HomeMy WebLinkAbout4.27.22 Butte County Public Health Strategic Plan
From:York, Danette
To:BOS
Cc:Nuzum, Danielle; Star, Nanette
Subject:Butte County Public Health Strategic Plan
Date:Wednesday, April 27, 2022 12:03:31 PM
Attachments:BCPH STRATEGIC PLAN 2022-2025.pdf
I am excited to share the recently completed Public Health Strategic Plan. We had help of a
consultant but I would like to thank our Assistant Public Health Director, Nanette for the many hours
she spent reviewing and cleaning up data tables etc. to get to this finished product. Please share as
you would like and feel free to reach out to me or Nan with questions.
Respectfully,
Danette York
Public Health Director
BUTTE COUNTY PUBLIC HEALTH
202 Mira Loma Drive | Oroville, CA 95965
| F: 530.538.2164
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Table of Contents
Letter from the Director ...................................................................................................................................2
Executive Summary .............................................................................................................................................3
Introduction ............................................................................................................................................................4
National Public Health Accreditation ........................................................................................................4
Ten Essential Public Health Services ..........................................................................................................5
Summary of Strategic Priorities ...................................................................................................................6
Overview of Butte County Public Health .................................................................................................6
Strategic Planning Process ............................................................................................................................7
Butte County Community Health Profile .................................................................................................8
Foundational Statements: Mission, Vision and Core Values ........................................................ 10
Priorities, Goals, Objectives and Strategies .......................................................................................... 11
Linkages to the Community Health Improvement Plan and Quality Improvement ........ 18
Implementation and Monitoring .............................................................................................................. 19
Appendices ........................................................................................................................................................... 20
Attachment 1. Strategic Planning Process Timeline ......................................................................... 20
Attachment 2. Key Informant (external) and Staff (internal) Participants ................................ 21
Attachment 3. SWOT Summary .............................................................................................................. 22
Attachment 4. Strategic Plan Revision and Action Plan Tracking Template ........................... 24
Butte County Public Health / 2022-2025 Strategic Plan 1 | Page
LETTER FROM THE DIRECTOR
Dear Colleagues and Community Members,
It is my pleasure to release the updated Butte County Public Health (BCPH) Strategic Plan. This plan
is the result of several months of engagement with public health staff, key community leaders and
public health partners to move towards improved health for all Butte County residents. This Strategic
Plan represents a shared vision for an integrated, culturally appropriate public health system that is
person-centered and advances health equity with strategies for achieving system outcomes and
population health improvements.
Much has changed in the landscape of public health since the last strategic plan was developed in
2018. The current COVID-19 pandemic demonstrated the vulnerability of public health and other
systems here and across the country. When combined with natural disasters, which have been
ongoing challenges in Butte County, the pandemic has further tested leadership and workforce
capacity at all levels. Thus, there is an even more urgent need to invest in the public health system
as well as address needs and inequalities for community members.
The Strategic Plan sets the direction for BCPH by organizing around six strategic priorities. These
priorities will strengthen our capacity to serve the community over the next three years while
continuing to support a culture of quality improvement. The goals and objectives outlined in this plan
are therefore crosscutting and overarching. Importantly, the plan provides a guide for addressing
social determinants of health in making decisions and allocating resources within Butte County.
Thank you for being part of such a wonderful community.
Sincerely,
Danette York, MPH, CPH
Public Health Director
Butte County Public Health / 2022-2025 Strategic Plan 2 | Page
EXECUTIVE SUMMARY
A robust and adequately funded public health system is necessary ublic
health interventions have reduced the burden of disease among some populations, but other groups are
at increased risk and require different approaches to disease prevention and control. A key component
of the national public health reaccreditation, this strategic planning process provided the opportunity for
reflection about achievements, examination of relevant data, assessment of current services and
outcomes, and identification of strategic priorities. The resulting strategic priorities were thoughtfully
selected using a lens of equity.
Input from community partners and stakeholder groups corroborated a number of the issues and priorities
identified to develop goals and objectives. Internal and external Strengths, Weaknesses, Opportunities
and Threats (SWOT) analyses helped provide a clear strengths, highlighted
weaknesses, identified opportunities with the potential to help BCPH achieve its vision, and singled out
certain threats that could reduce effectiveness.
Values: Integrity,
Mission: To promote individual,
Vision: Healthy, thriving
community-centered,
community, and environmental health
Butte County
collaboration, respect,
through prevention, education,
innovation, quality, equity
protection and intervention
The department will focus its efforts on the following goals and objectives:
A Safe and Healthy Environment
Prevent and timely respond to public health threats and challenges.
Focus on the development and promotion of policy that protects the health of Butte County residents
and promotes healthy lifestyles and environments.
Access and Engagement
Transform systems, structures and policies to enhance departmental capacity and practice to advance
health equity.
Cultivate and strengthen cross-sector partnerships for collective impact on health.
Work to integrate public health approaches and programs with clinical healthcare delivery systems.
Advance Health Equity
Identify barriers and implement a diversity and inclusion plan with opportunities for ongoing training.
Workforce Development and Performance
Recruit and retain well-qualified candidates who reflect the diversity of Butte County, and develop
procedures for growth, advancement and succession planning.
Continue to develop a culture of appreciation, empowerment and engagement.
Communication
Enhance internal and external communication through multiple approaches.
Invest in state-of-the-art technology and improve access to/use of quality data to inform actions.
