Illinois Project for Local Assessment of Needs

(IPLAN)Office of Epidemiology

and Health Systems DevelopmentDivision of Health Policy

September 28, 2001

What is IPLAN?

PPrimary goalsTo establish a process for community involvement andparticipation in community health assessment andplanningTo make local health departments accountable to theircommunities rather than to the state

PEssential elementsOrganizational capacity assessmentCommunity health needs assessmentCommunity health plan, focusing on a minimum of three priority health problems

What led to IPLAN?

Over a decade of strategic planning in public health

What led to IPLAN?

1984 - The Roadmap Committee Report

PFour principles for changeService delivery should be improved.Societal benefits should be effectively communicated.Quality of services should be improved and standardized.Funding should be increased.

What led to IPLAN?

1984 - The Roadmap Committee Report

PUnderlying belief

Services are most efficiently and effectively

provided at the local level.

What led to IPLAN?

1988 - Roadmap Implementation Task Force

PExamined existing policies, statutes, regulations, funding and administration of

public healthPVisioned an optimal public health system

andcompared it with the current system

PDeveloped 29 recommendations that were published in The Road to Better Health for

Allof Illinois

What led to IPLAN?

1990 - Project Health The Illinois Public Health Improvement Project

PConducted by more than 200 public health professionals from state and local health

departments, public health academia, and public health associations

PAdopted 27 of the RITF recommendationsPCatalyzed the development of progressive rules

forcertification of local health departments in Illinois

Requirements for Certification of Illinois Local Health Departments

Before and After 1993

Before July 1993

To be recognized as a local health department in Illinois, LHDs MUST DO –

1. Potable Water2. Food Sanitation

3. Maternal Health/Family Planning4. Child Health

5. Communicable Disease Control6. Private Sewage

7. Solid Waste8. Nuisance Control9. Chronic Disease10.Administration

After July 1993To be certified as a local health

department in Illinois, LHDs MUST–1. Assess community health needs2. Investigate hazards within the community3. Analyze identified health needs for their

determinants4. Advocate and build constituencies for public

health5. Prioritize among identified community health

needs6. Develop policies and plans to respond to

priority needs7. Manage resources and organizational

structures8. Implement programs and services to respond

to priority needs9. Evaluate programs and services

10.Inform and educate the community

Illinois Administrative CodeTitle 77: Public Health

Chapter 1: Department of Public Health

Subchapter H: Local Health Departments

Part 600: Certified Local Health Department Code

Illinois Administrative CodeSection 600.400: Certified Health Department Code

Public Health Practice Standards

The local health department shall, at least

once every five years, perform an

organizational capacity self-assessment

that meets the requirements set forth in

Section 600.410.

Illinois Administrative CodeSection 600.400: Certified Health Department Code

Public Health Practice Standards

A community health needs assessment

that systematically describes the prevailing

health status and health needs of the

population within the local health

department=s jurisdiction shall be

conducted once every five years.

Illinois Administrative CodeSection 600.400: Certified Health Department Code

Public Health Practice Standards

Develop a community health plan that

addresses at least three priority health

needs, identified pursuant to Section

600.400, during each certification period.

The IPLAN

Process

CommunityHealth

NeedsAssess

mentCommunityHealth Plan

Program Development

Implementation

Evaluation

What is the State’s role? Established the framework for the assessment

and plan (APEX-PH model)

Developed, enhances and maintains IPLAN data system

Conducts training and provides technical assistance

Reviews submitted assessments and plans for substantial compliance with the administrative rules

(every 5 years) and provides follow-up technical assistance

A Community Health Needs Assessment should contain--

A description of the health status and health problems most meaningful for the community in the data groupings contained in the IPLAN Data System:

$ Demographic & Socioeconomic Characteristics$ General Health & Access to Care$ Maternal & Child Health$ Chronic Disease$ Infectious Disease$ Environmental, Occupational, & Injury Control$ (Sentinel Events)

A Community Health Needs Assessment should contain--

$A description of the process and outcomes of setting priorities;

$A statement of purpose of the community health needs assessment that includes a description of

how the assessment will be used to improve health in the community;

$A description of the community participation process, a list of community groups involved in the

process, and method for establishing priorities;

