2015-2019 ATCPHD Strategic Plan

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ABILENE-TAYLOR COUNTY PUBLIC HEALTH DISTRICT

ORGANIZATIONAL STRATEGIC PLAN JANUARY 2015

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TABLE OF CONTENTS

ACKNOWLEDGMENTS………………………………………………………………………………..………...3

MESSAGE FROM THE DIRECTOR………………………………………………………………………….…4

ATCPHD STRATEGIC PRIORITIES & GOALS ……………………………………………………………...5

INTRODUCTION………………………………………………………………………………….………….……6

STRATEGIC PLANNING PROCESS AND TIMELINES……………………………………….…….……….8

RE-EVALUATION OF MISSION, VISION AND VALUES………………………………….………...……....9

SITUATIONAL ANALYSIS…………………………………………………………………….….……………..10

• SWOT ANALYSIS: THE COMPREHENSIVE SWOT……………………...……………………10

ENVIRONMENTAL ANALYSIS…………………………………………………………..…………………….10-12

• EXTERNAL ENVIRONMENTAL ANALYSIS……………………………….………..………….10-13 o Analysis of opportunities and threats……………………………………………………………..11 o Ranking of opportunities and threats…………………………………………………...…….…..12

• INTERNAL ENVIRONMENTAL ANALYSIS……………………………………..…...………....13 o Ranking of strengths and weaknesses…………………………………………..…………….…...13

• FINAL (CONDENSED) SWOT…………………………………………………………...………....14 • STAKEHOLDER ANALYSIS………………………………………………...……………………..15

STRATEGY FORMULATION ………………………………………………………..………..………………..16

STRATEGIC GOALS SELECTION………………………………………………...……………..…………….16-19

• TOWS MATRIX…………………………………………………………………………..…...……..17

• STRATEGIC GOALS SELECTION CRITERIA…………………………..……..…...…………..18

• ORGANIZATIONAL STRATGEIES, OBJECTIVES AND MEASURES……………..………..19

o Self-assessment tool for capacity to implement strategies…………………………………….....19

FINAL GOALS, OBJECTIVES AND MEASURES...…………………………………………...……….…….20-23

STRATEGY IMPLEMENTATION………………………………………………………………………..…….23-27

• THE ATCPHD BALANCED SCORECARD………………………………………..……….…….23-27

CONCLUSION……………………………….…………………………………..………………….....………….27

RESOURCES …………………………………………………………….……………………..………….……..28

APPENDICES………………………………………………………………………………......…..……………..29-40

WORKSHEET FOR MISSION, VISION AND VALUES…………………………………....………29-30

THE COMPREHENSIVE SWOT WORKSHEET………………………….………………..……....31-33

ATCPHD SWOT SURVEY…………………………………………………………………....……….33-36

AGENDA FOR STRATEGIC PLANNING RETREAT I………………………...………………….37-38

AGENDA FOR STRATEGIC PLANNING RETREAT II……………………………….………….39-40

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ACKNOWLEDGMENTS

The Abilene-Taylor County Public Health District (ATCPHD) would like to acknowledge the following individuals for their contribution to the success of the strategic planning process and the development of the ATCPHD Organizational Strategic Plan.

ATCPHD Internal Stakeholders Planning Team

Derrick L. Neal (Health Administrator)

Santos Navarrette (Assistant Health Administrator)

Dr. Peter Norton (Health Director/Authority)

Kay Durilla (Nursing Program Manager)

Jadyn Ashworth (Laboratory Manager)

Annette Lerma (WIC Director)

Dianne Tyler (Customer Service Rep III)

Nike Neuvenheim (Health Management Coordinator)

Jo Roberts (Health Admin Specialist)

Veronica Escalona (PHC/Health Admin Specialist)

Wayne Rose (Epidemiologist)

Charlotte Lambert (Health Planning Coordinator)

Thaddee Uwimana (Public Health Nurse III)

Mattie Pierre (Health Management Coordinator)

Derrick L. Neal, MPA Health Administrator Abilene-Taylor County Public Health District Santos Navarrette, MBA Assistant Health Administrator Abilene-Taylor County Public Health District Nike Neuvenheim, MPA Health Management Coordinator Abilene-Taylor County Public Health District

External Consultants/Facilitators Strategic Planning Analyst

Joanna Clark, MA Employee Engagement and Development Manager, City of Abilene Julie St-John, DrPH, MA, CHWI Assistant Professor, MPH Co-Director Department of Public Health Texas Tech University Health Sciences Center Graduate School of Biomedical Sciences

Olufemi Popoola, MPH Accreditation Fellow, University of North Texas Health Science Center

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MESSAGE FROM THE DIRECTOR

Dear Friends and Colleagues, I am pleased to present the Abilene-Taylor County Health District’s (ATCPHD) Organizational Strategic Plan for 2015. The ATCPHD continues to work on strengthening our capacity to serve the community, through quality public health services in a time of significant challenges, including fiscal constraints and a limited workforce. This specific Strategic Plan development was a process that engaged our staff in identifying “strategic priorities” for the goals and objectives that will be accomplished during this inaugural strategic plan period. The Health District is committed to continuing the journey, institutionalizing quality improvement, improving workforce competency development and operating a cutting edge local health department, while assuring sound use of fiscal resources. To achieve our mission, the Health District must fulfill the fundamental role of preventing and/or responding to imminent health threats such as disasters, hazardous materials exposure and preventable illness. We must also engage long-term strategies to address chronic diseases, poor nutrition, oral health, inadequate exercise, and tobacco use. This plan will guide the Health District’s work in carrying out our responsibilities in the most effective and efficient means possible. We must effectively collaborate with community based organizations, university systems, cities, schools, our faith based community, and our existing health care providers to establish comprehensive public health practices. To be successful in our efforts we must have a strategic plan that points out goals and provides the mapping needed for goal achievement. We are confident that our staff is up to the challenge of carrying out this ambitious Strategic Plan and look forward to the upcoming year of hard work on our path to achievement! Warm Regards,

Derrick Leonard Neal M.P.A., PhD Candidate

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ATCPHD STRATEGIC PRIORITIES & STRATEGIC GOALS

Strategic Priority #1: Health promotion

Goal 1: Expand educational and outreach opportunities

Strategic Priority #2: Internal processes/operations and staff development

Goal 1: Utilize organizational space efficiently

Goal 2: Conduct a staff training needs assessment

Strategic Priority #3: Service to community

Goal 1: Initiate a community health assessment to gain a better understanding of the community needs

Goal 2: Maintain an on-going community presence in an effort to achieve and maintain visibility

Strategic Priority #4: Financial sustainability

Goal 1: Balance fiscal responsibility with innovative funding

Goal 2: Institute Electronic Health Records (EHR) system

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INTRODUCTION

The Abilene-Taylor County Public Health District (ATCPHD) is a division within the Community Services Department of the City of Abilene. The City of Abilene, the Taylor County Commissioner’s Court, and the ATCPHD Health Advisory Board provide general oversight of the department’s programs and services. The ATCPHD provides public health care services to the residents within Abilene-Taylor County and 18 surrounding counties, commonly known as “The Big Country” (Figure 1). The 19 county service area has an estimated population of 428, 579 (U.S. Census Bureau, 2014). However, ATCPHD primarily provides services to the residents of Abilene-Taylor County with an estimated population of 120,099 (U.S. Census Bureau, 2014).

