Reading from the Same Page: New Jersey Drafts Public Health Practice Performance Standards for Local Health Departments

Development of practice standards for local public health officials

In 1999, the National Partnership for Social Enterprise worked with the New Jersey Department of Health and Senior Services (DHSS) to convene a group for rewriting public health practice standards for New Jersey's local health departments.

The Partnership, located in Morristown, N.J., is a nonprofit research group with expertise in health/health care and systems development.

The Problem

When the grant was made, New Jersey's public health system consisted of independent local health departments providing categorical programs without an integrated statewide systems approach. The system neither maximized the development of expertise regionally nor provided for collaborative partnerships between local health departments and community partners.

As part of the statewide effort to reengineer and modernize New Jersey's public health infrastructure, DHSS created a series of major initiatives, one of which was to develop state-of-the-art public health practice performance standards for local health departments.

Key Results

  • The National Partnership for Social Enterprise convened the writing group in a retreat from August 3–5, 1999, in Basking Ridge, N.J. In attendance were 19 participants representing 10 health-related associations and academic institutions in the state. (See Appendix 1 for details.) Subsequent meetings for further review and revision were held on November 29, 1999 and September 9, 2000.

    Writing group members were asked to analyze and recommend modifications to a working draft of practice standards, which were based on the 10 Essential Public Health Responsibilities that had been outlined by the 1997–1998 Public Health Task Force convened by DHSS and facilitated by National Partnership for Social Enterprise. (See Appendix 2 for details.)

    The Partnership's work was also defined by the task force's determination that to ensure public health capacity based on integrated systems, the local governmental public health system for New Jersey must:
    • Facilitate regional service capacity.
    • Base service delivery requirements on health assessments and risk factor surveys.
    • Emphasize the critical need for local partnerships with hospitals, medical practitioners, community organizations and policy officials.
    • Promote strong community relationships.
    • Allow communities the flexibility they need to meet their local health needs and to adapt quickly as roles and responsibilities change over time.

    At the retreat, the writing group produced a report called "Comments from Retreat & Executive Committee," in which comments and suggestions by each participant were detailed for each subchapter within a larger document, "Public Health Practice Standards for Local Health Agencies in New Jersey."

    After the retreat, project staff produced a work incorporating these suggestions, called "Draft Public Health Practice Standards for Local Boards of Health" (New Jersey State Sanitary Code 2001). This draft was reviewed by several health-related associations in New Jersey, the public health academic community, and the federal Centers for Disease Control and Prevention. It is expected that final rules will be adopted by December 2001 and implementation will occur over a three- to five-year period.

Dissemination

Project staff made four presentations on the project to health-related associations in New Jersey, devoted an issue of Public Health Practice Standards Newsletter to the topic, and wrote an article published in the September 2000 issue of Journal of Public Health Management and Practice.

After the Grant

Further work on the project of reengineering the state's public health infrastructure includes a Request for Applications, sent out on June 26, 2000, to all of New Jersey's 115 health departments, with the goal of funding three demonstration models that would follow the new practice standards:

  • A countywide model in which there is no county health department — that is, counties with only local health departments.
  • A multicounty model in a rural area, with two, three or four counties coming together to plan public health systems for those counties.
  • A mixed model, with counties that have county health departments whose jurisdiction does not extend throughout the county — that is, municipal and/or regional health departments holding jurisdiction in some areas of the county.

Project staff also plan to develop a performance measurement and accountability system to ensure that quality public health services are provided for all citizens of the state.

Funding

The Robert Wood Johnson Foundation (RWJF) supported this project through a grant of $9,300. The retreat project also received additional support from the Preventive Health and Health Services Block Grant in the amount of $5,000. In-kind contributions were made by DHSS and by numerous local and county governments and public health organizations through commitment of their professional staff's time.