Measuring local board of health effectiveness: A governance self-assessment

Context This presentation is an introduction to an updated assessment tool that aligns with NALBOH's 6 Functions of Public Health Governance, National Public Health Performance Standards Program, the Administrative Capacity and Governance Standards from the Public Health Accreditation Board, and proven elements of high-performing boards from the research of hospitals and health care systems. The tool illustrates methods of compliance with board responsibilities such as specific local health departments plan approval and monitoring. Experience implementing this tool with local boards of health will be shared.

Design This is a mixed methods study of local boards of health in Kentucky. Data was first analyzed on 2011-2012 board appointment documents. Appointment information regarding individual board members was collected on 1113 (97.4%) board members. Descriptive statistics were calculated for single county boards, counties within districts, and district boards. Boards were compared based on board size, composition, and ability to fulfill the intent of law regarding appointment requirements.

LBOH meeting minutes were collected and quantitatively analyzed based on state statutes and the Local Board of Health Self Evaluation tool. Finally, interviews were conducted with board members to establish the utility of the tool in the field and provide comparison between recorded meeting minutes and board perception.

Results/Conclusions: Local boards of health in Kentucky vary in their ability to fulfill the intent of law concerning the required board composition. Preliminary results reveal differences among counties of the Local Board of Health Self-Evaluation. This was an effective tool in capturing local board of health activities and the boards' current functionality with respect to effective governance characteristics. We support the use of this tool to evaluate board effectiveness in other states with local board of health governance.