The ATCPHD is located in downtown Abilene at 850 North 6th Street, Abilene, Texas. In 2005, a 23,000 square foot facility was built to accommodate the expansion of the programs and services provided by the health department. In January 2015, the ATCPHD will open the MERCY Health Care Center, located on 1902 Shelton Street, Abilene, Texas. The MERCY Health Care Center is a satellite clinic housing the Expanded Primary Health Care, Primary Health Care, STD and Family Programs. Currently, ATCPHD offers the following programs: Children, Adolescent, and Adult Immunizations; Tuberculosis Prevention and Control; Family Planning; Sexually Transmitted Disease Diagnosis and Treatment; Refugee Services; Dental Program; Primary Health Care; Expanded Primary Health Care; WIC; Vital Statistics; Public Health Emergency Preparedness; Epidemiology; Laboratory Services; and Texas Health Steps. The agency’s 54 full-time and 6 part-time professional and support staff will operate during the 2014-2015 fiscal year under a budget of $4.2 million. Grant funding accounts for $3 million, or 71% of the department’s budget.

As the ATCPHD continues to provide quality services for a growing population in the 21st Century, a priority is for the health department to establish strategies that facilitate positive health outcomes. The Public Health Accreditation Board (PHAB), a non-profit organization which administers public health department accreditation, requests that all health departments seeking accreditation submit a Strategic Plan as part of the application process. As the ATCPHD progresses toward accreditation, leadership within the organization recognizes both the importance of accreditation, and the establishment of a unified vision, ensuring program sustainability and the ability to revolutionize the provision of public health care services.

Since its inception, the ATCPHD adopted the following mission, “The Abilene-Taylor County Public Health District as a division of the Community Services Department of the City of Abilene is dedicated to providing quality preventative, educational and professional health services, which protect and improve the health of the entire community.” As a part of the strategic planning process, the ATCPHD has re-evaluated the existing mission, and updated its mission, vision, and values to reflect the current public health, healthcare, economic, political, and geographic environments and to embrace the future. In addition to this, the department has established four Strategic Priorities, consisting of multiple strategic goals, objectives, and measures, which will be implemented over a specified time frame.

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FIGURE 1. THE 19 COUNTIES SERVED BY THE ATCPHD

“The Big Country” area includes the following counties: Taylor, Brown, Callahan, Coleman, Eastland, Fisher, Haskell, Jones, Kent, Knox, Mitchell, Nolan, Shackelford, Stephens, Stonewall, Throckmorton, Tom Green, Runnels, Scurry

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STRATEGIC PLANNING PROCESS AND TIME-LINE

The development of the strategic plan involved extensive and detailed input from the ATCPHD Internal Stakeholders over the course of a ten-week period. The external consultants, strategic planning analyst, and planning team met frequently in an effort to ensure adherence to a rigorous time-line and continued development of an effective strategic plan.

The Planning Team engaged the support of External Stakeholders (Consultants, Facilitators, and Analysts), who were very knowledgeable about the process in its entirety. The following External Stakeholders were involved in the development of the strategic plan.

Joanna Clark, MA Employee Development and Engagement Manager City of Abilene

Olufemi Popoola, MPH Accreditation Fellow University of North Texas Health Science Center

Julie St-John, DrPH, MA, CHWI Assistant Professor, Department of Public Health Texas Tech University Health Sciences Center

The Planning Team designed a time-line for the strategic planning process.

Date Activity 09/20/2014 Initial meeting between the Planning Team and Strategic Planning Analyst to develop and design the

planning process and identify stakeholders. 09/30/2014 Meeting with External Stakeholders to discuss the strategic planning process.

10/01/2014 Design and formation of the SWOT Analysis; Mission, Vision, and Values worksheets.

10/02/2014 Planning Team, External and Internal Stakeholders meet to discuss and validate the worksheets.

10/10/2014 Distribution of the SWOT Analysis and Mission, Vision, and Values worksheets. Provision of instructional support to Internal Stakeholders, with regard to the worksheets.

10/13/2014 Collation of all responses from worksheets.

10/20/2014 Design and distribution of SWOT surveys.

10/22/2014

Collation and analysis of responses from SWOT surveys.

10/30/2014 Strategic Planning Retreat, Part 1(Affinity Group Session): Review and discussion of the Strategic Planning Process. Review of the existing Mission and adoption of a new Mission and Vision for the ATCPHD.

11/20/2014 Strategic Planning Retreat, Part 2: Discussion and formation of Values/Value Statements and strategy derivation.

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RE-EVALUATION OF MISSION, VISION AND VALUES

The existing Mission of the ATCPHD was re-evaluated, and a new Mission, Vision, and Values (MVV) were derived for the ATCPHD. A comprehensive MVV worksheet was developed for this process (Appendix I). In order to receive an all-inclusive response, all Internal Stakeholders were required to complete and submit this worksheet. The responses obtained from this worksheet were discussed in detail during the Affinity Group Session, in Part 1 of the Strategic Planning Retreat.

ATCPHD Mission, Vision and Values

MISSION

To provide preventative services to promote community health.

VISION

To be a premier, innovative health department, leading in the prevention of diseases.

VALUES

Professionalism: We exemplify professionalism through respect, excellence, and teamwork.

Quality: We provide exceptional, valuable services for our community.

Integrity: We serve with accountability and consistency to build community trust.

Innovation: We effectively use evidence-based strategies and best practices to advance public health.

Collaboration: We collaborate with internal and external stakeholders to promote community health and

prevent diseases.

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SITUATIONAL ANALYSIS

The planning team conducted a situational analysis to gain a current and comprehensive understanding of the general state of the ATCPHD’s internal and external operations. The situational analysis provided detailed information pertaining to the health department’s organizational infrastructure, enabling the establishment of long-term strategies. The planning team conducted the situational analysis utilizing the SWOT Analysis Worksheet, which allowed the internal stakeholders to evaluate fundamental internal and external processes within ATCPHD.

SWOT ANALYSIS: THE COMPREHENSIVE SWOT

A SWOT Analysis (strengths, weaknesses, opportunities, and threats) analysis was performed to identify the internal strengths and weaknesses, as well as the external opportunities and threats of the ATCPHD. Thirteen of fifteen internal stakeholders completed the SWOT Analysis Worksheet, a response rate of 93.3% (Appendix II). A condensed SWOT table (Table 3) depicts the SWOT analysis responses.

ENVIRONMENTAL ANALYSIS

The planning team performed an environmental analysis to gain a better understanding of the operational environment of the ATCPHD. For this purpose, the planning team compiled responses from the SWOT analysis and generated a survey based on the SWOT responses (Appendix III). The survey consists of two sections:

1. Opportunities and Threats (representing the external environment)

2. Strengths and Weaknesses (representing the internal environment)

EXTERNAL ENVIRONMENTAL ANALYSIS

ANALYSIS OF OPPORTUNITIES AND THREATS

Impact and probability plot (Figure 2)

This plot was used to assess the relative importance of external opportunities and threats in relation to the ATCPHD. Specifically, the plot depicts the impact and probability of the external factors, which are defined below.

Impact: The effect that this opportunity/threat might have on the ATCPHD. Probability: The possibility that this opportunity/threat will continue to be existent in the next 5 years.

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FIGURE 2. IMPACT AND PROBABILITY PLOT

A frontier line was set to delineate the external opportunities and threats that generate a high impact and probability of occurrence within the health department. Components that lie outside of the frontier line have a high impact and probability of occurrence. These components were adopted and included in the condensed SWOT table (Table 3). Components within the frontier line were ranked low regarding impact and probability of occurrence (Table 1, 3).

