Public Health Administration Mark Miller, Director Local Health Services September 11, 2014

Transcription

1 Public Health Administration Mark Miller, Director Local Health Services September 11, 2014

2 Major Personnel Changes -MDCH Sue Moran Jim Haveman Nick Lyons 2

3 Our Guiding Principles Our Mission is to protect, preserve, and promote the health and safety of the people of Michigan with particular attention to providing for the needs of vulnerable and underserved populations. Our vision is for Michiganders to be healthy, productive individuals, living in communities that support health and wellness, with ready access to an affordable, person centered, and community-based system of care. Leadership, Excellence, Teamwork 3

4 The Population Health Approach: Saving Lives & Reducing Health Care Cost Population Health the goal is to improve everybody s health! A comprehensive approach that focuses on health outcomes of a GROUP of individuals INVESTMENT directed at ROOT causes rather than treatment of symptoms Steps BEYOND the individual level-focus of mainstream medicine to address a broad range of factors

5 Population Health: Keeps People Safe and Healthy! Because our Public Health infrastructure is working, you can: Breathe clean air Be safe at work Live without fear of catching diseases Be safe from injury/violence Safe schools, safe walkways, safe streets, seat belts, baby car seats, bike helmets Readily access health care Safely eat at MI restaurants Rely on timely disaster response Tornadoes, floods, extreme heat, flu epidemics, and oil spills

6 Population Health Prevents Illness & Stops Disease in its Tracks It s about health, wellness and safety for YOU and ALL Michiganders: Healthier Homes: Radon and lead testing /remediation, smoke-free air, clean water, safe septic systems, asthma prevention Healthier Families: Prenatal care, newborn screening, breastfeeding, nutrition, safe sleep for babies, family planning, immunizations, healthy parenting, healthy food for pregnant women and children Healthier Communities: Walking trails, farmer s markets, community gardens, smoke-free beaches, swimmable lakes

7 Population Health Works Upstream, Saving Costs Downstream Chronic Disease Costs $10.6B Annually! Heart disease, stroke, cancer, and diabetes are major sources of illness, death, and health care costs Public Health Saves Money By: Promoting personal responsibility and cost-saving health care practices Encouraging healthy behaviors exercise, healthy foods, tobacco reduction, health screenings, immunizations Preventing epidemics and spread of disease Practicing cost-effective and innovative models to promote equity in health care

8 MI Population Health Has Winnable Battles! Winnable Battles are public health priorities known to have proven interventions with a huge health impact. For a good return on investment (ROI) Combat big problems with science & real world solutions to improve health, safety, and productivity in these areas: Food Safety Keep Michigan s food supply safe by preventing and responding to foodborne outbreaks Immunization Improving population health through cost-effective prevention methods a public health Best Buy Health Care-Associated Infections Ensure safety for all Michiganders by reducing healthcare-associated infections HIV Prevent new HIV infections and ensure quality health care for persons living with HIV Motor Vehicle Injuries Keep people safe on the road everyday Nutrition, Physical Activity, Obesity Support all Michiganders in achieving a healthy weight to reduce chronic disease and cost of care Teen Pregnancy Reduce teen pregnancy and its contribution to the poverty cycle for teens and their families Tobacco Prevent initiation of tobacco use, promote quitting, and ensure smoke-free environments

9 FY 2014 Major Initiatives Create a Healthier & Stronger Michigan Implement the Michigan 4 x 4 Plan MI Healthier Tomorrow Before and After-School Healthy Exercise Program Reduce Infant Mortality Home Visitation Program expansion Family, Maternal and Child Health Women, Infants & Children (WIC) Children's Special Health Care Services (CSHCS) Local Public Health Services Local Partners in Health Essential Local Public Health Services 2014 Funding Distribution Disease Prevention and Control Public Health Laboratory Influenza West Nile Virus Lead Abatement Public Health Preparedness 9

10 PHA Strategic Priorities Implement an integrated chronic disease strategy that addresses comorbidities, mental health, and chronic care hot spots Increase access to dental care Review the Public Health Code to better meet and anticipate needs of Michigan residents Reduce prescription drug abuse and increase compliance Increase immunization rates Build upon the 4 x 4 Plan to reduce obesity and further collaborate with partners Improve response from local communities in emergency situations Reduce disparities in health outcomes Provide comprehensive population health monitoring Utilize Michigan s Infant Mortality Reduction Plan to support healthy babies growth and changes in disparities Implement cross-system collaborative strategies to improve health outcomes from preconception through adolescence 5

11 The Michigan 4 X 4 Plan 4 Key Healthy Behaviors 1. Maintain a Healthy Diet 2. Engage in Regular Exercise 3. Get an annual physical 4. Avoid all tobacco use 4 Key Health Measures 1. Body Mass Index (BMI) 2. Blood Pressure 3. Cholesterol Level 4. Blood Sugar Level Strategies: - Public Awareness campaign - Community Coalitions - Policy and Environmental Changes - Businesses - State Level Coordination - State Agencies - Health Care Agencies - Schools 11

12 Strategies to Reduce Obesity Implement Multi Media Public Awareness Campaign MI Healthier Tomorrow Support Community Coalitions State Level Coordination Engage Partners and other State Agencies to Assist with Implementation Steering Committee and multiple work groups convened 12

13 Infant Mortality: Michigan s Plan Reduce Unintended Pregnancies Improve Women s Health Address Social Determinants of Health Expand Home Visiting Establish Progesterone Intervention for Preterm Promote Safe Sleep Implement Regional Perinatal System Eliminate Early Deliveries 13

