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pdfLocal Public Health System
Performance Assessment Instrument
Version 2.0
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
OMB Control No. 0920-0555
Expires: August 31, 2010
THE NATIONAL PUBLIC HEALTH PERFORMANCE STANDARDS PROGRAM
Local Public Health System Performance
Assessment Instrument
Version 2.0
Public reporting burden of this collection of information is estimated to average 16 hours per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the collection of information. An agency may not conduct or
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valid OMB control number. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance
Officer, 1600 Clifton Road NE, MS D-24, Atlanta, Georgia 30333; ATTN: PRA (0920-0555).
Program Partner Organizations
American Public Health Association
www.apha.org
Association of State and Territorial Health Officials
www.astho.org
Centers for Disease Control and Prevention
www.cdc.gov
National Association of County and City Health Officials
www.naccho.org
National Association of Local Boards of Health
www.nalboh.org
National Network of Public Health Institutes
www.nnphi.org
Public Health Foundation
www.phf.org
Local
Table of Contents
Introduction........................................................................................................iv
Crosswalk of Model Standards...........................................................................vi
Performance Assessment Instrument
• Essential Service 1
Monitor Health Status to Identify Community Health Problems....................... 2
• Essential Service 2
Diagnose and Investigate Health Problems and Health Hazards..................... 9
• Essential Service 3
Inform, Educate, and Empower People about Health Issues......................... 16
• Essential Service 4
Mobilize Community Partnerships to Identify and Solve Health Problems...... 24
• Essential Service 5
Develop Policies and Plans that Support Individual
and Community Health Efforts..................................................................... 29
• Essential Service 6
Enforce Laws and Regulations that Protect Health and Ensure Safety........ 39
• Essential Service 7
Link People to Needed Personal Health Services
and Assure the Provision of Health Care when Otherwise Unavailable.......... 44
• Essential Service 8
Assure a Competent Public and Personal Health Care Workforce................. 48
• Essential Service 9
Evaluate Effectiveness, Accessibility, and Quality of Personal
and Population-Based Health Services......................................................... 57
• Essential Service 10
Research for New Insights and Innovative Solutions to Health Problems...... 64
Supplemental Questionnaires
Respondent Information Form.......................................................................... 71
Priority Questionnaire....................................................................................... 77
Agency Contribution Questionnaire................................................................... 81
Local Public Health System Performance Assessment Instrument
iii
Local
National Public Health Performance Standards Program
An Introduction to the Local Public Health System Performance Assessment Instrument
The National Public Health Performance Standards Program (NPHPSP) assessments are intended to help users answer questions
such as “What are the activities and capacities of our public health system?” and “How well are we providing the Essential Public
Health Services in our jurisdiction?” The dialogue that occurs in answering these questions can help to identify strengths and
weaknesses and determine opportunities for improvement.
The NPHPSP is a partnership effort to improve the practice of public health and the performance of public health systems.
The NPHPSP assessment instruments guide state and local jurisdictions in evaluating their current performance against a set
of optimal standards.
Three assessment instruments have been designed to assist state and local partners in assessing and improving their public
health systems or boards of health. These instruments are the:
• State Public Health System Performance Assessment Instrument,
• Local Public Health System Performance Assessment Instrument, and
• Local Public Health Governance Performance Assessment Instrument.
The NPHPSP is a collaborative effort of seven national partners:
• Centers for Disease Control and Prevention, Office of Chief
of Public Health Practice (CDC/ OCPHP)
• American Public Health Association (APHA)
• Association of State and Territorial Health Officials (ASTHO)
• National Association of County and City Health Officials
(NACCHO)
• National Association of Local Boards of Health (NALBOH)
• National Network of Public Health Institutes (NNPHI)
• Public Health Foundation (PHF)
The three instruments were first released
in 2002 after a comprehensive development and testing process. Since the
NPHPSP began, 21 states and almost
1,000 localities (over 750 local jurisdictions and almost 200 boards of health)
have used the instruments and submitted
data. One or more of the NPHPSP instruments have been applied in 30 states.
In late 2005, the NPHPSP partnership
initiated a collaborative effort to update
the instruments, in order to ensure the
standards remain current and to seek
opportunities for improving the tools.
Similar to the development process of the
original instruments, the effort was guided
by three work groups of practitioners from
the field. Input from field test sites as well
as subject matter experts on a variety
of public health topics further informed
the revisions. The “Version 2” instrument
presented in this document is the result
of this initiative.
About the Performance Assessment Instruments
Each of the three NPHPSP instruments is based on the framework of the ten Essential Public Health Services. The Essential
Services represent the spectrum of public health activities that should be provided in any jurisdiction. Therefore, the instrument
itself is divided into ten sections – one for each of the Essential Services. Because many entities contribute to delivering the
Essential Services, the focus of the NPHPSP is the “public health system.” A public health system includes all public, private, and
voluntary entities that contribute to the delivery of the Essential Public Health Services within a given jurisdiction.
The purpose for undertaking a performance assessment is to strengthen and improve the public health system. The standards
were set at the optimal level; for this reason, participating jurisdictions will likely see many differences between their own performance and the “gold standard” presented in the instruments. System partners should seek to address these weaknesses and
also recognize and maintain areas in which they are strong.
iv
Local Public Health System Performance Assessment Instrument
Local
The topics addressed within each of the three instruments are
complementary and mutually-supporting, although each instrument may be used independently of the other. To view how the
instruments relate, a side-by-side comparison of the model
standard titles within each instrument follows this introduction.
However, because the state public health system, local public
health systems, and boards of health play important and
synergistic roles in public health within a state, a coordinated
application of all three instruments within the same timeframe
is considered ideal. Findings from a coordinated use of multiple
assessments may more effectively guide statewide efforts
to improve public health practice and performance.
The Local Public Health System Performance Assessment
The audience for this instrument is the local public health
system. This may include organizations and entities such
as the local health department, other governmental agencies,
healthcare providers, human service organizations, schools and
universities, faith institutions, youth development organizations,
economic and philanthropic organizations, environmental
agencies and many others. Any organization or entity that
contributes to the health or well-being of a community is considered part of the public health system. Ideally, a group that
is broadly representative of these public health system partners
will participate in the assessment process. By sharing their
diverse perspectives, all participants will gain a better understanding of each organization’s contributions, the interconnectedness of activities, and how the public health system can
be strengthened.
Essential Public Health Services
1. Monitor health status to identify
community health problems.
2. D
iagnose and investigate health problems
and health hazards in the community.
3. Inform, educate, and empower people
about health issues.
4. Mobilize community partnerships to identify and solve health problems.
5. Develop policies and plans that support
individual and community health efforts.
6. Enforce laws and regulations that protect
health and ensure safety.
7. L
ink people to needed personal health
services and assure the provision of health
care when otherwise unavailable.
8. Assure a competent public and personal
health care workforce.
9. Evaluate effectiveness, accessibility and
quality of personal and population-based
health services.
10. Research for new insights and innovative
For each Essential Service in the Local Instrument, the model
solutions to health problems.
standards describe or correspond to the primary activities
conducted at the local level. For example, model standards
in Essential Service #3 (inform, educate, and empower the
public about health issues) include Health Education and Promotion, Health Communication, and Risk Communication.
The number of model standards vary across the Essential Services; while some Essential Services include only two model
standards, others include up to four. There are a total of 30 model standards in this instrument.
Through the assessment process, participants from throughout the local public health system will have an opportunity to discuss
and determine how they are performing in comparison to each of the 30 model standards. Once the assessment is completed,
sites submit their data to the NPHPSP and receive a report summarizing their results within 24 hours. All of this information – the
responses to the assessment questions, the NPHPSP report, and the comments shared during the dialogue – can be used
to develop improvement strategies for the local public health system.
A variety of technical assistance and training resources are available to assist jurisdictions in undertaking the assessment and
post-assessment performance improvement activities. We encourage users to visit our website or contact the NPHPSP partners
to access these resources.
National Public Health Performance Standards Program Technical Assistance and Support
For general NPHPSP support and technical assistance resources, go to www.cdc.gov/od/ocphp/nphpsp/ or contact
1-800-747-7649 or [email protected].
For support with the NPHPSP Local Public Health System Assessment, users may also
contact NACCHO – www.naccho.org or 202-783-5550.
Local Public Health System Performance Assessment Instrument
Local
Crosswalk of Model Standards Within the Three NPHPSP Instruments
State Public Health System
Assessment
Essential Services
1. Monitor health status to
identify community health
problems.
2. Diagnose and investigate
health problems and health
hazards in the community.
1.1 Planning and Implementation
1.1 Population-Based
Community Health Profile
1.2 State-Local Relationships
1.3 Performance Management
and Quality Improvement
1.2 Current Technology to
Manage and Communicate
Population Health Data
1.4 Public Health Capacity and
Resources
1.3 Maintenance of Population
Health Registries
2.1 Planning and Implementation
2.1 Identification and Surveillance of Health Threats
2.2 State-Local Relationships
2.2 Investigation and
Response to Public Health
Threats and Emergencies
2.3 Performance Management
and Quality Improvement
3. Inform, educate, and
empower people about
health issues.
Local Public Health System
Assessment
2.4 Public Health Capacity and
Resources
2.3 Laboratory Support for
Investigation of Health
Threats
3.1 Planning and
Implementation
3.1 Health Education and
Promotion
3.2 State-Local Relationships
3.2 Health Communication
3.3 Performance Management
and Quality Improvement
3.3 Risk Communication
Local Public Health
Governance Assessment
1. Oversight for Community
Health Status Monitoring
2. Oversight for Public Health
Surveillance and Response
3. Oversight of Public Health
Information, Education and
Empowerment Activities
3.4 Public Health Capacity and
Resources
4. Mobilize community partnerships to identify and solve
health problems.
4.1 Planning and Implementation
4.1 Constituency Development
4.2 Community Partnerships
4.2 State-Local Relationships
4. Oversight for Constituency
Development and Partnership Building
4.3 Performance Management
and Quality Improvement
4.4 Public Health Capacity and
Resources
5. Develop policies and plans
that support individual and
community health efforts.
5.1 Planning and Implementation
5.1 Governmental Presence
at the Local Level
5.2 State-Local Relationships
5.2 Public Health
Policy Development
5.3 Performance Management
and Quality Improvement
5.4 Public Health Capacity and
Resources
5. Oversight of Public Health
Planning and Policy
Development
5.3 Community Health
Improvement Process
and Strategic Planning
5.4 Plan for Public
Health Emergencies
vi
Local Public Health System Performance Assessment Instrument
Local
Crosswalk of Model Standards Within the Three NPHPSP Instruments
Essential Services
6. Enforce laws and regulations that protect health and
ensure safety.
State Public Health System
Assessment
6.1 Planning and Implementation
6.2 State-Local Relationships
6.3 Performance Management
and Quality Improvement
6.4 Public Health Capacity and
Resources
7. Link people to needed
personal health services
and assure the provision of
health care when otherwise
unavailable.
7.1 Planning and
Implementation
7.2 State-Local Relationships
7.3 Performance Management
and Quality Improvement
7.4 Public Health Capacity
and Resources
8. Assure a competent public
health and personal health
care workforce.
8.1 Planning and
Implementation
Local Public Health System
Assessment
6.1 Review and Evaluation
of Laws, Regulations,
and Ordinances
Local Public Health
Governance Assessment
6. Oversight of Enforcement
of Public Health Laws and
Regulations
6.2 Involvement in the
Improvement of Laws,
Regulations, and
Ordinances
6.3 Enforcement of Laws,
Regulations, and
Ordinances
7.1 Identification of Personal
Health Service Needs
of Populations
7. Oversight for Public Health
Outreach and Linkage to
Personal Health Services
7.2 Assuring the Linkage
of People to Personal
Health Services
8.2 State-Local Relationships
8.1 Workforce Assessment,
Planning, and
Development
8.3 Performance Management
and Quality Improvement
8.2 Public Health Workforce
Standards
8.4 Public Health Capacity and
Resources
8.3 Life-Long Learning Through
Continuing
Education, Training,
and Mentoring
8. Oversight of Public Health
Workforce Issues
8.4 Public Health Leadership
Development
9. Evaluate the effectiveness,
accessibility, and quality
of personal and populationbased health services.
9.1 Planning and
Implementation
9.1 Evaluation of PopulationBased Health Services
9.2 State-Local Relationships
9.2 Evaluation of Personal
Health Services
9.3 Performance Management
and Quality Improvement
9.4 Public Health Capacity
and Resources
10. Research for new insights
and innovative solutions
to health problems.
9.3 Evaluation of the Local
Public Health System
10.1 Planning and
Implementation
10.1 Fostering Innovation
10.2 State-Local Relationships
10.2 Linkage with Institutions
of Higher Learning and/or
Research
10.3 Performance
Management and Quality
Improvement
10.4 Public Health Capacity
and Resources
9. Oversight and Evaluation for
Personal and Populationbased Health Services
10. Oversight of Public Health
Innovation and Research
10.3 Capacity to Initiate or
Participate in Research
Local Public Health System Performance Assessment Instrument
vii
Local
Performance Assessment Instrument
Local Public Health System Performance Assessment Instrument
Local
Essential Service #1: Monitor Health Status to Identify Community Health Problems
This service includes:
• Accurate, periodic assessment of the community’s health status, including:
- Identification of health risks, determinants of health, and determination of health service needs;
- Attention to the vital statistics and health status indicators of groups that are at higher risk than the total
population; and
- Identification of community assets that support the local public health system (LPHS) in promoting health and
improving quality of life.
