Questionnaire on LHO System

LHO = Local (Municipal) Health Officer

October, 2007

Please check all that apply – Are you a:

Local ( = Municipal) Health Officer Non-Government Representative

Municipal Official (Non-LHO) State Official

County Official Other (please specify) __________________

Please check which Maine DHHS District you represent:

Down East/Acadia = Washington/Hancock Mid Coast = Waldo/Lincoln/Knox/Sagadahoc

Central Maine = Somerset/Kennebec Cumberland

Lewiston/Auburn and Western Maine = Androscoggin/Oxford/Franklin

Aroostook Penobscot/Piscataquis York Statewide

How Should LHOs Fit Into the Emerging Statewide Public Health Infrastructure?

· What are the most important contributions LHOs make to their communities?

Now:

__________________________________________________________________________

Potential in future:

__________________________________________________________________________

· What do you think are the current biggest challenges faced by LHOs?

In their communities:

__________________________________________________________________________

From their municipal governments:

__________________________________________________________________________

From the LHO System as a whole:

__________________________________________________________________________

The 10 Essential Public Health Services (EPHS) and LHO Functions:

(Please refer to Comprehensive Community Health Coalition and EPHS document)

1. Monitor health status to identify community health problems.

Yes, this EPHS should apply to LHOs

If yes, please check one below:

LHOs should be the primary municipal source for this EPHS

LHOs should deliver this EPHS, along with other entities (may specify)

LHOs should have only an occasional role with this EPHS

LHOs should link to other entities who deliver this EPHS in the municipality or district

Other (please explain) ______________________________________________________

No, this EPHS should not apply to LHOs

2. Diagnose and investigate health problems and health hazards in the community.

Yes, this EPHS should apply to LHOs

If yes, please check one below:

LHOs should be the primary municipal source for this EPHS

LHOs should deliver this EPHS, along with other entities (may specify)

LHOs should have only an occasional role with this EPHS

LHOs should link to other entities who deliver this EPHS in the municipality or district

Other (please explain) ________________________________

No, this EPHS should not apply to LHOs

3. Inform, educate, and empower people about health issues.

Yes, this EPHS should apply to LHOs

If yes, please check one below:

LHOs should be the primary municipal source for this EPHS

LHOs should deliver this EPHS, along with other entities (may specify)

LHOs should have only an occasional role with this EPHS

LHOs should link to other entities who deliver this EPHS in the municipality or district

Other (please explain) __________________________

No, this EPHS should not apply to LHOs

4. Mobilize community partnerships to identify and solve health problems.

Yes, this EPHS should apply to LHOs

If yes, please check one below:

LHOs should be the primary municipal source for this EPHS

LHOs should deliver this EPHS, along with other entities (may specify)

LHOs should have only an occasional role with this EPHS

LHOs should link to other entities who deliver this EPHS in the municipality or district

Other (please explain) ______________________________________________________

No, this EPHS should not apply to LHOs

5. Develop policies and plans that support individual and community health efforts.

Yes, this EPHS should apply to LHOs

If yes, please check one below:

LHOs should be the primary municipal source for this EPHS

LHOs should deliver this EPHS, along with other entities (may specify)

LHOs should have only an occasional role with this EPHS

LHOs should link to other entities who deliver this EPHS in the municipality or district

Other (please explain) ______________________________________________________

No, this EPHS should not apply to LHOs

6. Enforce laws and regulations that protect health and ensure safety.

Yes, this EPHS should apply to LHOs

If yes, please check one below:

LHOs should be the primary municipal source for this EPHS

LHOs should deliver this EPHS, along with other entities (may specify)

LHOs should have only an occasional role with this EPHS

LHOs should link to other entities who deliver this EPHS in the municipality or district

Other (please explain) ______________________________________________________

No, this EPHS should not apply to LHOs

7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.

