INSIGHT & INSPIRATION FROM APHA’S 2012 MIDYEAR MEETING

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8 Survive All In This Friends Prevention, Strategies & Thrive Together For Health Opportunity & Equity for Health A State’s Perspective “Decimated” is the word session presenter Frances Phillips used to describe her state’s public health budget during the last five years. The cuts have been terrible for local health departments and hundreds of jobs have been lost, reported Phillips, deputy secretary for public health at the Maryland Department of Health and Mental Hygiene. But instead of pulling back, Maryland’s public health community is quickly adapting to the new environment and making real progress toward improving health as well as health care — and it has “nothing to do with the budget,” Phillips said. “What is happening locally now is truly phenomenal,” she said. “And that’s really where people’s lives change and where health happens.” Phillips reported on three areas that are helping Maryland public health workers do “more with less.” The first is building collaborative relationships and embedding public health goals into momentum already happening at the community level. As of summer <strong>2012</strong>, 17 local health improvement coalitions were working within a new framework created by Maryland’s recently launched State Health Improvement Process. The process marshals energy around 39 health objectives and sets short-term health improvement targets to be met by 2014. Phillips said that each goal must be backed up with locally available data, noting that it’s not good enough to reference state-level data “unless we can break it down locally where the health improvement action happens.” The state health department assists local coalitions by providing localized data, hosting a convening website and supporting the role of the local health officer in chairing the coalitions. Phillips emphasized that the state health department had zero funding to take on the coalitionbuilding endeavor. But the department capitalized on a “mutual understanding” with hospitals about the role that community prevention plays in helping hospitals come into compliance with ACA directives on quality care. It eventually led to the state hospital association providing about half a million dollars in start-up funds for local health improvement coalitions.
9 Survive All In This Friends Prevention, Strategies & Thrive Together For Health Opportunity & Equity for Health The second area that’s helping Maryland do more with less also involves hospitals — specifically, leveraging new ACA-related financial incentives aimed at improving health care delivery to strengthen community-based care. For example, Phillips said, there’s a lot of pressure on hospitals to avoid preventable readmissions and better manage services for high-cost health care users. In turn, hospitals are looking toward community partners, such as public health departments, to help empower residents with the tools and services they need to stay healthy at home and they’re providing the financial support to help make it happen. Phillips noted that it’s a tremendous opportunity to illustrate public health’s critical role in curbing health care spending. Lastly, Phillips turned to technology, which she predicted would help “advance public health in ways we haven’t even imagined.” Maryland is home to a robust health information exchange, with all 46 acute care hospitals signed on and sending in data. And while the data flowing through the exchange is certainly a boon for the clinical treatment of patients, its potential to enhance public health surveillance and intervention is “huge — it’s almost unthinkable,” Phillips told attendees. So, with funding from a private foundation, the Maryland health department launched the Maryland Health Data Innovation Contest, calling on people to submit innovative ideas on using the exchange data to address public health challenges. The winner, who received a $5,000 prize and worked at the Maryland Poison Center, proposed marrying data from the medical examiner on overdose fatalities with poison control center data on overdose fatalities and near-misses. The combined data can help public health workers conduct needs assessments and better measure the impact of interventions. Maryland’s health department continues to host a website where people can continue the brainstorming process. “We see the role of public health at the state level as a convener of good ideas,” Phillips said. From session 2001/2006, All In This Together: Public Health Community Benefit, June 27
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INSIGHT & INSPIRATION FROM APHA’S 2012 MIDYEAR MEETING

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