• Utilization of appropriate methods and technology, such as geographic information systems (GIS), to interpret and
communicate data to diverse audiences.
• Collaboration among all LPHS components, including private providers and health benefit plans, to establish and use
population health registries, such as disease or immunization registries.
LPHS Model Standard 1.1: Population-Based Community Health Profile (CHP)
The community health profile (CHP) is a common set of measures for the community to prioritize the health
issues that will be addressed through strategic planning and action, to allocate and align resources, and
to monitor population-based health status improvement over time.
The CHP includes broad-based surveillance data and measures related to health status and health risk
at individual and community levels including: demographic and socioeconomic characteristics; health
resource availability; quality of life; behavioral risk factors; environmental health indicators; social and
mental health; maternal and child health; death, illness, and injury; communicable disease; and sentinel
events. The CHP displays information about trends in health status, along with associated risk factors
and health resources. Local measures are compared with peer, state, and national benchmarks. Data and
information are displayed in multiple formats for diverse audiences, such as the media and communitybased organizations. Data included in the community health profile are accurate, reliable, and consistently
interpreted according to the science and evidence-base for public health practice.
To accomplish this, the local public health system (LPHS):
• Conducts regular community health assessments to monitor progress towards health-related objectives.
• Compiles and periodically updates a community health profile using community health assessment data.
• Promotes community-wide use of the community health profile and/or assessment data and assures that
this information can be easily accessed by the community.
Local Public Health System Performance Assessment Instrument
Local
Please answer the following questions related to Model Standard 1.1:
1.1.1 Has the LPHS conducted a community health assessment?
1.1.1.1 Is the community health assessment updated at least every 3 years?
1.1.1.2 Are data from the assessment compared to data from other
representative areas or populations?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
1.1.1.2 Discussion Toolbox
In considering 1.1.1.2, are health status data compared with data
from:
q Peer (demographically similar) communities?
q The region?
q The state?
q The nation?
1.1.1.3 Are data used to track trends over time?
1.1.1.4 Does the LPHS use data from community health assessments
to monitor progress toward health-related objectives?
1.1.1.4 Discussion Toolbox
In considering 1.1.1.4, do those objectives include:
q Locally-established health priorities?
q State-established health priorities?
q Healthy People 2010 objectives?
q Measures from the Health Plan Employer Data and
Information Set (HEDIS)?
q Other health-related objectives?
1.1.2 Does the LPHS compile data from the community health assessment(s) into
a community health profile (CHP)?
Do CHP data elements include:
1.1.2.1 Community demographic characteristics?
1.1.2.2 Community socioeconomic characteristics?
1.1.2.3 Health resource availability data?
1.1.2.4 Quality of life data for the community?
1.1.2.5 Behavioral risk factors for the community?
1.1.2.6 Community environmental health indicators?
1.1.2.7 Social and mental health data?
1.1.2.8 Maternal and child health data?
1.1.2.9 Death, illness, and/or injury data?
1.1.2.10 Communicable disease data?
1.1.2.11 Sentinel events data for the community?
Local Public Health System Performance Assessment Instrument
Local
1.1.2.12 H
as the LPHS identified the individuals or organizations responsible
for contributing data and /or resources to produce the CHP?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
1.1.2.12 Discussion Toolbox
In considering 1.1.2.12, do any of the following contribute data
and/or resources to the development of the CHP:
q Local health department?
q University or academic institution(s)?
q Private consultant(s)?
q Health/hospital system(s)?
q Managed care organization(s)?
q Other public sector agency or governmental entity(ies)?
q State level agency or organization(s)?
q National level agency or organization(s)?
q Community-based organization(s)?
q The general public?
1.1.2.13 D
oes each contributor of data have access to the completed CHP?
1.1.3 Is community-wide use of community health assessment or CHP data
promoted?
1.1.3.1 Is a media strategy in place to promote community-wide use
of the CHP?
1.1.3.2 Is the information easily accessible by the general public?
1.1.3.3 Do organizations in the LPHS use the CHP to inform health policy
and planning decisions?
Local Public Health System Performance Assessment Instrument
Local
LPHS Model Standard 1.2: Current Technology to Manage and Communicate Population
Health Data
Population health data are presented in formats that allow for clear communication and interpretation
by end users. Such formats include graphed trend data that allow for comparisons over time by relevant
variables such as gender, race, and geographic designation.
Tools such as geographic information systems (GIS) are used to combine geography, data, and computer
mapping to support the exploration of spatial relationships, patterns, and trends in health data. Use of
geocoded data (matching of street address to a corresponding latitude and longitude) is promoted, while
maintaining appropriate safeguards for confidentiality. Increased public access to GIS information provides
new insights to develop strategies that are appropriate for specific geographic areas and to align health status
indicators with health resources.
While the information in the Community Health Profile (CHP) is available in paper format, this information
is also available in a web-based version that is accessible to individuals, community groups, and other
organizations in a timely manner. Links to other sources of related information are provided.
To accomplish this, the LPHS:
• Uses state-of-the-art technology to collect, manage, integrate, and display health profile databases.
• Has access to geocoded data for geographic analysis.
• Uses computer-generated graphics to identify trends and/or compare data by relevant categories
(i.e., race, gender, age group).
Please answer the following questions related to Model Standard 1.2:
1.2.1 Does the LPHS use state-of-the-art technology to support health profile
databases?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
1.2.1 Discussion Toolbox
In considering 1.2.1, does the LPHS use state-of-the-art
technology to:
q Collect health profile database information?
q Manage health profile databases?
q Integrate health profile databases?
q Display health profile databases?
Local Public Health System Performance Assessment Instrument
Local
1.2.1.1 Is technology utilized to make community health data available
electronically?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
1.2.1.1 Discussion Toolbox
In considering 1.2.1.1 is community health data available:
q On one website?
q On one website linked to other websites?
q On multiple websites (same information on multiple sites)?
q On multiple (linked) websites (different information on different
sites)?
q On CD-ROM?
1.2.2 Does the LPHS have access to geocoded health data?
1.2.2 Discussion Toolbox
In considering 1.2.2, are data collected at the:
q County level?
q Zip code level?
q Census tract level?
1.2.2.1 Does the LPHS use geographic information systems (GIS)?
1.2.2.1 Discussion Toolbox
In considering 1.2.2.1, does the LPHS use GIS to:
q Display health-related information?
q Map health resources?
q Link databases?
q Analyze health issues?
1.2.3 Does the LPHS use computer-generated graphics to identify trends and/or
compare data by relevant categories (i.e., race, gender, age group)?
Local Public Health System Performance Assessment Instrument
Local
LPHS Model Standard 1.3: Maintenance of Population Health Registries
Population health registries track health-related events such as disease patterns and preventive health
services delivery (i.e., cancer registries facilitate tracking of cancer incidence, cancer stage at diagnosis,
treatment patterns, and survival probability; vaccine registries provide the real time status of vaccine
coverage for specified age groups in the community). The LPHS creates and supports systems to assure
accurate and timely reporting by providers.
Data are collected for registries in accordance with standards that assure comparability of data from public,
private, local, state, regional, and national sources. Collaboration among multiple partners facilitates the
aggregation of individual data to compile a population health registry used to inform policy decisions,
program implementation, and population research.
To accomplish this, the LPHS:
• Maintains and regularly contributes to population health registries using established criteria to report
identified health events.
• Uses information from one or more population health registries.
Please answer the following questions related to Model Standard 1.3:
1.3.1 Does the LPHS maintain and/or contribute to one or more population health
registries?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
1.3.1 Discussion Toolbox
In considering 1.3.1, does the LPHS maintain and/or contribute
to registries for:
q Immunization status of children?
q Immunization status of adults?
q Newborn screening?
q Birth defects and developmental disabilities?
q Trauma?
q Occupational injury?
q Environmental exposures?
q Asthma?
q Cancer?
q Diabetes?
q Other chronic diseases?
1.3.1.1 Are there standards for data collection?
1.3.1.2 Are there established processes for reporting health events to the
registry or registries?
1.3.1.2 Discussion Toolbox
In considering 1.3.1.2, are systems in place to ensure:
q Accurate reporting?
q Timely reporting?
q Unduplicated reporting?
Local Public Health System Performance Assessment Instrument
Local
1.3.2 In the past year, has the LPHS used information from one or more
population health registries?
NO
MINIMAL
MODERATE
1.3.2 Discussion Toolbox
In considering 1.3.2, is information used to:
q Inform policy decisions?
q Design programs?
q Implement programs?
q Conduct population research?
Local Public Health System Performance Assessment Instrument
SIGNIFICANT
OPTIMAL
Local
Essential Service #2: Diagnose and Investigate Health Problems and Health Hazards in the
Community
This service includes:
• Epidemiological investigations of disease outbreaks and patterns of infectious and chronic diseases and injuries,
environmental hazards, and other health threats.
• Active infectious disease epidemiology programs.
• Access to a public health laboratory capable of conducting rapid screening and high volume testing.
LPHS Model Standard 2.1: Identification and Surveillance of Health Threats
Surveillance systems are designed and maintained to monitor health events, to identify changes or patterns,
and to investigate underlying causes or factors. Epidemiological and behavioral science techniques are
used to collect data to identify risk factors for health threats. Local public health surveillance systems are
integrated with national and state surveillance systems to provide comprehensive monitoring of health
events using consistent collection and reporting procedures. Surveillance data are used to assess and
analyze health problems and hazards. Surveillance data are also used to examine the impact of health
hazards, behaviors, and risk factors on disease and mortality. Surveillance efforts also alert the local public
health system (LPHS) to community and health indicators that may signal public health emergencies
(e.g., natural and intentional disasters including biological and chemical incidents).
To accomplish this, the LPHS:
• Participates in integrated state, local and national surveillance system(s) that identify and analyze health
problems and threats.
• Collects timely reportable disease information from community health professionals who submit
information on possible disease outbreaks.
• Utilizes human and technological resources to support surveillance and investigation activities, including
state-of-the-art information technology and communication systems, as well as Masters and/or
Doctoral level statistical and epidemiological expertise to assess, investigate, and analyze health threats
and health hazards.
Local Public Health System Performance Assessment Instrument
Local
Please answer the following questions related to Model Standard 2.1:
2.1.1 Does the LPHS operate or participate in surveillance system(s) designed
to monitor health problems and identify health threats?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
2.1.2 Do community health professionals submit reportable disease information
in a timely manner to the state or LPHS?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
2.1.3 Does the LPHS have necessary resources to support health problem and
health hazard surveillance and investigation activities?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
2.1.1 Discussion Toolbox
In considering 2.1.1, does the system include local data for:
q Infectious diseases?
q Chronic diseases?
q Intentional and unintentional injury?
q Environmental hazards?
q Maternal and child health?
q Bioterror threats?
q Social and mental health?
Is the system:
2.1.1.1 Integrated with national and/or state surveillance systems?
2.1.1.2 Compliant with national and/or state health information exchange
guidelines?
2.1.1.2 Discussion Toolbox
In considering 2.1.1.2, is the system compliant with:
q Public Health Information Network (PHIN) guidelines?
q Health Insurance Portability and Accountability Act (HIPAA)?
10
2.1.1.3 Does the LPHS use the surveillance system(s) to monitor changes
in the occurrence of health problems and hazards?
2.1.3.1 Does the LPHS use information technology for surveillance
activities (e.g., geographic information systems, word processing,
spreadsheets, database analysis, and graphics presentation
software)?
2.1.3.2 Does the LPHS have (or have access to) Masters or Doctoral level
epidemiologists and/or statisticians to assess, investigate and
analyze public health threats and health hazards?
Local Public Health System Performance Assessment Instrument
Local
LPHS Model Standard 2.2: Investigation and Response to Public Health Threats and
Emergencies
Local public health systems must have capacity to respond rapidly and effectively to investigate public
health threats and emergencies which involve communicable disease outbreaks or chemical, biological,
radiological, nuclear, explosive or environmental incidents. With the occurrence of an adverse public health
event or potential threat, a collaborative team of LPHS professionals participates in the collection and
analysis of relevant data. A network of support and communication relationships exists in the LPHS, which
includes health-related organizations, public safety and rapid response teams, the media, and the general
public. Timely investigation of public health emergencies is coordinated through an Emergency Response
Coordinator, who leads the local effort in collaboration with LPHS partners in the event of a public health
emergency (e.g., health officer, environmental health director).
In order to have the capacity to investigate and respond to public health emergencies, the LPHS:
• Maintains written protocols to implement a program of case finding, contact tracing and source
identification and containment for communicable diseases or toxic exposures.
• Develops written protocols for the immediate investigation of public health threats and emergencies,
including natural and intentional disasters.
• Designates an Emergency Response Coordinator.
• Identifies personnel with the technical expertise to rapidly respond to potential biological, chemical,
or radiological public health emergencies.
• Evaluates incidents for effectiveness and opportunities for improvement.
Please answer the following questions related to Model Standard 2.2:
2.2.1 Does the LPHS maintain written protocols for implementing a program
of case finding, contact tracing, source identification, and containment for
communicable diseases or toxic exposures?
