NACCHO, District of Columbia
August 3, 2016
NACCHO, District of Columbia
August 3, 2016
This blog draws from NACCHO’s 2015 site visit to Seattle-King County Health Department as well as Janna Wilson’s article featured in NACCHO’s Winter Exchange issue. Local public health systems and practices are often adapting and transforming in response to the forces of change within their communities. While this change can sometimes be challenging, it also presents local health departments with the opportunity to strategize and re-think how they approach their work. After the ACA passed, Seattle-King County Health Department emerged as a leader in transformation. Since 2010, they have contributed to Washington State’s SIM grant-supported Accountable Communities of Health (ACH) collaborative, constructed a community-wide transformation plan, and re-organized the leadership structure of their organization to better serve both agency and community priorities. In doing so, Seattle-King County Health Department has positioned itself to better serve both agency and community priorities.
One unique way Seattle-King County Health Department altered their approach was by dividing up leadership positions. As opposed to having just one health official, they now have a health director and a local health official. Director Patty Hughes leads the department on community and stakeholder engagement, strategy, and administrative duties while Jeff Duchin, the local health official, leads on science matters. Dividing up the work ensures that the health department gives equal attention to both critical areas of the local health department. Both Jeff, the health official, and Patty, the health director, agree that this setup works well if individuals are able to be honest and clear with one another about goals and disagreements. Key to their successful partnership is a shared vision for the health department. Both Patty and Jeff would like the health department to have a well-established position and role in Seattle-King County. They both would like to see the health department focus their resources on tackling upstream preventions to better address the social determinants of health. Patty and Jeff see transformation as the opportunity for Seattle-King County to get more involved in these areas of public health. As a result of their shared vision, they have made efforts to engage with community partners on these types of projects.
In response to the passage of the ACA in 2010, Seattle-King County Health Department collaborated with other community stakeholders to develop a comprehensive transformation plan that is largely influenced by “buckets of prevention,” developed by the Centers for Disease Control and Prevention’s (CDC) associate director for policy John Auerbach. The King County Health and Human Services Transformation Plan envisions that “by 2020, the people of King County will experience significant gains in health and well-being because our community worked collectively to make the shift from a costly, crisis-oriented response to health and social problems, to one that focuses on prevention, embraces recovery, and eliminates disparities.” Seattle-King County Health Department employee Janna Wilson wrote about this in NACCHO’s latest issue of Exchange, saying, “The plan expresses the region’s intent to intertwine efforts that work at the level of individuals/families with those that operate at the level of community/social conditions to drive better health and prevention.”
The collaborative transformation plan includes an innovative project designed to tackle the persistent inequities across Seattle-King County by launching “communities of opportunity” (COOs). According to Janna Wilson, the overall goal is to “improve health, social, racial, and economic outcomes by focusing on place and policy/systems change, and to do so by partnering with communities to shape and own solutions.” With funding from the health department, the Seattle Foundation, and the King County Best Starts for Kids property tax levy, multiple sectors have come together to support this project. Additionally, different agencies are collaborating on strategies and evaluation approaches for the different geographic areas.
As Seattle-King County carries out this initiative that is rooted in community partnerships, policy development, data support, and evaluation, they seek to develop other place-based approaches to public health. Since Washington State received a SIM grant in 2014, regional Accountable Communities of Health (ACH) have taken hold and started to develop similar place-based strategies to transform population health. Those at Seattle-King County Health Department are hopeful that this work will prove to be successful in coordinating care approaches across the buckets of prevention and eliminating health inequities.