For more information on this project, contact Tim Mayer, Environmental Health Director, or Jill Weinischke, PACE EH Coordinator at the Polk County Health Department.
PUTNAM COUNTY HEALTH DEPARTMENT
PACE-EH Project Proposal
Environmental Health Community Involvement and
Innovation
Putnam County Health Department
All Florida county health departments, including Putnam County Health
Department (PCHD) participate in a Quality Improvement review process
through the Florida Department of Health Office of Performance
Improvement. This process assures that all county health departments
remain focused on continuously improving the quality of public health
services to Floridas residents and its visitors. County health
departments operate on a three-year Quality Improvement cycle where
opportunities for improvement are added to the strategic planning
process. PCHD had among the strongest quality improvement reviews of
all county health departments in 2003. During the 2003 Quality
Improvement review, Putnam CHD received commendations for a very
robust Quality Improvement Program and fifteen other program areas.
Commendations are significant achievements that must meet stringent
criteria that meets the standard of being unique, the best, the only
one in the state, and can be replicated by other county health
departments. The PCHD culture of commitment to performance
improvement is based heavily on the continuous assessment of the
communitys health, inclusion of community partnerships in diagnosing
community health problems, and the implementation of
best-practice/science-based interventions. PCHD has an excellent
foundation to ensure the success of PACE-EH.
Environmental health issues have taken center stage in the PCHD
Quality Improvement strategic planning process as a result of major
hurricanes that impacted Florida in August and September 2004.
Torrential rains from Charley, Frances, and Jean caused major flooding
in Putnam County that has lead to contamination of wells, sewage
runoff, and an explosion in mosquito populations. On October 12th, a
mosquito trap was retrieved in western Putnam County that contained
8,000 mosquitoes. The number of trapped mosquitoes that are seen in a
typical year seldom exceeds twenty-five mosquitoes in this area of the
county with numerous ponds that were dried-up prior to the recent
hurricanes. Of the 8,000 mosquitoes that were trapped, 7,000 were
estimated to contain West Nile and equine encephalitis. Putnam County
officials are very concerned about the disease risks to the residents
in this area as well as other residents who live along the St. Johns
River in East Putnam County. Many of the residents in these
communities are poor and/or elderly. Many of Putnams poorer residents
are at high risk of mosquito borne illnesses as a result of living in
non air-conditioning housing without screens on their windows and
doors.
Hurricanes have also created significant problems with drinking water.
Since the majority of Putnam County residents utilize wells as their
main source of potable water, there have long been significant
environmental health concerns that have worsened since the storms.
Anecdotal data from PCHDs own Environmental Health Program
specialists, Health Department medical professionals, and the local
medical community all suggest that there has been an increase in
bacterial, protozoan, and insect related illness and that these
problems may worsen before they improve. According to the Office of
Planning and Data Analysis most recent figures from 2000, Putnam
County already had high enteric disease rates per 10,000 population
that were 47% higher than the state rate (6.96 versus 4.73). The
enteric disease rate for children under age six is 3.99 per 1,000
children or 48.3% higher than the state rate of 2.69.
In March 2003, the PCHD began development and implementation of its
2003-2007 Quality Improvement strategic plan. One of the most
important goals that the Putnam County Quality Improvement Committee
has identified for 2003-2007 is the accomplishment of a comprehensive
community health assessment process.
Responding to important public health problems and focusing on
continuous organizational improvement have always driven PCHDs
strategic planning process. However, in 2003-2007, the completion of a
community needs assessment process has specifically been added to the
Quality Improvement plan. A community needs assessment that includes
all relevant stakeholders will have the effect of correctly
prioritizing those health and quality of life issues that are most
important to the community. It will also act as a workforce multiplier
by bringing together a larger number of persons with broad expertise
to help resolve the communitys problems. An area of particular
strength for the PCHD has been its ability to identify grant funded
science-based interventions that are replicable in the context of our
unique rural setting. This increases the assurance of success of
PACE-EH.
The Protocol for Assessing Community
Excellence (PACE)
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Although PCHDs long range goal is to complete a comprehensive
community health assessment that will focus on all aspects of the
health of the community, the current environmental health issues
indicate that there is a greater sense of urgency in developing
interventions. PACE-EH can be accomplished more quickly than MAPP.