Are protocols in place for:
2.2.1.1 Animal control?
2.2.1.2 Vector control?
2.2.1.3 Exposure to food-borne illness?
2.2.1.4 Exposure to water-borne illness?
2.2.1.5 Excessive lead levels?
2.2.1.6 Exposure to asbestos?
2.2.1.7 Exposure to other toxic chemicals?
2.2.1.8 Communicable diseases?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
Local Public Health System Performance Assessment Instrument
11
Local
2.2.2 Does the LPHS have current epidemiological case investigation protocols
to guide immediate investigations of public health emergencies?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
Does the individual:
2.2.3.1 Coordinate with the local health department’s emergency response
personnel?
2.2.3.2 Coordinate with local community leaders?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
2.2.4 Can LPHS personnel rapidly respond to natural and intentional disasters?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
Do these protocols address:
2.2.2.1 Infectious disease outbreaks?
2.2.2.2 Environmental health hazards and emergencies?
2.2.2.3 Chemical threats and incidents?
2.2.2.4 Biological agent threats?
2.2.2.5 Radiological threats?
2.2.2.6 Large-scale natural disasters?
2.2.2.7 Intentional incidents?
2.2.3 Has the LPHS designated an individual to serve as an Emergency
Response Coordinator within the jurisdiction?
2.2.4.1 Does the LPHS maintain a current roster of personnel with the
technical expertise to respond to natural and intentional emergencies
and disasters?
2.2.4.2 Does the LPHS have access to response personnel within one hour?
2.2.4.3 Does the LPHS have capacity to mobilize sufficient numbers of
trained professionals in an emergency (i.e., surge capacity)?
2.2.4.1-2.2.4.3 Discussion Toolbox
In considering 2.2.4.1-2.2.4.3, are the following personnel
available:
q Emergency management?
q State epidemiologists?
q Hazardous Material Response Teams?
q Infectious disease specialists?
q Law enforcement?
q Medical examiners/coroner?
q Microbiologists?
q State public health laboratory director?
q Toxicologists?
q Veterinarians?
q Mental Health Professionals?
q Nurses?
q Pharmacists?
q Health educators?
q Environmental health specialists?
q Mental health specialists?
q Physicians?
12
Local Public Health System Performance Assessment Instrument
Local
2.2.4.4 Does the LPHS have capacity to mobilize volunteers during
a disaster?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
2.2.5 Does the LPHS evaluate public health emergency response incidents for
effectiveness and opportunities for improvement (e.g., After Action Reports)?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
2.2.4.4. Discussion Toolbox
In considering 2.2.4.4, does the LPHS have procedures for:
q Maintenance of volunteer names and contact information
in an accessible directory?
q Contacting volunteers?
q Assuring that volunteers are knowledgeable about their role?
q Ensuring liability insurance coverage for volunteers during
a disaster?
2.2.5.1 Are findings incorporated into emergency plans?
Local Public Health System Performance Assessment Instrument
13
Local
LPHS Model Standard 2.3: Laboratory Support for Investigation of Health Threats
Laboratory support is defined as the ability to produce timely and accurate laboratory results for diagnostic
and investigative public health concerns. The actual testing may be performed outside the traditional public
health system, however, public health retains the responsibility for ensuring that proper testing and timely
results are available to the community.
In order to accomplish this, the LPHS:
• Maintains ready access to laboratories capable of meeting routine diagnostic and surveillance needs.
• Maintains ready access (24 hours-per-day/7 days-per-week) to laboratories capable of supporting
investigations of public health threats, hazards, and emergencies.
• Confirms that laboratories are in compliance with regulations and standards through credentialing and
licensing agencies.
• Maintains guidelines or protocols to address the handling of laboratory samples, which describe
procedures for storing, collecting, labeling, transporting, and delivering laboratory samples, and for
determining the chain of custody regarding the handling of these samples, as well as reporting findings.
Please answer the following questions related to Model Standard 2.3:
2.3.1 Does the LPHS maintain ready access to laboratories capable of meeting
routine diagnostic and surveillance needs?
NO
MINIMAL
MODERATE
2.3.1 Discussion Toolbox
In considering 2.3.1, do laboratory services include analysis
of clinical and environmental specimens such as:
q Identifying pathogenic microorganisms (including mycobacteria,
parasites, STDs, HIV, and other viruses)?
q Identifying anti-microbial resistant infections?
q Newborn testing?
q Testing on water, air, and soil?
14
Local Public Health System Performance Assessment Instrument
SIGNIFICANT
OPTIMAL
Local
2.3.2 Does the LPHS have ready access to laboratory services to support
investigations of public health threats, hazards, and emergencies?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
2.3.3 Does the LPHS utilize only laboratories that are licensed and/or
credentialed?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
2.3.4 Does the LPHS maintain current guidelines or protocols for handling
laboratory samples?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
2.3.2.1 Does the LPHS have access to laboratory services to support these
investigations within four hours of notification?
2.3.2-2.3.2.1 Discussion Toolbox
In considering 2.3.2 -2.3.2.1, do laboratory services include
analysis of clinical and environmental specimens such as:
q Biological agents?
q Chemical agents?
q Radiological agents?
q Infectious agents that are rarely encountered?
q Environmental agents that are rarely encountered?
2.3.2.2 Does the LPHS have access to at least one microbiology laboratory
within four hours of notification?
2.3.4 Discussion Toolbox
In considering 2.3.4, do guidelines or protocols for handling
laboratory samples include:
q Collecting samples?
q Labeling samples?
q Storing samples?
q Transporting or delivering samples?
q Determining the chain of custody with respect to the handling
of laboratory samples?
q Requirements for reporting findings to the local health
department having jurisdiction for specimen collection?
Local Public Health System Performance Assessment Instrument
15
Local
Essential Service #3: Inform, Educate, and Empower Individuals and Communities about Health
Issues
This service includes:
•H
ealth information, health education, and health promotion activities designed to reduce health risk and promote better
health.
• Health education and health promotion program partnerships with schools, faith communities, work sites, personal care
providers, and others to implement and reinforce health promotion programs and messages that are accessible to all
populations.
• Health communication plans and activities such as media advocacy and social marketing.
• Accessible health information and educational resources.
• Risk communication processes designed to inform and mobilize the community in time of crisis.
LPHS Model Standard 3.1: Health Education and Promotion
The local public health system (LPHS) actively creates, communicates, and delivers health information and
health interventions using customer-centered and science-based strategies to protect and promote the
health of diverse populations. The LPHS supports its health improvement objectives and responds to
public health issues with health education and health promotion initiatives that are based on the best
available scientific evidence of effectiveness in helping people make healthy choices throughout their lives.
Strong working relations include numerous agencies that are actively engaged in promoting and
implementing these activities.
The LPHS designs and implements a wide range of health education and health promotion activities. Health
promotion activities include any combination of educational and environmental supports that give individuals, groups, or communities greater control over conditions affecting their health. Health education is the
process by which the LPHS conveys information and facilitates the development of health-enhancing skills
among individuals and groups in the community. Health education serves to reinforce health promotion
messages within the community, ultimately helping to reduce health risk and improve health status.
To accomplish this, the LPHS:
• Provides the public, policymakers, and stakeholders with information on community health status and
health needs in the community, as well as information on policies and programs that can improve
community health.
• Plans, conducts, and evaluates targeted health education and health promotion activities to develop and
enhance knowledge and attitudes and assist in lowering risk or changing negative behaviors.
• Works with other entities within the system on health education and health promotion activities that
facilitate healthy living in healthy communities.
16
Local Public Health System Performance Assessment Instrument
Local
Please answer the following questions related to Model Standard 3.1:
3.1.1 Does the LPHS provide the general public, policymakers, and public and
private stakeholders with information on community health?
Does the LPHS provide information on:
3.1.1.1 Community health status (e.g., heart disease rates, cancer rates,
environmental risks)?
3.1.1.2 Community health needs, such as those identified by members of the
community or through a needs assessment tool such as APEXPH or
MAPP, including prevention and risk (e.g., obesity, smoking, etc.)?
3.1.2 Does the LPHS plan and conduct health education and/or health promotion
campaigns?
3.1.2.1 Are these campaigns based on sound theory, evidence
of effectiveness, and/or best practice?
3.1.2.2 Are campaigns designed to support healthy behavior among
individuals and their communities?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
3.1.2.2 Discussion Toolbox
In considering 3.1.2.2, do campaigns promote healthy behavior
for:
q Individuals?
q Interpersonal networks (e.g., families, friends, social networks)?
q Communities?
3.1.2.3 Are campaigns tailored for populations with higher risk of negative
health outcomes?
3.1.2.3 Discussion Toolbox
In considering 3.1.2.3, are campaigns appropriate to identified
populations:
q Culture?
q Age?
q Language?
q Gender?
q Socioeconomic status?
q Race/ethnicity?
q Sexual orientation?
Local Public Health System Performance Assessment Instrument
17
Local
3.1.2.4 Are campaigns designed to reach populations in specific settings?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
3.1.2.4 Discussion Toolbox
In considering 3.1.2.4, do these settings include:
q Personal health care delivery locations (e.g., doctor’s offices,
clinics, hospitals)?
q Worksites?
q Schools?
q Neighborhoods?
q Recreational facilities (e.g., public parks, health clubs)?
q Places of worship?
q Correctional facilities?
3.1.2.5 Does the LPHS evaluate health education and health promotion
activities on an ongoing basis?
3.1.2.5 Discussion Toolbox
In considering 3.1.2.5, do evaluations take into account the:
q Health issues addressed?
q Populations served?
q LPHS partners involved?
q Settings for health education activity (e.g., school, worksite,
religious institution, or community-at-large)?
q Communication mechanisms used (e.g., print, radio, television,
Internet, or face-to-face group encounters)?
q Program quality?
q Achievement of intended outcomes?
3.1.2.6 Are evaluation results used to revise and strengthen the programs?
3.1.3 Do LPHS organizations work together to plan, conduct, and implement
health education and promotion activities?
3.1.3.1 Do organizations work together on specific health promotion activities
(e.g., supermarkets and nutrition interventions)?
3.1.3.1 Discussion Toolbox
In considering 3.1.3.1, do organizations include:
q Public agencies?
q Private agencies?
q Volunteer organizations?
q Non-profit organizations?
q Community groups?
q Businesses?
18
Local Public Health System Performance Assessment Instrument
Local
3.1.3.2 Do LPHS entities work with community advocates and local media
outlets to publicize health promotion activities?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
3.1.3.2 Discussion Toolbox
In considering 3.1.3.2, do these collaborative activities address:
q Campaigns to change laws?
q Media campaigns?
Local Public Health System Performance Assessment Instrument
19
Local
LPHS Model Standard 3.2: Health Communication
Health communication encompasses the use of multiple communication strategies to inform and influence
individual and community decisions that enhance health. Health communication includes activities related
to media campaigns, social marketing, entertainment education, and interactive health communication.
Health communication serves to raise awareness of health risks and solutions, support adoption of healthy
behavior, and create advocacy for health policies and programs that empower people to adopt healthy
lifestyles.
The LPHS utilizes a variety of communication channels, such as interpersonal, small group, organizational,
community, and mass media, to reach people in a variety of settings, including home, school, work, and
community. The LPHS works collaboratively to identify the best contexts, channels, and content of health
messages in their community and to leverage resources for their implementation.
To accomplish this, the LPHS:
• Develops health communication plans addressing media and public relations, as well as guidelines for
sharing information among stakeholders.
• Utilizes relationships with media channels (e.g., print, radio, television, Internet) to share health
information with general and targeted audiences.
• Identifies and trains spokespersons on public health issues.
Please answer the following questions related to Model Standard 3.2:
3.2.1 Have LPHS organizations developed health communication plans?
3.2.1.1 Do LPHS organizations work collaboratively to link the
communication plans?
Do the communications plans:
3.2.1.2 Include policies and procedures for creating, sharing, and
disseminating information with partners and key stakeholders?
3.2.1.3 Identify different sectors of the population in order to create targeted
public health messages for various audiences?
3.2.1.4 Provide guidance for developing content and materials appropriate
to the type of dissemination channel?
3.2.1.5 Provide guidance for creating targeted public health messages using
various channels?
3.2.2 Does the LPHS establish and utilize relationships with the media?
20
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
Local Public Health System Performance Assessment Instrument
Local
3.2.2.1 Does the LPHS have policies and procedures in place to route
all media inquiries appropriately?
3.2.2.2 Does the LPHS have a mechanism in place to document and
respond to public inquiries?
3.2.2.3 Does the LPHS coordinate with local media to develop information
or features on health issues?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
3.2.2.1-3.2.2.3 Discussion Toolbox
In considering 3.2.2.1-3.2.2.3, does the LPHS monitor:
q The media’s use of information?
q Whether or not press releases generate stories or follow-up
inquiries from media outlets?
q If public health stories generate inquires from the public?
3.2.3 Has the LPHS identified and designated individuals such as public
information officers to provide important health information and answers
to public and media inquiries?
3.2.3.1 Are designated spokespersons adequately trained in providing
accurate, timely, and appropriate information on public health issues
for different audiences?
3.2.3.2 Does the LPHS have policies and procedures in place to coordinate
responses and public announcements related to public health issues?
Local Public Health System Performance Assessment Instrument
21
Local
LPHS Model Standard 3.3: Risk Communication
Risk communication is the provision of information by public health professionals to allow individual,
stakeholders, or an entire community to make the best possible decisions about their well-being in times
of crisis or emergency. Risk communication includes pre-event, event and post-event communication
planning. The LPHS identifies and analyzes potential risks in order to develop strategic plans for public,
media, partner, and stakeholder communication during public health emergencies, including terrorism.
