State procurement law: facilitating the collaboration between health department and school of public health.

The mark of an "academic health department" includes shared activity by academic and practice partners sustained over time. Despite a long history of productive interactivity, the Pennsylvania Department of Health and the University of Pittsburgh's Graduate School of Public Health often faced administrative hurdles in contracting for projects of mutual interest. Seeking to overcome these hurdles, the Commonwealth of Pennsylvania and the University of Pittsburgh's Graduate School of Public Health negotiated a Master Agreement on the basis of statutes designating both as "public procurement units." This provided a template for project specifications, standard financial terms, and a contracting process. Since taking effect, the Master Agreement has supported projects in policy development, capacity building, workforce development, program evaluation, data analysis, and program planning. This experience suggests an approach potentially useful for other states and localities seeking to solidify academic health department partnerships either envisioned for the future or already in place.

Cross-sector leadership development for preparedness.

After fall 2001, scientists and professionals recognized the importance of integrating public health with traditional first-response professions in planning and training for disasters. However, operationalizing this approach among professionals in the field confronted barriers that were both inter-cultural and jurisdictional. The Pennsylvania Preparedness Leadership Institute (PPLI) is a collaboration of the Pennsylvania Department of Health and the University of Pittsburgh Center for Public Health Preparedness. Team members are recruited from public health, emergency medicine, emergency management, hospitals, and public safety agencies from each of nine multi-county regions in Pennsylvania. Each team takes on a year-long project that addresses a strategic problem as a focus for capacity-building within its region. Unexpectedly during PPLI's first year in operation, a hepatitis-A outbreak tested whether one regional team could successfully mount the necessary integrated response. This experience, as well as the planned evaluation for PPLI, demonstrated both the successful processes and the positive impact of this integrated leadership training initiative.

Developing a local comprehensive environment and health tracking system: using what we know to improve health and the environment.

Recent national reports have highlighted the absence of a coordinated local, state, and national environmental health tracking system. Local environmental health agencies are struggling to design and implement data systems that will allow them to evaluate environmental exposures ecological trends, and health outcomes in order to formulate more effective prevention strategies. This paper articulates the need for local environment and health tracking systems, discusses efforts under way around the nation, and describes the initiative being undertaken in one county health department to address this need. It provides information on attributes of indicators to be included in such a system, sources of data, criteria for evaluating the usefulness of indicators, suggestions for involving the community and staff, management strategies for implementing a data system, and recommendations for resolving common barriers to data sharing and use. This information will be useful to agencies that wish to develop their own robust environment and health tracking systems to support the three core functions of public health and the 10 essential public health services.

A model for public health workforce development using the National Public Health Performance Standards Program.

Workforce development programs in public health should link improvements in workers' performance with improvements in their agencies' performance. The "ten essential services" of public health provide criteria for measuring both individual worker training (as in workforce competency standards) and agency performance (as in the Centers for Disease Control and Prevention's National Public Health Performance Standards Program). This shared foundation was the basis for a model strategic training program developed for use in a 500-employee urban county health department. Full implementation of this model as a foundation for assessment, curriculum development, and evaluation requires careful attention to management issues, confidentiality of employee records, and evaluation methodologies.

The perceived impact of privatization on local health departments.

OBJECTIVES: This article presents nationally representative data on the effects of privatization on local health departments (LHDs). METHODS: A stratified representative national sample of 380 LHDs was drawn from a national list of 2488 departments. Telephone interviews were conducted with 347 LHD directors. RESULTS: One half of the directors of LHDs with privatized services reported that privatization helped the performance of core functions. Privatization often resulted in increased time needed for management and administration. More than a third of LHD directors reported concern about loss of control over the performance of privatized functions and services. CONCLUSIONS: Privatization is part of a broader shift toward "managing" rather than directly providing public health services, yet privatization often reduces LHDs' control over the performance of services.

New approaches to safe drinking water.

Up to half the population of some states in the United States drink water from small systems not regulated by the Safe Drinking Water Act. The quality of the drinking water from these systems is generally unknown and may be suspect. In many jurisdictions, private wells are the primary source of water. In some instances, construction of wells may have met regulatory requirements but may not have adequately prevented disease transmission. Anecdotal information, periodic water-borne outbreaks, and recent well surveys suggest that there are public health concerns associated with these and similar systems. This article provides an assessment of the need for governmental oversight (regulatory and non-regulatory) of drinking water supplies, describes how a "systems-based" approach might be used to evaluate water supply systems and to identify and prevent possible contamination, and presents case studies describing the systems-based approach as well as a comprehensive approach to environmental health that includes drinking water regulation.