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RANKING OF OPPORTUNITIES AND THREATS

Based on the results of the impact and probabilities plot, the survey responses for opportunities and threats were ranked as either high (H) or low (L).

TABLE 1: RANKING OF OPPORTUNITIES AND THREATS FOR THE ATCPHD

N0 OPPORTUNITY IMPACT PROBA- BILITY

N0 THREAT IMPACT PROBA- BILITY

1 Several potential funding opportunities in Abilene-Taylor County and surrounding areas.

H H

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Inadequate community-wide health education directly affects organizational workflow and impacts quality of work. H H

2 City of Abilene Information Technology (IT) services are readily accessible to the ATCPHD staff H H

12 The Health Advisory Board lacks an equal representation of women and minority groups H L

3 Waiver 1115 has a good potential for funding.

H L

13 Under-utilization of the Family Planning, STD, and Expanded Primary Health Care Programs by clients. H H

4 Establish effective client referral services, i.e. FQHC, Hendrick Medical Center, Abilene Regional Medical Center, etc. H H

14 Limited resources for public health accreditation.

H H 5 Development of formal partnerships with

universities, trade schools, and other academic Institutions. H H

15 Political environment limits potential for collaboration/partnerships.

H H 6 Texas Tech University Health Sciences

Center's faculty members have expressed interest in a collaborative process that would support public health department accreditation and a community health assessment. H H

16 Staff within programs/sections are confronted with difficult/uncooperative clients.

L L 7 Employee development and training: City of

Abilene (Employee Development and Engagement Classes), University of Houston 360 degree project, DSHS training, etc. H H

17 External competition for funding opportunities in a grant-dependent health department.

H H 8 Intra-departmental communication has the

potential to improve. H H 18 Non-competitive pay threatens nursing staff

retention. H H 9 Mercy Health Care Center will accommodate

more programs and staff. H H

19 Low wages and a relatively higher cost of living in Abilene.

H H 10 Re-organization/clean-up of the dungeon will

provide more space for storage. H H

20 Lack of formal inter-organizational agreements such as an MOU, MOA and affiliate agreements. L L

21 Staff might decide to leave after receiving training. L L

Represents components that were adopted into the final SWOT.

This table was adopted from the impact and probabilities. It demonstrates components of the opportunities and threats that are critical to the operational environment of the ATCPHD.

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INTERNAL ENVIRONMENTAL ANALYSIS

RANKING OF STRENGTHS AND WEAKNESSES

Internal strengths were ranked according to their importance and sustainability, while weaknesses were ranked according to their importance and capacity for resolution. Components that were adopted into the Condensed SWOT Table include: strengths that were ranked high in importance and sustainability, and weakness that were that were ranked high in importance and low in capacity for resolution (Table 2, 3). Please reference Appendix III for the definition of importance, capacity to sustain, and capacity for resolution, as used in this table.

TABLE 2: RANKING OF STRENGTHS AND WEAKNESSES FOR THE ATCPHD

N0 STRENGTH IMPOR- TANCE

CAPACITY TO SUSTAIN

N0 WEAKNESS IMPOR-TANCE

CAPACITY TO RESOLVE

22 Comprehensive preventive health services are provided in a new and modern building. H H

33 Insufficient room for program/staff expansion in current building.

H L 23 Concerted efforts are being made toward

public health department accreditation, to improve quality of service. H H

34 Unnecessary supplies in storage units (dungeon) cause poor space utilization and may be hazardous. H L

24 Diverse, culturally competent, dedicated and loyal staff.

H H

35 Main health building and Mercy Health Care Center are not in close proximity to one another. L L

25 Leadership/Administration is forward thinking and open to new ideas. H H

36 Services are not integrated: Epi, Vital Statistics and Informatics. H L

26 Family Planning Program, Dental Program, and Lab have the potential to significantly increase revenue. H H

37 Important services are not located in current building: Mental Health, Environmental Health. L L

27 Good working relationship between the ATCPHD and external stakeholders (DSHS and City of Abilene). H H

38 Insufficient staff training: EHR, Preparedness, staff communication and development. H L

28 Leadership has a great capacity to manage funds/budget.

H H

39 Public health department accreditation suffers from lack of funds, guidance and direction. H L

29 New EHR hardware with a dedicated IT staff. H H

40 Inability to create an extension of clinical services for clients. L L

30 Ready disease surveillance and containment strategy.

H H

41 Grants: Over-dependence threatens program continuity and reduces valuable work time. H L

31 Collaborations exist with: Hendrick Medical Center, Abilene ISD, and United Way, Meals on Wheels, Head start, SNAP, TAMF, and ECI. H H

42 Understaffing-Nursing program, Dental, Lab, Billing services, Community Health Workers, etc.

H L 32 Several staff members with many years

of experience. H H 43 Lack of strong IT system for efficient

workflow. L L 44 Family Planning Program underutilized

(teenagers and men are excluded by the program). H L

Represents components that were adopted into the final SWOT.

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FINAL (CONDENSED) SWOT TABLE

The Condensed SWOT Table (Table 3) was derived from the results of the survey rankings. This table possesses a well-defined composition of strengths, weaknesses, opportunities and threats considered relevant by the ATCPHD Internal Stakeholders. Results of the Condensed SWOT were entered into a TOWS Matrix, which was utilized by Internal Stakeholders to generate multiple strategic goals.

TABLE 3. CONDENSED SWOT TABLE FOR THE ATCPHD

STRENGTH WEAKNESS • Comprehensive preventive health services are provided in a new

and modern building. • Concerted efforts are being made toward public health department

accreditation, to improve quality of service. • Diverse, culturally competent, dedicated and loyal staff. • Leadership/Administration is forward thinking and opens to new

ideas. • Family Planning Program, Dental Program, and Lab have the

potential to significantly increase revenue. • Good working relationship between the ATCPHD and external

stakeholders (DSHS and City of Abilene). • Leadership has a great capacity to manage funds/budget. • New EHR hardware with a dedicated IT staff. • Ready disease surveillance and containment strategy. • Collaborations exist with: Hendrick Medical Center, Abilene ISD,

and United Way, Meals on Wheels, Head start, SNAP, TAMF, and ECI.

• Several staff members with many years of experience.

• Insufficient room for program/staff expansion in current building. • Unnecessary supplies in storage units (dungeon) cause poor space

utilization and may be hazardous. • Services are not integrated: Epi, Vital Statistics and Informatics • Insufficient staff training: EHR, Preparedness, staff communication

and development. • Public health department accreditation suffers from lack of funds,

guidance and direction. • Grants: Over-dependence threatens program continuity and

reduces valuable work time. • Understaffing-Nursing program, Dental, Lab, Billing services,

Community Health Workers, etc. • Family Planning Program underutilized (teenagers and men are

excluded by the program).

OPPORTUNITY THREAT • Several potential funding opportunities in Abilene-Taylor County

and surrounding areas. • Establish effective client referral services, i.e. FQHC, Hendrick

Medical Center, Abilene Regional Medical Center, etc • Employee development and training: City of Abilene (Employee

Development and Engagement Classes), University of Houston 360 degree project, DSHS training, etc.

