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The Rise of Maine\'s First County Health Department
 

The Rise of Maine\'s First County Health Department

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The Sagadahoc County Board of Health is the first and only county board of...

The Sagadahoc County Board of Health is the first and only county board of
health (BOH) in Maine. This presentation will cover the genesis of a locally-built,
collaborative, volunteer county BOH; describe a unique approach to building
political will, professional support, and sustainability; and demonstrate how to
engage local stakeholders in meaningful, innovative public health initiatives
addressing the Ten Essential Public Health Services.

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  • Greetings. There are many, many famous people from Omaha. Among them are: Marlon Brando Montgomery Clift Peter and Henry Fonda Nick Nolte Warren Buffet Buddy Miles Andy Roddick Another famous Omahan was Malcolm X. If you have no critics you'll likely have no success. Malcolm X Stumbling is not falling. Malcolm X The future belongs to those who prepare for it today. Malcolm X
  • At the conclusion of this presentation and discussion, you will be able to: Describe the genesis of a locally-built, collaborative, volunteer County Board of Health Apply our unique approach to building political will, professional support, and sustainability for Maine’s first County Board of Health Replicate meaningful, innovative public health initiatives addressing the 10 Essential Public Health Services using best-practice methodologies
  • How many of you have ever been to Maine? What are your impressions? Maine is the northernmost portion of New England and is the country's easternmost state. It is known for its scenery—its jagged, mostly rocky coastline, its low, rolling mountains, and its heavily forested interior. Maine is the only U.S. state to have a name that is one syllable long, and, in bordering New Hampshire, is the only state which borders exactly one other state. Sagadahoc County
  • Sagadahoc County, displayed in the shaded region in the satellite image here, is located southern mid coast region of Maine. As of 2000, the population was 35,214. Its county seat is Bath . [1] In land area, it is the smallest county in Maine.
  • What you will notice in this zoomed image is that Sagadahoc County has a really funny shape. Like most municipal and county lines, Sagadahoc is largely based on waterways. This is a rural, suburban, and island county with A LOT of fresh and salt water dissecting it.
  • Sagadahoc County is a county located in the U.S. state of Maine . As of 2000, the population was 35,214. Its county seat is Bath . [1] In land area, it is the smallest of 16 counties in Maine, with a total area of 370 square miles. But it is 12 th in terms of population. Sir William Popham’s colony, having erected buildings and constructed a vessel, after a few months’ sojourn abandoned their settlement in 1608; but English fishermen and trappers continued to visit the rivers and shores of the County. Capt. John Smith, of Virginia fame, explored the region in 1614 ; Early European charters that included the land area currently known as Maine include two charters granted by James I of England. These were the Virginia charter of April 10, 1606, and the New England charter of  November 3, 1620. The charter of the Province of Maine was granted by Charles I to Sir Ferdinando Gorges in 1639. York County was established in 1640. It included all of present-day Maine. Lincoln County was set off from York in 1760. Sagadahoc County was incorporated from Lincoln in 1854. It is the smallest and newest county in Maine. The name "Sagadahoc" comes from the Abanaki word for the meeting of a river and the sea.The municipalities presently within Sagadahoc County are: Arrowsic, Bath, Bowdoin, Bowdoinham, Georgetown, Phippsburg, Richmond, Topsham, West Bath, and Woolwich -- one city (Bath) and nine towns. = 10 municipalities As of the census [4] of 2000 [5] , there were 35,214 people, 14,117 households, and 9,641 families residing in the county. The population density was 139 people per square mile (54/km²). There were 16,489 housing units at an average density of 65 per square mile (25/km²). The racial makeup of the county was 96.49% White , 0.92% Black or African American , 0.31% Native American , 0.63% Asian , 0.06% Pacific Islander , 0.38% from other races , and 1.21% from two or more races. 1.11% of the population were Hispanic or Latino of any race. There were 14,117 households out of which 33.20% had children under the age of 18 living with them, 54.60% were married couples living together, 9.60% had a female householder with no husband present, and 31.70% were non-families. 25.20% of all households were made up of individuals and 9.30% had someone living alone who was 65 years of age or older. The average household size was 2.47 and the average family size was 2.96. The median income for a household in the county was $41,908, and the median income for a family was $49,714. About 6.90% of families and 8.60% of the population were below the poverty line , including 12.20% of those under age 18 and 6.40% of those age 65 or over. 22.0% were of English , 11.6% Irish , 11.1% French , 10.6% United States or American, 8.0% French Canadian and 7.3% German ancestry according to Census 2000 . 96.1% spoke English and 2.2% French as their first language. SAGADAHOC mean “THE MOUTH OF THE RIVER” [go back one slide to show river mouth]
