The Affordable Care Act requires all nonprofit hospitals to complete a population-based community health needs assessment and an implementation plan based on the priorities in the Community Health Needs Assessments (CHNA). Currently, many hospitals are working with local health departments to develop the CHNA and the implementation plan. Since these plans must be developed every three years beginning in 2013, it is a great opportunity to expand the resources for population health activities.

The activities and programs of the local public health departments are organized under the three core functions of public health: assessment, policy development, and assurance. The assessment function involves the collection and analysis of information to identify important health problems. Policy development focuses on building coalitions that can develop and advocate for local and state health policies to address the high priority health issues. The assurance function makes state and local health agencies as well as health professionals responsible for ensuring that programs and services are available to meet the identified priority needs of the population.

Nebraska SHIP Priority 4: Nebraska has improved integration among public health, behavioral health and healthcare services.

This SHIP goal includes several activities that were planned for implementation:

• Local health departments complete community health needs assessments in collaboration with local hospitals.
• Local health departments implement community health improvement plans in collaboration with local hospitals.

Over the past thirteen years, all eighteen local public health departments have conducted a comprehensive community health assessment and have repeated the process at least once every five years. A majority of the departments use the Mobilizing for Action through Planning and Partnerships (MAPP) approach to update their local public health improvement plans approximately every five years. This process involves a thorough review of health needs, community health risks (e.g., tobacco use, obesity levels, and environmental quality), and the ease of access to health services (e.g., insurance coverage status, transportation). This process also involves input from a diverse group of community members and the development of local health priorities. Above to the left is a statewide breakdown of the local health departments in Nebraska. Below is a graphic depicting the MAPP process by which the state and some local health departments identify health priorities and formulate health goals.

Click here to learn more about the MAPP process: http://www.naccho.org/topics/infrastructure/MAPP/i...

The activities and programs of the local public health departments are summarized under the associated ten essential services of public health. The ten essential services of public health provide a working definition of the public health system and a guiding framework for the responsibilities of local public health partners.

1. Monitor Health Status to Identify and Solve Community Health Problems

2. Diagnose and Investigate Health Problems and Health Hazards in the Community

3. Inform, Educate, and Empower People about Health Issues

4. Mobilize Community Partnerships to Identify and Solve Health Problems

5. Develop Policies and Plans that Support Individual and Statewide Health Efforts

6. Enforce Laws and Regulations that Protect Health and Ensure Safety

7. Link People to Needed Medical and Mental Health Services and Assure the Provision of Health Care when Otherwise not Available

8. Assure a Competent Public Health and Personal Health Care Workforce

9. Evaluate Effectiveness, Accessibility, and Quality of Services within the Health Care Industry and Public Health Departments

10. Research and Gain New Insights and Innovative Solutions to Health Problems

While many local health departments collaborate to make Nebraska healthier, here is an example from the Northeast Nebraska Public Health Department:

The Northeast Nebraska Public Health Department (NNPHD) built community partnerships through the Mobilizing for Action through Planning and Partnerships (MAPP) process in 2007 and again in 2011-2013. This process includes data collection from every known data set for public health, hospitals, community action agencies, educational institutions, local and regional governmental entities and other non-governmental organizations. The NNPHD and the two Critical Access Hospitals located within the health district, Pender Community Health Center and Providence Medical Center, combined resources, time and efforts to coordinate these work products for the betterment of the community. Other collaborations between local health departments and area hospitals in Nebraska help to improve the quality and comprehensiveness of care for a variety of health priorities. These partnerships aim to create healthier communities and subsequently aid in creating a healthier state.

To learn more about how local health departments contribute to the public health system, please explore the Annual Report on the Public Health Portion of the Nebraska Health Care Funding Act (LB 692): http://dhhs.ne.gov/publichealth/Pages/puh_oph_lhd....