Loading...
HomeMy WebLinkAboutResolution 2248A Resolution RESOLUTION NO DIRECTING THE CITY MANAGER TO DEVELOP AN IMPLEMENTATION PLAN FOR THE RECOMMENDATIONS MADE BY THE BLUE RIBBON PANEL ON PUBLIC HEALTH IN CONJUNCTION WITH THE TARRANT COUNTY ADMINISTRATOR AND THE TARRANT COUNTY HOSPITAL DISTRICT ADMINISTRATOR. WHEREAS, the Blue Ribbon Panel on Public Health was created by the City of Fort Worth and Tarrant County for the purpose of studying public health management in the commumty• and making recommendations for the improvement of same; and, WHEREAS, the Blue Ribbon Panel on Public Health has submitted a list of recommendations for improvement of public health services m the communrty• and, WHEREAS, the Fort Worth Crty Council desires to consider implementing the Panel s recommendations m conjunction with Tarrant County through the Office of the County Administrator and the Tarrant County Hospital District, through the office of the District Administrator NOW, THEREFORE, BE IT RESOLVED by the Crty Council of the Crty of Fort Worth, Texas, that: The Crty Manager m conjunction with County Administrator and the Tarrant County Hospital District Administrator is directed to develop an implementation plan for the attached recommendations of the Blue Ribbon Panel on Public Health. Adopted this day of MAYOR KENNETH BARB CITY CO~JN~IL JAS 28 1997 Kiiiir t~ t.~a~+-s~.J ~r~d~1Wa~ ~ CITY OF FORT WORTH Recommendations of the Blue Ribbon Panel on Public .Health Bachground The City of Fort Worth/Tarrant County Public Health Departments are two separate fiscal entities currently united under one administrative umbrella. The Departments combine available resources to provide the core public health functions of assessment; assurance and policy development. Services are provided through two divisions, Health Services and Tecluiical and Regulatory Services Health Services Includes Disease Control and Personal Health. There are eleven remote clinic srtes and two school based clinics in addition to the medical care facilities at the 1800 Universrty Drive administrative offices and the T B Outreach Office on Rosedale. Disease control deals with tuberculosis sexually transmitted diseases, HIV/AIDS breast and cervical cancer screening and other communicable diseases and epidemiology Personal Health services provide maternal and child health programs, including WIC and Immunizations Technical and Regulatory Services includes Health Statistics and Information (vital records birth and death certificates, other health related statistics) Animal Control, Laboratory Consumer Health • (restaurant inspection, food permits, ordinance enforcement) and County Environmental Health. Public health departments throughout the United States are responding to mayor changes in the overall health care system, including the shift to managed care and pending government reform. Locally further challenges--the m~plementation of a managed care environment for Medicaid recipients in Tarrant County ai.d the resignation of Dr Nick Curry from his post as Public Health Director -create an imperative to examine these issues now and to evaluate the future position of the Fort Wortl~/Tarrant County Public Health Departments On October 25 26 1996 the Blue Ribbon Panel on Public Health met to study the services and structure of the Health Departments and make recommendations to the Fort Worth City Council and the Tarrant County Commissioners Court. The panel was composed of policy makers and staff from the City of Fort Worth, Tarrant County and the Tarrant County Hospital District. Regional experts in the field of public health from the Texas Department of Health,. the University of North Texas Health Science Center at Fort Worth, and the Clty of Milwaukee Health Department also participated u1 the. meeting Members of the Blue Ribbon Panel are • Tony Alcini president and chief executive officer of the Tarrant Count Hospital District/JPS Health Networl., • Recommendations of the Blue Ribbon Panel on Public Health Page 2 • Diorme Bagsby Tarrant County Commissioners Court, Precinct 1 • Fernando Trevino PhD MPH, chairman of the Department of Public Health and Prevention, University of North Texas Health Science Center at Fort Worth, and former president of the American Public Health Association, • G.K. Maenius, Tarrant County Administrator and Acting Health Director for the Tarrant County Health Department; • Hardy Murphy PhD Chairman of the Board of Managers; Tarrant County Hospital District/JPS Health Network; • Paul Nannis, Commissioner of Health, City of Milwaukee, and past president, U S Conference of Local Health Officers • William Riggins, Jr MD MPH, Regional Director Texas Department of Health, Public Health Region 8 • Marti VanRavenswaay Tarrant County Commissioners Court, Precinct 2 • • Libby Watson, City of Fort Worth Assistant City Mana er and Achn~ Health g Director for the Fort Worth Health Department; and • Virginia Nell Webber Fort Worth City Council, District 8 At the completion of this two-day conference, the Blue Ribbon Panel on Pubhc Health identified several issues to be decided by the respective policy making bodies and recommended an overall direction for the Public Health Departments Recommendations Identify essential core functions of public health and