Fiscal Stability and Quality Improvement
Implement an integrated performance management system into all levels of department operations.
Continue to develop a culture of appreciation, empowerment and engagement.
Butte County Public Health / 2022-2025 Strategic Plan 3 | Page
INTRODUCTION
Strategic planning is an activity used to set priorities, help focus energy and resources, strengthen
operations and ensure that staff and stakeholders are working toward common goals around intended
outcomes/results. A public health strategic plan acts as a guide for making decisions, allocating human
and financial resources, and pursuing objectives. The plan is internal to the organization and informed by
priorities noted during the planning process.
Public health has significant responsibilities, including the need to address factors sometimes not
associated directly with physical health. This ranges from income to safe and healthy housing, built
environments and green spaces, transportation, nutritious foods, accessible and affordable healthcare and
social and emotional support. This concept is called social determinants of health (SDOH) and it has
driven an approach to public health that is focused on improving the environment and community.
Addressing the SDOH in this strategic plan is not only important for improving overall health, but also for
reducing health disparities that are often rooted in social and economic disadvantages.
Changes brought on by a global pandemic provide unprecedented opportunities to raise the profile and
importance of disease prevention and health promotion; to substantially increase investment in best
practices and innovative approaches to health protection; and to expand the range and implementation of
evidence-based prevention interventions. For Butte County, the extraordinary disasters resulting in loss of
life and property and damage to the environment experienced since 2017compounded by the continuing
pandemichave affected the community across a myriad of aspects, with the long-range impact on the
public
This strategic plan (BCPH) history of leadership and
establishes clear goals, objectives, and
partnership activities over the next three years.
National Public Health Accreditation
Accreditation is a process aimed at advancing the quality and performance of public health agencies to
deliver essential public health services. The comprehensive set of standards of the National Public Health
Accreditation Board sets uniform performance expectations for health departments to provide the services
necessary to keep communities healthy.
1
BCPH successfully became nationally accredited on September 13, 2017 for a 5-year term. The
Strategic Plan is one requirement of accreditation. It aligns with other important assessment, planning,
and evaluation work such as a Community Health Assessment (CHA), Community Health Improvement
Plan (CHIP), and internal performance management and communication plans. BCPH is in the process of
preparing to apply for re-accreditation. Re-accreditation work continues to advance the performance and
quality of BCPH programs and services.
1
BCPH is one of 22 currently accredited local public health departments among the 61 health jurisdictions in California.
Butte County Public Health / 2022-2025 Strategic Plan 4 | Page
The 10 Essential Public Health Services
The 10 Essential Public Health Services provide a framework for protecting and promoting the health of
Butte County residents. They describe the public health activities BCPH undertakes to carry out the
mission of the department. Organized around three core functions of public healthassessment, policy
development and assurancethe Essential Services provide a set of concepts that collectively define
what the department does and how that work differs from other roles in the health field.
To achieve equity, as illustrated below, these services actively promote policies, systems, and overall
community conditions that enable optimal health for all and seek to remove systemic and structural
barriers that have resulted in health inequities.
Source: https://www.cdc.gov/publichealthgateway/publichealthservices/essentialhealthservices.html
Butte County Public Health / 2022-2025 Strategic Plan 5 | Page
Strategic Priorities
Strategic
Ensure a Safe and Healthy Living Environment
Priority I.
Strategic Enhance Access to Services and Promote Community Engagement and
Priority II. Collaboration
Strategic
Advancement of Health Equity
Priority III.
Strategic
Workforce Development and Performance
Priority IV.
Strategic
Enhanced Communication
Priority V.
Strategic
Quality Improvement and Fiscal Sustainability
Priority VI.
Overview of Butte County Public Health
BCPH provides a wide range of services in more than 60 programs that are designed to promote and
protect the health of all county residents and visitors. The department strives to address core public health
functions with a focus on prevention as much as possible. Leadership consists of the Public Health
Director, Public Health Assistant Director and Health Officer. To implement programs efficiently, the
department is organized into five major divisions:
Administration Division Provides fiscal, contractual, and operational management including
information systems, personnel management, and purchasing services. Additionally, vital statistics for
births and deaths in the County are registered and certificates issued, including burial permits, in
accordance with state law. The process of maintaining national accreditation is also a function of this
division.
Community Health Division Promotes health and wellness through: nursing case management and
occupational/physical therapy services for children with physically disabling health care needs under
services; immunizations; pregnancy care resources and case management through the Maternal Child
and Adolescent Health program; childhood lead poisoning prevention and response; communicable
disease prevention, investigations, education, surveillance, epidemiological follow-up, and monitoring
of treatment; data collection and analysis; and public health laboratory advanced testing capabilities.
COVID Division Pandemic response to COVID19 The Department Operations Center (DOC)
opened in February of 2020 in response to the COVID 19 pandemic. The DOC works closely with the
County EOC, Federal, State and regional partners to ensure the county is aligned with applicable
guidance and orders.
Butte County Public Health / 2022-2025 Strategic Plan 6 | Page
Environmental Health Division Provides services required by state law and Butte County Code to
meet environmental health and sanitary needs through: permitting and inspection of food
establishments; public swimming pools and spas, water wells, underground and above ground storage
tanks and wastewater systems; small water systems monitoring; solid and hazardous waste
management; and inspection of correctional/detention facilities.