To accomplish this, the LPHS:
• Develops an emergency communications plan to effectively create and disseminate materials for each
stage of a crisis according to recognized theories and methods.
• Ensures adequate resources to enable a rapid emergency communications response.
• Provides crisis and emergency communications training for employees and establishes protocols for the
dissemination of public information and instructions during a public health emergency.
• Maintains current, accurate 24 hours-per-day, 7 days-per-week contact information and collaborative
relations with news media, public information officers (PIOs), and partners.
Please answer the following questions related to Model Standard 3.3:
3.3.1 Has the LPHS developed emergency communications plan(s) that can be
adapted to different types of emergencies (i.e., disease outbreaks, natural
disasters, bioterrorism)?
Does the plan include:
3.3.1.1 Procedures for inter-agency coordination of plans dependent upon
the type of emergency (i.e., use of the plans to create a unified
emergency communications plan)?
3.3.1.2 Established lines of authority, reporting, and responsibilities for
emergency communications teams in accordance with the National
Incident Management System (NIMS)?
3.3.1.3 Procedures for alerting communities, including special populations,
about possible health threats or disease outbreaks?
3.3.1.4 Guidelines for providing necessary, appropriate information from
emergency operation center situation reports, health alerts, and
meeting notes to stakeholders, partners, and the community?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
3.3.1.4 Discussion Toolbox
In considering 3.3.1.4, do guidelines exist for:
q Identifying existing messages and materials that can be adapted
for use as appropriate?
q Developing content and materials and/or guidance about where
to locate appropriate content for messages?
q Identification of different types of information dissemination?
22
Local Public Health System Performance Assessment Instrument
Local
3.3.2 Does the LPHS have resources to ensure rapid communications response?
Does the LPHS:
3.3.2.1 Have the technological capacity (e.g., telephone, electronic, and print)
to respond to communication needs?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
3.3.2.1 Discussion Toolbox
In considering 3.3.2.1, does technological capacity include:
q A local Health Alert Network?
q A reverse 911 warning system?
q Broadcast fax?
q Broadcast e-mail?
q Public service announcements through local media?
3.3.2.2 Have staff to develop or adapt emergency communications materials
and to provide communications for all stakeholders and partners
in the event of an emergency?
3.3.3 Does the LPHS provide crisis and emergency communications training for
new and current staff?
3.3.3 Discussion Toolbox
In considering 3.3.3, is specific instruction provided for:
q Public information officers?
q Health communications specialists?
q Health education specialists?
q Emergency responders?
q Deployed staff?
3.3.4 Does the LPHS have policies and procedures in place to ensure rapid,
mobile response by public information officers?
3.3.4.1 Does the LPHS maintain a directory of emergency contact information for media liaisons, partners, stakeholders, and public information
officers?
3.3.4.2 Does the LPHS provide communication “Go-Kits” to assist in public
information officer response?
3.3.4.2 Discussion Toolbox
In considering 3.3.4.2, do kits include:
q Laptop computers with Internet access?
q CD-ROMs with elements of crisis communications plan?
q Portable printers?
q Redundant communication devices including mobile telephone
or satellite telephone, pager, and wireless email?
Local Public Health System Performance Assessment Instrument
23
Local
Essential Service #4: Mobilize Community Partnerships to Identify and Solve Health Problems
This service includes:
• Identifying potential stakeholders who contribute to or benefit from public health and increase their awareness of the value
of public health.
• Building coalitions and working with existing coalitions to draw upon the full range of potential human and material
resources to improve community health.
• Convening and facilitating partnerships and strategic alliances among groups and associations (including those not
typically considered to be health-related) in undertaking defined health improvement activities, including preventive,
screening, rehabilitation, and support programs, and establishing the social and economic conditions for long-term health.
LPHS Model Standard 4.1: Constituency Development
Constituents of the LPHS include all persons and organizations that directly contribute to or benefit from
public health. Constituents may include members of the public served by the local public health system
(LPHS), the governmental bodies it represents, and other health, environmental, and non-health-related
organizations in the community. Constituency development is the process of establishing collaborative
relationships among the LPHS and all current and potential stakeholders. As part of constituency development activities, the LPHS develops and operationalizes a communications strategy designed to educate
the community about the benefits of public health and the role of the LPHS in improving community health.
The LPHS operationalizes the communications strategy through formal and informal community networks,
which may include businesses, schools, healthcare organizations, the faith community, and community
associations.
For effective constituency development, the LPHS:
• Has a process to identify key constituents for population-based health in general and for specific health
concerns (e.g., a particular health theme, disease, risk factor, life stage need).
• Encourages the participation of its constituents in community health activities, such as in identifying
community issues and themes and engaging in volunteer public health activities.
• Establishes and maintains a comprehensive directory of community organizations.
• Uses broad-based communication strategies to strengthen linkages among LPHS organizations and
to provide current information about public health services and issues.
24
Local Public Health System Performance Assessment Instrument
Local
Please answer the following questions related to Model Standard 4.1:
4.1.1 Does the LPHS have a process for identifying key constituents
or stakeholders?
4.1.1.1 Does the LPHS maintain a current list of the names and contact
information for individuals and key constituent groups?
4.1.1.2 Are new individuals/groups identified for constituency building?
4.1.1.3 Are key constituents identified for general health issues (i.e., improved
health and quality of life at the community level)?
4.1.1.4 Are key constituents identified for specific health concerns (i.e., a
particular health theme, disease, risk factor, life stage need)?
4.1.2 Does the LPHS encourage the participation of constituents in improving
community health?
4.1.2.1 Does the LPHS encourage constituents from the community-at-large
to identify community issues and themes through a variety of means?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
4.1.2.1 Discussion Toolbox
In considering 4.1.2.1, are the following methods used:
q On-line resources?
q Community/town hall meetings?
q Ballot votes?
q Community surveys?
q Focus groups?
4.1.2.2 Does the LPHS support, through recruitment, promotion, and
retention, opportunities for volunteers to help in community health
improvement projects or activities?
Local Public Health System Performance Assessment Instrument
25
Local
4.1.3 Does the LPHS maintain a current directory of organizations that comprise
the LPHS?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
4.1.3 Discussion Toolbox
In considering 4.1.3, does the directory include:
q The local health department?
q The local governing entity, (e.g., board of health)?
q Other governmental entities (e.g., state agencies, other local
agencies)?
q Hospitals?
q Managed care organizations?
q Primary care clinics and physicians?
q Social service providers?
q Civic organizations?
q Professional organizations?
q Local businesses and employers?
q Neighborhood organizations?
q Faith-based institutions?
q Transportation providers?
q Educational institutions?
q Public safety and emergency response organizations?
q Environmental or environmental health agencies?
q Non-profit organizations/advocacy groups?
q Local officials who impact policy and fiscal decisions?
q Other community organizations?
4.1.3.1 Is the directory easily accessible?
4.1.4 Does the LPHS use communications strategies to build awareness of the
importance of public health?
4.1.4.1 Do communications strategies exist for building awareness with the
community-at-large?
4.1.4.2 Do communications strategies exist for facilitating communication
among organizations?
4.1.4.1-4.1.4.2 Discussion Toolbox
In considering 4.1.4.1-4.1.4.2, do communications strategies:
q Include councils, newsletters, community/town hall meetings,
and/or email list services?
q Occur with an established frequency?
q Effectively inform community constituents about public health
issues and services?
q Receive an evaluation of effectiveness?
q Provide a consistent message about public health issues?
26
Local Public Health System Performance Assessment Instrument
Local
LPHS Model Standard 4.2: Community Partnerships
Community partnerships and strategic alliances describe a continuum of relationships that foster the
sharing of resources and accountability in undertaking community health improvement. Public health
departments may convene or facilitate the collaborative process. The multiple levels of relationships among
public, private, or nonprofit institutions have been described as 1) networking, exchanging information for
mutual benefit; 2) coordination, exchanging information and altering activities for mutual benefit and to
achieve a common purpose; 3) cooperation, exchanging information, altering activities, and sharing resources for mutual benefit and to achieve a common purpose; and 4) collaboration, exchanging
information, altering activities, sharing resources, and enhancing the capacity of another for mutual benefit
and to achieve a common purpose. Multi-sector collaboration is thus defined as a voluntary strategic
alliance of public, private, and nonprofit organizations to enhance each other’s capacity to achieve
a common purpose by sharing risks, responsibilities, resources, and rewards.
Multi-sector partnerships such as community health improvement committees (community committees)
exist in some communities as formally constituted bodies (e.g., a community health planning council) while
in other communities they are less formal groups. The community committee is a dynamic collaboration
designed to be comprehensive and inclusive in its membership and its approach to community health
improvement.
To accomplish this, the LPHS:
• Establishes community partnerships and strategic alliances to assure a comprehensive approach
to improving health in the community.
• Assures the establishment of a broad-based community health improvement committee.
• Assesses the effectiveness of community partnerships and strategic alliances in improving community
health.
Please answer the following questions related to Model Standard 4.2:
4.2.1 Do partnerships exist in the community to maximize public health
improvement activities?
Do organizations within these partnerships:
4.2.1.1 Exchange information?
4.2.1.2 Alter or align activities related to the Essential Public Health Services?
4.2.1.3 Conduct collaborative decision-making and action?
4.2.1.4 Optimize resources to deliver Essential Public Health Services?
4.2.1.5 Share responsibilities to deliver Essential Public Health Services?
4.2.1.6 Include a broad representation of the community (including
representatives such as those listed in 4.1.3 Discussion Toolbox)?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
Local Public Health System Performance Assessment Instrument
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Local
4.2.2 Does the LPHS have a broad-based community health improvement
committee?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
Does this committee:
4.2.2.1 Participate in the community health assessment process?
4.2.2.2 Participate in the implementation of a community health improvement
process?
4.2.2.3 Monitor and evaluate progress toward prioritized goals?
4.2.2.4 Leverage community resources?
4.2.2.5 Meet on a regular basis?
4.2.3 Does the LPHS review the effectiveness of community partnerships and
strategic alliances developed to improve community health?
28
Does the review include:
4.2.3.1 An assessment of the effectiveness of partnership participation
in solving health problems?
4.2.3.2 Information on the satisfaction of constituents with partnership
efforts?
4.2.3.3 An assessment of the expertise and system capacity needed
to conduct partnership building activities?
4.2.3.4 Identification of actions to improve the partnership process and
capacity?
4.2.3.5 Implementation of actions recommended to improve the partnership
process and capacity?
Local Public Health System Performance Assessment Instrument
Local
Essential Service #5: Develop Policies and Plans that Support Individual and Community Health
Efforts
This service includes:
• An effective governmental presence at the local level.
• Development of policy to protect the health of the public and to guide the practice of public health.
• Systematic community-level planning for health improvement and public health emergency response in all jurisdictions.
• Alignment of local public health system (LPHS) resources and strategies with a community health improvement plan.
LPHS Model Standard 5.1: Governmental Presence at the Local Level
Every community must be served by a governmental public health entity. As the line of first defense, local
governmental public health entities play a vital role in ensuring the safety, health, and well-being of
communities. The governmental public health entity works in partnership with the community to assure the
development and maintenance of a flexible and dynamic public health system that provides the Essential
Public Health Services. In doing this, the local governmental public health entity coordinates or assures the
provision of quality public health services. Typically, the local health department (LHD) or a local branch
of the state health agency serves as the local governmental public health entity.
To accomplish this, the local public health system (LPHS):
• Includes a local governmental public health entity to assure the delivery of the Essential Public Health
Services to the community.
• Assures the availability of adequate resources for the local health department’s contributions to the
provision of Essential Public Health Services.
• Maintains an appropriate relationship with its local governing entity (e.g., local board of health, county
commission, state health agency).
• Coordinates with the state public health system.
Local Public Health System Performance Assessment Instrument
29
Local
Please answer the following questions related to Model Standard 5.1:
5.1.1 Does the LPHS include a governmental local public health presence (i.e.,
local health department) to assure the provision of Essential Public Health
Services to the community?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
Does the local health department:
5.1.1.1 Maintain current documentation describing its mission?
5.1.1.2 Maintain current documentation describing its statutory, chartered,
and/or legal responsibilities?
5.1.1.3 Assess its functions against the operational definition of a functional
local health department?
5.1.2 Does the LPHS assure the availability of resources for the local health
department’s contributions to the Essential Public Health Services?
Do resources for the local health department include:
5.1.2.1 Availability of legal counsel on issues related to the provision
of Essential Public Health Services?
5.1.2.2 Funding for mandated public health programs?
5.1.2.3 Funding for needed public health programs, as identified by the
community?
5.1.2.4 The personnel required to deliver Essential Public Health Services,
including a designated local health official?
5.1.2.5 The facilities, equipment, and supplies required to deliver Essential
Public Health Services?
5.1.3 Does a local board of health or other governing entity conduct oversight for
the local health department? (This question not scored.)
5.1.3.1 Has this local board of health or other governing entity completed the
National Public Health Performance Standards Program Local Public
Health Governance Performance Assessment Instrument?
(This question not scored.)
5.1.4 Does the LHD work with the state public health agency and other state
partners to assure the provision of public health services?
