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Local and Tribal Public Health System Improvement Grant

Public Health, Health Improvement Resources

The Public Health and Safety Division (PHSD) in the Montana Department of Public Health and Human Services (DPHHS) received funding from the Montana Healthcare Foundation to strengthen local and tribal health departments and local boards of health, strengthen community partnerships and increase the understanding of community’s health status, and to support targeted public health interventions.

34 local and tribal health departments are participating in the grant; 18 are completing a community health assessment; ten are completing a community health improvement plan and organizational strategic plan; and six are implementing targeted public health interventions.

DPHHS grantees

Public health in Montana is decentralized and most authority for public health lies with the local boards of health. The PHSD developed a two hour training and resource guide for local boards of health and tribal councils that contains an overview of public health, authorities for public health in Montana, an overview of the DPHHS and the PHSD, importance of community health planning, and public health accreditation. An accompanying tabletop exercise helps local health authorities work through a common real-life scenario – how to respond to a contaminated water supply – to reinforce the roles and responsibilities of the board of health, lead local public health official, sanitarian, and other key community stakeholders. To-date, 20 board of health trainings have been completed with additional trainings scheduled in 2016. Board of health or tribal council trainings are available to all local and tribal health departments, not only grant participants.

The impacts of these trainings to-date include many changes that will help improve the effectiveness and value of Montana’s health departments, including updates to bylaws or creation of entirely new bylaws, changes in board composition to ensure compliance with state law, and more regular, engaged meetings of these local boards of health. During 2016, PHSD will continue outreach to local and tribal health departments for board of health and tribal council trainings.

In addition, the PHSD is providing technical support for primary data collection through the use of the Community Assessment for Public Health Emergency Response (CASPER). The CASPER technique is a sampling methodology allowing population estimates for a defined area. The CASPER gives smaller counties and tribes a powerful new planning tool that will allow them to better understand the prevalent health issues in their communities, gather local health data otherwise unavailable, engage the community during the process, and develop a volunteer corps.

Grant activities are also leading to increased collaborations with mental health and primary care through the process of completing community health assessments; increased community participation and engagement; addition of new partners to the community health improvement planning process; and formation of new collaborations for addressing health issues including mental health. In addition, health departments are implementing a chronic-disease self-management program, evaluating and improving a rabies control program, implementing a suicide prevention and intervention project, expanding worksite wellness programs, implementing school wellness programs, and developing formal collaborations between agencies to implement more effective care for patients who are using emergency department services frequently.