Prevention and Health Promotion Division Provides education and health promotion information
to the community to help prevent negative health outcomes. Health education includes: Supplemental
Nutrition Assistance Program-Education (SNAP-Ed) through nutrition education with an emphasis on
obesity prevention; education and food vouchers to pregnant and breastfeeding women and children
ages 0-5 through the Women, Infants and Children (WIC) program; injury prevention and free/low cost
child car seats; emergency preparedness and response; oral health; and tobacco/vaping education.
Other Key BCPH Programs
Animal Control The department provides animal control services within the unincorporated
portions of the county and contracted services for the City of Biggs. Services include rabies
control, animal licensure, investigation of bites, containment of stray dogs, sheltering,
investigation of animal nuisances and cruelty, and dead animal pickup on County roadways.
Health Equity and Assessment The department has recently established a Health Equity
and Assessment Program whose program manager reports directly to the Assistant Director of
Public Health.
The department provides staffing under to First 5, whose Executive Director reports to the
Director of Public Health.
Strategic Planning Process
BCPH engaged an external consultant to facilitate information gathering and lead a staff-driven strategic
planning process. As part of the background information to inform the strategic plan, existing community
indicator data from the Community Assessment (CHA) and information from the Community Health
Improvement Plan (CHIP) were reviewed. Additional information was collected and analyzed from staff
interviews, an all-staff survey (internal input) and key informant interviews with community partners
(external input) to identify organizational strengths, weaknesses, opportunities and threats. All
information acquired helped determine strategic priorities.
Progress in meeting the goals and objectives of the previous strategic plan was also reviewed. In
selecting strategic priorities, the plan aligns with the CHIP to address some of the most pressing issues
identified in collaboration with the community. A fuller description of the strategic planning process and
timeline is provided in the appendices (Attachment 1).
Butte County Public Health / 2022-2025 Strategic Plan 7 | Page
BUTTE COUNTY COMMUNITY PROFILE
Demographic information helps to understand trends and project potential needs for public health services
for the population. The California Department of Finance Demographic Research Unit projected a 4.76.%
decrease in population between 2020 and 2021. According to the 2021 Census, Butte County has an
estimated population of 201,158.
Table 1. Population of Butte County, 2016-2021
Years Number Percent Change
2016 230,681 --
2017 233,080 1.04%
2018 234,627 .66%
2019 226,714 - 3.37%
2020 211,216 - 6.84%
2021 (estimates) 201,158
- 4.76%
Source: California Department of Finance, CA Population Estimates
Age distribution reflects the proportion of individuals at different life stages. Butte County continues to
have a somewhat stable age distribution and reflects the greatest population from the ages of 25 to 64,
workforce and family bearing age. The age structures may play a critical role in shaping community needs,
resources, and services.
Table 2. Age Distribution in Butte County, 2017-2019
2017 2019
Total Population Number Percent Number Percent
229,294 219,186
Under 5 years 12,387 5.4% 12,384 5.5%
5 to 9 years 14,888 6.5% 13,721 6.1%
10 to 14 years 10,780 4.7% 11,647 5.2%
15 to 24 40,138 17.5% 40,556 18.0%
25 to 64 109,678 47.9% 106,824 47.3%
65 to 84 35,887 15.6% 35,547 15.7%
85 and older 5,536 2.6% 5,136 2.3%
Source: U.S. Census Bureau, 2017 and 2019 American Community Survey
Racial and ethnic diversity has been increasing recently in Butte County. According to the 2019 Census,
the population demographics include White, at 70.8%, 17.2% of the population is Hispanic/Latino, 6.2%
identify with two or more races, followed by 4.7% Asian, 1.8% Black or African American, and 1.1%
American Indian and Alaska Native. As seen below in Table 3., Poverty Status in Butte County by Race
provides a snapshot of population groups that may further benefit from targeted public health services.
Those that live in poverty are at increased risk for mental illness, chronic disease, higher mortality, and
lower life expectancy.
Table 3. Poverty Status in Butte County by Race/Ethnicity, 2019
Race/Ethnicity Number Percent
American Indian / Alaska Native 409 16.20%
Pacific Islander / Native Hawaiian 100 16.70%
White 32,358 18.00%
Hispanic 7,380 20.60%
Two or more races 3,449 26.00%
Asian 2,833 27.60%
Source: U.S. Census Bureau, 2019 American Community Survey 1-Year Estimates
Butte County Public Health / 2022-2025 Strategic Plan 8 | Page
Mortality rates
monitoring, continued prevention, and intervention of specific conditions. According to the County Health
Status Profiles 2021, Butte County ranks below half of the state counties in deaths by homicide, followed
by motor vehicle accidents and coronary heart disease. However, out of 58 counties, Butte County ranks
as 50 with drug-induced deaths, lung cancer, and all cancers combined.