However, PACE-EH will not prevent the simultaneous preparation for a
broader community health planning effort through the Mobilizing for
Action through Partnership and Planning (MAPP). The completion of
PACE-EH will in fact improve the outcome of future MAPP efforts
through the experience that community partners gain by working
together to accomplish coordinated and interventions.
The PACE-EH process will be implemented utilizing the NAACHO PACE-EH
Guide. In fact, PCHD has already begun to initiate components of
PACE-EH and has begun to take steps to address identified needs. These
steps include
| PACE-EH Steps |
Person Responsible |
Completion Date |
1. Assess Agency and Community
Capacity
The PCHD has already begun preparations for completing a
community-based health assessment process by making
presentations to community leaders during a quality improvement
retreat in March. In May 2004, community-based health assessment
and planning was presented to the quarterly County Logic Meeting
that includes all city and county government officials. In July
2004, the PCHD formed a Chronic Disease Workgroup that includes
selected local leaders from the PCHD , Putnam County School
District Administration, Putnam County School District Nutrition
Services, North Palatka Weed and Seed District, Redlands
Christian Migrant Association, Corner Drug Store, Inc (substance
abuse and mental health services/youth shelter services), the
Drug Awareness Program, Palatka Police Department, Putnam
Community Health Center, Lee Conlee House Domestic Violence
Program, University of Florida Department of Dentistry (retired
dentist), and the Palatka Housing Authority. PCHD has
demonstrated commitment to this effort through inclusion of key
staff that includes the acting director for Environmental
Health, WIC Coordinator, Nutritionist, Social Work Services
Program Manager, and the Epidemiology Nurse. The Chronic Disease
Workgroup has met five times since July and has completed an
initial assessment of the community health priorities and
assets. The workgroup has also provided a forum to planning a
community-wide health assessment and it has begun to work
collaboratively on specific grant applications to address high
priority health issues in the county. The workgroup has worked
collaboratively to complete a breast cancer funding request to
Avon Foundation, is completing work on a Johnson and Johnson
Foundation grant application to address diabetes, and the
workgroup is supporting this proposal for PACE-EH. |
PACE-EH Coordinator, QI Team |
Jan 1-05 |
2. Define and Characterize the
Community
This process has been started through the Quality Improvement
Committee that has identified important persons in the community
who need to be involved in the community needs assessment
process. |
PACE Coordinator, QI Team |
Jan 1-05 |
3. Assemble a Community
Environmental Health Assessment Team
On October 11, 2004, the Chronic Disease Workgroup met and
agreed that an initial PACE-EH environmental health assessment
team would include the following representatives: All members of
the Chronic Disease Workgroup, representatives from the Putnam
County Commissioners, County Code Enforcement officials, City
government officials, St. Johns River Management District, city
public works officials, mosquito control representatives,
representatives from the Florida Department of Environmental
Protection, Florida Department of Fish and Game, local medical
professionals, representatives from the faith community,
minority representation, and private citizens. |
PACE Coordinator, QI Team |
Jan 1-05 |
4. Define the Objectives of the
Assessment
This will be accomplished by the PACE-EH Assessment Team and
will be led by the Social Work Services Program Manger who has
completed the Florida Department of Health sponsored
Facilitative Leadership Training. |
PACE Assessment Team |
Feb-1-05 |
5. Generate the Environmental
Health Issue List
The PACE-EH Assessment Team will develop a community forum that
will be well publicized and will include full representation of
the community and those who will be impacted by the strategies
that are developed. The process will utilize extensive sources
of data that will include community health profiles from Florida
CHARTS, County Behavioral Risk Factor Analysis, local
Environmental Health data, and local health data. In addition, a
community needs assessment questionnaire will be developed and
administered throughout the county. |
PACE-EH Assessment team, Community
Focus Group |
Mar-1-05 |
6. Describe the Environmental
Health System
This will include a strengths assessment and unmet needs
assessment of current systems that address environmental health
related issues. This will also include an assessment of barriers
to change and unique concerns within the county. |
PACE EH Coordinator, PACE-EH
Assessment Team |
May-1-05 |
7. Identify Appropriate
Community Environmental health Indicators
The PACE-EH Assessment Team, in conjunction with the Community
Focus Group will narrow the discussion of environmental health
issues into manageable action steps. |
PACE-EH Assessment Team, Community
Focus Group |
Jun-1-05 |
