We Have A New Look!!

We have redesigned both the web and our electronic newsletters!! Kristine Scott is our new webmaster!! Go to www.kpha.us on the web, to see this new wonderful look!! And, there are a few additional features, like a “Search”.

Our website now matches the Kansas Public Health Orientation Manual that was developed with specific colors developed in our grant from the Kansas Health Foundation for the manual. KALHD used these colors in their communications project funded by KHF and we want to continue those since they are both refreshing and “cool”! We hope others will begin adopting these for their public health “communications”. We hope you find the new look on our newsletters and our website refreshing and user friendly!

The Quarterly Newsletter will be sent out later this month and will include the article from President Goedeke, a summary on the Legislative Session, Orientation Manual update, and information on the upcoming KPHA Fall Conference in Topeka in September—Mark your calendars for September 18th and 19th!! One of our VISTA members is working on a new and professional logo for KPHA, so be watching for that, too!

Information From Past President Ed Kalas

Click here to see a copy of the results of the Local Public Health Systems Assessment tool of the National Public Health Performance Standards Program from the Centers for Disease Control. Shawnee County was a pilot project community for version 2 of the assessment.

Over 45 community health partners participated in and contributed over $12,000 in time and effort to complete the tool in September 2006.

Please join me for a review of the report and a meeting to determine if the community is still interested in pursuing system performance improvement and long-term strategic using the performance standards.

Place: Topeka-Shawnee County Public Library
Marvin Auditorium

Date: 6/17/2008

Time: 1:00 PM to 2:00 PM

RSVP: To Ed Kalas at edkalas@yahoo.com

If you know of any others interested in this information, feel free to forward it on. Also, if you have any questions you can contact me at edkalas@yahoo.com.

Ed Kalas
Public Health Partners
Silver Lake

CONCEPTS GUIDING PERFORMANCE STANDARDS DEVELOPMENT AND USE

Four concepts have helped to frame the National Public Health Performance Standards into their current format:

1. The standards are designed around the ten Essential Public Health Services (EPHS). These ten services are the foundation of any public health action and describe the full range of public health responsibilities. The EPHS were first articulated in 1994 in the Public Health in America statement. The use of the EPHS provides a way to describe and examine the breadth of public health practice, system performance, and infrastructure capability needed for both the state and local public health system levels.

2. The standards focus on the overall public health system, rather than a single organization. A public health system includes all public, private, and voluntary entities that contribute to public health activities within a given area. By focusing on the public health system, the contributions of all entities are recognized in assessing the provision of EPHS. Entities within a public health system can include hospitals, physicians, managed care organizations, environmental agencies, social service organizations, educational systems, community-based organizations, religious institutions and many others. All of these organizations play a role in working to improve the public’s health.

3. The standards describe an optimal level of performance, rather than provide minimum expectations. This assures that the standards can be used for continuous quality improvement. The standards will stimulate performance and infrastructure improvement in public health systems.

4. The standards are explicitly intended to support a process of quality improvement. System partners should use the assessment process and results as a guide for learning about public health activities throughout the system and determining how to improve services. The standards can also be used to advocate for improvements to better serve populations within a public health system.
Over 50% of the participants at the assessment said they were somewhat willing or very willing in pursuing the 18-24 month long MAPP (Mobilizing for Action through Planning and Partnerships) community health improvement process.

Board Member Dr. Ruth Wetta Hall Contributes To KPHA Data Consortium

Four workgroups were formed at the February Data Consortium meeting charged with laying the groundwork for reporting in their respective domains by selecting measures and indicators, identifying essential elements to include in the report designs and identifying existing and needed data to produce the reports. Work is to be completed in time for the Data Consortium to finalize recommendations in October 2008, which will be made to the KHPA board the following month. January 2009 is targeted for report implementation.

Access to Care, led by KHPA – has met twice; members researched and reported on numerous national and statewide datasets believed to include indicators related to this area. Quality and Efficiency, led by KFMC – has met twice. Incoming KPHA President, Sonja Armbruster is attending these meetings. The group has had much discussion about the intended audience(s) of the reports that are to be created. Health and Wellness, led by KDHE, KPHA member Paula Marmet – has met once. This group benefitted from work done by those which had met earlier, work that KDHE had done in reviewing the original list of indicators that the Data Consortium had suggested several months ago (especially in the area of chronic disease), and KDHE staff involvement on the steering committee of Healthy Kansans 2010. In addition to the chronic disease data, it was decided to gain additional information on health outcome indicators, environmental quality measures and injury prevention and disability indicators for a more complete picture of health and wellness. Affordability & Sustainability, led by KHI – has met twice. Dr. Ruth Wetta Hall, KPHA Secretary is participating in this group. Much discussion has taken place around two challenges facing this group: the fact that there are not a lot of commonly used indicators for this principle, and that “affordability” is not simply defined as “cost” – it varies, depending on one’s perspective (government, consumer, insurance provider, employer, etc.) The group decided to add an indicator to the five proposed by KHPA – Public Health Funding. Below is a summary of the information provided by Ruth that the workgroup will be working on:

Affordability and Sustainability Measures
Affordability and sustainability are measures of the value that purchasers and providers of insurance, medical goods and services get from the healthcare system compared to the amount of money available, budgeted and spent by each party. Affordability and sustainability are achieved when a balance is maintained between the amounts of money spent compared to the amount of benefit received, while being conscious of affordability across all populations within the system.