• Intra-departmental communication has the potential to improve. • Re-organization/clean-up of the dungeon will provide more space

for storage. • Development of formal partnerships with universities, trade schools,

and other academic Institutions. • Mercy Health Care Center will accommodate more programs and

staff. • Texas Tech University Health Sciences Center's faculty members

have expressed interest in a collaborative process that would support public health department accreditation and a community health assessment.

• City of Abilene Information Technology (IT) services are readily accessible to the ATCPHD staff

• Limited resources for public health accreditation. • Political environment limits potential for collaboration/partnerships. • External competition for funding opportunities in a grant-dependent

health department. • Non-competitive pay threatens nursing staff retention. • Low wages and a relatively higher cost of living in Abilene. • Inadequate community-wide health education directly affects

organizational workflow and impacts quality of work. • Under-utilization of the Family Planning, STD, and Expanded

Primary Health Care Programs by clients.

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STAKEHOLDER ANALYSIS

In preparation for strategy formulation, the planning team identified and prioritized internal and external stakeholders through the use of a stakeholder analysis (Figure 3). The planning team identified stakeholders through the critical examination of the SWOT analysis results (Table 1). The planning team identified four categories of stakeholders

During strategy formulation, the stakeholder analysis served as an important strategic planning tool, enabling the planning team to identify stakeholders who have a fundamental role in the ATCPHD strategic plan’s priorities, goals, and objectives. The ATCPHD will rely upon the guidance and support of these stakeholders.

FIGURE 3. STAKEHOLDER ANALYSIS FOR THE ATCPHD

STAKEHOLDERS THAT MEET OUR NEEDS STAKEHOLDERS THAT ARE KEY PLAYERS

1. Department of State Health Services 2. City of Abilene 3. Hendrick Medical center 4. Universities, trade schools, and other

academic institutions in Abilene 5. University of Houston 360 degree project 6. Potential individual and corporate funders in

Abilene 7. Dyess Air force Base

1. Leadership of the ATCPHD 2. Staff 3. Texas Tech University Health Sciences

Center Faculty

LEAST IMPORTANT STAKEHOLDERS STAKEHOLDERS WE MIGHT CONSIDER IN OUR STRATEGIES

1. City of Abilene IT services

1. Competitors for grants 2. Understaffed units: nursing, dental, lab,

billing, community health workers 3. Health advisory board

LOW

LOW

HIGH

HIGH

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STRATEGY FORMULATION

STRATEGIC PRIORITIES

The Planning Team identified the following four themes as critical across all areas of service, referred to as strategic priorities These priorities or themes were identified based upon the results of the SWOT Analysis; ATCPHD’s Mission, Vision and Values; and factors the Internal Stakeholders viewed as strong determinants of health outcomes. After significant review, the Planning Team and Strategic Planning Analyst selected the following priorities.

1. Financial sustainability

2. Internal processes/operations & staff training

3. Service to community

4. Health Promotion

STRATEGIC GOALS

The planning team compiled components of the final SWOT analysis into a TOWS Matrix in order to generate strategic goals for the ATCPHD. The TOWS Matrix served as a framework, which allowed the internal stakeholders to effectively analyze and associate all of the components of the condensed SWOT table, establishing definitive goals. The TOWS Matrix was used to generate several strategic goals within the scope of the strategic priorities (Figure 4).

STRATEGIC GOALS SELECTION

The planning team adopted strategy selection tools order to ensure that the most effective strategic goals were identified from those listed within the TOWS Matrix.

The planning team designed a Strategic Goals Selection Criteria table to guarantee that the strategic goals selected aligned with the newly established MVV. Every strategic alternative had to fulfill all the criteria within the table (Table 4).

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FIGURE 4. TOWS MATRIX

STRENGTH WEAKNESS

INTERNAL

FACTORS

EXTERNAL

FACTORS

1. Comprehensive preventive health services are provided in a new and modern building.

2 .Concerted efforts are being made toward public health department accreditation, to improve quality of service.

3. Diverse, culturally competent, dedicated and loyal staff.

4. Leadership/Administration is forward thinking and open to new ideas.

5. Family Planning Program, Dental Program, and Lab have the potential to significantly increase revenue.

6. Good working relationship between the ATCPHD and external stakeholders (DSHS and City of Abilene).

7. Leadership has a great capacity to manage funds/budget.

8. New EHR hardware with a dedicated IT staff. 9. Ready disease surveillance and containment strategy.

10.Collaborations exist with: Hendrick Medical Center, Abilene ISD, United Way, Meals on Wheels, Head start, SNAP, TAMF

1. Insufficient room for program/staff expansion in current building. 2. Unnecessary supplies in storage units (dungeon) cause poor space

utilization and may be hazardous. 3. Services are not integrated: Epi, Vital Statistics and Informatics 4. Insufficient staff training: EHR, Preparedness, staff communication

and development. 5. Public health department accreditation suffers from lack of funds,

guidance and direction. 6. Grants: Over-dependence threatens program continuity and reduces

valuable work time. 7. Understaffing-Nursing program, Dental, Lab, Billing services,

Community Health Workers, etc. 8. Family Planning Program underutilized (teenagers and men are

excluded by the program).

OPPORTUNITY SO (FUTURE) WO (INTERNAL FIX-IT)

1.Several potential funding opportunities in Abilene-Taylor County and surrounding areas

2. Establish effective client referral services, i.e. FQHC, Hendrick Medical Center, Abilene Regional Medical Center, etc.

3. Employee development and training: City of Abilene (Employee Development and Engagement Classes), University of Houston 360 degree project, DSHS training, etc.

4. Intra-departmental communication has the potential to improve. 5. Re-organization/clean-up of the dungeon will provide more space for

storage. 6. Development of formal partnerships with universities, trade schools, and

other academic Institutions. 7. Mercy Health Care Center will accommodate more programs and staff. 8. Texas Tech University Health Sciences Center's faculty members have

expressed interest in a collaborative process that would support public health department accreditation and a community health assessment.

9.City of Abilene Information Technology (IT) services are readily accessible to the ATCPHD staff

• Expand Educational and Outreach Opportunities

• Institute Electronic

Health Records (EHR) system

• Utilize space efficiently

• Conduct training needs assessment

THREAT ST (EXTERNAL FIX-IT) WT (SURVIVAL)

1 .Limited resources for public health accreditation. 2. Political environment limits potential for collaboration/partnerships. 3. External competition for funding opportunities in a grant-dependent health

department. 4. Non-competitive pay threatens nursing staff retention. 5. Low wages and a relatively higher cost of living in Abilene. 6. Inadequate community-wide health education directly affects organizational

workflow and impacts quality of work. 7. Under-utilization of the Family Planning, STD, and Expanded Primary

Health Care Programs by clients.

• Have on-going community presence in effort to achieve and maintain visibility

• Balance fiscal responsibility with innovative funding

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TABLE 4: STRATEGIC GOALS SELECTION CRITERIA FOR THE ATCPHD

STRATEGIC GOALS

Will this goal help to promote community health in Abilene and surrounding counties? Please indicate Yes/No

Will this goal position the ATCPHD as a leading Public Health Department? Please indicate Yes/No

Is this goal directed toward the provision of preventive services? Please indicate Yes/No

Does this goal conform to all the values of the ATCPHD? Please indicate Yes/No

STRATEGIC PRIORITY 1: HEALTH PROMOTION

GOAL 1.1 Expand Educational and Outreach Opportunities

YES YES YES YES

STRATEGIC PRIORITY 2: INTERNAL PROCESSES/OPERATION & STAFF DEVELOPMENT

GOAL 2.1 Utilize space efficiently

YES YES YES YES

GOAL 2.2 Conduct training needs assessment YES YES YES YES

STRATEGIC PRIORITY 3: SERVICE TO COMMUNITY

GOAL 3.1 Initiate a community health assessment (CHA) to have a better understanding of community needs

YES YES YES YES

GOAL 3.2 Have on-going community presence in effort to achieve and maintain visibility

YES YES YES YES

STRATEGIC PRIORITY 4: FINANCIAL SUSTAINABILITY

GOAL 4.1 Balance fiscal responsibility with innovative funding

YES YES YES YES

GOAL 4.2 Institute Electronic Health Records (EHR) system

YES YES YES YES

This table was utilized to confirm that our strategic goals fulfill all requirements of the selection criteria. All the final strategic goals derived from the TOWS matrix fulfill the selection criteria.