Table 5. Mortality (Death) Rates for Selected Conditions, 2021
County
Total Age-
Rank Age-Adjusted
Deaths Adjusted
Order Health Status Indicator County Death
2017-2019 CA Death
(of 58 CA Rate
Rate
counties)
25 Homicide 26 4.3 4.8
32 Motor vehicle traffic crashes 103 15.3 9.7
34 Coronary heart disease 799 82.8 80.6
42 Chronic liver disease and cirrhosis 141 18.4 12.1
45 Firearm related deaths 100 14.4 7.5
46 Accidents (unintentional injuries) 492 62.8 34.1
47 All causes 7,161 777.2 592.6
48 Female breast cancer 103 21.2 18.7
50 All cancers 1,500 164.9 131.4
50 Lung cancer 350 37.5 24.5
50 Drug induced deaths 172 25 14.3
Source: California Department of Public Health, California Comprehensive Master Death Files, \[2017-2019\]. Updated 6.29.2021
Butte County Public Health / 2022-2025 Strategic Plan 9 | Page
FOUNDATIONAL STATEMENTS
VISION
A healthy, thriving Butte County
MISSION
To promote individual, community, and environmental health through prevention, education,
protection and intervention
CORE VALUES
All staff of Butte County Public Health use the following core values, both internally and
externally:
Integrity Conduct all business transparently and accountably.
Community-centered Strive to meet the needs of those we serve through
inclusion.
Collaboration Commit to work together with community partners and
stakeholders.
Respect Understand and welcome the diversity of community
members.
Innovation Embrace new ideas and encourage initiative.
Quality Deliver value through evidence-based or promising
practices.
Equity Implement policies and practices in which people have
opportunities that match their needs, and address the
social and economic factors that shape health outcomes.
Butte County Public Health / 2022-2025 Strategic Plan 10 | Page
PRIORITIES, GOALS, OBJECTIVES AND STRATEGIES
STRATEGIC PRIORITY I. Ensure a Safe and Healthy Living Environment
Goal A. Prevent and respond to public health threats and challenges
Objectives Strategies
1. Develop an Information 1a. Improve security and reliability of public health IT infrastructure.
Technology recovery plan for
1b. Identify and track IT equipment.
public health applications by
December 2022
2. Implement IT recovery plan by 2a. Train staff in data protection, HIPAA hi-tech, and cyber security.
2023
3. 3a. Provide clarifying messages and education on the safety and
and awareness of vaccine effectiveness of vaccines through presentations to the community and
preventable diseases and professional organizations.
available vaccines.
3b. Tailor culturally appropriate vaccination-acceptance-boosting
messages.
3c. Expand vaccination access to the community.
Goal B. Promote and protect the relationship between population health and the built environment
Objectives Strategies
1. Reduce the burden of chronic 1a. Provide information to local planners and health-related leaders on
disease in the population the role the built environment plays in impacting health and health
through an active lifestyle, outcomes in the community.
proper nutrition, and reduced
1b. Work in partnerships with organizations that can facilitate access to
exposure to toxic conditions by
walkable and bikeable neighborhoods, trails and pathways.
June 2025.
2. Increase the opportunities for 2a. Participate in and when possible, help plan community efforts that
children and adults, including offer safe, affordable recreational programs.
seniors and people with
2b. Collaborate with partners to provide equipment and/or improve
disabilities, to participate in non-
existing recreational and/or exercise equipment in local parks and
sedentary activities by
recreation areas.
December 2023.
2c. Integrate health considerations into Butte County General Plan
and/or other area plans/policies as applicable.
2d. Promote more integration of disabilities and senior education into
existing programs and increase access to classes/services on
increasing movement safely.
Butte County Public Health / 2022-2025 Strategic Plan 11 | Page
Goal C. Promote healthy lifestyles and environments for Butte County residents
Objectives Strategies
1. Improve childhood nutrition by 1a. Engage populations experiencing health inequities through
increasing the percentage of community food assessments, and other efforts to assess food access.
fresh fruits and vegetables
consumed by children by June
banks and similar efforts that link people, particularly in food deserts, to
2025
fresh produce.
1c. Expand partnerships with cultural centers, after school centers and
boys and girls clubs to provide nutrition education classes or cooking
lessons to increase exposure to fresh fruits and vegetables.
1d. Expand current tray waste analysis in local schools and provide data
to nutrition coalitions to drive changes to school meals services.
1e. Expand partnerships to move edible food from the waste stream to
community-based organizations.
2. Improve food safety by 2a. Standardize food inspections.
reducing the percentage of
2b. Consistently educate food facilities on food safety utilizing
food facilities with major
established protocols.
violations observed during
routine inspections by June
2025
3. Increase the number of dogs 3a. Promote dog licensing on social media and with animal stake-
licensed in unincorporated holders throughout the county using an educational campaign.
Butte County by December
3b. Address complaints to ensure all dog licenses are obtained as
2024
applicable.
3c. Ensure dog licensing information is accessible and available to all
community members through a variety of formats.
4. Work with Behavioral Health 4a. Apply a public health approach for preventing opioid misuse, opioid
and community-based addiction and opioid overdose deaths.
organizations to reduce by
4b. Promote early screening of children and youth, to identify those with
June 2025 the impact of
or at risk for behavioral health issues.
mental and substance use
disorders through partnerships
4c. Implement a trauma-informed approach in BCPH policies and
in prevention, early
practices.
identification and recovery
support.
4d. Collaborate with community partners to educate the public to
recognize the signs of behavioral health issues and link to resources.
4e. Support adoption of evidence-based or promising practices
prevention strategies.
Butte County Public Health / 2022-2025 Strategic Plan 12 | Page
STRATEGIC PRIORITY II. Enhance Access to Services and Promote Community
Engagement and Collaboration
Goal A. Promote an understanding by community residents of how to access and engage in public health
programs and services
Objectives Strategies
1. Expand equitable access to 1a. Expand communication to include multiple languages, increase
high-quality services, programs accessibility to updated online resources (webpage, social media and
and information by December increased paid media), make platforms more interactive and establish
2024 patient and provider portals.
