A little off-topic

Over the past month, I’ve had a few experiences that don’t have much to do with public health business planning, but something to do with public health. I traveled to Greece for two weeks, spending time in the Cyclades islands of Folegandros and Santorini, and in the capital, Athens. Greece is an interesting mixture when it comes to public health:

1. They have a very good health care safety net system, paid for by the state. A couple of cab drivers told us how proud they were of their public health program. One was less enthusiastic because, although he himself, who has significant health issues, has never had a problem getting care, he “had heard that some people have some bureaucratic hassles.” He doesn’t realize the “bureaucratic hassles” we have in the states – even if you have health insurance, but especially if you do not!

2. Everyone smokes. Greece is Europe’s biggest-smoking nation: more than 40% of adults smoke. I don’t think we realize what a job we’ve done in this country to curb smoking, until you go to a nation where everywhere you turn – restaurants, stores, taxi-cabs – people are smoking. Greece is attempting to impose anti-smoking laws now – as of July 1, new laws banning smoking from hospitals, schools, and public places are going into effect. But restaurants can avoid the ban if they create smoking sections and they will also be allowed to ban non-smokers if they don’t want to have a smoking section! This is the third attempt in 10 years to curb smoking in Greece: it will be a hard habit to break.

3. Greek highways and roads are not for the timid. Greece ranks among the highest European countries in terms of road traffic accidents per kilometer traveled. Athens has done a great job of making itself more pedestrian friendly in recent years, although the narrow streets, lack of attention to speed limits, and lack of attention to parking regulations makes it difficult in places to get around on foot and it would be impossible in a wheel chair.

4. On the other hand, compared to my suburban American home I was able to walk much, much more in Greece than I am at home. Exercise came naturally and easily, built in to every day just getting from here to there. In one place we went, cars weren’t even allowed within the town limits. There’s something to the idea that “car culture” destroys the chance to live an active life.

5. When they tell you not to drink the water, don’t drink the water. They know what they’re talking about!

And, finally, the first thing I did when I got back to the states was get the flu! "Welcome Home!"

They say traveling is a great way to see your own home in a new light. It helps me to appreciate what we do well in the states, and what we could do better.

From the Management Academy Director

Recently, I attended the UNC-Chapel Hill Minority Health Videoconference. The title for this year's event was Breaking the Cycle: Investigating the Intersection of Education Inequities and Health Disparities. The speakers were

1. Reginald Weaver, Past President, National Education Association;
2. Dina Castro, Scientist, UNC FPG Child Development Institute;
3. Nicholas Freudenberg, Distinquished Professor and DPH Program Director in Urban Health Hunter College of Health Sciences/City University of New York; and
4. Lillian Sparks, Executive Director, National Indian Education Association

Each presenter spoke of the connection between education and the public's health and they made recommendations for each field.

They spoke of the need for more training and the need for programs focused on school-based health clinics, mental health programs and services aimed at teens on sexuality and HIV transmission. What are you doing within your community to provide a stable lifestyle to produce successful and healthy students? Please share with us.

Life Planning... get real!

One of the great benefits of a management development program is that it helps you manage your life. Our Management Academy students regularly report that they see improvements first in their performance as a parent or as a spouse as a result of trying to develop themselves as managers. Planning skills, negotiation skills, dialog skills, measurement skills, teamwork skills-- they all transfer.

For some of us, work performance begins at home. Are you taking care of yourself? Are you asking for what you need? Are you having the good, real discussions with your life partner that insure you are fulfilled and whole, working on the priority issues and both pulling in the same direction? In other words, are you doing life planning?

Life plans put work plans into perspective. Karl Umble likes to say that the goal is less about balance and more about "harmony." And the skills are essentially the same for both: the ability to plan well and then push through to execution, to work the plan into existence.

As the skin horse says to the velveteen rabbit, it takes a lot of love and attention to go from a stuffed toy to being real. In this respect, the velveteen rabbit is in line with a long stretch of work on authentic leadership, the notion that leaders have to let their personality come through the role to be maximally effective. They have to be present and real.

Last word is this: congratulations Anne on your wedding-- great team!

-- Steve Orton

From the Management Academy Director

In addition to the South Carolina Department of Health and Environmental Control, we have recently received other positive updates of plans that are being implemented and teams that are moving ahead to have an impact on their community.

The Gaston County Health Department, Gastonia, North Carolina, is preparing to break ground for their new Highland Health Center. The team participated in the Management Academy 2007-2008 cohort, along with their community partner, Gaston Family Health Services. They recently received $1.3 million thanks to the American Recovery and Reinvestment Act. The team members were Paula Black, Renee Clark, Veronica Feduniec, William (Bill) Gross, and Selenna Moss. The health department director is Colleen Bridger.