Furthermore, we decided to critically examine the selected strategic goals, objectives and measures by assessing the ATCPHD’s capacity to fulfill these within the established time frame. In order to achieve this, we utilized the Self-Assessment Tool for Capacity to Implement Strategies (Table 5).

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ORGANIZATIONAL STRATEGIES, OBJECTIVES AND MEASURES

The planning team further refined the final strategic goals into objectives and measures. The objectives define the specific actions that need to be completed in order to actualize the goals, while the measures further define the deliverables and timeline needed to ensure that the goals are effectively implemented. To confirm appropriate, realistic and achievable goals, objective and measures, the planning team utilized a self-assessment tool (Table 5) to evaluate them.

TABLE 5: SELF-ASSESSMENT TOOL FOR CAPACITY TO IMPLEMENT STRATEGIES

The planning team used the assessment tool as a guide for the strategic objectives and measures. We noted that on a larger scale these factors may form part of the strategic needs of the ATCPHD; however, the inclusion of these factors within the assessment tool allowed the team to adequately compare the department’s capacities against strategic goals and measures.

1. Competency/skills/equipment 2. Time 3. Staff strength/manpower 4. Responsible staff 5. Funds

The strategic goals, measures and objectives selected satisfied all the criteria within the assessment tool.

Note: The actual description of each goal is provided in Table 4.

GOAL Do we have the Basic competency/skills/equipment needed to implement this goal?

Do we have sufficient time to implement this goal?

Is there enough manpower to enforce this goal?

Can we assign a staff member to oversee the implementation of this goal?

Do we have the funds to implement this goal?

1.1 YES YES YES YES YES


2.2 YES YES YES YES YES 3.1 YES YES YES YES YES




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FINAL GOALS, OBJECTIVES AND MEASURES

The ATCPHD must select and implement strategies that support the mission, vision, and values of the health department. The ATCPHD adopted the following final strategic goals, objectives and measures.

Table 6.1 Strategic Priority #1: Health promotion

Strategic Goal 1.1 Expand educational and outreach opportunities

Objective 1.1.1 Education: Develop partnerships with hospitals and academic institutions

Measure 1.1.1 Develop partnerships within 12 months

Objective 1.1.2 Education: Develop curriculum for hypertension, diabetes control/prevention, women’s health, and healthy living

Measure 1.1.2 Develop curriculum within 12 months

Strategic Goal 1.2 Outreach: Each department must seek out two new community partnerships

Objective 1.2.1 Identify community organizations; legislative outreach opportunities

Measure 1.2.1 Identify community organizations within 2 months

Objective 1.2.2 Develop outreach policy (internal)

Measure1.2.2 Develop an outreach policy within 2 months

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Table 6.2 Strategic Priority #2: Internal processes/operations and staff development

Strategic Goal 2.1 Utilize organizational space efficiently

Objective 2.1.1 Clean up dungeon Measure 2.1.1 Clean up dungeon within 6 months

Objective 2.1.2 Open Mercy Clinic

Measure 2.1.2 Open Mercy Clinic in 2 months

Objective 2.1.3 Implement routine shredding

Measure 2.1.3 Implement routine shredding in 2 months

Strategic Goal 2.2 Conduct staff training needs assessment

Objective 2.2.1 Each program submits a training needs list within 2 months

Measure 2.2.1 Establish a committee of program representatives to develop and submit a list of at least six training preferences within 2 months

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Table 6.3 Strategic Priority #3: Service to Community

Strategic Goal 3.1 Initiate a community health assessment to gain a better understanding of community needs

Objective 3.1.1 Establish partnerships with external organizations

Measure 3.1.1 Establish partnerships within 3 months

Objective 3.1.2 Research and apply for funding opportunities

Measure 3.1.2 Research and apply for funding opportunities within 6 months

Objective 3.1.3 Establish a project time table for goal 3.1

Measure 3.1.3 Establish time table within 1 month

Strategic Goal 3.2. Maintain an on-going community presence in effort to achieve and maintain visibility

Objective 3.2.1 Establish partnerships with key community stakeholders, faith-based organizations, and conduct stakeholder needs assessment

Measure 3.2.1 Within 6 months

Objective 3.2.2 Expand the scope of existing programs

Measure 3.2.2 Within 8 months

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Table 6.4 Strategic Priority #4: Financial Sustainability

Strategic Goal 4.1. Balance fiscal responsibility with innovative funding

Objective 4.1.1 Set payment guidelines for services and follow through

Measure 4.1.1 Set guidelines within 12 months

Objective 4.1.2 Increase revenue from grants

Measure 4.1.2 Increase revenue from grants by 10% within 12 months

Strategic Goal 4.2 Institute Electronic Health Records system (EHR)

Objective 4.2.1 Identify funding sources for software and get funds

Measure 4.2.1 Identify funding sources for software and get funds within 12 months

Objective 4.2.2 Implement EHR in stages

Measure 4.2.2 Implement EHR in stages within 12 months

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STRATEGY IMPLEMENTATION

THE BALANCED SCORECARD

The balanced scorecard was derived to ensure that the strategic goals are monitored, effectively implemented, and fulfill high organizational performance standards. In addition to the strategies, objectives and measures, the balanced scorecard contains the specific targets, as well as the personnel that will take ownership of these strategies to guarantee that they are well implemented (Table 7).

The exact descriptions of goals are provided in pages 20-23.

THE ATCPHD BALANCED SCORECARD

TABLE 7.1 STRATEGIC PRIORITY 1: HEALTH PROMOTION

GOAL OBJECTIVES (What we want to do)

TARGET (How long it will take us to get there)

MEASURES (How we want to get there)

WHO IS RESPONSIBLE

Minimally Successful

Fully Successful

Exceeds Fully Successful

1.1

1.1.1 Education: Develop partnerships with hospitals and academic institutions. 1.1.2 Education: Develop curriculum for hypertension, diabetes control/prevention, women’s health, and health living.

12 months

12 months

6 partners/ year 1 curriculum /year

9 partners/ year 2 curricula/ year

12 partners/ year 4 curricula/year

Health Management Coordinator/ Nursing staff Health Management coordinator/ Nursing staff

1.2

1.2.1 Identify community organizations: legislative outreach opportunities 1.2.2 Develop outreach policy (internal)

6 months

4 months

6 months

4months

2 months

2 months

1 month

1 month

Health Management Coordinator/ Nursing staff

Please refer to table 6.1 for the complete description of goals, objectives and measures.