Indicator 1: Health Insurance Premiums

1. Trend in the average premiums for employer for an individual
2. Trend in the average premiums for employer for a family Trend in the average premiums for employee for an individual MEPS data and/or A/H Premium Rate Filings)
3. Trend in the average premiums for employee for a family
4. Trend in the average premiums for Med Supp Insurance plans
5. Trends in enrollment in Kansas Health Insurance Associations high risk pool
6. Trend in average per member per month premium for Medicaid and SCHIP beneficiaries

Indicator 2: Cost Sharing for Consumers

1. The percent of family income the average premiums for an individual represents
2. The percent of family income the average premiums for a family
3. The percent of family income the average deductable for an individual
4. The percent of family income the average deductable for a family represents
5. The percent of family income the average co-pay for an individual)
6. The percent of family income the average co-pay for a family
7. Trend in number of Kansans claiming above 7.5 % of out of pocket medical expenses on the federal income taxes.
8. Trend in the percentage of Kansans not seeking medical care due to the cost.

Indicator 3: Uncompensated Care

1. Trend in the aggregate total of uncompensated care
2. Trend in disproportionate share hospital payments
3. Trend in number and costs of consumers receiving free services from local health departments and safety net clinics due to uninsured and underinsured.
4. Trend in the rates of the uninsured

Indicator 4: Medicaid and SCHIP

1. Trend in number of enrolled by category of eligibility and county.
2. Trend in the rate of enrollment growth or decline.
3. Trend in the number of not enrolled but eligible
4. Trend in aggregate service costs
5. Trend in aggregate administrative costs
6. Trend in waiver costs per participant
7. Trends in service costs by category of eligibility
8. Trends in state revenues for Medicaid and SCHIP
9. Trends in economic stability in Kansas to project growth or decline of need for Medicaid and SCHIP.

Indicator 5: Health and Health Care Spending

1. Trend (e.g., over time, county, provider type) the costs of the top 10 most costly service/good categories (or types of service/goods).
2. Compare costs of top 5 most common and highest cost goods or services across payors
3. Trend overall state budget for preventative care, wellness initiatives, and health.
4. Trend spending on preventative services
5. Compare across payors spending on preventative services

Indicator 6: Public Health

1. Trend budget for safety net clinics
2. Trend number of consumers receiving services through safety net clinics and local health departments.
3. Trend per consumer, per dollar spending at safety net clinics and local health departments.
4. Trend budget for community mental health services
5. Trend number of consumers receiving services through community mental health centers.
6. Trend per consumer, per dollar spending at community mental health centers.
7. Trend sliding scale fees at safety net clinics.

National News—from the APHA Legislative Call on June 9th

US House Committee Approves Three Public Health Bills

On May 7, the U.S. House Energy and Commerce Committee approved three public health bills. The Health Centers Renewal Act (H.R. 1343) would reauthorize through 2012 the 48-year-old program community health centers program. Over 6,300 community health centers across the country provide health care to an estimated 17 million uninsured and underinsured people per year. The U.S. Senate Health, Education, Labor, and Pensions (HELP) Committee approved a similar bill (S. 901) in November, 2007. The panel also approved the Poison Center Support, Enhancement and Awareness Act (H.R. 5669). This bill would reauthorize through 2014 the poison centers’ national toll-free number, national media campaign and grant program. Poisoning is considered the second most common form of unintentional death in the U.S. with roughly 32,000 poison-related deaths in 2005. Finally, the panel approved the Conquer Childhood Cancer Act (H.R. 1553). This bill would provide $30 million through 2013 to promote pediatric cancer research and awareness within the HHS and NIH. It would support the pediatric cancer research institutes at the National Cancer Institute, establish a population-based national childhood cancer database and serve as an information service for patients and families. The U.S. Senate Health, Education, Labor and Pensions Committee approved a similar bill (S. 911) in November, 2007.

US House and Senate Pass Veto Proof Farm Bill

In late May, the U.S. House and Senate overwhelmingly passed the 2007 Farm Bill conference agreement. Both chambers passed the bill by veto proof margins of 316-108 and 82-13 respectively. Unfortunately the President lived up to his promise and vetoed the legislation. Both chambers voted to override the President’s veto, but due to a clerical error in which one of the titles of the bill was mistakenly left out of the bill that was vetoed by the President, the House was forced to pass a new bill that contains the missing title. The Senate and House quickly took up the measure and quickly passed a veto proof bill. APHA has strongly supported the legislation, which contained a number of provisions aimed at improving health and nutrition including the expansion of the Fresh Fruit and Vegetable Program at the Department of Agriculture that provides free fresh fruits and vegetables to low-income children in our nation’s schools, a significant increase in funding to feed our nation’s poor, greater assistance for food banks and community food projects, as well as the expansion of other key safety net and nutrition programs that will benefit the health of millions of Americans. APHA worked with a number of other public health, environmental and produce industry partners to win passage of the legislation.