The following are Subcommittees or Projects undertaken by the Public Health Functions Project:

A. Public Health Expenditures:

The Public Health Functions Project, the Office of Planning and Evaluation, and the Office of Disease Prevention and Health Promotion have sponsored a number of projects intended to provide a more complete picture of the Nation’s expenditures on population-focused public health. The various projects have been designed to identify mechanisms that would provide both information on the overall size of the investment in public health at different levels of government and information on the distribution of the expenditures across the component essential services of public health (as described in the Public Health Functions Project statement Public Health in America).

    1.    Federal:        

• FY 95 (Public Health Service Agencies Only), published in MMWR
• FY 96 (Public Health Service Agencies Only), distributed to Public Health Functions Project participants
• FY 97 (HHS plus EPA), in process

    2.    State:

• 1993-94, 8 States, public health agency only, published in MMWR and separate report by Public Health Foundation
• 1995-96, 9 States, health, mental health, substance abuse and environmental agencies, published in MMWR, Journal of Public Health Management and Practice, separate report by Public Health Foundation
• 1998, 2 States (see 1998 entry under local expenditures)

    3.    Local:

• 1995-96, States participating in state expenditure study asked to estimate local expenditures within their jurisdictions
• 1997, 3 local health departments, published as separate report by Public Health Foundation
• 1998, all local health departments in 2 States, planning now underway

B. Public Health Guideline Development: The Public Health Functions Project mission states as one of its goals, "develop and publish a full set of evidence-based guidelines for sound public health practice."

1. Guide to Community Preventive Services: In response to the aforementioned goal, the Centers for Disease Control and Prevention (CDC) volunteered to fund and staff the development of the Guide to Community Preventive Services. Similar to The Guide to Clinical Preventive Services, there is a 12 member Task Force of national experts. In addition to this Task Force, all of the partners of the Public Health Functions Project have a liaison role. Regular updates on this project are given at the Public Health Functions Working Group meetings.
2. Public Health Practice Guidelines: The development of public health practice guidelines was first done by the Council on Linkages Between Academia and Public Health Practice. Two sets of guidelines were developed: cardiovascular disease prevention and tuberculosis treatment completion. The Council is linking their work with the above Guide to Community Preventive Services, possibly by assisting in the field testing.

C. Public Health Workforce, Training, and Education: This Subcommittee and it’s three subgroups, Workforce Group, Competency-Based Curriculum Group, and the Distance Learning System Development Group, have just completed over two years of work with the report, The Public Health Workforce: An Agenda for the 21st Century. This report is the first step in the Public Health Functions Project taking action in public health workforce issues. Currently, these groups are not meeting, but in the near future we may have to pull together a meeting to coordinate follow-up action items.

D. Healthy People 2010: The newest Subcommittee to the Project, this group is working on developing a focus area on public health infrastructure for Healthy People 2010. The Public Health Practice Program Office, Centers for Disease Control and Prevention, is coordinating development of national objectives for the proposed Healthy People 2010 focus area on public health infrastructure on behalf of the Public Health Functions Steering Committee. To date, two national workgroup meetings with representatives from Federal, national, State, and local levels have been held. Draft objectives are being formulated and circulated to a wide range of partners. The framework for the chapter development is the ten essential public health services and the four major components of infrastructure—systems, competencies, relationships and resources. For additional information, please contact Pomeroy Sinnock, Ph.D., by telephone at (770) 488-2469, or by e-mail at pxs1@cdc.gov.

E. Public Health Data: The Public Health Functions Project has a goal related specifically to data: "Collaborate with the PHS Data Policy Committee to identify the information and data needs for the effective implementation of the essential services of public health, and develop a strategy for the interface between the personal services and population-wide systems, ensuring the availability of information necessary to both." The PHS Data Policy Committee is an internal DHHS committee which has not met in over a year now, however the DHHS Data Policy Committee (includes all Department agencies, not just the Public Health Service agencies), another internal committee, is who we are working with now.

1. Public Health Infrastructure Data: This is a project being done by the Lewin Group to develop a survey to gather public health infrastructure data. The project is near the end and a report is expected this fall.
2. Action Plan for Improving State and Local Health Information: This is a five-year project, funded through a cooperative agreement with the Office of Minority Health and the Public Health Foundation. Several of the agencies of the Public Health Functions Project pool together money for this activity to continue the dialogue among State and local public health agencies, public sector substance abuse, mental health, and environmental agencies, and private sector organizations around data and information-systems issues.