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TABLE 7.2 STRATEGIC PRIORITY 2: INTERNAL PROCESSES/OPERATIONS AND STAFF DEVELOPMENT




WHO IS RESPONSIBLE


Fully Successful


2.1

2.1.1 Clean up dungeon 2.1.2 Open Mercy Clinic 2.1.3 Implement routine shredding

6 months 2 months 2 months

Remove damaged equipment & move other equipment to Mercy Clinic by March 2015. >2 months >2 months

Remove damaged equipment & move other equipment to Mercy Clinic by March 2015. Send to auction. 2 months 2 months

Remove damaged equipment & move other equipment to Mercy Clinic by March 2015. Send to auction and develop inventory list. <2 months <2 months

Assistant Health Administrator and volunteers

2.2

2.2.1 Each program submits a training needs list

2 months Establish a committee of program representatives to develop and submit a list of at least six training preferences in >2months

Establish a committee of program representatives to develop and submit a list of at least six training preferences in 2 months

Establish a committee of program representatives to develop and submit a list of at least six training preferences in <2 months

Health Administrator


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TABLE 7.3 STRATEGIC PRIORITY 3: SERVICE TO COMMUNITY





WHO IS RESPONSIBLE


Fully Successful


3.1

3.1.1 Establish partnerships with external organizations 3.1.2 Research and apply for funding opportunities

6 months

6 months

>6 months >6 months

6 months 6 months

3 months 3 months

Assistant Health Administrator and Health Management Coordinator

3.2

3.2.1 Establish partnerships with key community stakeholders, faith-based organizations and conduct stakeholders needs assessment 3.2.2 Expand the scope of existing programs

6 months

8 months

>6 months

>8 months

6 months 8 months

3 months <8 months

Assistant Health Administrator and Health Management Coordinator

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TABLE 7.4 STRATEGIC PRIORITY 4: FINANCIAL SUSTAINABILITY




WHO IS RESPONSIBLE


Fully Successful


4.1

4.1.1 Set payment guidelines for services and follow through 4.1.2 Increase revenue from grants by 10%

Within 12 months Within 12 months

>12 months >12 months

12 months 12 months

6 months 6 months

Nursing Program Manager

4.2

4.2.1 Identify funding sources for software and get funds 4.2.2 Implement EHR in stages

Within 12 months Within 12 months

>12 months

>12 months

6 months 6 months

3 months 3 months

Assistant Health Administrator


CONCLUSION

The 21st Century, the era of the Affordable Care Act, is a time for health care systems across the nation to focus on population health outcomes, as well as the economic, social, political, and other environments within which these outcomes occur. Consequently, it is vital that organizations must create a unified vision and establish a direct lifeline to the communities and people they serve. Through the development of a mission, vision, and values and a strategic plan, the Abilene-Taylor County Public Health District will remain at the precipice of change. As we move forward as an organization and continue to facilitate positive health outcomes within the community, our services and programs will be sustained by a solid foundation grounded in our core values: professionalism, quality, integrity, innovation, and collaboration.

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RESOURCES

1. National Association of City and County Health Officials. (2014). Accreditation Preparation:

Community Health Assessment and Community Health Improvement Plan Prerequisites.

Retrieved from: http://www.naccho.org/topics/infrastructure/chachip/

2. Public Health Accreditation Board. (2014). What are the Benefits of Public Health Department

Accreditation? Retrieved from:

http://www.phaboard.org/accreditation-overview/what-are-the-benefits/

3. National Association of City and County Health Officials. (2013). Branding Your Local Health

Department: The Process. Retrieved from:

http://www.naccho.org/advocacy/LHDcommunications/upload/BrandProcessGuide.pdf

4. National Association of City and County Health Officials. (2014). Developing an LHD Strategic

Plan. Retrieved from:

http://www.naccho.org/topics/infrastructure/accreditation/strategic-plan-how-to.cfm

5. National Association of City and County Health Officials. (2014). Local Health Department Self-

Assessment Tool. Retrieved from:

http://www.naccho.org/topics/infrastructure/accreditation/upload/Self-Assessment-Interactive.pdf

6. Association of State and Territorial Health Officials. (2014). Strategic Planning and Guidance and

Resources to Assist State and Territorial Health Agencies in Developing a Strategic Plan.

Retrieved from:

http://www.astho.org/Accreditation-and-Performance/Strategic-Planning-Guide/Home/

7. U.S. Census Bureau. (2014, July 8). State & County Quick Facts: Taylor County, T.X. Retrieved

December 01, 2014, from http:quickfacts.census.gov.

8. Texas Department of State Health Services. (2014). Texas Population, 2018 (Projections).

Retrieved from: https://www.dshs.state.tx.us/chs/popdat/st2018.shtm

http://www.phaboard.org/accreditation-overview/what-are-the-benefits/

http://www.naccho.org/advocacy/LHDcommunications/upload/BrandProcessGuide.pdf

http://www.naccho.org/topics/infrastructure/accreditation/strategic-plan-how-to.cfm

http://www.naccho.org/topics/infrastructure/accreditation/upload/Self-Assessment-Interactive.pdf

http://www.astho.org/Accreditation-and-Performance/Strategic-Planning-Guide/Home/

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APPENDIX

APPENDIX I

MISSION, VISION AND VALUES WORKSHET FOR THE ATCPHD

MISSION, VISION AND VALUES (MVV) WORKSHEET FOR ABILENE-TAYLOR COUNTY PUBLIC HEALTH DISTRICT.

As part of the strategic planning process, Abilene-Taylor County Public Health District will be developing its Mission, Vision and Values (MVV). ATCPHD Mission: Our purpose. ATCPHD Vision: Our view for the future. ATCPHD Values: Our principles, beliefs and fundamental expectations.

The purpose of the MVV is to create a backbone for the ATCPHD strategic plan. This document will guide you with the development of your mission, vision, and value statements for the ATCPHD. VALUES: What you are required to do: 1. Review the City-wide MVV for the city of Abilene (attached). This will give you an idea of what the MVV should look like.

2. Examine any mandates/performance measures in your programs/sections. This will ensure that your final statement is aligned with the goals of your

program/section.

3. Use the following value words to guide the development of a final statement: Ethics, Respect, Collaboration, Integrity, Teamwork, Excellence, and Accountability, Learning, Community focus, Innovation, Continuous improvement.

4. Choose one/two value words that accurately depict the values of the ATCPHD. Be sure to consider these value words in your final statement 5. In the blank spaces provided below, write down one or two value statements for the ATCPHD.

An example of a value statement that includes the value words; ethics and integrity is “We value accountability and maintaining the trust of the community”. Note: This is used only as an example. 1.

2.

MISSION: What you are required to do: 1. Review the City-wide MVV for the city of Abilene (attached). This will give you an idea of what the MVV should look like.

30

2. Examine any mandates/performance measures in your programs/sections. This will ensure that your final mission statement is aligned with the goals of your program/section.

3. Consider the following questions:

a) What are the basic social and political needs we are expected to fulfill or address? b) What is our role in filling these needs or addressing these problems? c) How will we recognize or anticipate, and respond to these needs or problems? d) Who are our stakeholders? e) How should we respond to our stakeholders? f) What is our philosophy and what are our core values?

4. Think about one statement that accurately depicts the mission of the ATCPHD. This statement should attempt to answer the questions above.

5. In the blank spaces provided below, write down your own mission statement for the ATCPHD.

An example of a mission statement that answers the above questions is “To promote, protect, and assure conditions for optimal health for residents of Madison County through leadership, partnership, prevention and response.” …. Madison County Health Department (Illinois). Note: This is used only as an example. 1.

