Hello! My name is Jenna and I am yet another CU nursing student. 

The Core Public Health Services draft gives a thorough overview of how “Public Health” should best be implemented in Colorado communities, however it is lacking in a few areas. I believe that utilizing some of the strategies that nurses employ during a community health assessment may benefit public health services in Colorado.

-         During the assessment phase, it would be important to incorporate a system that identifies the problems of highest priority, especially when multiple problems exist (Stanhope & Lancaster, 2006). Identifying priorities can best be done by investigating: 1) how difficult it would be to address the problem, 2) the consequences if the problem is ignored, 3) the community and population outcomes if the problem is not fixed, 4) the cost of putting the solutions in place, 5) the impact of politics, values in the community, and funding on the measures needed to fix the problem, and 6) the expectations of the community (Stanhope and Lancaster, 2006). Priorities should be identified after answering these questions, and the problems with the highest priority should be focused on first. 

-         The planning stage may benefit from a deeper analysis of the problems the community faces. It would be important to investigate the source of the problem as well as the effects it may have on the community (Stanhope & Lancaster, 2006). If you can identify the source of the problem, then in the future you may be able to prevent it. Recognizing the relationships between problems may also be helpful (Stanhope & Lancaster, 2006). If one problem is affecting or leading to another problem, it may be possible to manipulate one factor and have two good outcomes.

-         Implementation of interventions for community health problems is a component of public health that was only briefly touched upon in the Core Public Health Services draft. When thinking about implementing solutions, the method of implementation must be considered. Who is going to decide upon the change? (Will it be voted on by the public? Will it be decided by the government? Will it be put into place by the public health nurses?) How is the change going to be brought about? How is the public going to be notified and educated? (By flyers? Phone calls? E-mail? Written letters? Education classes?) Who is going to distribute the information? (Public Health employees? Volunteers?) Who is going to pay for the workers, the interventions, and the subsequent evaluation of the changes put in place? It is important to understand how a change is going to be enacted, because every community is different, and the intervention will have no effect if it does not reach the community members.

Resources:

Stanhope, M., & Lancaster, J. (2006). Foundations of nursing in the community:

            Community-oriented practice. St. Louis: Mosby Elsevier.  

The Colorado Department of Public Health and Environment. (2009). The core public

health services draft. Retrieved on November 22, 2009 from http://www.cophip.org/applications/RegistrationManager/publicForum.asp?topicID=25

On June 4, 2008, Governor Bill Ritter signed the Colorado Public Health Reauthorization Act.  It requires boards, agencies, and public officials such as The Colorado Department of Public Health and Environment and The State Board of Health to collaboratively develop state and local public health plans that set priorities for the public health system in Colorado.  “The primary purpose of the Act is to assure that core public health services are available to every person in Colorado with a consistent standard of quality.”  (CDPHE,  2009).  The ten goals of the Colorado Statewide Public Health Improvement Plan are as follows: 

·         Goal 1:  Optimal community, environmental, and personal health

·         Goal 2:  Equitable access to core public health services

·         Goal 3:  Highest quality programs and services

·         Goal 4:  Accountability

·         Goal 5:  Collaborative leadership

·         Goal 6:  Effective use of public health resources

·         Goal 7:  A well-trained workforce to serve Colorado

·         Goal 8:  Communicate the value of public health

·         Goal 9:  Partnerships

·         Goal 10:  Community participation

Optimal community, environmental, and personal health are key points that any health care provider should identify as educational points with every patient.  The anticipated outcome of this goal, stated by the Colorado Department is “…the public health system will ensure optimal health for all Coloradans from birth to old age.”  (CDPHE,  2009).  Even though Colorado was ranked one of the slimmest states in the nation, Governor Bill Ritter tells CalorieLab, Inc. “We’re not spared from the national obesity epidemic, and we must remain vigilant in order to guard against it. We’re doing all we can to encourage Coloradans — especially our kids — to take advantage of the natural resources our state offers in order to stay fit, healthy and happy.”   (CalorieLab, Inc.  2008)