14 Disease Control, Prevention and Epidemiology Epidemiology Epidemiological response to over 100,000 communicable disease referrals annually Receipt of over 10,000 live emergency department reports DAILY allows rapid characterization of outbreaks and evaluation of impact Toxicology Toxicology response to oil spill (evacuation, river closure reopening) Response to illnesses and deaths associated with substances such as bath salts and synthetic marijuana Immunization 2010: Michigan ranked #4 in U.S. for childhood immunization rates (79%) Michigan Care Improvement Registry contains over 80 million vaccine records for 7.4 million people and accessed by 25,000 users 14

15 Disease Prevention and Control Public Health Lab Over 7.2M services provided to over 356,339 individuals. Infectious specimens tested: 102,776 Newborn screening specimens tested: 121,786 Blood lead/environmental lead specimens tested: 42,058. Fish Monitoring Program Report downloads 8,500 Emergency Notifications >1M message recipients 15

16 Disease Prevention and Control: Lead Abatement $1.25 Million in General Fund Awarded ( FY 14) for Lead Abatement Goal: Abate 80 Homes through the Lead Safe Home Program 16 Homes Completed or lead work in progress Approximately 28 additional homes In or ready for Bidding Process Bidding additional units per month 66 New Applications for Assistance Received Since Funding Began Total Applications On Service List 152 Goal: Perform Elevated Blood Lead Environmental Home Investigations on 60 homes in the Detroit area 10 EBL Environmental Investigations performed or in progress in Detroit since October 1 Expected to complete 60 investigations by year end. Goal: Field services and Lead Inspection and Risk Assessments for families and property owners statewide Includes Lead Inspection, laboratory costs, data entry and lead paint analyzer maintenance On track, In Progress

17 Major MCH Program Areas include: Family, Maternal, and Child Health Family planning Teen pregnancy services Outreach and education for at-risk moms and infants Lead poisoning testing Michigan Model School based clinics - Safe delivery Vision/hearing screening Children s Special Health Care Services 17

18 WIC Supplemental Food Program for Women, Infants and Children 255,954 monthly WIC participants 55% of infants born in MI are on WIC program $184M in food packages for 152,000 families $14M in fresh fruits and vegetables provided to participants Every Ounce Counts campaign to increase breastfeeding rates Funding Source: US Department of Agriculture - $205.4 M Private Revenue - $58.3 M 18

19 Office of Public Health Preparedness Constantly vigilant and monitoring the health and safety of the population through surveillance systems, health security intelligence reports and 24/7/365 staffing of the Community Health Emergency Coordination Center. Coordinate a system for rapid delivery of emergency medications to the population within 48 hours. Assessed 100% ready to respond by the CDC for the past 4 years. Maintain a 140-bed mobile medical field hospital with teams to augment health services when needed during a terrorism incident or other disasters. All 8 Regional Healthcare Coalitions utilize a statewide electronic bed reporting system to identify available hospital beds for appropriate patient care during a disaster response or disease outbreak. Support state, regional healthcare coalitions, local health departments, tribal, healthcare/hospital /EMS and long term care exercises annually for protection of the population s health and quality improvement in emergency response. 19

20 2015 Budget Highlights $18.2 Billion ELPHS funding, up $1.5 million Mental Health and Wellness Commission Jail Diversion Aging Rural Visitation Breast Cancer Screening Diabetes and Kidney Lead Healthy Kids Dental

21 Population Health - Budget Public Health 9.8 M Michiganders 21

22 Essential Local Public Health Services Funds support services in every Michigan County and benefits every Michigan citizen (FY 2015 funding is $40.9 M) Service Examples: Vaccines provided Child vision & hearing screenings Restaurant inspections Service Results: Higher immunization rates, less vaccine preventable disease More children who can see and hear well and learn better in school Safer Food Sexually Transmitted Disease Exams Less cost to the healthcare system for STD complications 22

23 Essential Local Public Health Services $40.8 million for FY2015 Services: Immunization, CD, STD, Hearing and Vision Screening, Food Protection, Public Water Supply, Private Groundwater Supply, and on-site Sewage Management History: Cost-Sharing, LPHO, Review in 2002, ELPHS Future:? Change Allocation?? True Block Grant? 23

24 MI Local Health Department Map Services: 5 million Visits: 4.6 million Patients: 1.4 million 30 County HDs 14 District HDs 1 City HDs 24

25

26

27 Proposed Local Health Departments Outstate Spates Cabot Woods Perkins Brown MDCH Division Health, Wellness And Disease Control, March 2014 STD Section, Jan 07 Villegas Cochran Sheppard (Jackson) Haritos

28 Michigan Health Endowment Fund Blue Cross Blue Shield Listening Tour 12 applications Probably 6-8 Awards MALPH Applied $3-5 Million Awards by October Full and Open Process by 2015 Healthendowmentfund.org

29 Enterovirus-D68 (EV-D68) Severe Respiratory Illness in non-neonatal children Generally million cases per year Increased need for hospitalization Asthma associated No confirmed Michigan Cases KC, St. Louis, Denver Michigan Syndromic Surveillance System MDCH Laboratory Can Test

30 Other Issues Ebola Unaccompanied Alien Children Legislative Priorities: IBM, Scope of Practice, Elliott-Larsen, Roads, Human Trafficking, Medical Marijuana E-cigs Epi-pens Local Health Reimbursement Workgroup Health Plan Rebid

31 MDCH Contact Info and Useful Links Mark Miller: Website: Facebook: Useful Links: Executive Budget: MI Healthier Tomorrow: Michigan Health and Wellness: Michigan Vital Records: Michigan Infant Mortality: Healthy Michigan Plan: 31