FY 2013
This document describes the process followed by the Hertford County Public Health Authority’s Senior Management Team to modify the three year strategic objectives and identify the FY 2012 strategic priorities. This document and the resulting plan were presented to the BOH for their final approval on March 28, 2011. Barbara H. Earley , RN, MSN / Process and Results
Table of Contents
Executive Summary 3
Session Agendas 4
Mission and Vision 5
Overarching Goals 6
Volume Statistics 7
Funding Trends 8
Health Statistics 9
Community Input 9
Infrastructure Capacity 10
Community Priorities Identified by Healthy Carolinians and Health Promotion 10
Environmental Scan 11
Visioning/Future State 12
New, Deleted and Revised Strategic Objectives 13
Strategic Objectives for FY 2011-2013 15
Implementation Plans for Strategic Priorities 18
Appendices 19
Volume Statistics for FY 2010 24
Stakeholder/Key Informant Survey Summary-January 2010 27
Infrastructure Assessment by Management Team Members 37
Executive Summary
Hertford County Public Health Authority began establishing an annual strategic plan in the fall of 2000. For the next nine years, the Management Team participated in a two day process for the purpose of recommending revisions to the five year strategic planning objectives and priority objectives for the upcoming calendar year to the Hertford County Board of Health. The Board of Health either had an additional meeting or extended their regular monthly meeting to receive and act on the management team’s recommendation. The initial five year plan was for 2001-2005 followed by a five year plan for 2006-2010. Beginning in 2010, the plan was decreased to three years, 2011-2013, due to the rapid changes in public health programs primarily related to funding. The CY 2009 priorities were extended to June 30, 2010 to allow for the strategic priorities to be established in February 2010 for the Fiscal Year 2010-2011. This change from the calendar year to the fiscal year was to allow for the budgeting of items and activities related to the fiscal year strategic priorities. Each year, the agency’s Director of Health Planning/Resource Development has led the strategic planning process by facilitating discussion of the agency's mission, vision and goals, providing data sets and facilitating brainstorming and various nominal group techniques.
In February 2011, the Management Team revised the mission, goals, three year strategic plan and identified 4 priority objectives.
The fiscal year 2012 priority strategic objectives are:
· Advocate to implement policy and environmental changes related physical activity, nutrition and tobacco.
· Assure assess to mandated and essential public health services.
· Improve utilization of technology applications with emphasis on utilizing HIS, Barnstorm and Munis.
· Assure successful fiscal Management of Home Health Services.
Prior to identifying these priorities, the Management Team reviewed county health statistics with analysis, qualitative input from varying community groups, annual trending of volume statistics for personal health, community health, environmental health and home health services and the relative percent of fiscal support received from the primary funding sources.
This review of data was followed by an analysis of the internal and external environment, a visioning exercise, a review of the health promotion and the Hertford Partners for Health community actions plans and a review of the infrastructure survey completed prior to the session by the individual management team members.
Strategic objectives from the current multiyear plan were reviewed and those that have been accomplished or are no longer relevant are eliminated, some are revised to better reflect the activity level desired and additional objectives are added based on the previous review of data and facilitated planning activities. From the revised multi-year strategic planning objectives, 2 community health priorities and 2 agency priorities were selected for focus during the next fiscal year.
All strategic objectives will be addressed by the entire Management Team but each is assigned to a manager to establish an action plan and update the progress. The priorities will be discussed during the monthly senior Management Team meeting and activities reported the Board of Health. All non-priority strategic objectives are reviewed by the Management Team on a quarterly basis.
The following documents will further detail our strategic planning process on February 23-24, 2011. On March 28, 2011 the Board of Health approved the recommended revisions in the vision and goals and accepted the revised mission, goals, strategic objectives and priorities for fiscal year 2011-2012.
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Session Agendas
The agenda for the February strategic planning session was very similar to last year’s agenda except for two revisions. A review of the community health assessment priority action plans and health promotion action plans were included to ensure key problem areas are being addressed either by the agency and/or the community and a discussion of the strategic priorities and the fiscal year 2012 budget occurred. The agenda for the two-day session can be found below.
