (EPHS 7) at identifying populations with barrier to care. Making sure

that the community has the available services and resources to health care is a major role of this essen-

tial service


Colleges and universities Department of Transportation and other

transportation services Department of Veterans' Affairs Elected officials and policymakers Employment assistance organizations Faith-based organizations Healthcare providers Healthcare systems Hospitals and clinics Law enforcement agencies and

emergency services personnel Lesbian, gay, bisexual, transgender

(LGBT) organizations Local Board of Health or other local

governing entity


Managed care organizations Non-profit organizations/Advocacy

organizations Nursing homes Primary care clinics, including Federally


Public and private schools Public assistance programs Social services Substance abuse or mental health

organizations Tribal and cultural leaders United Way

LPHSA 2014 FINDINGS

Results Summary



Optimal

None













Mental Health working with clients to reduce bar-riers– modeling clinics based on feedback

Significant activity to identify ne/unmet needs of the community

Increase in bilingual staffing has led to an increase in access services

There are not enough services for the needs of the community

Not enough staffing for the needs of community Need for mobile clinics Providing unique needs of different populations

done in a culturally competent way


Across the county, agency contributions consist of focusing efforts and resources on areas of most need.

Some agencies are listening to clients and working toward breaking barriers by modeling and linking clients to services based on client feedback.

Efforts include facilitation of communication of transportation to the community so services can be easily reached.

Transportation is a major issue as well as ensuring there are enough providers in the health care sys-tem.


7.1 Model Standard: Identification of Personal Health Service Needs of Populations Moderate

7.1.1 Identify groups of people in the community who have trouble accessing or connecting to personal health services?

Moderate

7.1.2 Identify all personal health service needs and unmet needs throughout the community? Moderate

7.1.3 Defines partner roles and responsibilities to respond to the unmet needs of the commu-nity?

Minimal

7.1.4 Understand the reasons that people do not get the care they need? Moderate


7.2 Model Standard: Assuring the Linkage of People to Personal Health Services Moderate

7.2.1 Connect (or link) people to organizations that can provide the personal health services they may need?

Moderate

7.2.2 Help people access personal health services, in a way that takes into account the unique needs of different populations?

Moderate

7.2.3 Help people sign up for public benefits that are available to them (e.g., Medicaid or med-ical and prescription assistance programs)?

Moderate

7.2.4 Coordinate the delivery of personal health and social services so that everyone has ac-cess to the care they need?

Minimal


EPHS 8 – Assure a Competent Public and Personal Health Care Workforce

Essential Public Health Service (EPHS 8) serves to maintain public health workforce standards. Ensur-

ing there is an efficient process for licensing and credentialing as well as education on leadership devel-

opments and cultural competencies.

LPHSA 2014 FINDINGS

Results Summary



Colleges and universities Emergency Medical Services Employers Foundations Hospitals and clinics Human resources departments Local Board of Health or other local

governing entity Local chambers of commerce



organizations Primary care clinics, including Federally


Professional associations Public Information Officers


Optimal

None













8.1 Model Standard: Workforce Assessment, Planning, and Development Minimal

8.1.1 Set up a process and a schedule to track the numbers and types of LPHS jobs and the knowledge, skills, and abilities that they require whether those jobs are in the public or private sector?

Minimal

8.1.2 Review the information from the workforce assessment and use it to find and address gaps in the local public health workforce?

Minimal

8.1.3 Provide information from the workforce assessment to other community organizations and groups, including governing bodies and public and private agencies, for use in their organizational planning?

Minimal


8.2 Model Standard: Public Health Workforce Standards Moderate

8.2.1 Make sure that all members of the public health workforce have the required certifi-cates, licenses, and education needed to fulfill their job duties and meet the law?

Moderate

8.2.2 Develop and maintain job standards and position descriptions based in the core knowledge, skills, and abilities needed to provide the essential public health services?

Moderate

8.2.3 Base the hiring and performance review of members of the public health workforce in public health competencies?

Moderate


8.3 Model Standard: Life-Long Learning through Continuing Education, Training, and Mentoring

Moderate

8.3.1 Identify education and training needs and encourage the workforce to participate in available education and training?

Moderate

8.3.2 Provide ways for workers to develop core skills related to essential public health ser-vices?

Moderate

8.3.3 Develop incentives for workforce training, such as tuition reimbursement, time off for class, and pay increases?

Moderate

8.3.4 Create and support collaborations between organizations within the public health sys-tem for training and education?

Minimal

8.3.5 Continually train the public health workforce to deliver services in a cultural competent manner and understand social determinants of health?

Moderate


8.4 Model Standard: Public Health Leadership Development Minimal

8.4.1 Provide access to formal and informal leadership development opportunities for em-ployees at all organizational levels?

Moderate

8.4.2 Create a shared vision of community health and the public health system, welcoming all leaders and community members to work together?

Moderate

8.4.3 Ensure that organizations and individuals have opportunities to provide leadership in areas where they have knowledge, skills, or access to resources?

Moderate

8.4.4 Provide opportunities for the development of leaders representative of the diversity within the community?

Minimal













More cultural competency training is going on than in the past

Health Equity training is training is required for all Public Health staff

County employees have access to Government Excellence

Succession planning discussed, but it is not really addressed by many

Need for better university collaboration with the county

No tuition reimbursement known for some groups, time off for classes


Across the county, agency contributions consist of leadership development actives.

CSU San Marcos is currently launching a certifi-cate on cultural and linguistically appropriate ser-vices and competencies for healthcare practition-ers.

Workforce assessments also took place in Coachella Valley.

Education is available but not easy to access. Edu-cation should be more accessible and easy to reach.