8. Select Standards
The PACE-EH Assessment Team will determine how success will be
measured based on the results of local data and the development
of quantifiable outcomes. |
PACE-EH Assessment Team |
Sep-1-05 |
9. Create Issue Profiles
Environmental Health priorities will be determined by the
Community Focus Group process. |
PACE-EH Assessment Team |
Oct-1-05 |
10. Rank Issues
The Community Focus Group will rank environmental issues, based
on such factors as potential for serious risk to the public
health, perception of significance to the community, the values
of the community, challenges from competing interests, local
capacity to implement interventions, types of resources
available, commitment to address identified problem areas,
leadership, and financial capacity. |
Community Focus Group |
Oct-1-05 |
11. Set Priorities for Action
For each environmental health issue that the Community Focus
Group identifies, an action plan will be developed that is
expected to improve or resolve the concern. This plan will
include specific interventions that will be used, who will be
responsible for the intervention, target dates for completion,
and how we will know that the goal has been achieved. |
Community Focus Group |
Oct-1-05 |
12. Evaluate Progress
The data systems of FMDC, PCHD, Putnam Community Health Center,
and other local sources will be used to track progress. In
addition, Community Focus Groups and follow-up questionnaires
will be used to identify improvements, changes, challenges, and
opportunities for improvement in the environmental health target
areas. |
PACE-EH Coordinator, PACE-EH
Assessment Team, Community Focus Group |
Dec-1-05 |
13. Define Success
Definitions for success will be developed for each action
priority. The determination of success will be completed in
Community Focus Groups with refinements in definitions through
the Assessment Team. The definitions of success will be
quantifiable, measurable, and specifically tied to each action
priority. PCHD will provide leadership to the process by helping
to identify science-based interventions to replicate that have
been proven to be successful in other communities with similar
rural characteristics. |
PACE-EH Assessment Team, PACE-EH
Community Focus Group |
Dec-1-05 |
The Putnam County PACE-EH project will be defined as the
accomplishment of the thirteen steps outlined in the Protocol for
Assessing Community Excellence in Environmental Health (PCE-EH).
Success also will be defined as having completed the PACE-EH steps
with full involvement of the community and the successful
implementation of science-based interventions.
What will be Purchased with the Dollar
Amount?
|
PACE-EH funds will be utilized to pay for one fourth of the salary
of the Social Work Services Program Manager for one year. The SWSPRM
is a professional position that is part of the Putnam County Health
Department Management Team. The duties of the person in this position
include collaborating with community partners in defining public
health priorities and developing grant funding applications to address
identified health needs. In addition the SWSPM works as part of the
Quality Improvement Team Benchmarking Committee and identifies
science-based intervention models that can be replicated within the
community. Other duties include providing clinical and administrative
supervision for domestic and sexual violence intervention program
services and assisting the Health Department in developing renewal
contracts for health department programs that are grant funded. The
costs associated with PACE-EH include:
Salary
-
Project Manager Social Work Services Program Manager
.25FTE $11,816
-
Fringe Benefits .25 FTE SWPSM salary X 38% $ 4, 489
-
Travel (100 miles per month X 12 months X $.29 per
mile) $ 348
-
Photocopying $ 600
-
Printing of Survey Results $ 2,447
-
Supplies and Materials for meetings $ 300
-
Total $20,000
Expectations of the project continuing
after 12-month period
|
The PCHD and its community partners are committed to continuing the
PACE-EH process indefinitely after the first year through continued
participation in the process and through in-kind donations for PACE-EH
activities. In addition, an established Chronic Disease Workgroup will
continue to bring together a group of professionals from within the
community to complete funding applications to support priority health
initiatives within the county.
Contact Information: Larry J. Kearley, LCSW, CAPP
Social Work Services Manager, QI Benchmarking Chair
Address: Putnam County Health Department
2801 Kennedy Street
Palatka, FL 32177
Phone: (386) 326-3232 Fax: (386) 326-3350
Suncom: 868-3200 Suncom Fax: 868-3350
Administrator: Laurey S. Gauch, Administrator
Address: Putnam County Health Department
2801 Kennedy Street
Palatka, FL 32177
Phone: (386) 326-3221 Fax: (386) 326-3350
Suncom: 868-3200 Suncom Fax: 868-3350
Business Manager: Robin Wright, Administrative Services
Director
Address: Putnam County Health Department
2801 Kennedy Street
Palatka, FL 32177
Phone: (386) 326-3254 Fax: (386) 326-3350
Suncom: 868-3350 Suncom Fax: 868-3350
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