A1. Workforce: Despite the critical role that public health plays in the health ecosystem, for many decades, it has suffered from neglect and disinvestment regardless of the dedicated and mission-driven workforce. Many years of job loss and attrition has further decimated the workforce. When COVID-19 struck, armed with a limited workforce, tools, technology and resources, public health launched a heroic effort to protect the population through testing, contact tracing, health education, mitigation strategies, health communications, vaccinations, and messaging on countering misinformation.
Houston Health Department (HHD) plans to focus on strategic areas with limited resources to meet the challenges of the future. The most valuable investment that public health has, is its workforce. Strategies to provide incentives or pay increases, hiring bonuses for hard-to-fill positions, job skills and cross cutting content area trainings of various types will be provided for retention. HHD will also focus on shoring its workforce by strategically retaining and retraining staff in areas of outbreak management, health education, health communication, data analytics, care coordination, laboratory services, administrative and infrastructure, call center, rapid response, and public health corps units. The rapid response and public health corps units, consisting of mostly existing staff, will be nimble and trained and ready to respond to any emergent nursing or community needs.
1B. Foundational Capabilities: The Houston Health Department (HHD), a full-service health department, serves a diverse population that exhibits deep health and income inequality. When faced with emergencies and natural disasters such as flooding, hurricanes, and disease outbreaks, the most underserved populations are also the most severely impacted. To serve a very large and geographically dispersed population, HHD chooses to strengthen resources in four areas of its infrastructure. These are 1) Compliance and Contracts 2) Quality Improvement 3) Accreditation 4) Partnerships to advance Equity.
1)HHD will create a robust contract management system that includes an electronic repository for all department contracts, grants, amendments, renewals, and all relevant supporting documentation including ordinances. 2) The quality improvement unit will standardize departmental strategic/operational plans, and objectives to promote quality, effectiveness, collaboration, and efficiency across departmental programs and services to allow for standardization, consistency, efficiency, documentation, and continuous learning. 3) HHD has been accredited since 2014 (this includes receiving its reaccreditation in May 2021), by continuing to meet national standards for performance and quality. HHD is continually improving in line with national public health standards while building health and equity. 4) HHD has formed many partnerships to enhance community outreach by community-based organization partners to advance equity. HHD plans to nurture and retain these and envisions that these partnerships could serve as an extension of the health department in the community.
A 3. Data Modernization: For the last decade, public health advocacy organizations and Centers for Disease Control have issued a call to action to modernize the data systems in public health. Many surveillance systems remain outdated and are expected to function when there are increased demands on it (such as during a pandemic). HHD will work on electronic case reporting (eCR) as the primary focus for improvement. Investments to improve its capacity and functionality will improve interoperability in our systems.