30
5.1.4.1 Have state partners completed the National Public Health
Performance Standards Program State Public Health System
Performance Assessment Instrument with input from the local level?
(This question not scored.)
Local Public Health System Performance Assessment Instrument
Local
LPHS Model Standard 5.2: Public Health Policy Development
As used in this instrument, the phrase “policy development” involves the means by which problem identification, technical knowledge of possible solutions, and societal values join to set a course of action (IOM,
1988). Policy development is not synonymous with the development of laws, rules, and regulations (which
are the focus of Essential Service # 6). Laws, rules, and regulations may be adopted as tools to implement
policy, but good policies must precede good legislation. Policy development is a process that enables
informed decisions to be made concerning issues related to the public’s health.
The LPHS works with the community to identify policy needs and gaps to develop policies to improve the
public’s health. The LPHS promotes the community’s understanding of, and advocacy for, policies to improve health, and serves as a resource to elected officials to establish and maintain public health policies.
To assure effective public health policy, the LPHS:
• Contributes to the development and/or modification of public health policy by facilitating community
involvement and engaging in activities that inform the policy development process.
• Alerts policymakers and the public of potential public health impacts (both intended and unintended) from
current and/or proposed policies.
• Reviews existing policies at least every three to five years.
Please answer the following questions related to Model Standard 5.2:
5.2.1 Does the LPHS contribute to the development of public health policies?
5.2.1.1 Does the LPHS engage constituents in identifying and analyzing
issues?
5.2.1.2 Does the LPHS advocate for prevention and protection policies for
those in the community who bear a disproportionate risk for mortality
or morbidity?
5.2.1.3 Within the past year, has the LPHS been involved in activities that
influenced or informed the public health policy process?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
5.2.1.3 Discussion Toolbox
In considering 5.2.1.3, did these activities include:
q Preparation of informational materials (e.g., issue briefs, media
statements, talking points, fact sheets)?
q Public testimony?
q Participation on local boards or advisory panels responsible for
health policy advisement?
q Participation on state and/or national boards or advisory panels
responsible for health policy advisement?
Local Public Health System Performance Assessment Instrument
31
Local
32
5.2.2 Does the LPHS alert policymakers and the public of public health impacts
from current and/or proposed policies?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
5.2.3 Does the LPHS review public health policies at least every three to five
years?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
Do reviews include:
5.2.3.1 Assessment of outcomes and/or consequences?
5.2.3.2 Examination of potential community health impact of other policy
areas (e.g., fiscal, social, environmental)?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
Does the review process include:
5.2.3.3 Community constituents, including those affected by the policy?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
Local Public Health System Performance Assessment Instrument
Local
LPHS Model Standard 5.3: Community Health Improvement Process and Strategic Planning
Community health improvement includes traditional public health, environmental health, and health services
categories, as well as business, economic, housing, land use, health equity and other community issues
affecting the public’s health. The community health improvement process involves an ongoing collaborative,
community-wide effort by the LPHS to identify, analyze, and address health problems; assess applicable
data; inventory community health assets and resources; identify community perceptions; develop and
implement coordinated strategies; develop measurable health objectives and indicators; identify
accountable entities; and cultivate community “ownership” of the entire process. The community health
improvement process provides the opportunity to develop a community-owned plan that will lead
to a healthier community.
The community health improvement process is further strengthened by the organizational strategic
planning activities of LPHS members, including the local health department. To effectively leverage
community resources and optimize outcomes, organizations within the LPHS make efforts to review
and align their organizational strategic plans with the community health improvement process.
To accomplish this, the LPHS:
• Establishes a community health improvement process, which includes broad-based participation and
uses information from community health assessments as well as perceptions of community residents.
• Develops strategies to achieve community health improvement objectives and identifies accountable
entities to achieve each strategy.
Because the activities of the local health department should be focused on community public health needs
and issues, specific attention is given to this organization’s strategic plan. The local health department:
• Conducts organizational strategic planning activities and reviews its organizational strategic plan
to determine how it can best be aligned with the community health improvement process.
Please answer the following questions related to Model Standard 5.3:
5.3.1 Has the LPHS established a community health improvement process
(e.g., MAPP, PACE EH)?
5.3.1.1 Did the community health improvement process use an established
tool such as MAPP or PACE-EH?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
Local Public Health System Performance Assessment Instrument
33
Local
5.3.1.2 Is there broad participation in the community health improvement
process?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
5.3.1.2 Discussion Toolbox
In considering 5.3.1.2, do participants include a broad spectrum
of representatives of the LPHS:
q Community residents?
q Local health department?
q The local health department’s governing entity
(e.g., board of health)?
q Other governmental entities?
q Hospitals?
q Managed care organizations?
q Primary care clinics and physicians?
q Social service providers?
q Civic organizations?
q Professional organizations?
q Local businesses and employers?
q Neighborhood organizations?
q Faith institutions?
q Transportation providers?
q Educational institutions?
q Public safety and emergency response organizations?
q Environmental or environmental-health agencies?
q Non-profit organizations/advocacy groups?
q Local officials who impact policy and fiscal decisions?
Does the process include:
5.3.1.3 Information from community health assessments?
5.3.1.4 Issues and themes identified by the community?
5.3.1.5 Identification of community assets and resources?
5.3.1.6 Prioritization of community health issues?
5.3.1.7 Development of measurable health objectives?
5.3.1.8 Does the process result in the development of a community health
improvement plan?
5.3.1.8.1 Is the community health improvement plan linked to a state
health improvement plan? (This question not scored.)
5.3.2 H
as the LPHS developed strategies to address community health
objectives?
5.3.2.1 Have the individuals or organizations accountable for the
implementation of these strategies been identified?
5.3.2.1 Discussion Toolbox
In considering 5.3.2.1, have these individuals or organizations:
q Agreed to defined responsibilities and timetables for activities?
q Started to implement these strategies?
q Determined how to effectively utilize the community assets and
resources that were identified?
34
Local Public Health System Performance Assessment Instrument
Local
5.3.3 Does the local health department (LHD) conduct a strategic planning
process?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
5.3.3 Discussion Toolbox
In considering 5.3.3, does the LHD’s organizational strategic
planning process include:
q Identification of forces (trends, events, or factors) that may
impact health or the LPHS?
q Assessment of organizational strengths and weaknesses?
Are strategic plans:
q Reviewed annually?
q Revised at least every three to five years?
5.3.3.1 Does the LHD review its organizational strategic plan to determine
how it can best be aligned with the community health improvement
process?
Local Public Health System Performance Assessment Instrument
35
Local
LPHS Model Standard 5.4: Plan for Public Health Emergencies
An “All-Hazards” emergency preparedness and response plan describes the roles, functions and
responsibilities of LPHS and other entities in the event of one or more types of public health emergencies.
LPHS entities, including the local health department, emergency management, law enforcement, fire
departments, health care providers, and other partners work collaboratively to formulate emergency
response plans and procedures. Careful planning and mobilization of resources and partners prior to an
event is crucial to a prompt and effective response. The plan should create an all-hazards response
infrastructure, in that it outlines the capacity of the LPHS to respond to all public health emergencies
(including natural and intentional incidents and disasters), while taking into account the unique and complex
challenges presented by chemical, biological, radiological, nuclear and explosive incidents. These plans
describe community interventions necessary to prevent, monitor and control the incident.
In order to plan for public health emergencies, the LPHS:
• Establishes a task force to develop and maintain emergency preparedness and response plans.
• Develops a plan that defines public health disasters and emergencies that might trigger implementation
of the LPHS emergency response plan, describes organizational responsibilities, and establishes
standard operating procedures and clearly outlines alert and evacuation protocols.
• Tests the plan through the staging of one or more “mock events,” and revises the plan as necessary
at least every two years.
Please answer the following questions related to Model Standard 5.4:
5.4.1 D
o LPHS organizations participate in a task force or coalition of community
partners to develop and maintain local and/or regional emergency
preparedness and response plans?
36
NO
MINIMAL
MODERATE
Local Public Health System Performance Assessment Instrument
SIGNIFICANT
OPTIMAL
Local
5.4.1.1 Does task force participation include broad representation from the
LPHS?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
5.4.1.1 Discussion Toolbox
In considering 5.4.1.1, does participation include:
q Local health department?
q State public health agency?
q State laboratory (if separate from agency)?
q City/County/State government (other than the public health
agency)?
q Schools (i.e., public education)?
q Emergency Management Agency?
q Environmental agencies with responsibilities for fire, health,
water, air quality, and consumer safety?
q Health organizations (including urgent care centers, private
physicians offices, nursing homes, custodial care facilities,
home health care provider agencies, hospitals, poison centers,
pharmacies, primary and community health centers, mental
health, and occupational health)?
q Local Emergency Planning Committee?
q National Guard?
q Private sector (i.e., trade and business organizations, industry
and labor)?
q Public information officer for local jurisdiction?
q Public safety (i.e., fire, police)?
q Public works/sanitation?
q Transportation systems?
q Volunteer organizations (e.g., Red Cross)?
q Veterinarians?
q Coroner’s office?
5.4.2 Does the LPHS have an all-hazards emergency preparedness and response
plan?
Does the plan:
5.4.2.1 Identify public health disasters and emergencies that might trigger
its implementation?
5.4.2.2 Align with existing plans, protocols and procedures for emergency
response within the community?
5.4.2.2 Discussion Toolbox
In considering 5.4.2.2, does the plan align with:
q State/local emergency management plans?
q Hospital disaster plans?
q Pre-hospital triage protocols?
q Surge capacity plans?
q National Incident Management System?
q Risk communication plans and protocols?
q Mental health plans?
q Vulnerability assessment plans?
Local Public Health System Performance Assessment Instrument
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Local
5.4.2.3 Clearly outline protocols and standard operating procedures for
emergency response?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
5.4.2.3 Discussion Toolbox
In considering 5.4.2.3, do protocols:
q Describe the organizational responsibilities and roles of all plan
participants?
q Include an established chain-of-command among plan
participants?
q Include protocols for all Emergency Support Functions (e.g.,
FEMA system)?
q Include protocols to alert affected populations?
q Include protocols for alerting disabled persons and vulnerable
populations?
q Include an evacuation plan?
q Include plans for mass casualty care?
q Identify community assets that could be mobilized by plan
participants to respond to an emergency?
q Include procedures for receipt and deployment of assets from
the Strategic National Stockpile?
q Include plans for remediation and long-term recovery?
5.4.3 Has the All-Hazards plan been reviewed and, if appropriate, revised within
the past two years?
5.4.3.1 Has any part of the plan been tested through simulations of one
or more “mock events” within the past two years?
5.4.3.1 Discussion Toolbox
In considering 5.4.3.1, were tests through:
q Tabletop drills?
q Functional drills?
q Full scale drills?
38
5.4.3.2 Did the mock event include a written After Action Report identifying
opportunities for improvement?
5.4.3.3 Was the plan modified based on these findings?
Local Public Health System Performance Assessment Instrument
Local
Essential Service #6: Enforce Laws and Regulations that Protect Health and Ensure Safety
This service includes:
• The review, evaluation, and revision of laws, regulations, and ordinances designed to protect health and safety to assure
that they reflect current scientific knowledge and best practices for achieving compliance.
• Education of persons and entities obligated to obey or to enforce laws, regulations, and ordinances designed to protect
health and safety in order to encourage compliance.
• Enforcement activities in areas of public health concern, including, but not limited to the protection of drinking water;
enforcement of clean air standards; emergency response; regulation of care provided in health care facilities and programs;
re-inspection of workplaces following safety violations; review of new drug, biologic, and medical device applications;
enforcement of laws governing the sale of alcohol and tobacco to minors; seat belt and child safety seat usage; and
childhood immunizations.
LPHS Model Standard 6.1: Review and Evaluation of Laws, Regulations, and Ordinances
The local public health system (LPHS) reviews existing federal, state, and local laws, regulations, and
ordinances relevant to public health in the community, including laws, regulations, and ordinances
addressing environmental quality and health-related behavior. The review focuses on the authority
established for laws, regulations, and ordinances as well as the impact of existing laws, regulations, and
ordinances on the health of the community. The review also assesses compliance, opinions of constituents,
and whether laws, regulations, and ordinances require updating.
In order to accomplish this, the LPHS:
• Identifies public health issues that can only be addressed through laws, regulations, or ordinances.
• Is knowledgeable about current federal, state, and local laws, regulations, and ordinances that protect
the public’s health.
• Reviews public health laws, regulations, and ordinances at least once every five years.
• Has access to legal counsel for assistance in the review of laws, regulations, and ordinances.
Local Public Health System Performance Assessment Instrument
39
Local
Please answer the following questions related to Model Standard 6.1:
6.1.1 Does the LPHS identify local public health issues that can only be addressed
through laws, regulations, and ordinances?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
6.1.2 Is the LPHS knowledgeable about federal, state, and local laws, regulations,
and ordinances that protect the public’s health?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
6.1.2 Discussion Toolbox
In considering 6.1.2, is the LPHS knowledgeable about laws,
regulations, and ordinances for:
q Food safety, protection and/or handling?
q Water quality?
q Air quality?
q Emergency preparedness and response?
q Quarantine and isolation?
q Injury prevention?
q Handling and disposal of toxic and chemical waste?
q Exposure-related diseases (including communicable and
environmental exposures)?
q Regulations of health and social service facilities (e.g., nursing
homes, home heath care providers, and other long term
providers)?
q Day care centers and schools?
q Housing and property maintenance?
q Sanitation?
q Promotion of healthy behavior (e.g., regulations for alcohol and
tobacco use, seat belt use, etc.)?