To give our nation the best chance at successfully integrating a healthier lifestyle for generations to come, our wisest option is to begin with our school age children.  Currently, and due to the financial climate in our nation, schools are experiencing budget cuts at alarmingly high rates.  These budget cuts nearly always affect the Physical Education aspects of our children’s education.  The poorly developed idea of forcing PE cuts not only limits the amount of education our children receive in this content area but also teaches them that their physical well-being is simply an option.  The successful implementation of this Act will give our children a better chance at learning what healthy lifestyles are as well as the opportunity to teach the generations after them the importance of living healthy.  That being said, is there any talk about additional funding for schools or options for schools to consider for this needed funding?   

CalorieLab, Inc.  (2008).  Mississippi is the fattest state for 3rd straight year, Colorado still leanest, D.C. loses weight.  Retrieved from http://calorielab.com/news/2008/07/02/fattest-states-2008/

Colorado Department of Public Health and Environment. (2008). Colorado public health reauthorization act – SB 08-194 Executive summary. Retrieved November 20, 2009, from the Colorado Department of Public Health and Environment’s Web site:  http://www.cdphe.state.co.us/opp/publichealthact/SB194execsum.pdf

Colorado Department of Public Health and Environment.  (CDPHE).  (2009).  Uniting Public Health Conference.   Preparing for bridge day: 2009 draft plan for improving Colorado’s public health system.  Retrieved 11/21/2009, from http://www.cophip.org/applications/RegistrationManager
/my_documents/my_files/final.COPHIP_Draft_For_Bridge_Day_9.30.09.pdf

My name is Joel, and I am a student in my senior year at the University of Colorado’s College of Nursing.  Along with myself, you may have noticed a rather large influx of responses from many of my fellow classmates—this in accordance with a recent assignment (optional) in partial fulfillment of our Public Health Nursing curriculum. I am sure that many of my fellow classmates are finding this course as unexpectedly fulfilling as I have. It has been a pleasure to see the valiant efforts our government, its subsidiary agencies, and concerned citizens put forth to ensure the well-being of so many others. Witnessing first hand the amount of work and resources required to fulfill this ongoing need has transformed my spark of interest in this subject to a definite willingness to render personal service. I look forward, more and more, to the days where in I am assigned to help in reassuring the health of our community by delivering immunizations or vaccinations to those in need. Therefore, I am already investigating avenues where in I might be able to volunteer other such similar services on a regular basis after my upcoming graduation and subsequent transition into the field of professional nursing.

That being said, I have a brief inquisition concerning one particular element within the recent proposal addressing this state’s position, and potential resolution, concerning its public’s health. In response to the Colorado Public Health Reauthorization Act, signed by Governor Bill Ritter on June 4^th, 2008 (Colorado Public Health Reauthorization, 2008, p.1); the Colorado Department of Public Health and Environment issued the DRAFT Colorado Health Improvement Plan in order to address this multifaceted issue (2009 Draft, 2009, p. 27). Within this rather complex and comprehensive proposal, underneath the content heading Core Public Health Services, is a list of 10 Essential Public Health Services developed by the Core Public Health Functions Steering Committee (p. 27). Identified in section numbers 4, 5, and 8 within this segment, are specific references to the development and utilization of professional and public resources to attain the proposed plans goals. Being a current representative of the healthcare community, with even growing credentials; how might I become more involved in aiding this great cause? More so, how can I find the information to guide me in this venture?

It is clearly evident that those overseeing this extremely important project have utilized a wide variety of resources. Why then, if the world of online technology is implemented in the spread of the news of this project, is it not being used to support in its subsequent resolution? Is there some form of link within this project’s website to aid the direction of public/professional volunteer enrollment? Am I simply missing it? Would not your plans be further benefited by a direct link to volunteer information and potential registration?  Likewise, if I could find a way to offer my services towards achieving this magnificent goal; what type of liability do I personally hold? Is there some sort of method to protect the charitable provision of medical services by a licensed healthcare professional?