Yes, this EPHS should apply to LHOs

If yes, please check one below:

LHOs should be the primary municipal source for this EPHS

LHOs should deliver this EPHS, along with other entities (may specify)

LHOs should have only an occasional role with this EPHS

LHOs should link to other entities who deliver this EPHS in the municipality or district

Other (please explain) ______________________________________________________

No, this EPHS should not apply to LHOs

8. Assure a competent public health and personal health care workforce.

Yes, this EPHS should apply to LHOs

If yes, please check one below:

LHOs should be the primary municipal source for this EPHS

LHOs should deliver this EPHS, along with other entities (may specify)

LHOs should have only an occasional role with this EPHS

LHOs should link to other entities who deliver this EPHS in the municipality or district

Other (please explain) ______________________________________________________

No, this EPHS should not apply to LHOs

9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services.

Yes, this EPHS should apply to LHOs

If yes, please check one below:

LHOs should be the primary municipal source for this EPHS

LHOs should deliver this EPHS, along with other entities (may specify)

LHOs should have only an occasional role with this EPHS

LHOs should link to other entities who deliver this EPHS in the municipality or district

Other (please explain) ______________________________________________________

No, this EPHS should not apply to LHOs

10. Research for new insights and innovative solutions to health problems.*

Yes, this EPHS should apply to LHOs

If yes, please check one below:

LHOs should be the primary municipal source for this EPHS

LHOs should deliver this EPHS, along with other entities (may specify)

LHOs should have only an occasional role with this EPHS

LHOs should link to other entities who deliver this EPHS in the municipality or district

Other (please explain) ______________________________________________________

No, this EPHS should not apply to LHOs

· What services should the LHOs receive from the new District Public Health Offices of Maine CDC/DHHS? (These offices house health inspectors, public health nurses, field epidemiologists, and new district public health officers.) Some possibilities include: training, technical assistance, consultations, etc.

__________________________________________________________________________

· Rate other key organizations and sectors that LHOs should partner with in a district:

1 = Strong formal link 2 = Informal link 3 = No link

_____ CCHCs (comprehensive community health coalitions = Healthy Maine Partnerships)

_____ Municipal health departments in Bangor and/or Portland

_____ Hospitals/health care system

_____ County governments.

For those rated with a “1”, please indicate how the role should be formalized. Please check all that apply:

State statute Contract Memorandum of understanding (MOU or MOA)

Other (Please specify) ____________________________________________________

· What services should LHOs receive from Augusta-based Maine CDC/DHHS, as opposed to their District Offices?

__________________________________________________________________________

· Which local officials or institutions are best suited to be the primary municipal or local area contact for the following emergency situations?

Isolation/Quarantine

Local Health Officer

Municipal Government (including Municipal Emergency Management)

District Maine CDC Offices

Law Enforcement

County Government/County Emergency Management

Health Care System

Vaccine Distribution

Local Health Officer

Municipal Government (including Municipal Emergency Management)

Law Enforcement

District Maine CDC Offices

County Government/County Emergency Management

Health Care System

Implementing Social Distancing Measures (school closures, etc.)

Local Health Officer

Municipal Government (including Municipal Emergency Management)

Law Enforcement

District Maine CDC Offices

County Government/County Emergency Management

Health Care System

· Besides Augusta-based Maine CDC, which are best suited to provide public health consultations to County Emergency Operations Centers in a public health emergency situation?

Maine CDC District Health Officers

Designated Local Health Officer

Designated County Health Officer

Designee from local health care system

Other (please specify) _____________________________________________________________

· Are there other trends, factors, or events you believe should be addressed as the LHO system, as part of the public health system, is being revised?

__________________________________________________________________________

· Are there other concerns you would like us to know about?

__________________________________________________________________________

Local Health Officer (LHO) Feedback on LHO Qualifications

The following questions refer to statutory language recently adopted:

Title 22, Chapter 153, §451 The local health officer must be qualified by education, training or experience in the field of public health or a combination as determined by standards adopted by department rule no later than June 1, 2008. A person who is employed as a local health officer who is not qualified by education, training or experience must meet qualification standards adopted by department rule no later than June 1, 2009. On or after June 1, 2009, a person may not be appointed and employed as a local health officer unless that person is first qualified pursuant to the standards set by department rule.