6.1.3 Does the LPHS review the laws, regulations, and ordinances that protect
public health at least once every five years?
Do reviews:
6.1.3.1 Determine whether laws, regulations, and ordinances provide the
authority to carry out the Essential Public Health Services?
6.1.3.2 Assess compliance with public health laws, regulations, and
ordinances?
6.1.3.3 Determine the impact of existing laws, regulations, and ordinances
on the health of the community?
6.1.3.4 Determine whether public health laws, regulations, and ordinances
require updating?
6.1.4 Do governmental entities within the LPHS have access to legal counsel
to assist with the review of laws, regulations, and ordinances related to the
public’s health?
40
Local Public Health System Performance Assessment Instrument
Local
LPHS Model Standard 6.2: Involvement in the Improvement of Laws, Regulations, and
Ordinances
Having identified local public health issues that are not adequately being addressed through existing laws,
regulations, and ordinances, the LPHS participates actively in the modification of existing laws,
regulations, and ordinances and the formulation of new laws, regulations, and ordinances designed
to assure and improve the public’s health. This participation includes the drafting of proposed legislation
and regulations, involvement in public hearings, and periodic communication with legislators and regulatory
officials.
In order to accomplish this, the LPHS:
• Identifies local public health issues that are not adequately addressed through existing laws, regulations,
and ordinances.
• Participates in the modification of existing laws, regulations, and ordinances and/or the formulation
of new laws, regulations, and ordinances designed to assure and improve the public’s health.
• Provides technical assistance for drafting proposed legislation, regulations, and ordinances.
Please answer the following questions related to Model Standard 6.2:
6.2.1 Does the LPHS identify local public health issues that are not adequately
addressed through existing laws, regulations, and ordinances?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
6.2.2 Within the past five years, have LPHS organizations participated in the
development or modification of laws, regulations, or ordinances for public
health issues that are not adequately addressed through existing laws,
regulations, and ordinances?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
6.2.2 Discussion Toolbox
In considering 6.2.2, did this work involve:
q Communication with legislators, regulatory officials, or other
policymakers regarding proposed legislation, regulations,
or ordinances?
q Participation in public hearings regarding proposed legislation,
regulations, or ordinances?
6.2.3 Do LPHS organizations provide technical assistance to legislative,
regulatory or advocacy groups for drafting proposed legislation, regulations,
or ordinances?
Local Public Health System Performance Assessment Instrument
41
Local
LPHS Model Standard 6.3: Enforcement of Laws, Regulations, and Ordinances
The LPHS recognizes the unique role of the government to enforce public health laws, regulations, and
ordinances. The authority of the governmental organizations within the LPHS to enforce public health laws,
regulations, and ordinances varies from state to state and between jurisdictions within states. In many
communities, the local health department exercises regulatory enforcement that is delegated or contracted
to it by federal, state, county, or municipal government entities. In other communities, enforcement authority
may be retained by the state or delegated to one or more private entities whose authority may cross local
jurisdictional boundaries.
To enforce laws, regulations, and ordinances, the LPHS:
• Identifies organizations within the LPHS that have authority to enforce public health laws, regulations,
or ordinances.
• Assures that a local governmental public health entity is appropriately empowered through laws and
regulations to act in public health emergencies and implement necessary community interventions.
• Assures that all enforcement activities are conducted in accordance with laws, regulations, and
ordinances.
• Informs and educates individuals and organizations of the meaning and purpose of public health laws,
regulations, and ordinances with which they are required to comply.
• Evaluates the compliance of regulated organizations and entities.
Please answer the following questions related to Model Standard 6.3:
6.3.1 Do governmental public health entities within your LPHS have the authority
to enforce laws, regulations, or ordinances related to the public’s health?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
6.3.2 Is the local health department or governmental public health entity
empowered through laws and regulations to implement necessary
community interventions in the event of a public health emergency?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
42
6.3.1.1 Does a document (paper or electronic) exist that identifies the roles
and responsibilities of each governmental entity with enforcement
authority?
6.3.1.2 Do governmental entities with enforcement authority provide their staff
who engage in or support enforcement activities, with formal training
on compliance and enforcement?
Does this entity’s authority include power to:
6.3.2.1 Implement quarantine and isolation?
6.3.2.2 Implement mass immunization and dispensing clinics?
Local Public Health System Performance Assessment Instrument
Local
6.3.3 Does the LPHS assure that all enforcement activities are conducted
in accordance with applicable laws, regulations, and ordinances?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
6.3.4.1 Is dissemination of this information integrated with other public health
activities (e.g., health education, communicable disease control,
health assessment, planning)?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
6.3.5 In the past five years, has the LPHS assessed the compliance of institutions
and businesses in the community (e.g., schools, food establishments, day
care facilities) with laws, regulations, and ordinances designed to ensure the
public’s health?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
Does the LPHS:
6.3.3.1 Have the appropriate power and ability to prevent, detect, manage,
and contain emergency health threats?
6.3.3.2 Conduct enforcement activities within the time frame stipulated
in laws, regulations, or ordinances?
6.3.3.3 Conduct enforcement activities in compliance with due process and
civil rights protections?
6.3.4 Does the LPHS provide information about public health laws, regulations,
and ordinances to the individuals and organizations who are required
to comply with them?
6.3.4 Discussion Toolbox
In considering 6.3.4, does the information explain:
q What the laws, regulations, and ordinances are?
q Why the laws, regulations, and ordinances exist?
q How to comply with applicable laws, regulations, and
ordinances?
Did the assessment:
6.3.5.1 Include input from the regulated institutions and businesses regarding
their perceived difficulties with compliance?
6.3.5.2 Examine the extent of resistance to, or support for, enforcement
activities by regulated institutions and businesses?
6.3.5.3 Include input from key stakeholders (other than the regulated institutions and businesses) of those laws, regulations, and ordinances
regarding the extent of their support for enforcement activities?
Local Public Health System Performance Assessment Instrument
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Local
Essential Service #7: Link People to Needed Personal Health Services and Assure the Provision
of Health Care when Otherwise Unavailable
This service includes:
• Identifying populations with barriers to personal health services.
• Identifying personal health service needs of populations with limited access to a coordinated system of clinical care.
• Assuring the linkage of people to appropriate personal health services through coordination of provider services and
development of interventions that address barriers to care (e.g., culturally and linguistically appropriate staff and materials,
transportation services).
LPHS Model Standard 7.1: Identification of Personal Health Service Needs of Populations
The local public health system (LPHS) identifies populations who may encounter barriers to personal health
services. Identified barriers may be due to age, lack of education, poverty, culture, race, language, religion,
national origin, physical and/or mental disability, or lack of health insurance. In order to ensure equitable
access to personal health services, the LPHS has defined and agreed upon roles and responsibilities for the
local governmental public health entity, hospitals, managed care plans, and other community health care
providers in relation to providing these services.
To accomplish this, the LPHS:
• Identifies populations in the community who may experience barriers to the receipt of personal health
services.
• Defines personal health service needs for the general population and for those populations who may
experience barriers to personal health services. This includes defining specific preventive, curative, and
rehabilitative health service needs for the jurisdiction.
• Assesses the extent to which personal health services in the jurisdiction are available and utilized
by populations who may encounter barriers to care.
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Local Public Health System Performance Assessment Instrument
Local
Please answer the following questions related to Model Standard 7.1:
7.1.1 Does the LPHS identify any populations who may experience barriers
to personal health services?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
7.1.1 Discussion Toolbox
In considering 7.1.1, are the following populations taken into
account:
q Children (less than 18 years of age)?
q Persons 65 years of age and older?
q Persons who may encounter barriers due to lack of education?
q Persons with low income?
q Persons with cultural or language barriers?
q Persons who may encounter barriers because of their race
or ethnicity?
q Persons with physical disabilities?
q Persons with mental illness?
q Uninsured or under-insured persons?
q Persons who may encounter barriers due to geographic
location?
q Persons with religious barriers?
q Lesbian, gay, bisexual, and trans-gendered individuals?
q Persons with addictions?
q Persons coming out of correctional institutions?
q Homeless persons?
q Undocumented immigrants?
7.1.2 Has the LPHS identified the personal health service needs of populations
in its jurisdiction?
7.1.2.1 Have personal health service needs been identified for populations
who may experience barriers to care?
7.1.2.1 Discussion Toolbox
In considering 7.1.2.1, does the LPHS determine the needs for:
q Outreach services to link people to care?
q Primary medical care (including clinical preventive services)?
q Care (case) management?
q Hospital care?
q Tertiary medical care?
q Restorative or rehabilitative care?
q Social services?
q Mental health services?
q Substance abuse treatment services?
q Oral health services?
7.1.3 Has the LPHS assessed the extent to which personal health services
in its jurisdiction are available to populations who may experience barriers
to care?
7.1.3.1 Has the LPHS assessed the extent to which personal health services
are utilized by populations who may experience barriers to care?
Local Public Health System Performance Assessment Instrument
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Local
LPHS Model Standard 7.2: Assuring the Linkage of People to Personal Health Services
The LPHS supports and coordinates partnerships and referral mechanisms among the community’s public
health, primary care, oral health, social service, and mental health systems to optimize access to needed
personal health services. The LPHS seeks to create innovative partnerships with organizations such as
libraries, parenting centers, and service organizations, that will help to enhance the effectiveness of LPHS
personal health services.
To accomplish this, the LPHS:
• Links populations to personal health services, including populations who may encounter barriers to care.
• Provides assistance in accessing personal health services in a manner that recognizes the diverse needs
of unserved and underserved populations.
• Enrolls eligible beneficiaries in state Medicaid or Medical and Prescription Assistance Programs.
• Coordinates the delivery of personal health and social services to optimize access.
Please answer the following questions related to Model Standard 7.2:
7.2.1 Does the LPHS link populations to needed personal health services?
NO
MINIMAL
MODERATE
7.2.1 Discussion Toolbox
In considering 7.2.1, does the LPHS assure the provision of
services to the following populations who may encounter barriers
to care:
q Children (less than 18 years of age)?
q Persons 65 years of age and older?
q Persons who may encounter barriers due to lack of education?
q Persons with low income?
q Persons with cultural or language barriers?
q Persons who may encounter barriers because of their race
or ethnicity?
q Persons with physical disabilities?
q Persons with mental illness?
q Uninsured or under-insured persons?
q Persons who may encounter barriers due to geographic
location?
q Persons with religious barriers?
q Lesbian, gay, bisexual, and trans-gendered individuals?
q Persons with addictions?
q Persons coming out of correctional institutions?
q Homeless persons?
q Undocumented immigrants?
46
Local Public Health System Performance Assessment Instrument
SIGNIFICANT
OPTIMAL
Local
7.2.2 Does the LPHS provide assistance to vulnerable populations in accessing
needed health services?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
7.2.3 Does the LPHS have initiatives to enroll eligible individuals in public benefit
programs such as Medicaid, and/or other medical or prescription assistance
programs?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
7.2.4 Does the LPHS coordinate the delivery of personal health and social
services to optimize access to services for populations who may encounter
barriers to care?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
Does this assistance include:
7.2.2.1 Culturally and linguistically appropriate staff to assist population
groups in obtaining personal health services?
7.2.2.2 Culturally and linguistically appropriate materials?
7.2.2.3 Transportation services for those with special needs?
7.2.4.1 Are services targeting the same populations co-located to optimize
access?
7.2.4.2 Are services targeting the same populations coordinated among
providers to optimize access?
7.2.4.2 Discussion Toolbox
In considering 7.2.4.2, does coordination of services occur among
these providers:
q The local health department?
q Other governmental agencies providing services to these
populations (e.g., social services)?
q Hospitals providing services to the community?
q Managed care plans active in the community?
q Charitable organizations active in the community?
q Organizations representing populations within the community?
q Federally Qualified Health Centers?
Local Public Health System Performance Assessment Instrument
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Local
Essential Service #8: Assure a Competent Public and Personal Health Care Workforce
This service includes:
• Assessment of all of the workers within the local public health system (LPHS) (including agency, public, and private
workers, volunteers, and other lay community health workers) to meet community needs for public and personal health
services.
• Maintaining public health workforce standards, including efficient processes for licensure/credentialing of professionals
and incorporation of core public health competencies needed to provide the Essential Public Health Services into
personnel systems.
• Adoption of continuous quality improvement and life-long learning programs for all members of the public health
workforce, including opportunities for formal and informal public health leadership development.
LPHS Model Standard 8.1: Workforce Assessment, Planning, and Development
Workforce assessment is the process of determining the competencies, skills, and knowledge; categories
and number of personnel; and training needed to achieve public health and personal health goals. It is a
community process that includes the identification of those available to contribute to the provision of the
Essential Public Health Services and the particular strengths and assets that each brings. Workforce
assessment includes the projection of optimal numbers and types of personnel and the formulation of plans
to address identified workforce shortfalls or gaps.
To accomplish this, organizations within the local public health system (LPHS):
• Establish a collaborative process to periodically determine the competencies, composition, and size
of the public and personal health workforce that provides the Essential Public Health Services.
• Identify and address gaps in the public and personal health workforce, ideally using information from the
assessment.
• Distribute information from the workforce assessment to community organizations, including governing
bodies and public and private agencies, for use in their strategic and operational plans.
