Kandiyohi - Renville Community Health Board ***** Horizon Public Health
Kandiyohi-Renville Community Health Board Harlen Madsen, Kandiyohi County Board of Commissioners and Kandiyohi-Renville CHB Jill Bruns, Kandiyohi-Renville Community Health Administrator Horizon Public Health Todd Schneeberger, Grant County Board of Commissioners and Horizon CHB Sandy Tubbs, Horizon Public Health Administrator
Today s Goals: Describe the spectrum of cross-jurisdictional sharing (CJS) arrangements or shared services Consider potential motivations for change Gain insight into what makes it work? Or not.. Become familiar with the Roadmap for CJS Initiatives Know where and when you might hit the potholes Learn from the experiences and celebrate the accomplishments of two CJS initiatives
Cross-jurisdictional sharing is the deliberate exercise of public authority to enable collaboration across jurisdictional boundaries to deliver essential public health services. Collaboration means working across boundaries and in multi-organizational arrangements to solve problems that cannot be solved or easily solved by single organizations or jurisdictions.* *Source: Rosemary O Leary, School of Public Affairs and Administration, University of Kansas
Cross-Jurisdictional Sharing Spectrum Informal and Customary Arrangements Service Related Arrangement Shared Functions with Joint Oversight Regionalization Handshake Information sharing Equipment sharing Assistance for surge capacity Service provision agreements (contract for public health nuisance ) Purchase of staff time (Dietician services for WIC program) Joint projects addressing one or more jurisdictions (shared SHIP program) Shared capacity (e.g., joint Env Health services) New entity formed by merging existing LHDs Integration of 1 or more LHD into existing LHD Looser integration Tighter integration
Reduced costs both overall costs and unit costs Greater productivity and economy of scale Ability to employ more robust and current service management systems Increased eligibility in some instances for state and federal grants
Greater range of public health services and/or functional capacities available Improved quality of services - Timeliness - Accessibility - Professional level Ability to meet state, national or other performance standards
A roadmap to develop cross-jurisdictional sharing (CJS) initiatives Developed by the CSPHS Based on learnings from demonstration sites (and other published material) See handout Also available at: http://www.phsharing.org/roadmap/
Phase 1: Explore Is CJS a feasible approach to address the issue you are facing? Who should be involved in this effort? Phase 2: Prepare and Plan How exactly would it work? Phase 3: Implement and Improve Let s do it!
Phase 1: 2013 - Forming a single Community Health Board Motivation for change What made it work? Where were the potholes?
The Constituents of Kandiyohi and Renville Counties Kandiyohi County Renville County Kandiyohi Renville Community Health Board Kandiyohi County Local Board of Health Renville County Local Board of Health CHS Administration Agency Renville County CHS Finance Agency Kandiyohi County CHB Legal Advisor CHB Advisory Committee CHB Medical Consultant Kandiyohi County Public Health Renville County Public Health CHS Administrator Jill Bruns Director of Finance Ann Stehn Medical Consultant Medical Consultant CHS Administration Services CHS Fiscal Services Performance Improvement and Planning Dark Line indicates delegated agreement Dash Line indicates contractual services This organizational chart is for programs and contracts where the Community Health Board has authority and responsibility. Please see Joint Powers Agreement and Delegation Agreements. Shared Services such as Environmental Health, SHIP QI Councils, TBD
Phase 2 : Full integration of Environmental Health Project Goals: Align policies, procedures, categories, fees, and ordinances between Kandiyohi and Renville Counties by November 30, 2013. Issue licenses to establishments as one entity (Kandiyohi-Renville CHB) by January 1, 2014. Standardize environmental health inspections and documentation across the health department by October 31, 2014.
The Partners Kandiyohi-Renville Community Health Board Environmental Services Integration Meeting at least monthly : Jill Bruns, Administrator; Dave Distad, EHS; Chris Wenisch, EHS; Denise Kragenbring, Supervisor; Brenda Menier, MDH Consultant (Board Member Harlan Madsen has also been vested in the project) The Idea Kandiyohi and Renville County joined to form a new Community Health Board (CHB) on Jan 1, 2013. To continue with a delegation agreement with the Minnesota Department of Health, we were required to integrate our environmental health licensing functions to meet standards. The CHB strongly desired to keep the licensing local and to make the environmental health program stronger and of better quality for both the citizens and licensed establishment we serve.
Phase 1: Forming a single CHB (Douglas and Mid-State merged in 2011) Phase 2: Integration of 3 separate Public Health Departments (Douglas, Pope and Stevens Traverse Grant) into a single 5-county Public Health Department (January 1, 2015) Goal was to answer one question: Will integration of three local health departments result in a more efficient and effective Public Health Department with greater capacity to meet the current and future challenges facing our communities?
A strong and stable trunk supports a healthy tree with many branches laden with green, full leaves. A strong and stable public health structure supports a healthy public health department with robust programs and services that meet the changing needs of the population it serves.
Following the Roadmap What made it work? Or not? Where were the potholes?
The biggest Aha! Moment was: From a Commissioner perspective From an Administrator perspective The one thing that I would do differently would be to: From a Commissioner perspective From an Administrator perspective The single greatest benefit of this shared services arrangement is: From a Commissioner perspective From an Administrator perspective