Visioning the Los Angeles County Public Health Department: Strategic Planning in the Era of Health Reform

Strategic planning by local health departments has taken on increased importance in the era of health reform with its concomitant expanded access to care, the growing availability of health information, and the likelihood of ongoing budgetary pressures on public health funding. The Los Angeles County Department of Public Health (LAC-DPH) began a strategic planning process in the summer of 2011 to ensure better alignment of the department's core functions within this changing landscape. To inform this process, the LAC-DPH Office of Planning analyzed internal and external trends and policy issues. This environmental scan included surveys of DPH staff and external partners as well as key informant interviews with national public health experts and other key opinion leaders in Los Angeles County. DPH's leadership then engaged in a prioritization process that analyzed this data, burden of disease, and other factors to identify strategic areas for organizational change. Departmental subject area experts participated in workgroups to refine goals and objectives and linkages to performance measures for these strategic priority areas. The strategic planning process was conducted within the framework of broader community health planning, using Public Health Accreditation Board requirements as a guiding goal. This session will examine the lessons learned including effective ways of obtaining data to inform priority setting, determining suitable criteria to conduct prioritization processes, and navigating the tension between comprehensiveness (all programs see their work reflected in the plan) and being strategic (identifying cross-cutting, high-priority areas). This session will also discuss how a large, urban public health department confronts the increasing demands for policy-level /social determinants work while categorical funding and demand for clinical public health services diminishes. New initiatives for LAC-DPH will also be highlighted within the strategic plan, along with proposed resource allocations.