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Local Public Health System Performance Assessment Instrument
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Please answer the following questions related to Model Standard 8.1:
8.1.1 Within the past three years, has an assessment of the LPHS workforce been
conducted?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
8.1.1 Discussion Toolbox
In considering 8.1.1, did the assessment:
q Include participation from multiple organizations within the
LPHS?
q Determine the composition (i.e., job titles and demographics)
of the workforce by occupational categories?
q Determine the size of the workforce by enumerating the number
of workers in workforce categories?
q Determine existing workforce skills and experience?
q Address the role of volunteers and other lay community health
workers?
q Identify areas for improvement?
8.1.2 Whether or not a formal assessment has been conducted, have shortfalls
and/or gaps within the LPHS workforce been identified?
8.1.2.1 Were gaps related to workforce composition identified?
8.1.2.2 Were gaps related to workforce size identified?
8.1.2.3 Were gaps related to workforce skills and/or experience identified?
8.1.2.4 Were recruitment and retention shortfalls identified?
8.1.2.5 Is this knowledge used to develop plans to address workforce gaps?
8.1.2.6 Have the organizations within the LPHS implemented plans for
correction?
8.1.2.7 Is there a formal process to evaluate the effectiveness of plans
to address workforce gaps?
8.1.3 Were the results of the workforce assessment and/or gap analysis
disseminated for use in LPHS organizations’ strategic or operational plans?
Was this information provided to:
8.1.3.1 Community leaders?
8.1.3.2 Governing bodies?
8.1.3.3 Public agencies?
8.1.3.4 Elected officials?
Local Public Health System Performance Assessment Instrument
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Local
LPHS Model Standard 8.2: Public Health Workforce Standards
Organizations within the LPHS develop and maintain public health workforce standards for individuals who
deliver and/or contribute to the Essential Public Health Services. Public health workforce qualifications
include certifications, licenses, and education required by law or established by local, state, or federal
policy guidelines. In addition, core and specific competencies that are needed to provide the Essential
Public Health Services are incorporated into personnel systems. These standards are linked to job
performance through clearly written position descriptions and regular performance evaluations.
To accomplish this, organizations within the LPHS:
• Are aware of and in compliance with guidelines and/or licensure/certification requirements for personnel
contributing to the Essential Public Health Services.
• Periodically develop, use, and review job standards and position descriptions that incorporate specific
competency and performance expectations.
• Evaluate members of the public health workforce on their demonstration of core public health
competencies and those competencies specific to a work function or setting and encourage staff
to respond to evaluations and performance goal adjustments by taking advantage of continuing
education and training opportunities.
Workforce standards are essential for each organization within the local public health system, but are
particularly important for the local health department (LHD) where a large concentration of public health
professionals exists. To fulfill these important obligations the LHD:
• Develops written job standards and/or position descriptions for all LHD personnel.
• Conducts annual performance evaluations of personnel within the LHD.
Please answer the following questions related to Model Standard 8.2:
8.2.1 Are organizations within the LPHS aware of guidelines and/or licensure/
certification requirements for personnel contributing to the Essential Public
Health Services?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
8.2.2 Have organizations within the LPHS developed written job standards and/or
position descriptions for all personnel contributing to the Essential Public
Health Services?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
8.2.3 Do organizations within the LPHS conduct annual performance evaluations?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
50
8.2.1.1 Are organizations within the LPHS in compliance with guidelines
and/or licensure/certification requirements for personnel contributing
to the Essential Public Health Services?
Local Public Health System Performance Assessment Instrument
Local
8.2.4 Does the LHD develop written job standards and/or position descriptions for
all personnel?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
8.2.4 Discussion Toolbox
In considering 8.2.4, do job standards and/or position
descriptions:
q Specify job competencies for each position?
q Specify types and levels of experience and education for each
position?
q Specify certifications or licenses required for certain positions?
q Include performance expectations?
8.2.4.1 Are job standards and/or position descriptions reviewed periodically?
8.2.5 Does the LHD conduct performance evaluations?
8.2.5 Discussion Toolbox
In considering 8.2.5, does the LHD:
q Conduct performance evaluations annually?
q Base performance evaluations on the demonstration of core
public health competencies?
q Base performance evaluations on demonstration
of competencies specific to a work function or setting?
q Base performance evaluations on direct observations of staff
performance?
q Adjust performance goals for individual workers as part of the
performance evaluation?
q Train evaluators in techniques for performance appraisal as
part of an overall performance improvement process (e.g., 360
employee evaluation)?
q Use performance evaluation plans to establish leadership
expectations and to recognize leadership competence on both
individual and collaborative levels in both internal and external
settings?
q Where unions exist, conduct performance evaluations
in accordance with union policy?
Local Public Health System Performance Assessment Instrument
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Local
LPHS Model Standard 8.3: Life-Long Learning Through Continuing Education, Training, and
Mentoring
Continuing education and training include formal and informal educational opportunities. This may encompass distance learning, workshops, seminars, national and regional conferences, and other activities
intended to strengthen the professional knowledge and skills of employees contributing to the provision of
the Essential Public Health Services. Experienced mentors and coaches are available to less experienced
staff to provide advice and assist with skill development and other needed career resources. Opportunities
are available for staff to work with academic and research institutions, particularly those connected with
schools of public health, public administration, and population health disciplines. Through these academic
linkages, the public health workforce, faculty, and students are provided with opportunities for relevant
interaction, which enriches both settings.
The complexity of promoting health and preventing disease in a country as diverse as the United States
requires the public health workforce to continually learn and apply this new knowledge. The population in
the United States continues to be diverse in terms of race, ethnicity, faith beliefs, age, economics, education, life-style preference and other demographic characteristics. Factors such as the social environment,
physical environment, economic status, genetic predisposition, behavioral risk factors, and health care also
influence health and well-being. An understanding and respect for this diversity and the underlying factors
that address health are critical to the performance of all of the Essential Public Health Services. The LPHS
respects diverse perspectives and cultural values and expects staff to demonstrate cultural competence in
all interactions based on the dignity and value of each individual as a professional colleague or community
member.
To accomplish this, organizations within the LPHS:
• Identify education and training needs and encourage opportunities for workforce development.
• Provide opportunities for all personnel to develop core public health competencies.
• Provide incentives (e.g., improvements in pay scale, release time, tuition reimbursement) for the public
health workforce to pursue education and training.
• Provide opportunities for public health workforce members, faculty and student interaction to mutually
enrich practice-academic settings.
Please answer the following questions related to Model Standard 8.3:
8.3.1 Does the LPHS identify education and training needs so as to encourage
opportunities for workforce development?
52
Is workforce development encouraged and/or provided through:
8.3.1.1 Distance learning technology?
8.3.1.2 National, state, local and regional conferences?
8.3.1.3 Staff cross-training?
8.3.1.4 Coaching, mentoring and modeling?
8.3.1.5 Does the LPHS provide refresher courses for key public health issues
(e.g., HIPAA, non-discrimination, and emergency preparedness)?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
Local Public Health System Performance Assessment Instrument
Local
8.3.2 Does the LPHS provide opportunities for all personnel to develop core
public health competencies?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
8.3.2 Discussion Toolbox
In considering 8.3.2, are the following core competencies
addressed in the opportunities provided by the LPHS:
q Analytic skills/assessment skills?
q Basic public health science skills?
q Cultural competency skills?
q Communications skills?
q Community dimensions of practice skills?
q Financial planning and management skills?
q Leadership and systems thinking skills?
q Policy development/program planning skills?
Do these training opportunities include:
8.3.2.1 An understanding of the Essential Public Health Services?
8.3.2.2 An understanding of the multiple determinants of health to develop
more effective public health interventions?
8.3.2.2 Discussion Toolbox
In considering 8.3.2.2, does training address such determinants
of health as:
q Culture?
q Race/ethnicity?
q Gender?
q Economic status?
q Educational attainment?
q Genetic predisposition?
q Environmental influences (natural and built)?
8.3.2.3 Cultural competence to interact with colleagues and community
members?
8.3.3 Are incentives provided to the workforce to participate in educational and
training experiences?
8.3.3 Discussion Toolbox
In considering 8.3.3, do these incentives include:
q Career advancement?
q Time off for coursework or conferences?
q Tuition reimbursement?
q Recognition by supervisors?
q Registration and paid attendance to conferences
and meetings?
Local Public Health System Performance Assessment Instrument
53
Local
8.3.3.1 Does the LHD have dedicated resources for training and education?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
8.3.3.1 Discussion Toolbox
In considering 8.3.3.1, are the following available for training and
education:
q A dedicated budget?
q Personnel (e.g., a training coordinator)?
8.3.4 Are there opportunities for interaction between staff of LPHS organizations
and faculty from academic and research institutions, particularly those
connected with schools of public health?
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LPHS Model Standard 8.4: Public Health Leadership Development
LPHS leadership is demonstrated by both individuals and organizations that are committed to improving
the health of the community. Leaders play a vital role in assuring the creation of a public health system,
the implementation of the Essential Public Health Services, and the creation and achievement of a shared
vision of community health and well-being. LPHS leadership may be provided by the local governmental
public health entity, may emerge from the public and private sectors or the community, or may be shared
by multiple stakeholders. The LPHS encourages the development of leadership capacity that is inclusive,
representative of community diversity, and respectful of the community’s perspective.
To accomplish this, the organizations within the LPHS:
• Provide formal (e.g., educational programs, leadership institutes) and informal (e.g., coaching, mentoring)
opportunities for leadership development for employees at all organizational levels.
• Promote collaborative leadership through the creation of a public health system with a shared vision and
participatory decision-making.
• Assure that organizations and/or individuals have opportunities to provide leadership in areas where their
expertise or experience can provide insight, direction, or resources.
• Provide opportunities for development of diverse community leadership to assure sustainability of public
health initiatives.
Please answer the following questions related to Model Standard 8.4:
8.4.1 Do organizations within the LPHS promote the development of leadership
skills?
Is leadership skill development promoted by:
8.4.1.1 Encouraging potential leaders to attend formal leadership training?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
8.4.1.1 Discussion Toolbox
In considering 8.4.1.1, do members of the LPHS workforce
participate in the following:
q National Public Health Leadership Institute?
q Regional or state public health leadership institutes?
q Executive management seminars or programs?
q Graduate programs in leadership/management?
8.4.1.2 Mentoring personnel in middle management/supervisory positions?
8.4.1.3 Promoting leadership at all levels within organizations that comprise
the LPHS?
8.4.1.4 Establishing financial resources to support leadership development
on an ongoing basis?
8.4.2 Do organizations within the LPHS promote collaborative leadership through
the creation of a shared vision and participatory decision-making?
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NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
8.4.3 Does the LPHS provide leadership opportunities for individuals and/or
organizations in areas where their expertise or experience can provide
insight, direction, or resources?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
8.4.4 Does the LPHS recruit and retain new leaders who are representative of the
population diversity within their community?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
56
8.4.2.1 Across LPHS organizations, are there established communication
mechanisms that encourage informed participation in decisionmaking (e.g., forums, list serve)?
8.4.4.1 Does the LPHS provide opportunities to develop community
leadership through coaching and mentoring?
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Essential Service #9: Evaluate Effectiveness, Accessibility, and Quality of Personal and PopulationBased Health Services
This service includes:
• Evaluating the accessibility and quality of services delivered and the effectiveness of personal and population-based
programs provided.
• Providing information necessary for allocating resources and reshaping programs.
LPHS Model Standard 9.1: Evaluation of Population-Based Health Services
The local public health system (LPHS) regularly evaluates the accessibility, quality, and effectiveness
of population-based health services (e.g., injury prevention, physical activity, immunizations) and progress
towards program goals. The LPHS has established performance criteria, or used externally established
performance criteria (e.g., Healthy People 2010 objectives or The Guide to Community Preventive Services),
to evaluate specific indicators for population-based services. The evaluation of population-based health
services is built on the analysis of health status, service utilization, and community satisfaction data
to assess program effectiveness and to provide information to allocate resources and reshape programs.
To accomplish this, the LPHS:
• Evaluates population-based health services against established criteria for performance, including the
extent to which program goals are achieved for these services.
• Assesses community satisfaction with population-based services and programs through a broad-based
process, which includes residents who are representative of the community and groups at increased risk
of negative health outcomes.
• Identifies gaps in the provision of population-based health services.
• Uses evaluation findings to modify the strategic and operational plans of LPHS organizations to improve
services and programs.
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Please answer the following questions related to Model Standard 9.1:
9.1.1 In the past three years, has the LPHS evaluated population-based health
services?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
9.1.1 Discussion Toolbox
In considering 9.1.1, do evaluations include assessments of such
services as:
q Physical activity promotion?
q Overweight and obesity prevention?
q Tobacco use prevention?
q Substance abuse prevention?
q STD prevention?
q Injury prevention?
q Environmental health?
q Immunization programs?
9.1.1.1 Are established criteria used to evaluate population-based health
services?
9.1.1.1 Discussion Toolbox
In considering 9.1.1.1, do these criteria include:
q Established goals for access to population-based health
services (e.g., access to immunizations started by two months
of age)?
q Quality standards for population-based health services (e.g.,
multicomponent interventions that include education to increase
vaccine coverage)?
q Established targets for the effectiveness of population-based
health services (e.g., rates of immunization by six months)?
