% Children eligible for free lunch 36 38 Health care costs $11,147 $10,365 %could not see doctor due to cost 13 13 Per Capita (person) income 2009-2013 $23,851 $26,046 Median household income 2014 $52,666 $48,138 Source: Office of Policy, Research and Strategic Planning. 2013. Available at ; countyhealthrankings.org/2014 METHODS.
Good medical facilities Clinical services; reaching low income population with preventative care Immunizations WIC program Sharing information in schools Programs to decrease barriers Mental health Infection control Environmental Health Continue to implement public health programs Smoking cessation Involvement of local hospital Prescription Drugs Communicable diseases Posting inspection results Abandoned homes Mentoring and education of teens Bullying, school safety (school resource officer, sheriff meeting with students) Prevention services Drug Needle use Sexual abuse/trafficking Poverty/economics Access to food, healthy food choices, food quality New sewage rules, waste management Circleville water quality Teen Pregnancy Smoking Make people aware of the health department and what is does More community health resources More public health screenings Try to get people involved; more community involvement such as churches Churches helping with addiction Public outreach with coordination of services Better support effort in doctor’s offices Increase doctors and optometrists Better police/sheriff investment or concern More education in schools ie drugs, sex Improve education in general Wellness programs, 5K runs or walkathon, community adoption of healthy lifestyle Addressing obesity Preventing pregnancy/safe sex programs Advertising things for teens Need more money/funding Overall, the community felt that the Pickaway County health department was providing necessary services but that there were several areas that needed to be addressed or that were missing.
2.1 Model Standard: Identification and Surveillance of Health Threats At what level does the local public health system: 2.1.1 Participate in a comprehensive surveillance system with national, state and local partners to identify, monitor, share information, and understand emerging health problems and threats? 100 2.1.2 Provide and collect timely and complete information on reportable diseases and potential disasters, emergencies and emerging threats (natural and manmade)? 100 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? 75 2.2 Model Standard: Investigation and Response to Public Health Threats and Emergencies At what level does the local public health system: 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? 100 2.2.2 Develop written rules to follow in the immediate investigation of public health threats and emergencies, including natural and intentional disasters? 100 2.2.3 Designate a jurisdictional Emergency Response Coordinator? 100 2.2.4 Prepare to rapidly respond to public health emergencies according to emergency operations coordination guidelines? 100 2.2.5 Identify personnel with the technical expertise to rapidly respond to possible biological, chemical, or and nuclear public health emergencies? 100 2.2.6 Evaluate incidents for effectiveness and opportunities for improvement? 100
2.3 Model Standard: Laboratory Support for Investigation of Health Threats At what level does the local public health system: 2.3.1 Have ready access to laboratories that can meet routine public health needs for finding out what health problems are occurring? 100 2.3.2 Maintain constant (24/7) access to laboratories that can meet public health needs during emergencies, threats, and other hazards? 100 2.3.3 Use only licensed or credentialed laboratories? 100 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? 100 ESSENTIAL SERVICE 3: Inform, Educate, and Empower People about Health Issues 3.1 Model Standard: Health Education and Promotion At what level does the local public health system: 3.1.1 Provide policymakers, stakeholders, and the public with ongoing analyses of community health status and related recommendations for health promotion policies? 50 3.1.2 Coordinate health promotion and health education activities to reach individual, interpersonal, community, and societal levels? 50 3.1.3 Engage the community throughout the process of setting priorities, developing plans and implementing health education and health promotion activities? 75 3.2 Model Standard: Health Communication At what level does the local public health system:
ESSENTIAL SERVICE 6: Enforce Laws and Regulations that Protect Health and Ensure Safety 6.1 Model Standard: Review and Evaluation of Laws, Regulations, and Ordinances At what level does the local public health system: 6.1.1 Identify public health issues that can be addressed through laws, regulations, or ordinances? 100 6.1.2 Stay up-to-date with current laws, regulations, and ordinances that prevent, promote, or protect public health on the federal, state, and local levels? 100 6.1.3 Review existing public health laws, regulations, and ordinances at least once every five years? 100 6.1.4 Have access to legal counsel for technical assistance when reviewing laws, regulations, or ordinances? 100 6.2 Model Standard: Involvement in the Improvement of Laws, Regulations, and Ordinances At what level does the local public health system: 6.2.1 Identify local public health issues that are inadequately addressed in existing laws, regulations, and ordinances? 100 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? 100 6.2.3 Provide technical assistance in drafting the language for proposed changes or new laws, regulations, and ordinances? 100 6.3 Model Standard: Enforcement of Laws, Regulations, and Ordinances At what level does the local public health system: 6.3.1 Identify organizations that have the authority to enforce public health laws, regulations, and ordinances? 100
