Restructuring Maine Public Health Nursing To Address Areas of Greatest Need Background Maine?s Public Health Nursing Program as it stands today is functioning much like it did when the program ?rst began in 1920 as the Division of Public Health Nursing and Child Hygiene. For nearly a century, the program has provided health services in Maine homes and communities, while also ?lling in the healthcare system?s gaps. These services can range from service as a school nurse, to hospital discharge management, prenatal care, post-partum care for mothers and newborns, and wellness checks. But changes in how health care is delivered, including rural health centers, telemedicine, and population-based health promotion services leaves the 1920 model obsolete. It is unsustainable. While public health nursing has modernized with advances in medicine and nursing theory, current and emerging reimbursement strategies challenge the existing model even further. There are many opportunities for enhanced coordination, which if moved forward will avoid reactive care that leads to service duplication and system inef?ciency. The changing health care landscape demands that the public health nursing program adapt, prioritize and ensure that resources are focused on the most pressing public health needs in Maine. With that in mind, Maine is restructuring its approach to Public Health Nursing across the state. Identifying Public Health Priorities Many sources were tapped to identify current public health priorities. They include: I Public Health Data 0 Recent public health events (Ebola, measles) - Issues of both public health and safety (increases in elder abuse, substance-affected babies] 0 Assessment by Public Health Nurse supervisors The data clearly shows that certain areas of the State have speci?c needs that require more staff resources. Public Health Nursing Areas of Focus Infectious Disease Latent and Active Tuberculosis Vaccine Clinics Support to CDC Field Epidemiologists Refugee Health The Medically Fragile MaineCare?s complex cases Pediatric health needs that need additional support to the primary care medical home or family Substance-affected babies and children entering the child welfare system Children with developmental delays or disabilities known to child welfare Services for elderly to support aging in place Health Promotion - Child Care Providers Consultation services for overall health and safety practices Policy development assistance Wellness and safety support For example, nearly 20 percent of all babies born affected by substance were born in Bangor. But we did not adjust our service priorities to be sure those infants thrived; instead, we chose to continue providing routine school nurse services. Focusing on active and latent tuberculosis was pre?empted so our staff could continue to conduct follow- up home based visits with families, many of whom were already connected to a pediatrician or primary care provider. Now, the realignment of resources across the State re?ects the needs of particular geographic areas. It is critically important that data continues to be analyzed every two to four years to re-assess public health needs and to adjust sta??ing and resources when necessary. Public health nursing priorities must be driven by good data. What Realignment Accomplishes Maintains a skilled workforce of professional nurses across the state Creates staf?ng patterns based on identi?ed needs in DH HS Places resources where they are needed in communities Focuses our work to address critical public health issues Encourages public health nursing consultation within DHHS to address the health needs of our most vulnerable and needy populations Moving Fomrd We recognize that many important steps must be taken to ensure the transition to this new Public Health model. This work will take place over the coming months. These steps include: Engaging Public Health Nursing staff to develop performance measures and expectations Educating social services agencies, health care providers and consumers Continuing the analysis of service delivery across the healthcare spectrum to better define Public Health Nursing?s role and reduce service duplication Developing speci?c skills Within the workforce to address focus areas Reinforcing channels of communication to ensure all appropriate DH HS programs are engaged to address consumer?s needs Strengthening the role of non-medically trained personnel [Community Health Workers) in system navigation and support Filling vacancies to ensure appropriate staff levels Mary (2. Mayhem?: Paul R. inPnge, Governor Public Health Nursing Management Meeting 221 State Street, DHHS-3 May 5,2015 Adobe Connect call in information for Stacy: To dial in to the conference bridge: 11:00 12:30 Conference Number: 1?877-455?0244, Participant Code: 8793033495 To join the meeting on your computer (to see the speakers and slides): Welcome and Background Ken Albert Resource Allocation Sheryl Peavey Timeline Valerie Ricker Roles and Responsibilities Debra Wigand, Ken Albert Discussion and Next Steps - Dispatch from home policy 0 Capturing time documentation 10 minutes 11:00? 11:10 15 minutes 11:10 11:25 11:25-11:40 15 minutes 20 minutes 11:40 12:00 30 minutes 12:00? 12:30