1b. Utilize text messaging when appropriate.
1c. Increase availability of online scheduling.
2. Integrate the voices of 2a. Strengthen partnerships with cultural centers to increase access to
underrepresented communities services and participation in community feedback methods.
into all policy, program, and
2b. Expand outreach and promotion events to underserved populations
resource decisions by June
and geographic areas.
2023.
2c. Use a lens of equity and incorporate diversity in developing grant
scopes of work.
Goal B. Cultivate and strengthen cross-sector partnerships
Objectives Strategies
1. By December 2023, provide 1a. Build and maintain support of multi-sector coalitions in public health
leadership, development and priority areas to coordinate strategies, leverage assets, and mobilize
support to diverse strategic change.
partnerships.
1b. Explore opportunities for partnerships with community-based
organizations to implement CalAIM Community Support Services.
2. Integrate public health values 2a. Continue to strengthen collaboration with local healthcare providers
with clinical health care delivery and external health systems.
systems by December 2023.
Butte County Public Health / 2022-2025 Strategic Plan 13 | Page
STRATEGIC PRIORITY III. Advance Health Equity
Goal A. Build a shared understanding and internal capacity for advancing health equity to ensure all Butte
County residents have the chance to be as healthy as possible
Objectives Strategies
1. Identify barriers to diversity and 1a. Examine hiring processes to identify barriers to diversity and
inclusion in all BCPH inclusion.
processes by December 2022.
1b. Redesign hiring processes to eliminate institutional barriers to
diversity and inclusion.
2. Develop and implement a 2a. Apply a health equity lens to all new and existing internal programs
and services.
diversity and inclusion plan by
July 2023.
2b.
advance health equity.
3. Provide ongoing educational 3a. Promote the availability of cultural and linguistic competency training
and training opportunities for for staff that aligns with the cultural and language variations of Butte
BCPH staff to incorporate a
health equity framework into
programs and services by
June 2025.
Goal B. Enhance community capacity to increase health equity
Objectives Strategies
1. Promote opportunities for 1a. Provide technical assistance to community partners concerning
community partners to learn polices, systems, and environmental changes and data analysis to
more about health equity by enhance health equity.
June 2024.
1b. Identify community champions to engage in health-related initiatives.
2. Facilitate collaborative efforts 2a. Maintain continuous partnerships with other County departments,
to reduce the impact of the providers and community stakeholders to create policies, systems, and
social determinants of health environments to enhance health equity.
by June 2025.
Butte County Public Health / 2022-2025 Strategic Plan 14 | Page
STRATEGIC PRIORITY IV. Workforce Development and Performance
Goal A. Build and inspire a diverse team to take effective action around public health priorities.
Objectives Strategies
1. Recruit well-qualified 1a. Identify and work to mitigate barriers to recruiting and retaining staff
candidates who reflect the and to understand where candidates may drop-off in the hiring process.
diversity of Butte County by
1b. Create and publish more descriptive/ accurate recruitment postings to
June 2025.
reflect expected job duties, expectations and languages preferred of
vacant position(s).
1c. Create a standard operating procedure for the interview process to
ensure consistency.
1d. Collaborate with high schools, community colleges, and schools of
medicine, nursing, and public health to strengthen and diversify the public
health workforce pipeline.
2. Provide tools and training 2a. Continue to grow a comprehensive system of professional
opportunities to retain and development for staff that will promote continuous learning around the
develop staff to grow and 10 essential public health services.
advance professionally by June
2b. Support and maintain an innovative work environment.
2025.
2c. Support internal cross-training and/or job shadowing plan.
2d. Create and implement an onboarding standard operating procedure
connecting staff to multiple divisions and the overall flow of the
department.
3. Develop and implement a 3a. Identify, develop and nurture existing high-potential talent.
succession plan to elevate
3b. Create more diversity and inclusion by providing equitable
appropriate staff to
opportunities for coaching and mentoring.
management and leadership
positions by June 2025.
Goal B. Build and sustain a work culture where staff are acknowledged, empowered, and engaged.
Objectives Strategies
1. By December 2022, increase 1a. Solicit ideas and insights from staff and apply input whenever
opportunities for BCPH staff to possible.
participate in and be
1b. Identify and increase opportunities for giving team members
recognized for their contribution
permission to take action and make decisions.
to the department.
Butte County Public Health / 2022-2025 Strategic Plan 15 | Page
STRATEGIC PRIORITY V. Communication
Goal A. Maximize utilization of available resources, services and information.
Objectives Strategies
1. Develop an outreach plan to 1a. Share specific outcomes, with data when possible, from BCPH
increase community and programs to communicate public health results and achievements.
provider awareness of BCPH
1b. Employ a variety of media outlets to keep the general public informed
brand, programs and services
about trending health issues.
as applicable.
1c. Draw attention to the value, roles and responsibilities of public health.
2. Increase BCPH staff 2a. Hold regularly scheduled discussions and/or trainings on department
awareness of department programs and services.
programs and services by June
2b. Create multiple communication approaches to message policy
2025.
priorities, emerging issues, opportunities for learning, and specific team
roles.