Session 1 – February 23, 2011
9:00 – 9:15 am / Review of Agenda- Barbara9:15 – 9:30 am / Review mission, vision and goals- Barbara
Quantitative Data Review:
9:30 – 9:45 am / 2010 SOTCH Report Demographics, Health Statistics and Analysis: Susan
9:45 - 9:50 am / Revisit 2010 County Health Ranking - Barbara
9:50 – 10:15 am / Program volume trends and discussion of changes- Susan and Diane; Review of financial trends-Ramona; review of grant funding-Barbara
10:15-10:30 am / Break
Qualitative Data Review:
10:30 – 10:45 am / 2010 Key Informant Surveys – Barbara
10:45 – 10:50 am / 2009 Murfreesboro Family Planning Survey- Barbara
10:50-10-55 am / 2010 HIV Focus Group- Barbara
10:55 – 11:05 am / Respond to MT Infrastructure Survey-Group
11:05 – 11:30 am / Envision the future of HCPHA – Barbara/group
11:30 -12:30 pm / Identify internal environmental factors influencing strategic planning (SW0T)- NGT x 2
12:30 – 1:00 pm / Lunch
1:00 – 2:00 pm / Identify external environmental factors influencing strategic planning (SW0T)- NGT x 2
2:00 - 2:15 pm / Review non-priority agency strategic objectives and identify revisions/deletions –assigned managers
2:15 – 2:25 pm / Break
2:25 - 2:35 pm / Continue review of non-priority agency strategic objectives and identify revisions/deletions –assigned managers
2:35 - 3:00 pm / Review non-priority community health strategic objectives and identify revisions/deletions –assigned managers
Session 2 - February 24, 2011
9:00 – 9:05 am / Recap previous session’s activities/today’s agenda and methods- Barbara9:05 – 9:20 am / Brief overview of current strategic priorities for FY 2010-2011-assigned managers (2-3 minutes each priority)
9:20 – 9:30 am / Review of Health Promotion/Healthy Carolinians Action Plans - Susan
9:30 - 10:15 am / Identify new community health strategic objectives based on emerging needs and issues identified during Session 1 - brainstorming- group
10:15– 10:25 am / Break
10:25 – 10:30 am / Recap new community health strategic objectives – Barbara
10:30 - 11:15 am / Identify new agency strategic objectives based on emerging needs and issues identified during Session 1 - brainstorming- group
11:15 – 11:25 am / Recap new agency strategic objectives – Barbara
11:25 - 12 noon / Select priority community health strategic objectives for FY 2011-2012 -NGT Round 1and Round 2- group
12 N – 12:30 pm / Lunch
12: 30 – 12:35 pm / Recap priority community health objectives- Barbara
12:35 - 1:00 pm / Revise priority objectives to match the results desired by the end of the fiscal year- Barbara /group
1:00-1:15 pm / Assign priorities to MT members-Diane and Ramona
1:15-2:15 pm / Discussion of potential Action Plans for each priority objective-group
2:15 - 2:25 am / Break
2:25 - 2:50 pm / Connecting the budget to priority objectives based on preliminary action plans-Ramona
2:50 - 3:00 pm / Evaluation, Next steps – Barbara
Mission and Vision
The basic mission of the agency has been the same since it was established in 2000 but the explanation of the mission was revised at intervals. The Management recommended the elimination of the explanation to further simplify the mission statement and to eliminate the ambiguous "for who" statement. A revision of the vision statement was not recommended.
The Hertford County mission and abbreviated vision statement can be found below. The paragraph highlighted in yellow has been eliminated.
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Overarching Goals
During the 2003 Strategic Planning session, the HCPHA Management Team established 12 overarching goals under which all community health and agency strategic objectives would fall. Prior to this planning session, there were 14 goals; 9 community health goals and 5 agency/internal goals. The Management Team is recommending that five of the goals be revised to provide clarity, five of the goals be eliminated because revised goals now include or they are implied in the other goals. The balance of goals is four community health and five agency goals.
The words underscored have been added. Eliminated words have been struck through. All changes are highlighted in yellow.