VISION:

What you are required to do: 1. Review the City-wide MVV for the city of Abilene (attached). This will give you an idea of what the MVV should look like.

2. Examine any mandates/performance measures in your programs/sections. This will help to ensure that your final statement is aligned with the goals of

your program/section. 3. Consider the following questions:

a) What critical issue(s) are we currently encountering, and how will the issue(s) progress within the next five years? b) How will we resolve these issue(s) in the future? c) How will Taylor county and surrounding areas benefit from these changes?

4. Think about one statement that accurately depicts the vision of the ATCPHD. This statement should answer the questions above.

5. In the blank spaces provided below, write down a vision for the ATCPHD.

An example of a vision that considers the above questions is: “The Northern Kentucky Health Department will be a nationally recognized leader in advancing the health and safety of the community”. Note: that is used only as an example

1.

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APPENDIX II

SWOT WORKSHEET FOR THE ATCPHD

SECTIONS S.W.O.T. (Strengths, Weaknesses, Opportunities, Threats)

1. Existing and Additional Buildings/Facilities S: W:

O: T:

2. ATCPHD Administration S: W:

O: T:

3. Health Advisory Board S: W: O: T:

4. Current Funding/Resources S: W:

O: T:

5. Financial Management/Stewardship of Fund S: W:

O: T:

6. Information Technology (IT) S: W:

O: T:

7. Equipment/Supplies S: W:

O: T:

8. Workforce (adequate number of staff, competency/skill-set, staff turnover)

S: W:

O: T:

9. Intra-departmental Communication S: W:

O: T:

10. Quality of Public Health Services S: W:

O: T:

11. Assessment (Surveillance, Epidemiology, and Laboratory Capacity) S: W:

O: T:

12. Outreach and Involvement in Community S: W:

O: T:

13. Customer Service S: W:

O: T:

14. Accreditation S: W:

O: T:

15. Community Partnership Development (hospitals, Dyess Air-Force Base, universities, businesses, Federally Qualified Health Centers, non-profits, individuals, etc.)

S: W:

O: T:

16 Programs Please identify any program-specific strengths, weaknesses, opportunities or threats.

a) Administration S: W:

32

O: T:

b) Dental Program S: W:

O: T:

c) Emergency Preparedness S: W:

O: T:

d) Epidemiology S: W:

O: T:

e) EPHC S: W:

O: T:

f) Family Planning Program S: W:

O: T:

g) Laboratory S: W:

O: T:

h) PHC S: W:

O: T:

i) Refugee Program S: W:

O: T:

j) STD Program S: W:

O: T:

K) Texas Health Steps S: W:

O: T:

l) TB Control Program S: W:

O: T:

m) Vital Statistics S: W:

O: T:

n) WIC S: W:

O: T:

17 Additional Funding/ Resources S: W:

O: T:

18 Federal, state, and local policies and mandates S: W:

O: T:

19 Current/Future Healthcare Trends S: W: O: T:

20 Intergovernmental relations between ATCPHD and Taylor County S: W:

O: T:

21 Relationship between City of Abilene, Community Services, ATCPHD Leadership, and ATCPHD staff

S: W:

O: T:

22 Relationship between ATCPHD and Texas DSHS S: W:

O: T:

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23 Fiscal Climate (Taylor County, City of Abilene, Federal, State and Local government)

S: W:

O: T:

24 Access to and linkage with Clinical Care S: W:

O: T:

25 Quality of life in Taylor County and surrounding counties

S: W: a) Transportation O: T:

b) Income S: W:

O: T:

c) Cost of living S: W:

O: T:

d) Other S: W:

O: T:

Additional Indicators S.W.O.T. (Strengths, Weaknesses, Opportunities, Threats)

1 S: W: O: T:

2 S: W: O: T:

3 S: W: O: T:

4 S: W: O: T:

APPENDIX III

ATCPHD SWOT SURVEY

INSTRUCTIONS:

Please use the link below to complete the SWOT Survey for the ATCPHD. The survey should take no longer than 7 minutes to complete. All items require a response. PLEASE SUBMIT ALL RESPONSES BY COB ON TUESDAY, OCTOBER 21st, 2014. DO NOT SUBMIT MORE THAN ONE SURVEY. Thank you in advance for taking the time to complete the survey. This survey is made up of 4 types of statements: (1) OPPORTUNITIES (2) THREATS (3) STRENGTHS, AND (4) WEAKNESSES. There are a total of 43 statements. All statements within the survey have been derived from responses in the SWOT Analysis Worksheets. I. OPPORTUNITIES AND THREATS: Please rank each statement based upon its IMPACT and PROBABILITY. Impact: The effect that this opportunity/threat might have on the ATCPHD. Probability: The possibility that this opportunity/threat will continue to be existent in the next 5 years. II. STRENGTHS : Please rank each statement based upon its importance and capacity to be sustained Importance: The significance of this strength to the ATCPHD.

34

Capacity to sustain: The ATCPHD’s ability to maintain this strength in the next 5 years Ill. WEAKNESSES: Please rank each statement based upon its importance and capacity for resolution. Importance: The significance of this weakness to the ATCPHD. Capacity for resolution: The ATCPHD's ability to create a solution within the next 5 years.

1. Several potential funding opportunities in Abilene-Taylor County and surrounding areas

2. City of Abilene Information Technology (IT) services are readily accessible to the ATCPHD staff.

OPPORTUNITY OPPORTUNITY 5 4 3 2 1 5 4 3 2 1 Impact Impact Probability Probability 3. Waiver 1115 has a good potential for funding. 4. Establish effective client referral services, i.e. FQHC, Hendrick Medical

Center, Abilene Regional Medical Center, etc. OPPORTUNITY OPPORTUNITY 5 4 3 2 1 5 4 3 2 1 Impact Impact Probability Probability 5. Development of formal partnerships with universities, trade schools, and other

6. Texas Tech University Health Sciences Center's faculty members have expressed

academic Institutions. interest in a collaborative process that would support public health department accreditation and a community health assessment.

OPPORTUNITY OPPORTUNITY 5 4 3 2 1 5 4 3 2 1 Impact Impact Probability Probability 7. Employee development and training: City of Abilene (Employee Development and

8. Intra-departmental communication has the potential to improve.

Engagement Classes), University of Houston 360 degree project, DSHS training, etc.

OPPORTUNITY OPPORTUNITY 5 4 3 2 1 5 4 3 2 1 Impact Impact Probability Probability 9. Mercy Health Care Center will accommodate more programs and staff.

10. Re-organization/clean-up of the dungeon will provide more space for storage.

OPPORTUNITY OPPORTUNITY 5 4 3 2 1 5 4 3 2 1 Impact Impact Probability Probability 11. Inadequate community-wide health education directly affects organizational workflow and impacts quality of work.

12. The Health Advisory Board lacks an equal representation of women and minority groups.

THREAT THREAT 5 4 3 2 1 5 4 3 2 1 Impact Impact Probability Probability 13. Under-utilization of the Family Planning, STD, and Expanded Primary Health Care Programs by clients.

14. Limited resources for public health accreditation.

THREAT THREAT 5 4 3 2 1 5 4 3 2 1

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Impact Impact Probability Probability 15. Political environment limits potential for collaboration/partnerships.