3. Update BCPH web pages by 3a. Consistently include BCPH branding in all internal and external
2023 to enhance sharing public communications.
health stories, providing
3b. Create compelling narratives using personal stories that residents
information for the public and
have agreed to share.
offering a place for the public to
3c. Identify and use appropriate evocative visual images that can
question.
improve message recall, create emotional responses, and contribute to
sustained changes in beliefs about and attitudes toward public health
issues.
3d. Frame messages to acknowledge a role for individual decisions
about behavior but emphasize the impact of the social determinants of
health.
3e. Create a standard operating procedure for program staff to follow to
get information posted in a timely manner.
Goal B. Maintain development and implementation of the Community Health Assessment (CHA) and
Community Health Improvement Plan (CHIP), and make the public aware of goals, progress and
challenges
Objectives Strategies
1. Annually through June 2025 1a. -based technology (e.g.
share in a report with dashboards, scorecards, etc.) to document ongoing progress of CHA/
community members and CHIP measures and indicators.
partners from key sectors the
1b. Develop a formal charter and/or process to guide CHA/CHIP
status of CHA/CHIP
activities.
implementation strategies.
1c. Ensure process meets community partner needs and that they
remain engaged throughout CHA/CHIP development and
implementation.
1d. Explore the implementation of CHA/CHIP projects and/or activities
through local community-based organizations that may have increased
access/capacity to apply for and receive external funding streams.
Butte County Public Health / 2022-2025 Strategic Plan 16 | Page
STRATEGIC PRIORITY VI. Quality Improvement and Fiscal Sustainability
Goal A. Promote an effective and efficient quality improvement system
Objectives Strategies
1. Continue to build and 1a. Educate leadership and staff on QI tools and techniques.
implement a Quality
1b. Continue to develop the depa
Improvement (QI) program,
organization, roles and responsibilities, membership, staffing,
ensuring it is integrated into
administrative support and budget and resource allocation.
all aspects of the department
by June 2023.
1c. Encourage QI communication, engagement, and participation for all
divisions, programs, and staff.
1d. Schedule and implement periodic department-wide internal QI
audits and assessments.
1e. Review the BCPH QI Plan annually and update as needed.
2. Optimize information 2a. Enhance current modernization investments such as cloud
technology investments to computing, data input and reporting improvements, shared services
improve process efficiency and a digital strategy to make it easier to access information using
and enable innovation by BCPH websites and tools.
June 2025.
3. Continue to build and 3a. CHIP, Strategic Plan, and QI Plan are
implement a Program linked to and/or align with the program performance management
Performance Management system.
system that is integrated
3b. Continue to develop and/or refine the program performance
Into all levels of department
management measures, collection methods and frequency, and
operations by June 2022.
reporting protocols.
3c. Ensure the program performance management system is used to
identify, inform, and/or prioritize department QI projects.
3d. Develop processes/protocols to analyze program performance
management system progress and ensure communication of results to
all staff.
Goal B. Maintain an effective system of financial stewardship
Objectives Strategies
1. Ensure resources are expended 1a. Maintain existing funding resources and increase when available
in compliance with funder and cost neutral or cost/beneficial to the department.
requirements and local policy
1b. Develop a process to determine if potential funding opportunities
and procedures.
align with public health priorities or community needs.
2a. Participate in trainings and create department-specific training
2. Increase proficiency in the
Financial System by 2025. resources.
2b. Develop department specific reports that will provide data to guide
financial decisions.
Butte County Public Health / 2022-2025 Strategic Plan 17 | Page
LINKAGES WITH THE CHIP AND QI
Community Health Improvement Plan (CHIP) Alignment
As a nationally accredited health department, Butte County Public Health strives to achieve population
health outcomes through policies, processes and plans. Aligning and coordinating health promotion and
equity across a wide range of partners is essential to the success of the department. Continuous
community engagement and collaboration allows for increased efficacy in addressing public health issues
and concerns. As part of the strategic planning and re-accreditation process, BCPH reviewed the CHIP in
alignment with the selected strategic priorities in this strategic plan. While the strategic plan is unique in
that it addresses internal organizational roles and responsibilities and workforce initiatives that are not in
the CHIP, the priorities within this plan will help drive assessment, evaluation and activities that can
Quality Improvement
Quality improvement (QI) is a critical part of increasing BCPH organizational capacity and working with
communities to improve the health status of the populations performance management (PM)
process helps improving effectiveness,
empowering employees, and streamlining decision making. The formal PM and QI processes (utilizing the
PDSA model) were developed and implemented during the initial accreditation effort. Despite the
efficiencies that were gained, completing and maintaining PMQI work has been a challenge. Various
reasons for this interruption since 2017 include:
ponse to emergencies and disasters such as the Oroville Spillway, the
CAMP and North Complex Fires that devastated whole communities during 2018 and 2020, and the
COVID-19 pandemic.
Redirection of many staff from their customary program and administrative work to respond to these
events for long-periods of time (weeks, months, and even years). PMQI projects and activities are
recognized as important but, unfortunately, had to take a lower priority while responding to
emergencies.
The department has experienced a significant level of personnel turnover in recent years. A large
number of individuals originally trained to facilitate PMQI projects/activities have left, and many new
staff have not yet had an opportunity to receive training regarding PMQI benefits, roles, and
processes.
A solid foundation for PMQI exists in the form of plans, metric/indicator formats and facilitation guides.
However, they need to be reviewed, updated as needed, and introduced to new staff. Leadership strongly
supports department-wide PMQI, and implementing these formal activities will continue to grow and
improve the department.
