Foundation Viewpoints: Insights from the W.K. Kellogg Foundation

The title of this article implies change. And in fact, the goal of this initiative is to transform and strengthen the public health infrastructure so that states, communities, and their public health agencies may respond to the challenge to protect and improve the public's health in the 21st Century. An expected outcome will be the development of strategic plans for implementation by states and local communities-plans that provide viable and concrete courses of action for the modernization and pursuit of the public health mission and vision for the 21st Century.

States and communities around the country have already begun the dialogue to define the elements and indicators of their strategic plans. Over the next three years, the Turning Point partnerships will undoubtedly uncover the need for a course of action, guiding principles, and/or procedures considered to be advantageous and expedient to creating and sustaining their vision. This course of action(s), principles and/or procedures deemed by the partners as essential to creating and sustaining the vision of the partners, will be their Turning Point "policy agenda." A policy agenda will be one of the tools for assuring that subsequent actions are consistent with the desired transformation and that the transformed system has an impact which is in fact systemic and sustained.

Public policy can be defined quite broadly; the definition provided by the Coalition for Healthier Cities and Communities serves as one example. It may include public policies such as social and economic policy; regulatory action; policies related to service delivery, structures, and mechanisms; and private policies and practices. For example, if partners decide that the sharing of consumer information across agencies is essential to the elimination of duplication of services and the creation of a seamless system of care, then there will be the need for policies regarding confidentiality. Another scenario may be the establishment of financing policies for school-based health services to exist as an element in a community's overall plan for accessible primary care.

While the issues on the policy agenda will vary from state to state and community to community, all systems planning partnerships will need to develop an agenda that will support their vision. As states and communities determine and establish a policy agenda, they will deliberate the underpinnings of their values and priorities as revealed in their visions and missions. Through this very iterative, intentional, and evolutionary process, they will journey towards a transformed and strengthened public health system.

The W.K. Kellogg Foundation and The Robert Wood Johnson Foundation, in partnership with the National Program Offices, are eager to support and facilitate such journeys into the 21st Century.