This SCHSAC workgroup is no longer active.

Blueprint for Successful Local Health Departments Workgroup (2009-2010)

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Charge

This workgroup will answer the following questions: What makes a strong local public health organization? What factors contribute to its success? How do different “operating environments” (e.g., the unique local mix of politics, finances, personalities and geography) influence public health outcomes for the community? The workgroup will identify both positive and negative trends in organizational change currently affecting local health departments, and will identify and recommend strategies for maintaining and strengthening public health roles and responsibilities in today’s operating environments.

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Background

Local public health in Minnesota functions within a wide variety of governance and organizational structures. Most jurisdictions provide public health through the oversight of a community health board; several others function within a human services board. Local public health in some cities/counties is organized as a stand-alone department, and in others is part of a larger department (e.g., human services) or organization (e.g., hospitals). Some local public health departments include two or more counties, while others are comprised of a single county, or even a single city. Operating environments also vary, from those in which public health has a strong presence within its organizational structure (including autonomy, a separate budget, access to the county board, etc.), to those in which public health plays a more limited role.

In 1976, when the Community Health Services Act was passed, a “blueprint” was laid out for local health department and community health board (CHB) governance and structure. CHBs, and by extension local health departments, were allowed to organize themselves according to certain parameters set by the legislation and with guidance from the Minnesota Department of Health (MDH). This original blueprint represented the best thinking of the time on what would make a strong and successful local public health system. As the system matured, CHBs made adjustments to their public health structures based on the needs and desires, as well as the political and fiscal realities of their communities.

Over the last decade a handful of counties have made changes to their organizational and operating environments that affect local public health, either by merging departments, changing the governance structure, or both. The frequency of this kind of discussion and decision now appears to be increasing as local elected officials look for ways to address significant budget concerns.

Thus far the system has changed in a piecemeal fashion, and without the benefit of clear guidelines (either based on experience or science). This workgroup seeks to update the blueprint for a strong and successful local health department in Minnesota. It will work to identify the factors which ensure the strength and efficacy of a local health department. The recommendations and products created by this group will be developed through a consensus process and will combine over 30 years of experience with an understanding of the emerging scientific evidence on this topic.

Issues related to governance and organizational structures for public health that may be considered by this workgroup include:

  • Missions, funding, and staffing;
  • Leadership and authority;
  • Issues posed by potential accreditation;
    (e.g., functions that local health departments will be required to carry out; the voluntary nature of accreditation; what it would mean for some of Minnesota’s local health departments to be accredited and others not, etc.)
  • Strategies for maintaining focus on the public health mission of primary prevention and population-based practice;
  • Impact of various structures on the state/local partnership;
  • Best practices/methods for maintaining strong public health functions within various structures; and
  • Multi-county, regional and/or other models of shared services.
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Methods

A workgroup will be convened, with membership representing all types of public health governance and organizational structures currently in Minnesota, including local public health professionals, local elected officials, human services directors, and some members from outside the public health system.

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Members

  • Larry Kittelson, Chair, Mid-State CHB
  • Elizabeth Auch, Countryside CHB
  • John Baerg, Watonwan CHB
  • Ann Bajari, Meeker-McLeod-Sibley CHB
  • David Benson, Nobles-Rock CHB
  • Merrilee Brown, Scott CHB
  • Patricia Coldwell, Association of Minnesota Counties (AMC)
  • Christopher Dahlberg, Carlton-Cook-Lake-St. Louis CHB
  • Renee Frauendienst, Stearns CHB
  • Rachel Green, QUIN CHB
  • Lester Kachinske, Itasca County Human Services
  • Karen Main, Goodhue CHB
  • Susan Morris, Isanti-Mille Lacs CHB
  • Julie Ring, Local Public Health Association (LPHA)
  • Diane Thorson, Otter Tail CHB
  • Pat Adams, MDH Representative
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Products

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Meeting Summaries

July 12, 2010 Meeting Summary (PDF: 26KB / 3 pages)
May 26, 2010 Meeting Summary (PDF: 34KB / 4 pages)
Mar. 3, 2010 Meeting Summary (PDF: 44KB / 3 pages)
Feb. 3, 2010 Meeting Summary (PDF: 54KB / 4 pages)
Nov. 12, 2009 Meeting Summary (PDF: 45KB / 4 pages)
Sept. 23, 2009 Meeting Summary (PDF: 49KB / 3 pages)
Aug. 26, 2009 Meeting Summary (PDF: 51KB / 4 pages)
July 1, 2009 Meeting Summary (PDF: 56KB / 5 pages)

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