Community Health Committee

Pethnic & racial groupsPmedical & hospital communityPmental health & social service

organizationsPcooperative extension service

PschoolsPlaw enforcement organizations

Pvoluntary organizationsPfaith community

Pbusinesses and economic development

PunionsPyouth, senior citizens, other

target populations

Prioritize Community Health Problems

P Hanlon MethodP Nominal Group

P Delphi TechniqueP PEARL (Propriety, Economics,

Acceptability, Resources, and Legality)

Detailed Analysis of Community Health Problems

aka - NCAA Chart

Health Problem Analysis Worksheet

Risk Factors

Health Priority

Indirect Contributing FactorsDirect Contributing

Factors

Risk Factors

Health Priority

Indirect Contributing FactorsDirect Contributing

Factors

Health Priority

A situation or condition of people which is considered undesirable, is likely to exist in the future, and is measured as death, disease, or

disability.

Risk Factors

Health Priority

Indirect Contributing FactorsDirect Contributing

Factors

Risk Factor

A scientifically established factor (determinant) that

relates directly to the level of a health problem.

Risk Factors

Health Priority

Indirect Contributing FactorsDirect Contributing

Factors

Direct Contributing Factor

A scientifically established factor that directly affects the level of a risk factor.

Indirect Contributing Factors

A community specific factor that directlyaffects the level of the direct contributing

factor.

Risk Factors

Health Priority

Indirect Contributing FactorsDirect Contributing

Factors

Outcome Objective

The level to which a health problem

(priority) should be reduced.

Risk Factors

Health Priority

Indirect Contributing FactorsDirect Contributing

Factors

Risk Factors

Health Priority

Indirect Contributing FactorsDirect Contributing

Factors

Impact Objective

The level to which a risk factor should be

reduced.

Intervention Strategy

Demonstrated to be effective or used as national model and should address an impact

objective.

Risk Factors

Health Priority

Indirect Contributing FactorsDirect Contributing

Factors

Impact Objective

The level to which a risk factor should be

reduced.

Health Problem Outcome Objective

Risk Factor Impact Objective

Contributing Factors

Community Health Plan: Worksheet

Proven Intervention Strategies

Resources Available Barriers

Tobacco Use By 2002, reduce cigarette smoking to a prevalence of no more than 24 percent

among people aged 18 and older. (Baseline: 1996 BRFS percentage 27.3).

AddictionSedentary Lifestyle

HypertensionAdvertising (Indirect)

Coalition will implement CDC=s community-based tobacco control program,

focusing on delaying initiation, cessation programs, and advertising control.

Coalition will provide support to LHD with in-kind donations, staff,

and clinical counseling space.

Cerebrovascular Disease (Stroke) By 2004, reduce stroke deaths to no more than 70 per 100,000 (Baseline: 1997 crude rate 76.5 per 100,000).

Limited number smokers seeking counseling.

Media messages promote smoking.Peer pressure.

Health Problem Outcome Objective

Risk Factor Impact Objective

Contributing Factors

Community Health Plan: Worksheet

Proven Intervention Strategies

Resources Available Barriers

Description of the Health Problem, Risk Factors and Contributing Factors

Corrective Actions

Proposed Community Organizations

Evaluation Plan

Community Health Plan

Description of the Health Problem, Risk Factors and Contributing Factors

Corrective Actions

Proposed Community Organizations

Evaluation Plan

The problem is the high death rate associated with cerebrovascular disease (county CR = 76.5, state CR =61.7 p/100,000 or 23% above state rate). The major risk factor is cigarette smoking and county has higher percentage of

smokers (27.6%) , especially males (31%) than state (24%, 28%, respectively). Addiction appears to be the chief contributing factor.

In order to effectively address this health problem a multi-sited and multi- targeted campaign is required to delay initiation of smoking behavior, assist persons attempting to quit, and provide counter advertising to tobacco promotions.

A coalition of community groups, including the LHD, Cancer Society, Lung Association, General Hospital, Teens Against Butts will collaborate with in- kind donations, staff, and clinical counseling space to assist in meeting objectives.

Coalition will meet quarterly to assess progress in achieving goals. Coalition will use the evaluation tool developed by the CDC to determine effectiveness of

programming efforts. Surveys will be conducted amongst coalition members to ascertain stakeholder satisfaction with program.

Community Health Plan