  • Dr. Hugh Tilson who provided the impetus for the creation of Maine’s first County Health Department, run by a Board of Health, in Sagadahoc County believes very strongly in the County model. Most public health systems in the U.S. are either county-based or at least rely heavily on counties to provide local focus for sub-state decentralized programs. Maine does not. A group of us, lead by Dr. Tilson convinced the Sagdahoc County Commissioners that this was not only a good idea, but was essential. We believe that a county health structure has three fundamental bases: First, local public health is important. An effort in any public arena which is solely based in its state’s capital will not work because people need services locally. Second, public health requires government efficiency. In Maine, the public health infrastructure had devolved into each of the 488 municipalities. That’s too many, because public health requires focused effort and you cannot easily muster the necessary skills and energies in 488 individual enterprises. Third, public health requires governance. There is a national consensus that protecting the public health requires a political jurisdiction. We selected counties as a place for that. After all, to enforce health laws today we often need the courts and the sheriff, which are both county based. It made sense to turn to counties for leadership in this area. The structure for such a county organization was already in place. Lastly, the data told us so. Let me explain . . .
  • VISION – healthy people in healthy protected communities. (read full vision) MISSION – (read full mission) ORGANIZATION – read full organization) MEMBERSHIP - summarize Formal Structure Chair LHO Report Agenda and Minutes are public Ex-Officio Members and Guests GOVERNANCE – Board elects a Chair and Chair-Elect from its membership CONDUCT Bimonthly Meetings – Robert’s Rules of Order are followed BOH County Courthouse LHO City Hall
  • Who we are is as important as what we do. For it is the membership, both in terms of expertise at the table, as well as representation of our most vulnerable populations, that makes this enterprise so rich and meaningful. We have representatives from . . . on our Board and as regularly attending ex-officio members.
  • Meaning and accountability Including the 10 essential services Leadership Model the way Inspire a shared vision Challenge the process Enable others to act Encourage the heart (Kouzes & Posner)
  • 2.1 History When Maine became a state in 1820, there was very little public health infrastructure. This continued until 1885, when the legislature authorized Maine’s municipalities to establish local Boards of Health, each headed by a Local Health Officer (LHO). Over the next three decades, the State Board of Health gradually gained authority over statewide activities such as drinking water and restaurant inspections. The programmatic and regulatory functions of the State Board of Health became the Maine Department of Health in 1917.That following fall, the 1918 influenza pandemic swept through Maine, claiming the lives of about 5,000 people, mostly adolescents and young adults. Almost 500 independent local boards of health attempted to control the pandemic with little consistency and oversight, with mixed results. In 1919, immediately following the pandemic, the Maine legislature transferred all statewide health guidance to the Maine Department of Health. The municipal requirement for having a Local Health Officer was retained, but health officers were placed under the direct supervision of the Department of Health, and their duties focused on reporting public health threats to the state.In 1931, the Department of Health became the Bureau of Health within the Department of Health and Welfare. The Bureau of Health became the Maine CDC in 2005 as part of the new Department of Health and Human Services.
  • Greetings. There are many, many famous people from Omaha. Among them are: Marlon Brando Montgomery Clift Peter and Henry Fonda Nick Nolte Warren Buffet Buddy Miles Andy Roddick Another famous Omahan was Malcolm X. If you have no critics you'll likely have no success. Malcolm X Stumbling is not falling. Malcolm X The future belongs to those who prepare for it today. Malcolm X

