Kevin Dick is the Washoe County District Health Officer in Reno, Nevada.
In April 2013, I was appointed interim Health Officer of the Washoe County Health District. The Health District, like many, was experiencing years of declining revenue and deficit spending. Our position was unsustainable and, after years of reacting to budget cuts, little strategic direction remained. Fortunately, the District Board of Health encouraged me to seek an independent fundamental review of the Health District’s programs, operations, and financial position to provide recommendations for a new direction forward.
The Public Health Foundation (PHF) agreed to provide a team to perform this review of the Health District and proposed a framework of using the Public Health Accreditation Board (PHAB) standards and the Public Health Uniform National Data System (PHUND$) to accomplish the comprehensive review we sought. A team with vast expertise and experience with public health was assembled which included,
Dr. Leslie Beitsch,
Carol Moehrle, and
Matthew Stefanak.
The review began with an initial visit by the team during which they met with each of our divisions, Board of Health members, city and county managers, as well as community public health and regulated stakeholders. The Health District leadership then completed a self-assessment using the PHAB standards and submitted financial documentation to the review team. This information was “ground-truthed” through a follow-up visit and further discussions with Health District staff. Specifically, the team reviewed a portion of the documents cited in the self-assessment and discussed activities and actions that had occurred in the accreditation domains to verify and follow-up on the information submitted and the status of the health district and its various divisions.
After completing the fundamental review, the team prepared a
report containing 24 recommendations on how to address key issues facing the Health District, including:
- Establishing a strategic direction
- Improving fiscal and performance management
- Increasing revenues
- Controlling costs
Based on these recommendations, the District Board of Health agreed on a path forward for the Health District over the coming years. We are tracking progress to implement the recommendations on a monthly basis and have already made significant progress in a number of areas. Examples include:
- Expanding hours of access to immunization and vital records services
- Identifying environmental health services for which fees are not currently collected
- Improving time coding for cost and performance assessments
- Conducting cost-benefit analysis of programs
- Building quality improvement capabilities and an organizational culture of quality
- Initiating a Community Health Assessment/Community Health Improvement planning process
With the technical assistance from PHF to conduct the fundamental review and help to communicate the new direction to our community partners, we are now well aligned and preparing for accreditation. The review team’s encouragement and support for me and the Health District contributed significantly to my decision in October 2013 to continue in the role of the District Health Officer.
Visit the Washoe County District Health Website to see the full report, Washoe County Public Health: A Fundamental Review.
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