F. Public Health Communications: One of the main priorities of the members of the Public Health Functions Project is to get the general public more aware of what public health is and does for them.

1. National Public Health Week: The National Public Health Week Steering Committee meets regularly to initiate plans for National Public Health Week, usually held the first full week of April. Preliminary indications are that all fifty states participated in 1997 in promoting Public Health Week events. The dates selected for 1998 are April 6-12, and the multi-year theme will be "Healthy People in Healthy Communities." Cogate Palmolive has partnered this year to underwrite publication of the 1998 planner’s guide. There is also the potential of a photo contest and national kick-off event in Washington, D.C. to inaugurate the week-long celebration. Jennifer Wierwille from APHA is the current chair.
2. Public Health Information Strategy: This Subcommittee was working on a plan to coordinate public health information releases with Progress Reviews of Healthy People 2000 and other major publications of the Department of Health and Human Services. Currently, the activities of this Subcommittee are on hold awaiting further departmental approval.

G. Managed Care and Public Health: This group was formed in 1995 to share information on what the partners of the Project were doing around managed care so that collaboration may occur. This group has not felt the need to meet in over a year.

1. HEDIS: In 1995, the National Committee for Quality Assurance (NCQA) began working on a new version of the Health Plan Employer Data and Information Set (HEDIS 3.0), used to measure and report on quality of care provided by the Nation's managed care organizations. Previous versions of HEDIS were lacking any focus on prevention or public health measures. The Public Health Functions Project responded to an open call to propose new measures for HEDIS 3.0 and at least half of the 33 new measures adopted into HEDIS 3.0 were proposed directly by the Public Health Functions partners and the Public Health Functions Project mainly due to the collaboration and leadership which the Public Health Functions Project provides for its members.
2. County-Level Tracking of Public Health Functions and Policies: Mathematica Policy Research, Inc. under contract with the U.S. Public Health Service, Office of Disease Prevention and Health Promotion, is conducting a study of how health system changes are impacting public health functions at the county level. Case studies of local health departments will be conducted in 12 communities to measure changes in health departments’ capacity to carry out the 10 essential public health functions for select population-based programs. The communities included in the case studies are: Little Rock, AR; Phoenix, AZ.; Orange County, CA; Indianapolis, IN, Miami, FL; Boston, MA; Lansing, MI; Newark, NJ; Syracuse, NY; Cleveland OH; Greenville, SC; and Seattle, WA. Topics to be addressed in site visits include: (1) arrangements or agreements between local health departments and managed care organizations to conduct population-based public health functions; (2) changes in the scope and volume of population-based public health functions carried out by local health departments; (3) changes in local health departments’ budget for personal and population-based services; and (4) degree to which local health department directors' perceive they are fulfilling the objectives and carrying out essential public health functions. The study is designed to collect baseline information for 1996 and subsequent data at two year intervals. The study is a collateral investigation to the broader Community Tracking Study funded by the Robert Wood Johnson Foundation and conducted by the Center for Studying Health System Change. That study will provide important contextual information on the broad health system changes that are occurring in each community.

H. Essential Services: In March 1993, work began on the future role of public health in a reformed health care system. Identifying the core functions of public health and creating a common terminology and description of the functions was the first step. Though the three core functions of public health developed by the Institute of Medicine’s report, The Future of Public Health (1988) were widely accepted among public health’s policy and academic community, they did not explain to legislators or the general public what public health does. An initial attempt to further define the functions of public health were included in President Clinton’s Health Security Act (1993). As a result, in 1994 several revised versions began to appear from several different public health groups. In an effort to coordinate a single list for the public health community to use, the Core Public Health Functions Project was developed by Dr. Philip Lee, then Assistant Secretary for Health. A subcommittee of the Working Group, the Essential Services Work Group was formed to further refine the language. The Public Health in America statement subsequently developed was reviewed and adopted by the Core Functions Working Group and Steering Committee. In 1995, the name of this group was changed to the Public Health Functions Working Group and Steering Committee.

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Last modified: September 24, 1999