assign to most appropriate provider Transitioq, medical care provided by the Public Health Departments' through their Personal Health Services and Disease Control divisions to the Tarrant County Hospital District. Create new partnerships for the provision of health to our citizens as a single continuum, from community based prevention to individual medical care. One of the purposes of a managed care enviroiunent is to ensure that each participant will have a medical home and receive care through a preventive primary care provider With their focus on maternal and child health and communicable disease, the Health Departments cannot be a complete medical home to their patients The Departments can provide the core functions of public • Recommendations of the Blue Ribbon Panel on Public Health Page 3 health in partnership with other providers without directly providing the necessary medical care By transrtioning the medical care portion of these services to the Tarrant County Hospital District, patients can have the benefit of a medical home while the community receives the assurance and assessment services provided by the Health Departments However the combination of Health Department and TCHD cltnics should not simply result m a combined system. Anew synergy should be developed which incorporates the public health model of outreach and case management at the front end with a continuum of care module as part of the medical home concept. The combination of these two elements should create a higher quality health care model for Tarrant County citizens Additionally the Public Health Department should increase its capabilities to conduct public health related surveillance v~nthm the County to detect and recognize health risks and disease outbreaks These capabilities should include data trend analysis visual surveillance and other techniques which rdenhfy potential health risks and result m disease control The City of Fort Worth should eliminate the requirement that the Public Health Director be a physician. State- law does not require that a local Director of Public Health be a physician. State law does require a physician to serve as the designated Health Authority The Health Authority position can be a full-tune position employed b~ the Health Departments or a contract position. The transrtioning of medical care to the Hospital District and increasing the emphasis on assessment and assurance changes the focus of the department significantly By eliminating this requirement, as broad a range of candidates as possible can be sought to fill this positron Begin recruitment of new Public Health Director immediately based on above decisions. Formerly the Public Health Dn•ector was a direct employee of the City of Fort Worth. Tarrant County contracted with the Crt~ of Fort Worth for the Director s services to administer the County Health Department and serve as the County Health Authority • • Recommendations of the Blue Ribbon Panel on Public Health Page 4 I-Bring the new public Health Director should be anoint City County process Refine transfer of services to Tarrant County Hospital District. The Panel foresees a shift of employees and grants from the affected Health Department programs now funded through the City of Fort Worth and Tarrant County It is possible that some programs that include the provision of medical care need to continue under the auspices of the Health Departments Employee issues, including retirement benefits, should be addressed proactively Timing of the transfer should be exampled closer Address and decide the governance issue. Options to include. the creation of a non taxing Health District; a City Health Department; or a Count<~ Health Department; and the establishment of an advisory Board of Health, regardless of which structure is decided upon. • The Panel felt rt was important that this issue be resolved nor to hiring a new dp-ector The resolution of this issue will help determine the qualifications of a new director and the new director won t be seen in a negative fight by anyone dissatisfied with the decisions made The advisory board would be on going regardless of the governance form selected. It would focus on public health policy issues and assist with monitoring primary care providers as part of the assessment and assurance core functions Hire new Public Health Director After a point search involving both the City of Fort Worth and Tarrant Count< a new Public Health Director should be hired. Charge Public Health Director with implementing changes. One of the first tasks of the new Public Health Director ~yill be to oversee the smooth unplementation of the changes, including the transfer of services to other providers The Director will also face the challenge of ensuring that the restructured Health Department continues to fulfill its mission r~ U Recommendations of the Blue Ribbon Panel on Public Health Page 5 New Public Health Director ties into Healthy Communities model. The purpose of the Healthy Communities initiative is to create a process by which to create a safer healthier place for all people to live by defining and utihzmg the resources available. The model forms a cooperative coalition of individual agencies and organizations from all facets of the community to achieve this purpose. •