Continuing education for non-management staff is minimal or moderate


EPHS 9 – Evaluate Effectiveness, Accessibility and Quality of Personal & Population-

Based Health Services

Essential Public Health Service (EPHS 9) is directed toward quality improvement. Evaluation must be

ongoing and should examine personal and population health services, as well as the public health sys-

tem.

LPHSA 2014 FINDINGS

Results Summary



Consultants Faith-based organizations Foundations Hospitals and clinics Local Board of Health or other local

governing entity Local Health Department or other

government public health agency Managed care organizations

Non-profit organizations/Advocacy organizations

Primary care clinics, including Federally Qualified Health Centers (FQHCs) and community health centers

Public and private schools Service providers Service recipients


Optimal

None










9.1 Model Standard: Evaluation of Population-Based Health Services Minimal

9.1.1 Evaluate how well population-based health services are working, including whether the goals that were set for programs were achieved?

Moderate

9.1.2 Assess whether community members, including those with a higher risk of having a health problem, are satisfied with the approaches to preventing disease, illness, and in-jury?

Minimal

9.1.3 Identify gaps in the provision of population-based health services? Minimal

9.1.4 Use evaluation findings to improve plans and services? Minimal


9.2 Model Standard: Evaluation of Personal Health Services Moderate

9.2.1 Evaluate the accessibility, quality, and effectiveness of personal health services? Minimal

9.2.2 Compare the quality of personal health services to established guidelines? Minimal

9.2.3 Measure satisfaction with personal health services? Minimal

9.2.4 Use technology, like the internet or electronic health records, to improve quality of care? Moderate

9.2.5 Use evaluation findings to improve services and program delivery? Moderate


9.3 Model Standard: Evaluation of the Local Public Health System Minimal

9.3.1 Identify all public, private, and voluntary organizations that provide essential public health services?

Minimal

9.3.2 Evaluate how well LPHS activities meet the needs of the community at least every five years, using guidelines that describe a model LPHS and involving all entities contrib-uting to essential public health services?

Minimal

9.3.3 Assess how well the organizations in the LPHS are communicating, connecting, and co-ordinating services?

Minimal

9.3.4 Use results from the evaluation process to improve the LPHS? Minimal












There is a broad breadth of organizations repre-sented in many coalitions

Numerous data resources Openness of system partners to reach out and

work with other sectors

Lack of behavioral assessment throughout the sys-tem

More focus groups need to be done to assess com-munity satisfaction

System needs to make better use of data to im-prove plans and processes


Across the county, numerous agencies are work-ing on data collection and evaluation.

HARC surveys communities and provides data to other agencies for evaluation.

Desert AIDS Project have medical interventions and treatment protocols that are all evaluated. Building Healthy Communities work is reflective of the needs of the community.

Gaps are easy to identify, the struggle lies in imple-menting change after gaps have been identified.

More resources are needed to fill the gaps to im-prove the system.




EPHS 10 – Research New Insights and Innovative Solutions

Essential Public Health Service (EPHS 10) aims to provide accurate and periodic assessments of the

community’s health status. Monitoring health registries, identifying health risks, vital statistics and

identification of resources play major roles of this service.

LPHSA 2014 FINDINGS

Results Summary



Colleges and universities Employers Foundations Hospitals and clinics Human resources departments Local Board of Health or other local

governing entity



organizations


Optimal

None









10.2 Model Standard: Linkage with Institutions of Higher Learning and/or Research Moderate

10.2.1 Develop relationships with colleges, universities, or other research organizations, with a free flow of information, to create formal and informal arrangements to work together?

Moderate

10.2.2 Partner with colleges, universities, or other research organizations to do public health research, including community-based participatory research?

Moderate

10.2.3 Encourage colleges, universities, and other research organizations to work together with LPHS organizations to develop projects, including field training and continuing ed-ucation?

Moderate


10.1 Model Standard: Fostering Innovation Minimal

10.1.1 Provide staff with the time and resources to pilot test or conduct studies to test new so-lutions to public health problems and see how well they actually work?

Minimal

10.1.2 Suggest ideas about what currently needs to be studied in public health to organizations that do research?

Minimal

10.1.3 Keep up with information from other agencies and organizations at the local, state, and national levels about current best practices in public health?

Moderate

10.1.4 Encourage community participation in research, including deciding what will be stud-ied, conducting research, and in sharing results?

Moderate


10.3 Model Standard: Capacity to Initiate or Participate in Research Minimal

10.3.1 Collaborate with researchers who offer the knowledge and skills to design and conduct health-related studies?

Minimal

10.3.2 Support research with the necessary infrastructure and resources, including facilities, equipment, databases, information technology, funding, and other resources?

Minimal

10.3.3 Share findings with public health colleagues and the community broadly, through jour-nals, websites, community meetings, etc.?

Moderate

10.3.4 Evaluate public health systems research efforts throughout all stages of work from plan-ning to impact on local public health practice?

Minimal












Riverside county does a great job keeping up with best practices

The health system does great work partnering with colleges, universities and other learning in-stitutions

CBO’s are providing resource and dialogue with the community

Numerous pilot projects that are not being taken to the next step; there is not much sharing of re-sults.

System is limited; there is a need for more oppor-tunities to get feedback and have evaluations com-pleted.


Across the county, stakeholders are working for new innovative solutions in the county.

Coachella economic development Agency has a IHUB supporting medical innovations and re-search.

Regional Access Project is working to collaborate with researchers. Building Healthy Communities is connecting researchers to0 the communities themselves.

Although research is happening in the community; it is not enough.

More collaboration and follow through of projects need to be going on for the betterment of the com-munity.


riverside county local public health system assessment (lphsa) 2014 draft

Documents