Montana Sets a Course for Change

 By the Montana Public Health Improvement Task Force

Montana's Turning Point Initiative will build on a solid base of public health improvement activities. "We have always had and have been building on our vision," says Nancy Ellery, Health Policy and Services Division Administrator in Montana's Department of Public Health and Human Services. "Now we have the mechanism to move forward and, more than that, a clearly defined structure and a way to measure our progress."

More than five years ago, national health and welfare reform spurred public health professionals in our state, as in many others, to examine our public health system. Public health officers saw an erosion of their capacity to meet ongoing and emergency needs, coupled with a growing requirement to plan for change. In response, leaders formed the Montana Public Health Improvement Task Force (PHITF), which benefits from the participation of a broad range of individuals and organizations, including the Department of Environmental Quality; the state public health, hospital, and primary care associations; managed care organizations; academic institutions; elected officials; state and local governmental public health; and many other important partners. This body produced a Public Health Improvement Plan in 1995, which, highlighting thirteen recommendations, reflects Montana's vision and commitment to healthier communities and a stronger public health system.

The Montana Turning Point Initiative will build on the work of the PHITF partnership. Its thirteen recommendations will become the groundwork of a re-invigorated work plan. Our major goals for public health improvement as we head into the next six months are:

Increasing Montana's Public Health System's Capacity

• Assist local public health agencies in assessing their capacity to perform their community-level public health responsibilities.

• Publish a review and revision of the public health core functions and standards defined in the Public Health Improvement Plan.

• Establish a Public Health Training Institute for educating state and local public health personnel.

• Develop a plan to inform Montanans more effectively about the role and value of public health.

Supporting Public Health Collaboration

• Assist four local partnerships in building and sustaining their local public health capacity.

• Participate in Montana's Healthy Communities Coalition and other private/public partnerships.

Increasing Accountability

• Recommend new budget reporting to track public health expenditures more accurately.

• Review Montana public health laws to clarify roles and responsibilities of state and local agencies.

"It was gratifying, although not surprising," said project leader Robert W. Moon, "that the Plan's objectives fit well with the Turning Point national objectives. With Turning Point, we can also draw on the strength and expertise of our national partners to move ahead with public health improvement in Montana."

Building Capacity at the Community Level

Using the Public Health Improvement Plan as their blueprint, four local partnerships will build and sustain local capacity to fulfill core functions. The four local partnerships represent Montana's very broadly dispersed and diverse communities. From rural, sparsely populated areas of the state to university communities, the local partnerships will play a key role in building our local public health capacity. Says Audrey Stromberg of the Sheridan County Partnership in Plentywood, Montana, "We are in the beginning stages of strengthening and building on our existing partnerships. We recognize the need to involve a greater variety of partners from throughout the community and we are beginning to do that. For example, at our first informational meeting, we added eight new community partners who had not previously signed memorandums of agreement or been involved in the coalition." The participating local communities will use the Turning Point planning process to reshape and invigorate local-level public health capacity while also supporting the further development of complementary state-local system linkages by partaking in the statewide planning process.

The Montana Public Health Improvement Task Force is coordinating the statewide Turning Point planning process in the State of Montana. In partnership with the statewide coalition, four communities received Turning Point grants: The Cornerstone Project in Northwest Montana; the Fort Peck Health Coalition, which includes Roosevelt, Valley, and Daniels Counties; the Gallatin County Public Health Alliance; and the Sheridan County Turning Point Partnership.