BCPH is in the process of redesigning the PMQI system to align Essential Public Health
, policies, and priorities such as the CHA, CHIP, Workforce
Development, and Health Equity. The goal is for the revised PMQI system to better inform and guide the
projects and activities.
Butte County Public Health / 2022-2025 Strategic Plan 18 | Page
IMPLEMENTATION
AND MONITORING
The Accreditation Program Manager is tasked with evaluating and reporting progress on the strategic
plan. This full-time position presents the strategic plan progress reports to the senior leadership team so
that goals and objectives can be adjusted as needed (see Attachment 4 for the preliminary templates).
To implement the strategies, goals and objectives listed above the department will develop an annual
internal action plan. The action plan will identify a project lead as well as a timeline for implementation.
The leads will be responsible for action plan implementation and tracking to determine progress in meeting
the objectives.
Senior leadership and management will meet at six-month intervals to review reports on implementation
and progress of action plans and consider the progress on the strategic plan. At that time, barriers will be
identified and changes in direction implemented if necessary. Pro
performance measures will be communicated to staff and, as appropriate, to community partners through
various channels.
Butte County Public Health / 2022-2025 Strategic Plan 19 | Page
APPENDICES
Attachment 1
STRATEGIC PLANNING PROCESS TIMELINE SUMMARY
DATE EVENT/STEPS
June 2021 Reviewed and evaluated progress of the BCPH 2015-18 Strategic Plan.
Determined the schedule for updating the plan.
July 2021 Developed a scope of work (SOW) and budget, then issued a Request for
Proposal (RFP) for an external public health strategic planning consultant to
help facilitate the process.
August 2021 Reviewed RFP responses and selected the consultant; negotiated the SOW
and entered into contract.
October - Held initial planning meetings with the consultant to organize logistics.
November 2021 Reviewed CHA, CHIP and other relevant Butte County data and documents to
inform the planning. Held a kick-off meeting (October 22, 2021) with senior
leadership and Division Directors (the strategic planning team) to introduce the
consultant team, discuss project approach, activities and timeline, and reach
consensus on role of staff and consultants. Identified diverse community
leaders/advocates/agency representatives, and conducted Key Informant
interviews to solicit perspectives about community needs, identify Strengths,
Weaknesses, Opportunities and Threats, and suggested priorities;
administered an all-staff online survey and conducted one-on-one interviews
with senior leadership and Division Directors for the same purpose.
December 1, 2021 Met to review a summary of the internal/external input and discuss its
implications for strategic priorities and goals. Staff also reviewed the mission,
vision and core values and made several changes to reflect current and future
department strategic needs.
December 17, 2021 Collaboratively developed strategic priorities and worked on goals and
activities that would guide future activities of the department.
January 2022 Reviewed and finalized the strategic planning goals, objectives and strategies.
AImprovement Plan.
Additional content was developed to put the strategic planning framework into
context.
February 2022 Team reviewed the Strategic Plan for final input and revised based on
feedback.
March - April 2022 The Butte County Public Health 2022-2025 Strategic Plan is posted on the
BCPH intranet page and website to share with staff, partners and the
community.
April 2023 Senior Leadership and Division Directors develop action plans to implement
the Strategic Plan.
Butte County Public Health / 2022-2025 Strategic Plan 20 | Page
Attachment 2
Key Informant (External) Interviewees
Individual Affiliation
Tiffany McCarter African American Family Cultural Center, ED
John Fleming Ampla Health
Scott Kennelly Behavioral Health Director
Paula Daneluk Butte County Development Services
Kory Honea Butte County Sheriff
Mary Sakuma Butte County Superintendent of Schools, Office of Education
Mark Orme Chico City Manager
Shelby Boston Director of Department of Employment and Social Services
Mike Wiltermood Enloe Medical Center CEO
Anna Bauer First 5 Butte County
Reyna Nolta Hispanic Resource Council
Laura Cootsona Jesus Center, homeless shelter, mobile clinics
Steve Stark Orchard Hospital CEO
Eric Rapport Regional Water Board
Andrea Mox Stonewall Alliance, LGBT*Q+ center
Jovanni Tricerri Vice President, North Valley Community Foundation
Senior Leadership (Internal) Interviewees
Individual Affiliation
Danette York Public Health Director
Nanette Star Assistant Public Health Director
Monica Soderstrom Division Director, Community Health
Elaine McSpadden Division Director, Environmental Health
Erin Cox Division Director, COVID
Jodi Nicholas Division Director, Public Health Administration
Jodi Putnam Division Director, Public Health Prevention
Lisa Almaguer Communications Manager/Public Information Officer
Ryan Soulsby Program Manager, Animal Control
Butte County Public Health / 2022-2025 Strategic Plan 21 | Page
Attachment 3
SUMMARY OF SWOT RESULTS
Key Informants (external input)
The Key Informants (community partners/leaders) were asked during individual interviews what
characteristics allowed BCPH to meet community needs (strengths) and what challenges reduced the
. These strengths and weakness characteristics
represented the internal environment of the organization. They were then asked to identify events BCPH
could take advantage of to become more effective (opportunities), and events that could negatively impact
ability to perform (threats), referring to the external environment the department may
not be in control of.