Also, we were contacted recently by a team from the Wilkes County Health Department, Wilkesboro, North Carolina. They participated in the Management Academy for Public Health in the 2008-2009 cohort, which just graduated in March, 2009. Their project focused on the issue of childhood obesity prevention for under-served Latino children. The program is a collaboration between the health department, the Wilkes Family YMCA, Wilkes Partnership for Children, and HOLA of Wilkes County. The program is known as "Y on Wheels" and is up and running. The team members were Melissa Black, Rose Marin, Donna Shumate and Judy West. The health director is Beth Lovette.

We look forward to having a new Management Academy for Public Health cohort starting August 2009 and we look forward to the opportunity to share the book, Public Health Business Planning: A Practical Guide with them.

Outcomes Story, South Carolina

I got a nice email from an alum a couple of weeks ago, Marie Horton from the South Carolina Dept of Health and Environmental Control, DHEC.

We were in the 2001-2002 group. Our project concerned training food establishment staff with the help of a video we produced on food safety. The video was based on our SCDHEC health inspector inspection sheet... The project was a success. I ended up pushing the video through to completion and we had it translated into Spanish and Mandarin a few years ago. The Environmental Health Division has it up on our SCDHEC website, if you want to take a look.

Here's a link to the "food protection" links page at DHEC. Note that DHEC staff partnered with the restaurant association to create and fund this video. This is all by way of background for what comes next:

The Environmental Health Division is working on a new product. They received grant money to produce a food defense video to prevent intentional food contamination. The planning meeting is next week and they have asked me to come and represent our Management Academy team. They want input on our experience in preparing our video.

Just wanted to share that with you. The work lives on!!!!!!!!!

I love the fact that this team implemented their plan. And I love the fact that their experience-- the specifics of what they did and the general lessons about business planning-- continue to bear fruit. Onward and upward!

-- Steve Orton

From the Management Academy Director

This is such an exciting part of the year for the Management Academy for Public Health. Not only have we had 7 teams apply from North Carolina, but we have also been fortunate enough to be able to offer team scholarships as a part of a collaborative effort between NACCHO and the NC Institute for Public Health. The scholarships are for teams that are entering the Action Cycle of the MAPP (Mobilizing Action through Planning and Partnerships) process and are interested in strengthening the implementation phase by developing a business plan centered on a sustainable business that addresses a community health issue. Applications have been received from across the country and we are looking forward to an opportunity to work with the selected teams. Please take the time to share with us your thoughts about the MAPP process and other processes that your health departments have been involved in. We think this is a great opportunity and we are so excited to share the book - Public Health Business Planning and the UNC-CH's Management Academy for Public Health program with new participants.

Business Planning and Flu Epidemics

Like everyone else in the public health community, we have been thinking a lot about swine flu lately. Public health leaders, managers and practitioners are scrambling to plan for what may come.

I recently contact John Dreyzehner, District Director of the Cumberland Plateau Health District in the Virginia Department of Health. Dr. Dreyzehner has sent many teams to the Management Academy over the years. We wrote about some of those in Chapter 7 of the book, “Competitors and Partners,” pages 68 – 69. One of the programs produced by a team from Dr. Dreyzehner’s district was called “Flu’s Clues,” an influenza vaccination program for children ages 3 – 9, based at the local Head Start programs and elementary schools

Steve and I posted back in November (17th and 20th) about “Flu’s Clues.” The program is now in its third year – now called “See you later fluigator” or “Fluigator” for short, with a sick alligator as a mascot, to avoid intellectual property issues. I asked Dr. Drehzehner whether having the program in place was making swine flu preparation any easier. Here are his thoughts:

“[The vaccination program] certainly increases ours and our partners confidence in being able to push out vaccines and treatments. At this point we can do points of distribution/Dispensing (PODs) in our sleep. The challenge at the moment, as is to be expected, is universal agreement on how/if to widely employ the present Tamiflu resource and to do it in a fashion that is consistent with legal equirements and good medical practice.

“There is understanding that we have to target it to the ill for treatment and, some think, their caretakers to begin at the first sign of illness. In one concept of operations I drafted we have accessible PODs open 8-12 hours daily at various location as drive through or walk -up (will spacing to prevent transmission). No ill (but sometimes exposed people) come in and complete and sign a medical attestation form regarding the illness in the person they are responsible for and get a course for that person(s) AND a reserve course for themselves and any other exposed in the household/place exposed to begin with the onset of fever and respiratory symptoms. In this way, the entire population can be assured the treatment is available for use in 12 hours or less to any one at any time. This works as long as this tricky virus remains sensitive. That is the readers digest version of one of my plans. But it is very doable.”

It sounds as if the Cumberland Plateau Health District is ready to do what it needs to do to address this possible epidemic. The challenge is deciding exactly what ought to be done – but it’s good to have the infrastructure in place to do it. They have that infrastructure in place because somebody thought of an idea, they partnered with important community institutions, they wrote a business plan that accounted for funding it, and they implemented it.

Let's hear from some of our readers -- what are you doing about swine flu? What obstacles are you coming up against?