A Healthier Future for West Virginia - Healthy People 2010

23 - Public Health Infrastructure

Objectives

Background

In the mid-1990s, public health officials in West Virginia realized that without major restructuring and increased financial support there was an extreme risk of local health departments closing their doors. Many health departments were already reducing staff and relying on clinical programs to provide financial support. In response to this crisis, officials began addressing how to improve health care in rural West Virginia. These discussions centered around the problems of improving access and quality of care and eliminating wasteful and unnecessary duplication of services. Since that time, state and local officials have taken major steps to create a stronger public health infrastructure that integrates activities throughout the state and local levels by improving the systems, competencies, relationships, and resources that enable county health departments to perform essential basic public health services.

Among policymakers and public health professionals in West Virginia, there has been a growing sense that public health, either as a governmental activity or commitment of society, is neither clearly defined, adequately supported, nor fully understood. Therefore, it became evident that the purpose and delivery of public health needs to be examined and incorporated fully into the future community health care system to ensure its continued availability.

The mission of public health in West Virginia is to establish a public health system designed to:

• assess and monitor the health status of the population;
• promote a healthy and productive life for West Virginians;
• protect the public's health from adverse environmental factors, and
• assure a health care delivery system that has adequate resources and qualified public health professionals to provide a continuum of care including basic disease control activities; comprehensive primary care; coordinated emergency medical services, and integrated hospital services.

The West Virginia Bureau for Public Health (WVBPH) is the centralized governmental body that manages public health in West Virginia. Organizationally, it is composed of eight offices in addition to the Commissioner's Office. These offices are Community and Rural Health Services, Maternal, Child & Family Health Services, Epidemiology and Health Promotion, Chief Medical Examiner, Environmental Health, Nutrition, Laboratory, and Health Facilities Licensure and Certification. These offices provide certain funding, technical assistance, training, and oversight activities to local public health departments and other health care providers. The Commissioner of the Bureau for Public Health is the state health officer and is the overseer of the operations of WVBPH offices and is responsible for the distribution of state funding and enforcement of public health laws.

West Virginia has 55 counties. Each county commission is responsible for creating, establishing, and maintaining a county board of health. Forty-seven counties have their own public health administrative offices. Two counties have united under one board of health. The remaining six counties have established a combined board of health. Each local board of health is responsible for directing, supervising, and carrying out matters relating to the public health of their respective counties or municipalities. The purpose of the board is to insure the consistent performance of duties related to basic public health services and other health services and the enforcement of the laws of this state and county ordinances pertaining to public health. WV State Code defines basic public health services as those services that are necessary to protect the health of the public and that a local board of health must provide. The three areas of basic public health services are communicable and reportable disease prevention and control, community health promotion, and environmental health protection. Each board must appoint a physician to serve as the local health officer. The local health officer supervises and directs the activities of the local board's health services, health department employees, and facilities. The health officer must also enforce county and state public health laws and submit reports to the state on communicable and reportable disease.

The Public Health Infrastructure's Healthy People 2010 objectives focus on the components that support the delivery of basic public health services: a skilled work force, integrated electronic information systems, computer technology, technical support and training, performance-based standards, and a linked state and local public health system improvement plan.

The Objectives

OBJECTIVE 23.1. Increase public health employee access to the Internet.
23.1a. Increase the number of local health departments with at least one Internet workstation to 100%. (Baseline: 51% in 1999)
23.1b. (Developmental) Increase the proportion of local health departments that provide Internet and e-mail access for at least 75% of their employees. (Baseline data available in FY2001)

Data Sources: West Virginia Bureau for Public Health (WVBPH), Office of Community and Rural Health Services (OCRHS), Division of Public Health Nursing and Administration (PHNA); Department of Health and Human Resources (DHHR), Management Information Systems (MIS)