The Rise of Maine\'s First County Health Department The Rise of Maine\'s First County Health Department Presentation Transcript

  • The Rise of Maine’s First County Health Department Steven J. Trockman, MPH Chair, Sagadahoc County Board of Health 18 th Annual Conference  August 6, 2010  Omaha, NE
  • Objectives
    • Genesis
    • Support & Sustainability
    • Innovation
  • WHERE are we?
  •  
  •  
    • Geography
    • History
    • Demographics
    Sagadahoc means . . .
  • WHY a County Board of Health?
    • Local public health services
      • Maine’s public health infrastructure
    • Efficient government
      • Leadership imperative
    • Public health requires governance
      • 10 Essential Services
    • The data told us so
      • What data?
  • Timeline 2002-2004 2006 2008 2007 2010 2009 THINK TANK JOINED NALBOH & NACCHO LAUNCHED “SHIP”; CREATED LHO FORUM; GRANT-FUNDED HEALTH STATUS ASSESSMENT BOARD OF HEALTH CREATED; MODUS OPERANDI STRATEGIC ALLIANCE WITH ACCESS HEALTH PUBLIC HEALTH DISTRICTS CREATED 2005 COMMUNITY HEALTH STATUS ASSESSMENT; FORCES OF CHANGE 2001 CONCEIVED SAGADAHOC HEALTH IMROVEMENT PROJECT (SHIP)
  • Modus Operandi
    • Vision
    • Mission
    • Organization
    • Membership
    • Governance
    • Conduct
  • WHO are we? Public Health Healthcare Allied Health Emergency Management Public Safety Community Volunteer Services Business/Industry
  • WHO are we?
    • Q: Are we a Board of Health or a Health
    • Department (LPHA)?
    A: Yes.
  • HOW did we pull it off?
  • HOW did we pull it off?
    • Relationships
      • Invited our “competition” on board
    • Meaning
    • Accountability
      • Strategic Planning; Formative & Outcome Evaluation
    • Perseverance
    • Leadership!*
    *Reference: Kouzes & Posner, The Leadership Challenge, 4th Ed. (2007)
  •  
  • Successes
    • Strategic Alliances
    • Local Health Officers
      • Training
      • Preparedness
      • Lead Poisoning Prevention
      • Municipal Health Information Kiosks
      • “ File of Life”
    • Emergency Fuel Program
    • Pandemic Influenza
      • Preparedness
      • Response
    • Medication Collection
    • Public Awareness
      • “ Public Health and You”
      • Press Releases
      • Op-Ed Columns
      • National Awareness and Engagement
  • Challenges
    • Volunteerism
    • Turnover and other transitions
    • Accountability and follow-through
    • Personal agendas
    • History (esp. Local Health Officers)
    • Changing face of Maine’s public health infrastructure
    • Funding
  • Local Health Officers
    • A little history . . .
  •  
  •  
  • What’s Next?
    • Heart Health: HeartSafe Communities
    • Alternate Care Sites
    • Jail Health
    • Winter Safety
      • Cold-related Injuries; CO Poisoning
    • Health Care Reform
    • Website and Social Media Presence
    • New Board Membership
    • Continued Strategic Planning
  • Acknowledgements
    • Sagadahoc County Board of Health
    • Sagadahoc County Commissioners
    • Marla H. Davis, MSN, RN, TTS-C
      • Immediate Past-Chair
    • Misty D. Green
      • Director, Emergency Management
    • Jennifer Gunderman-King, MPH
      • District Public Health Liaison
    • Hugh H. Tilson, MD, MPH
      • Health Officer
  • The Rise of Maine’s First County Health Department Steven J. Trockman, MPH Chair, Sagadahoc County Board of Health 18 th Annual Conference  August 6, 2010  Omaha, NE