· Should some trainings be required, regardless of education and experience? If so, please specify.

__________________________________________________________________________

· About how many hours of training should be required every three years?

__________________________________________________________________________

· Who should offer the required trainings – Maine CDC central staff; Maine CDC field staff located in health districts; and/or other organizations (please specify names of organizations if possible)?

__________________________________________________________________________

· Rate your preferences for the way LHO trainings are provided:

1 – Strongly dislike 2 – Don’t prefer 3 – Don’t care 4 – Prefer 5 – Strongly prefer

_____ District in person

_____ District videoconferencing

_____ Telephone conferences

_____ Online

_____ Other (please specify) ____________________________

· What are some key topic areas the required trainings should focus on - the LHO statutes and their application; most common problems addressed by LHOs; and/or other topics (please specify)?

__________________________________________________________________________

· What types of educational background should be considered as meeting some, if not all, the requirements? And, should this background meet some or all of the requirements?

__________________________________________________________________________

· What type of experience should be considered as meeting some, if not all, the requirements? And, should this background meet some or all of the requirements?

__________________________________________________________________________

· Do you have any other feedback on the upcoming LHO requirements?

__________________________________________________________________________

Statutory Revision Feedback for LHOs

· Do you think the current statutory duties are insufficient or too many or just right?

__________________________________________________________________________

What changes, if any, would you like to see to them?

__________________________________________________________________________

· Do you think the current statutory authorities are insufficient or too many or just right?

__________________________________________________________________________

What changes, if any, would you like to see to them?

__________________________________________________________________________

· Do you think the secondary statutory authorities are insufficient or too many or just right?

__________________________________________________________________________

What changes, if any, would you like to see to them?

__________________________________________________________________________

· Are there statutes you think should be eliminated? If so, please name them.

__________________________________________________________________________

· Are there gaps in current statute that should be addressed? If so, please name them.

__________________________________________________________________________

· Are there situations that you feel the Maine CDC/DHHS should not have oversight of the LHOs? (See statute excerpt below for reference.) If so, please specify these situations.

Title 22, Chapter 153, §154:

“local health officer is subject to the supervision and direction of the department”...... “Departmental intervention. If the local health officer, or individual designated as the local health officer pursuant to section 451, fails to perform the duties of the local health officer as those duties are described under this section, the department may intervene to perform those duties.”

__________________________________________________________________________

Meeting Evaluation for LHOs

We are planning similar meetings around the state over the next few months. We would greatly appreciate your feedback on this meeting, especially about how we can change the format and content in order to improve being able to achieve the meeting objectives.

Please rate each meeting element below and feel free to write in suggestions on how to change them.

1 = Poor 2 = Fair 3 = Good 4 = Very Good 5 = Excellent

Did the meeting meet the objectives of: Rating

· Participants will have a better understanding of the

§ definition and core functions of public health……………………………. ______

§ history of LHO system………………………………………………………. ______

§ current statutory duties and authorities…………………………………… ______

§ current issues under discussion – new requirements for LHOs
and possible revisions to statute………………………………………….. ______

· Participants will have an opportunity to provide feedback on the role of
LHOs in the public health system, the new requirements for LHOs, and
possible revisions to LHO statute………………………………………………… ______

· Participants will also have some understanding of some common
dilemmas and answers to common questions that arise on the job………….. ______

Please rate each meeting element below and feel free to write in suggestions on how to change them.

1 = Poor 2 = Fair 3 = Good 4 = Very Good 5 = Excellent

Rating Element

______ Overall meeting objectives

______ Format of the meeting - how the meeting was conducted

______ Content of the meeting – the actual topics presented

______ How the topics were presented

______ Meeting length

______ Seating arrangement

______ Handouts

What suggestions do you have for this type of meeting being conducted in your area of the state?

_____________________________________________________________________________