OBJECTIVE 23.2. Increase access to continuing education and training for public health agency employees to develop competency in basic public health services.
23.2a. Increase the number of continuing education units (CEUs) in public health studies made available to public health nurses to allow them to meet 100% of their continuing education requirements, either by initiating trainings or providing information to all health departments on access to trainings available through other sources. (Baseline: 50% in 1999)
23.2b. (Developmental) Increase the number of trainings provided by the DHHR - WVBPH to meet 100% of the continuing education requirements for certification for public health sanitarians. (Baseline data available in 2000)

Data Sources: WVBPH, OCRHS, PHNA; Office of Environmental Health Services (OEHS)

FLAGSHIP OBJECTIVE
OBJECTIVE 23.3. Increase to 232 the number of public health performance-based standards that local health departments are required to meet as defined in WV State Code 16-1-2. (Baseline: 133 in FY2000)

Data Source: WVBPH, OCRHS, PHNA Annual Program Plan

OBJECTIVE 23.4. Increase to 100% the percentage of local health departments that link their health improvement plan with a statewide public health system improvement plan. (Baseline: 0% in FY2000)

Data Source: WVBPH, OCRHS, PHNA

OBJECTIVE 23.5. Increase to five the number of state regional epidemiologists that provide or assure comprehensive epidemiology services to support basic public health services for local health departments. (Baseline: three in 2000)

Data Source: WVBPH, Office of Epidemiology and Health Promotion (OEHP), Division of Surveillance and Disease Control

OBJECTIVE 23.6. (Developmental) Increase the proportion of state public health laws, rules, and regulations that are reviewed and evaluated to assure the delivery of basic public health services and submit proposed legislation as needed for revisions. (Baseline data available in 2000)

Data Source: WVBPH, Legislative and Regulatory Subcommittee

OBJECTIVE 23.7. Increase to 90% the proportion of local health departments that gather data in a consistent manner on the cost of delivering basic public health services as defined in WV Code 16-1-2. (Baseline: 14% in 1998)

Data Source: WVBPH, Basic Public Health Services Cost Subcommittee

Meeting the Objectives

Health Promotion Channels for Achieving Objectives:

• Worksites
• Schools
• Public Health Programs
• Networks
• Health Care System
• Higher Education

Strategic planning has already begun to meet the 2010 objectives. Increased state and local funding has provided each health department with computers to allow electronic data collection and transmission of reports. Public health work force needs have been identified through a statewide survey. Committees of state and local public health workers have been organized to develop performance standards and to implement a quality improvement plan.

A technical assistance and training committee is now developing continuing education and staff development for public health employees. Current public health laws are being reviewed and revised by the Legislative and Regulatory Subcommittee. A financial committee has been formed to determine the cost of delivering basic public health services.

The interaction between local and state government is a combined effort defining the role of public health agencies in enhancing the health of the community. The vision is to revitalize the public health infrastructure and rebuild the system of public health at all levels of government and to have vital elements in place to assure the public health mission is addressed.

Work Group Members

Janet Briscoe, RN, BSN, Work Group Leader, Nursing Coordinator, Division of Public Health Nursing and Administration, WVBPH
Ann Bolyard, Transition Coordinator, Division of Health Promotion, WVBPH
Julie Miller, RN, MSN, Administrator, Boone County Health Department
Omayma Touma, MD, Health Officer, Cabell-Huntington Health Department
Dan Christy, Director, Health Statistics Center, WVBPH
Chris Curtis, Assistant Commissioner, WVBPH
Stan Mills, Cabell-Huntington Health Department
Mickey Plymale, Administrator, Wayne County Health Department
Cathy Taylor, Workforce Development Coordinator, WVBPH
Karen Dawson, RN, BSN, Administrator, Clay County Health Department
Joyce Holmes, Associate Director, Division of Health Promotion, WVBPH
Henry G. Taylor, MD, MPH, Commissioner, WVBPH
Kay Shamblin, RN, BSN, Director, Division of Public Health Nursing and Administration, WVBPH

For More Information

Public Health Nursing and Administration
Office of Community and Rural Health Services
350 Capitol Street, Room 515
Charleston, WV 25301-3716

This page was last updated June 27, 2001.
For additional information about HP2010, contact Chuck Thayer at (304) 558-0644 or Chuck.E.Thayer@wv.gov