Community Health Goals
1. Prevent, detect and control communicable diseases and protect against environmental hazards.
2. Prevent, detect and control chronic diseases through health promotion and risk reduction.
3. Ensure access to health care for all residents through partnerships in the community or direct services.
4. Ensure health services, including skilled home health services, for vulnerable/at-risk populations including the disabled, maternal, child, adolescent, minority and senior adults.
5. Ensure residents are protected against harmful environmental hazards.
6. Provide skilled home health services.
7. Provide health promotion and risk reduction services.
8. Provide health planning and develop resources.
9. Strengthen the Agency’s community relations.
Agency Goals
1. Employ a diverse, professional workforce with strong work ethics and accountability of all staff.
2. Develop and maintain and appropriately utilize of a state of the art information technology systems.
3. Assure appropriate financial management of the Public Health Authority
4. Inform the residents of our services and the impacts of those services on the community’s health
5. Respond to Disasters and to the Community during recovery
Volume Statistics
Some of the volume statistics usually compared for trending were not available for this planning session because of problems at the state level with the Health Information System.
The FY 2010 volume statistics/productivity units were compared to the previous four years and the three or five year average for the past five fiscal years. These tables are available in the appendix. Key points and possible explanations for change in volume include:
Personal Health Services (see page 24)
· Some data not available-unable to print off of HIS.
· Child Health Services provided were higher than have been for the last five years. Primarily due to Flu immunizations and health physicals for pre-K and Kindergarten children at the schools.
· Dental Screens lower than last year. Staff time was more focused in flu vaccinations.
· Total Family Planning visits were up by 149 from last year. Preliminary data reported monthly shows that new client enrollment decreased but the HIS report is the more trusted data source; not currently available.
· Adult Health Services increased by 3,300. The HIS print out was not available but the manager feels that HIV Clients are being reported under adult health now . Also directly observe therapy for TB clients and of course immunizations with Flu shots being higher during the FY 2011 year.
· STD and other communicable disease related services were down slightly.
· Over twice the number of children received immunizations from the health department last fiscal year-predominately the flu vaccine-both regular and H1H1.
Community Health (see page 24)
· Maternity Care Coordination Units of Care were 1,600 units lower than the previous year. Medicaid reimbursement for services was reduced so the staffing level was reduced accordingly.
· Non-billable Maternity Health Services data was not available for analysis.
· Child Services Coordination clients were 17 less than last year. Reduced reimbursement led to reduced staffing.
· Only one Newborn Assessment Visits was completed-short staffed.
Home Health (see page 25)
· The number of admissions in all four counties served were lower than last year; 221 fewer clients total. Staff turnover was the reason given for this reduction in volume.
· Home Health Therapies were up in Hertford, Bertie and Northampton. They were lower in Gates County because occupational therapy services are not available there.
Environmental Health (see page 26)
· Newly installed wastewater systems and site evaluations completed were all lower than have been in previous five years due to the economy.
· Number of wastewater systems repaired increased as did the inspection of existing systems.
· 100% of all food, lodging, childcare centers and swimming/wading pools were inspections were completed-due to a new energetic staff.
Funding Trends
As shown in the following table and graph, the HCPHA Operating Budget increased every year from 2005-2009. The budget decreased slightly in fiscal year 2010 primarily due to:
· A reduction in Medicaid reimbursement for case management services
· Loss or reduced funding for several grant and State funded programs, (Diabetes Sentinel, Regional Diabetes, HIV Services, Health Check)
The operating budget for Fiscal Year 20110 is $5,481,825.
Fiscal Year
/2005
/2006
/2007
/2008
/2009
/2010
Budget
/4.5
/4.8
/5.1
/5.3
/5.4
/5.0
Funding Sources
State public health appropriations were the primary funding source for the agency, followed by Medicare reimbursement during fiscal year 2008 and 2009. In fiscal year 2010, state public health appropriations were again the highest contributors at 41% followed by Medicaid reimbursement for personal health and outreach services at 24%. The county had contributed from 2-4% of the total operating budget the last four years. According to a Profile compiled by NACCHO, the North Carolina average percentage of total local health department revenues from local government is 29%.
Health Statistics