16. Staff within programs/sections are confronted with difficult/uncooperative clients.

THREAT THREAT Mark only one oval per row. Mark only one oval per row. 5 4 3 2 1 5 4 3 2 1 Impact Impact Probability Probability 17. External competition for funding opportunities in a grant-dependent health

18. Non-competitive pay threatens nursing staff retention.

department THREAT THREAT 5 4 3 2 1 5 4 3 2 1 Impact Impact Probability Probability 19. Low wages and a relatively higher cost of living in Abilene

20. Lack of formal inter-organizational agreements such as an MOU, MOA and affiliate agreements.

THREAT THREAT 5 4 3 2 1 5 4 3 2 1 Impact Impact Probability Probability 21. Staff might decide to leave after receiving training. 22. Comprehensive preventive health services are provided in a new and

modern building. THREAT STRENGTH 5 4 3 2 1 5 4 3 2 1 Impact Importance Probability Capacity to sustain 23. Concerted efforts are being made toward public health department accreditation, to improve quality of service.

24. Diverse, culturally competent, dedicated and loyal staff.

STRENGTH STRENGTH 5 4 3 2 1 5 4 3 2 1 Importance Importance Capacity to sustain Capacity to sustain 25. Leadership/Administration is forward thinking and open to new ideas.

26. Family Planning Program, Dental Program, and Lab have the potential to significantly increase revenue.

STRENGTH STRENGTH 5 4 3 2 1 5 4 3 2 1 Importance Importance Capacity to sustain Capacity to sustain 27. Good working relationship between the ATCPHD and external stakeholders (DSHS and City of Abilene).

28. Leadership has a great capacity to manage funds/budget.

STRENGTH STRENGTH 5 4 3 2 1 5 4 3 2 1 Importance Importance Capacity to sustain Capacity to sustain 29. New EHR hardware with a dedicated IT staff. 30. Ready disease surveillance and containment strategy. STRENGTH STRENGTH 5 4 3 2 1 5 4 3 2 1 Importance Importance Capacity to sustain Capacity to sustain

36

31. Collaborations exist with: Hendrick Medical Center, Abilene lSD, United Way,

32. Several staff members with many years of experience.

Meals on Wheels, Head start, SNAP, TAMF, and ECI. STRENGTH STRENGTH 5 4 3 2 1 5 4 3 2 1 Importance Importance Capacity to sustain Capacity to sustain 33. Insufficient room for program/staff expansion in current building.

34. Unnecessary supplies in storage units (dungeon) cause poor space utilization and may be hazardous.

WEAKNESS WEAKNESS Mark only one oval per row. Mark only one oval per row. 5 4 3 2 1 5 4 3 2 1 Importance Importance Capacity to sustain Capacity to sustain 35. Main health building and Mercy Health Care Center are not in close proximity to one another

36. Services are not integrated: Epi, Vital Statistics and Informatics.

WEAKNESS WEAKNESS 5 4 3 2 1 5 4 3 2 1 Importance Importance Capacity to sustain Capacity to sustain 37. Important services are not located in current building: Mental Health, Environmental Health.

38. Insufficient staff training: EHR, Preparedness, staff communication and development.

WEAKNESS WEAKNESS 5 4 3 2 1 5 4 3 2 1 Importance Importance Capacity to sustain Capacity to sustain 39. Public health department accreditation suffers from lack of funds, guidance and direction.

40. Inability to create an extension of clinical services for clients.

WEAKNESS WEAKNESS 5 4 3 2 1 5 4 3 2 1 Importance Importance Capacity to sustain Capacity to sustain 41. Grants: Over-dependence threatens program continuity and reduces valuable work time.

42. Understaffing-Nursing program, Dental, Lab, Billing services, Community Health Workers, etc.

WEAKNESS WEAKNESS 5 4 3 2 1 5 4 3 2 1 Importance Importance Capacity to sustain Capacity to sustain 43. Lack of strong IT system for efficient workflow. 44. Family Planning Program underutilized (teenagers and men are

excluded by the program). WEAKNESS WEAKNESS 5 4 3 2 1 5 4 3 2 1 Importance Importance Capacity to sustain Capacity to sustain

37

APPENDIX IV

AGENDA FOR STRATEGIC PLANNING RETREAT I

Abilene-Taylor County Public Health District

Strategic Planning Retreat, Part 1 October 30, 2014, 8:30 a.m. – 11:30 a.m.

I. Session I, Strategic Planning, 8:30 a.m.–9:30 a.m.

A. Welcome & Introduction • Joanna Clark, City of Abilene, Employee Development & Engagement Manager • Femi Popoola, MPH, University of North Texas Health Science Center

Accreditation Fellow B. Strategic Planning Process • Importance of a Strategic Plan, Derrick Neal • Importance of a Mission & Vision, Santos Navarrette • Importance of Values, Nike Neuvenheim C. Strategic Planning Analysis, Femi Popoola • Comprehensive SWOT, Surveys, Values Table, Condensed SWOT, Stakeholder

Analysis, TOWS Matrix, Where do we go from here?

38

II. Session II, Mission, Vision, Values

A. Introduction • MVV Process & Formation of Groups, Joanna Clark

B. Break 9:30 a.m.–9:40 a.m. C. ATCPHD Mission Statement, Joanna Clark, 9:40 a.m.-10:40 a.m. • Group Discussion • Creation of Mission Statement D. ATCPHD Vision Statement, Joanna Clark • Group Discussion • Creation of Vision Statement E. Break 10:40 a.m.-10:50 a.m. F. ATCPHD Values, Joanna Clark, 10:50 a.m.-11:30 a.m. • Group Discussion • Creation of Values G. Conclusion, Nike Neuvenheim • Part 2, to be continued shortly… Thank you for your participation and contribution!

APPENDIX V

AGENDA FOR STRATEGIC PLANNING RETREAT II

39

APPENDIX V

AGENDA FOR STRATEGIC PLANNING RETREAT II

Abilene-Taylor County Public Health District Strategic Planning Retreat, Part 2

November 20, 2014, 8:30 a.m.-3:00 p.m.

I. Strategic Planning Process, Part 2, Femi Popoola, (8:30 a.m.-8:40 a.m.)

• Brief review of the October 30th Strategic Planning Retreat, Where will we

go from here?

• Explanation of the TOWS Matrix, Strategic Goals Selection Criteria, Self-

Assessment Tool, and Balanced Scorecard (documents within the packet)

II. Values, Joanna Clark, (8:40 a.m.-9:30 a.m.)

• Brainstorming

• Development of Values & Value Statements

III. Break (9:30 a.m.–9:45 a.m.)

IV. TOWs Matrix, Joanna Clark, (9:45 a.m.-10:45 a.m.)

• Development of Strategic Goals

V. Break, (10:45 a.m.-11:00 a.m.)

VI. Strategic Goals Selection Criteria & Self-Assessment Tools, Joanna Clark, (11:00

a.m.-12:30 p.m.)

• Review, critique, and completion of Strategic Goals

• Discussion-Identifying and Refining Goals

VII. Lunch provided by Subway, (12:30 p.m.-1:00 p.m.)

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VIII. Balance Scorecard, Joanna Clark, (1:00 p.m.-1:45 p.m.) • Discussion of the development of Objectives and Measures • Break, (1:45 p.m.-2:00 p.m.) • Complete Balanced Scorecard, (2:00 p.m.-3:00 p.m.)

IX. Thank you for your participation!

Strategic Priorities Strategic Goals

Objectives, Targets,

Measures, Responsibility

Implementation

41

Documents

2015-2019 ATCPHD Strategic Plan