9.1.1.2 Does the evaluation determine the extent to which program goals are
achieved for population-based health services?
9.1.1.2 Discussion Toolbox
In considering 9.1.1.2, does evaluation of program goals include
determining:
q Access to population-based health services?
q Quality of the population-based health services?
q Effectiveness of the population-based health services?
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9.1.2 Does the LPHS assess community satisfaction with population-based health
services?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
9.1.3 Does the LPHS identify gaps in the provision of population-based health
services?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
9.1.4 Do organizations within the LPHS use the results of population-based health
services evaluation in the development of their strategic and operational
plans?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
Does the assessment:
9.1.2.1 Gather input from residents representing a cross-section of the
community?
9.1.2.2 Determine if residents’ needs are being met, including those groups
at increased risk of negative health outcomes?
9.1.2.3 Determine residents’ satisfaction with the responsiveness to their
complaints or concerns regarding population-based health services?
9.1.2.4 Identify areas where population-based health services can
be improved?
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LPHS Model Standard 9.2: Evaluation of Personal Health Services
The LPHS regularly evaluates the accessibility, quality, and effectiveness of personal health services,
ranging from prevention services to acute care to hospice care. Special attention is given to the ability
of community providers to deliver services across life stages and population groups. An important
component of the evaluation is a survey of client satisfaction. The clients surveyed are representative
of all actual and potential users of the system. The survey addresses satisfaction with access to the system
by populations with barriers to personal health services, usability of the system by all clients, and
inclusiveness of services.
To accomplish this, organizations within the LPHS:
• Evaluate the accessibility, quality, and effectiveness of personal health services.
• Evaluate personal health services against established standards.
• Assess the satisfaction of clients (including those at increased risk of negative health outcomes).
• Use information technology to assure quality of personal health services and communication among providers.
• Use evaluation findings to modify their strategic and operational plans and to improve services and programs.
Please answer the following questions related to Model Standard 9.2:
9.2.1 In the past three years, have organizations within the LPHS evaluated
personal health services for the community?
Were the following assessed:
9.2.1.1 Access to personal health services?
9.2.1.2 The quality of personal health services?
9.2.1.3 The effectiveness of personal health services?
9.2.2 Are specific personal health services in the community evaluated against
established standards (e.g., JCAHO, State licensure, HEDIS)?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
9.2.2 Discussion Toolbox
In considering 9.2.2, does the evaluation include an assessment
of such services as:
q Clinical preventive services?
q Primary health care services?
q Specialty care services?
q Oral health services?
q Mental health services?
q Outpatient surgery services?
q Emergency care services?
q Hospital care services?
q Rehabilitative care services?
q Home health care services?
q Long-term care services?
q Hospice care services?
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9.2.3 Does the LPHS assess client satisfaction with personal health services?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
9.2.3 Discussion Toolbox
In considering 9.2.3, does the assessment:
q Determine the adequacy of the scope of personal health
services offered?
q Examine how well services meet personal health needs
of clients, including those at increased risk of negative health
outcomes?
q Identify areas for improvement?
q Determine client satisfaction with the responsiveness to their
complaints or concerns regarding personal health services?
q Determine client satisfaction with systems related to payment
for personal health services (e.g., Medicaid, Medicare, managed
care plans, preferred provider plans)?
9.2.3.1 Were surveyed clients representative of past, current and potential
users of services?
9.2.4 Do organizations within the LPHS use information technology to assure
quality of personal health services?
9.2.4.1 Do organizations use electronic health records?
9.2.4.2 Is information technology used to facilitate communication among
providers (e.g., Health Information Exchange or Regional Health
Information Organizations)?
9.2.5 Do organizations within the LPHS use the results of the evaluation in the
development of their strategic and operational plans?
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LPHS Model Standard 9.3: Evaluation of the Local Public Health System
A local public health system includes all public, private, and voluntary entities, as well as individuals
and informal associations that contribute to the delivery of the Essential Public Health Services within
a jurisdiction. The evaluation focuses primarily on the performance of the LPHS as a whole. The local
governmental public health entity takes a lead role in convening a collaborative evaluation process.
Organizations engaged in the evaluation process use established criteria to assess LPHS activities, the
achievement of goals, and any lapses in quality. The standards used are consistent with NPHPSP or similar
standards. Community perceptions are a vital component of the evaluation. The evaluation findings are
regularly used to inform the community health improvement process and to improve services and programs.
To accomplish this, the LPHS:
• Identifies community organizations or entities that contribute to the delivery of the Essential Public Health
Services.
• Evaluates the comprehensiveness of LPHS activities against established criteria at least every five years
and ensures that all organizations within the LPHS contribute to the evaluation process.
• Assesses the effectiveness of communication, coordination, and linkage among LPHS entities.
• Uses information from the evaluation process to refine existing community health programs, to establish
new ones, and to redirect resources as needed to accomplish LPHS goals.
Please answer the following questions related to Model Standard 9.3:
62
9.3.1 Has the LPHS identified community organizations or entities that
contribute to the delivery of the Essential Public Health Services?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
9.3.2 Is an evaluation of the LPHS conducted every three to five years?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
Does the evaluation:
9.3.2.1 Assess the comprehensiveness of LPHS activities?
9.3.2.2 Use established standards (e.g., National Public Health Performance
Standards Program)?
Local Public Health System Performance Assessment Instrument
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9.3.2.3 Do LPHS entities participate in the evaluation of the LPHS?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
9.3.2.3 Discussion Toolbox
In considering 9.3.2.3, consider whether participating LPHS
entities include:
q The local governmental public health agency (i.e., local health
department)?
q The local governing entity (i.e., board of health)?
q Other governmental entities (e.g., state agencies, other local
agencies)?
q Hospitals?
q Managed care organizations?
q Primary care clinics and physicians?
q Social service providers?
q Mental health providers?
q Civic organizations?
q Professional organizations?
q Local businesses and employers?
q Neighborhood organizations?
q Faith-based organizations?
q Educational institutions?
q Public safety and emergency response organizations?
q Environmental or environmental-health agencies?
q Non-profit organizations?
q Advocacy groups?
q Local officials who impact policy and fiscal decisions?
q Other community organizations?
9.3.3 Has a partnership assessment been conducted that evaluates the
relationships among organizations that comprise the LPHS (e.g., the
NPHPSP or an evaluation of a partnership within the MAPP process)?
9.3.3.1 Is the exchange of information among the organizations in the LPHS
assessed?
9.3.3.2 Are linkage mechanisms among the providers of population-based
services and personal health services assessed (e.g., referral
systems, memoranda of understanding)?
9.3.3.3 Is the use of resources (e.g., staff, communication systems)
to support the coordination among LPHS organizations assessed?
9.3.4 Does the LPHS use results from the evaluation process to guide community
health improvements?
Are the results from the evaluation process used:
9.3.4.1 To refine existing community health programs?
9.3.4.2 To establish new community health programs?
9.3.4.3 To redirect resources?
9.3.4.4 To inform the community health improvement process?
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Essential Service #10: Research for New Insights and Innovative Solutions to Health Problems
This service includes:
• A continuum of innovative solutions to health problems ranging from practical field-based efforts to foster change in public
health practice, to more academic efforts to encourage new directions in scientific research.
• Linkages with institutions of higher learning and research.
• Capacity to undertake timely epidemiological and health policy analyses and conduct health systems research.
LPHS Model Standard 10.1: Fostering Innovation
Organizations within the local public health system (LPHS) foster innovation to strengthen public health
practice. Innovation includes practical field-based efforts to foster change in public health practice as well
as academic efforts to encourage new directions in scientific research.
To accomplish this, organizations within the LPHS:
• Enable staff to identify new solutions to health problems in the community by providing the time and
resources for staff to pilot test or conduct studies to determine the feasibility of implementing new ideas.
• Propose public health issues to organizations that do research for inclusion in their research agendas.
• Research and monitor best practice information from other agencies and organizations at the local, state,
and national level.
• Encourage community participation in research development and implementation (e.g., identifying
research priorities, designing studies, preparing related communications for the general public).
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Please answer the following question related to Model Standard 10.1:
10.1.1 D
o LPHS organizations encourage staff to develop new solutions to health
problems in the community?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
10.1.2 D
uring the past two years, have LPHS organizations proposed
to research organizations one or more public health issues for inclusion
in their research agenda?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
10.1.3 D
o LPHS organizations identify and stay current with best practices
developed by other public health agencies or organizations?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
10.1.1.1 D
o LPHS organizations provide time and/or resources for staff
to pilot test or conduct studies to determine new solutions?
10.1.1.1 Discussion Toolbox
In considering 10.1.1.1, do organizations:
q Develop solutions that consider broad issues affecting the
public’s health (i.e., race/gender/age discrimination, lack
of affordable/quality housing and education, locating waste
facilities in residential neighborhoods, transportation)?
q Identify barriers to implementing innovative solutions to health
problems within the community?
q Implement those innovations most likely to improve public
health practice?
10.1.3 Discussion Toolbox
In considering 10.1.3, are the following used to identify best
practices:
q Scientific publications?
q Professional associations?
q National and state conferences?
10.1.4 D
o LPHS organizations encourage community participation in the
development or implementation of research?
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LPHS Model Standard 10.2: Linkage with Institutions of Higher Learning and/or Research
The LPHS establishes a wide range of relationships with institutions of higher learning and/or research
organizations, including patterns of mutual consultation, and formal and informal affiliation. Such relationships can occur with schools of public health as well as with schools and departments of medicine, nursing,
pharmacy, allied health, business and environmental science. The LPHS establishes linkages with other
research organizations, such as federal and state agencies, associations, private research organizations,
and research departments or divisions of business firms. The LPHS links with one or more institutions
of higher learning and/or research organizations to co-sponsor continuing education programs.
To accomplish this, the LPHS:
• Develops relationships with these institutions that range from patterns of consultation to formal and
informal affiliations.
• Partners with institutions of higher learning or research to conduct research activities related to the
public’s health, including community-based participatory research.
• Encourages collaboration between the academic/research and practice communities, including field
training experiences and continuing education opportunities.
Please answer the following questions related to Model Standard 10.2:
10.2.1 Does the LPHS develop relationships with institutions of higher learning
and/or research organizations?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
10.2.1 Discussion Toolbox
In considering 10.2.1, do these relationships include:
q Consultations?
q Formal affiliations?
q Informal affiliations?
q Technical assistance?
10.2.2 Does the LPHS partner with at least one institution of higher learning and/
or research organization to conduct research related to the public’s health?
10.2.2 Discussion Toolbox
In considering 10.2.2, are there partnerships for:
q Community-based participatory research?
q Public health systems research?
q Interdisciplinary research?
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10.2.3 D
oes the LPHS encourage collaboration between the academic and
practice communities?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
10.2.3 Discussion Toolbox
In considering 10.2.3, does this interaction include:
q Exchange of faculty and public health workforce members?
q Arrangements with institutions of higher learning and/or
research organizations to provide field training or work-study
experiences for their students or interns?
q Co-sponsored continuing education for the public health
workforce?
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LPHS Model Standard 10.3: Capacity to Initiate or Participate in Research
Organizations within the LPHS initiate and/or participate in research that contributes to epidemiological and
health policy analyses and improved health system performance. Health systems research encompasses
both population-based and personal health care services research. This research includes the examination
of factors related to the efficient and effective implementation of the Essential Public Health Services (public
health systems research) as well as the study of variables that influence health care quality and service
delivery (health services research).
The capacity to initiate or participate in timely epidemiological, policy, and health systems research begins
with ready access to researchers with the knowledge and skill to design and conduct research in those
areas. This capacity also includes the availability of resources, such as a technical library, on-line services,
and information technology. Capacity also includes facilities for analyses, and the ability to disseminate and
apply research findings to improve public health practice.
To accomplish this, the LPHS:
• Includes or has access to researchers with the knowledge and skill to design and conduct health-related
studies.
• Ensures the availability of resources (e.g., databases, information technology) to facilitate research.
• Disseminates research findings to public health colleagues and others (e.g., publication in journals,
websites).
• Evaluates the development, implementation, and impact of LPHS research efforts on public health
practice.
Please answer the following questions related to Model Standard 10.3:
10.3.1 Does the LPHS have access to researchers (either on staff or through other
arrangements)?
NO
MINIMAL
MODERATE
10.3.1 Discussion Toolbox
In considering 10.3.1, do one or more of the researchers have
training or experience in the following:
q Epidemiology?
q Health policy?
q Health economics?
q Health services?
q Public health systems?
q Community-based participatory research?
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SIGNIFICANT
OPTIMAL
Local
10.3.2 Is there access to resources to facilitate research within the LPHS?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
10.3.3 Does the LPHS disseminate findings from their research?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
10.3.4 Does the LPHS evaluate its research activities?
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
NO
MINIMAL
MODERATE
SIGNIFICANT
OPTIMAL
10.3.2 Discussion Toolbox
In considering 10.3.2, do these resources include:
q Databases?
q Technical libraries?
q Distance learning?
q On-line resources?
Does the LPHS evaluate the:
10.3.4.1 Development of research activities?
10.3.4.2 Implementation of research activities?
10.3.4.3 Impact of research activities on public health practice?
10.3.4.4 Involvement of community representatives in collaborative
research efforts (i.e., community-based participatory research)?
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| File Type | application/pdf |
| File Modified | 2008-04-14 |
| File Created | 2008-04-14 |