Key Informant-Identified (External Input)
Strengths Weaknesses
Competent infrastructure and response of staff to Under resourced in workforce (animal control
pandemic and disasters, (i.e., navigated the COVID mentioned twice)
situation really well)
Takes too narrow a view of PH scope (not proactive
Good partnerships with other county agencies, facilities enough around social determinants of health),
and non-profits attributing it to lack of staff
Approachable Community engagement that happened around the
CHA needs to be strengthened
Very open to collaboration and feedback; transparent
Staff turnover too many changes in point of contact
presentations and guidelines to BOS) Not a strong enough voice/visible enough with health
messages (too concerned about political fallout)
Constructive relationhips vis-à-vis enforcement
responsibilities Website is not helpful for finding information
Serves as a social safety net for some services Not enough connection/visibiity with schools
Website is feature-rich; use of social media Seem a little too bureaucratic
Find the right balance in the county, politically Different answers depending on who is asked;
sometimes mixed messages
Offering direct clinic services to help with access
Not all relevant materials/messages are available to
Seem strategic about going after grants
non-English populations
More efficient/more engaged than other N. CA health
Environmental Health ordinances and regs and
departments
standards for practice need more clarity, updating
Opportunities Threats
Take advantage of newer technology/software platforms Retirements and lack of succession funding
(e.g., data sharing of patient records and consolidating
Lack of local bipartisan support for public health
medical information); become more digital
Low local public trust for PH, e.g., distrust over COVID
Keep momentum of COVID-inspired relationships going,
mandates
continue breaking down siloes
Working in conservative anti-government enivronment
Be more of a leader/convener, especially to leverage
Facing an overall leadership deficit/burnout without
funding
enough in the pipeline to fill it
Being a central place for referrals could be a robust
Pandemic variants; new diseases could wipe us out
partnership opportunity
Poor internet access in pockets of the county impede
Opportunities in community education around opiod
disaster response capacity
addiction (availability of opiod settlement funds?)
Not figuring out how to evolve in a post-COVID world
Opportunities in community education re THC levels once
cannabis dispensaries are approved
Missed the boat on Whole Person Care by passing it up;
net effect was a perception of passivity
Leadership around CalAIM
Butte County Public Health / 2022-2025 Strategic Plan 22 | Page
Public Health Staff (internal input)
The SWOT summary below combines input from the all-staff survey and the strategic planning team of
leadership/Division Directors. This information was used to help further refine the vision, value statements
and strategic priorities. Consistent themes identified through the SWOT analysis were workforce,
technology, quality improvement, communication and collaborative partnerships.
Senior Leadership-Identified (internal input)
Strengths Weaknesses
Talented staff, dedicated to their work Some staff resistant to change
Competent, supportive leadership High staff turnover/vacancies
Experienced in real-life emergency response; Non-competitive wages = hiring/ retention
rapid/flexible responses challenges
Up-to-date on PH topics/issues Hiring process not well streamlined
Workforce
Division Directors have full support of upper Need more bilingual/diverse staff
leadership
Benefit of having unions to utilize full skilllset
Institutional knowledge; expertise Scope of work for Animal Control outsized for
current funding
Recognition/appreciation of staff
Skilled fiscal staff to get reimbursement
Better use of available data (e.g., CHA, CHIP)
Some CQI measures not being used
Having direct services (i.e., the PH clinic)
Missed oppportunities due to no grant writer
l
a
Focus on education over prosecution; use of
Admin silos reduce communication
n
r
de-escalation skills for volatile situations
e
Need for IT training/ more IT tools
Infrastructure/
t
n
Good audit results
I
Programs
No department-wide health record filing system
Centralized policies and procedures
Could be doing more with prevention/
promotion, if had more staff
Training for Microsoft 365/Sharepoint platforms
Internal communication not always clear
Good community linkages (but some BCPH depends on the same stakeholders; need
partnerships need strengthening) to expand
Willingess to offer PH expertise to CBOs, others Some community linkages based on personal
Living in a small county/community = knowing
Culture/
one another Need better focus through equity lens
Communication
Not clear who to call for info/help at other County
agencies
Outdated web pages; difficult to get info on it
Standard operating guidelines to make
institutional knowledge more accessible
Opportunities Threats
Better use of social media to extoll BCPH Decline of trust in PH due to COVID mandates/
positives compliance
Turn COVID and other disaster responses into Physical threats, e.g., COVID clinics, for Home
Visitor staff
l
e
a
n
prioritized
$$ available for COVID and to beef up CD
r
e
t
Climate change wildfires, drought
Enhanced partnerships with Behav Health
x
E
Politically conservative county; PH issues not
The plan for a new Family Resource Center
always well appreciated
CalAIM
Switch from Anthem BC to Partnership Health
Emerging diseases/variants
SB 65 can improve child death reviews
Some legislation, e.g., SB 1383, intended for
University/college as a recruiting tool
consumer protection increased workload
Use technology upgrades to be more paperless
Butte County Public Health / 2022-2025 Strategic Plan 23 | Page
Attachment 4
Strategic Plan Revision Tracking Template
Section/Pages
Date Responsible Staff CHIP Alignment QI/PM Alignment
Affected
Reporting Rubric
The status of each strategic plan goal is reported using the following rubric:
1 2 3 4 5
Goal is in process of being Goal is in process of
Goal is not Goal is in process of
Goal #
addressed but a being addressed, on
adequately being addressed and Goal completed
barrier/need must be track no issues
addressed nearly complete
resolved to accomplish it perceived
1
2
3
etc.
Butte County Public Health / 2022-2025 Strategic Plan 24 | Page