Awareness issue, resources are there. ESSENTIAL SERVICE 9: Evaluate Effectiveness, Accessibility, and Quality of Personal and Population-Based Health Services STRENGTHS WEAKNESSES OPPORTUNITIES FOR IMMEDIATE IMPROVEMENT / PARTNERSHIPS PRIORITIES OR LONGER TERM IMPROVEMENT OPPORTUNITIES 9.1 Model Standard: Evaluation of Population-Based Health Services funding 9.2 Model Standard: Evaluation of Personal Health Services 9.3 Model Standard: Evaluation of the Local Public Health System ESSENTIAL SERVICE 10: Research for New Insights and Innovative Solutions to Health Problems STRENGTHS WEAKNESSES OPPORTUNITIES FOR IMMEDIATE IMPROVEMENT / PARTNERSHIPS PRIORITIES OR LONGER TERM IMPROVEMENT OPPORTUNITIES 10.1 Model Standard: Fostering Innovation 10.2 Model Standard: Linkage with Institutions of Higher Learning and/or Research
Results The data you created now establishes the foundation upon which to set priorities for performance improvement and identify specific quality improvement (QI) projects to support your priorities. Based upon the responses provided during the assessment, an average was calculated for each of the ten Essential Services. Each Essential Service score can be interpreted as the overall degree to which the public health system meets the performance standards (quality indicators) for each Essential Service. Scores can range from a minimum value of 0% (no activity is performed pursuant to the standards) to a maximum value of 100% (all activities associated with the standards are performed at optimal levels). Figure 2 displays the average score for each Essential Service, along with an overall average assessment score across all ten Essential Services. Examination of these scores can immediately give a sense of the local public health system's greatest strengths and weaknesses. Note the black bars that identify the range of reported performance score responses within each Essential Service.
3. Community health outcomes with includes concerns of smoking, diabetes, obesity, cancer and dental care 4. Funding issues surrounding County public health services 5. Implications of the Affordable Care Act, and State legislative issues such as Issue 3 legalization of marijuana. Table 3. Threats and Opportunities of Pickaway County’s Forces of Change FORCES THREATS OPPORTUNITES ECONOMIC Lack of Funding *No levy for several years *Less money available for direct services and prevention programs *Decreases support system for high-risk or high-needs populations *need more time seeking grant funding *Job loss that affects the infrastructure of social systems and public health programs *Awareness for levy *Health department roles; need for increased incentive to collaborate between offices and programs. *shift responsibility of some programs to private sector or nonprofit agencies or streamline services. *Create new systems to reach more clients efficiently. Weak economy *Increase in number of unemployed and underemployed *motivation for business development *Increase in Medicaid and in uninsured or underinsured *Role of ACA *Increase partnerships and collaborations *Increase in foreclosures and housing issues *Increase social support Global threat *Threat of economic downturn and uncertainty *Increase partnerships and social support ENVIRONMENTAL Sewage Laws *Lack of awareness *Contaminates water supply *Compliance and informing of new laws statewide *Clean and redesign public spaces and parks Water run-off *Contaminates water supply *Lack of awareness *enforcement and education *Increase community value by improving environment Foodborne outbreaks *impact on community *Increase environmental services *improve awareness Emergency Preparedness *impact on community *mandated
SOCIAL Aging Population *Aging workforce *Increase need for handicap *Increase in need for caretakers and hospice accommodations *Increase in cost associated with end of life care *Improve collaboration of services (senior center, new senior housing, Safe Banking Program, medications, sheriff and judicial cooperation for issues of abuse) *Coordinate Medicare, social services; improve palliative and end of life care; coordination with nursing facilities Socioeconomic disparity *Children and families with unmet needs, food assistance *Association with poor health and economic outcomes *Lost industry *Association with mental health issues *Association with poor dental care *Homelessness *Coordinate and improve services, especially hard to reach groups * form partnerships to offer opportunites to underserved *Economic development plan to increase employment opportunities (P3, OCU Business Innovation Center) *Identify skills (OCU, Job and Family Services) Mental issues *limitation of resources *strain on mental health services and social systems *potential for increase in community violence and homicides *Goal for integrated services *Partnerships for DAWN program *increase funding for ADAMH *funding for children and adolescent mental health care Dental issues *limited coverage and availability *disproportionately affects low income and lower educated groups *effect on health *affects children *increase availability *find funding for school sealant program Immigration *strain on existing insurance system *increase number of unemployed and underemployed *Social disparity *collaboration with services *need for interpretative services *vaccination LEGAL/POLITICAL Legislative Health Care Reform (ACA) *Difficulty implementing new requirements *Unaware or confusion about system *Cost of implementation *Collaborate to comply with requirements for EMR *Increase in access to care for more people *Potential to improve quality of care Elections 2015/2016 *Legalization of marijuana *Depending on election outcome –changes in health care, social policies, foreign relations *shift in law enforcement *may shift Employee Handbook policies *depends of election outcomes