I will personally strive to find the information I seek—though I believe wholeheartedly that you may be losing countless numbers of other willingly individuals due to the increased effort required to find this necessary information. I believe greatly in the validity of the Colorado Health Improvement Plan —as do many in my similar position (2009 Draft, 2009, p. 27). Therefore, it would seem prudent for this project’s leaders to consider these and other similar inquisitions when they reveal their final proposal in the upcoming months. As a proud Colorado resident and community member—I thank you for your efforts and time concerning this all important endeavor.

Sincerely,

            Joel R. Jacquart

References

Colorado Department of Public Health and Environment. (2008). Colorado public health reauthorization act – SB 08-194 Executive summary. Retrieved November 20, 2009, from the Colorado Department of Public Health and Environment’s Web site: http://www.cdphe.state.co.us/opp/publichealthact/SB194execsum.pdf

Colorado Department of Public Health and Environment. (2009, September 23). 2009 Draft plan for improving Colorado’s public health system. Retrieved November 20, 2009, from the Colorado Department of Public Health and Environment’s Web site: http://www.cophip.org/applications/RegistrationManager
/my_documents/my_files/final.COPHIP_Draft_For_Bridge_Day_9.30.09.pdf

After reading through the Core Public Health Services draft a few things stood out to me.

�Public health core services shall meet the needs of the population served by the county or district. In some jurisdictions, the services may be provided by other counties, community organizations or agencies; however, the county or district public health agency has an obligation to assure that core services are available� (Page 1, lines 12-15) (CDPHE, 2009).  I feel that if some counties public health is provided through a different county that we will see a discrepancy in the care available to these counties.  I would guess that the counties that would receive their public health from another county will be the less populated areas which tend to not have healthcare readily available to them as it is, public health services should be easily accessible to all member of the state. 

On page 5, lines 7-8; �Establish procedures for working across jurisdictional boundaries and/or for requesting assistance in the delivery of public health services� (CDPHE, 2009).  I think this is especially important.  If and when Colorado ever has a public health emergency, already having it in place, the ability for public health officials to work across the board will prove to be very beneficial.

The last thing that caught my eye in this draft was the section on Emergency Preparedness and Response (pages 3-4).  I am an EMT and know that in the case of a disaster all first responders, EMT, paramedics and firefighters will be a big part of the efforts.  It was not clearly stated how both EMS services and public health services would effectively work together.  I feel it would be very beneficial to have a plan clearly in place for the coordination of efforts of these two entities. 

I am reviewing the Public Health Reauthorization Act for my Public Health Nursing class at CU and found the discussion board topics presented in this forum to be extremely interesting. I have always believed that everyone that resides in the United States should have access to basic health care services, especially public health services, regardless of where they live or who they are and was encouraged to read that Colorado has set out to accomplish this public healthcare plan. From reading this document, it seems that this project will be a tremendous undertaking for many different levels of professionals but one that will potentially provide the residents of Colorado with an increase in a healthier population as well as an opportunity to take control of their own health and wellness.

As for the document outlining the core public health services, I was encouraged to read the specific section regarding the development of assessments and programs aimed specifically towards Prevention and Population Health promotion. By assessing these individual Colorado communities, it will allow local agencies to target the specific health issues that are most prevalent and then formulate the required healthcare interventions and services needed for these areas. One specific line from this section of the document that definitely caught my attention was the inclusion of line 28 which speaks directly to the assurance of health care delivery in a culturally and linguistically appropriate manner (p. 3). With the significant amount of culturally diverse individuals residing in Colorado, it is of significant importance to constantly consider that cultural sensitivity is a huge component in providing effective healthcare promotion and prevention.   

With learning about these public health initiatives set forth by Colorado, I am looking forward to following how this plan will develop after full implementation as well as the progress and/or setbacks that are encountered along the way. To be drafting a plan such as this is such a tremendous step in the right direction to providing healthier options and access to care to future generations of individuals that make Colorado their home.