DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT State Board of Health COLORADO MINIMUM QUALITY STANDARDS FOR PUBLIC HEALTH SERVICES 6 CCR 1014-9 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ Section 1 – Purpose and Authority for Rule 1.1 This rule recognizes that each community in Colorado should provide high-quality public health services regardless of its location.

1.2 This rule recognizes that through the adoption of measurable standards for public health services, Colorado’s public health system will continuously improve the quality of its services and programs, demonstrate accountability, and raise public health capacity.

1.3 This rule uses national standards developed by the Public Health Accreditation Board as a basis to direct local public health agencies across Colorado to work toward a level of capacity and process that is indicative of a widely accepted definition of a well-functioning public health agency.

1.4 This rule further recognizes that local public health agencies are essential to the provision of quality and comprehensive public health services throughout the state and are critical partners with the Colorado Department of Public Health and Environment in maintaining a strong public health system.

1.5 This regulation is adopted pursuant to the authority in section 25-1-503 et seq., C.R.S. and is intended to be consistent with the requirements of the State Administrative Procedures Act, section 24-4-101 et seq. (the "APA"), C.R.S.

Section 2 – Definitions 2.1 All definitions that appear in Section 25-1-502, C.R.S., shall apply to these rules.

2.2 "Agency" means a county or district public health agency established pursuant to section 25-1-506.

2.3 "Core public health" shall be defined by the state board and shall include, but need not be limited to, the assessment of health status and health risks, development of policies to protect and promote health, and the assurance of provision of the essential public health services.

A. Core Public Health Services were defined by the State Board of Health in 6 CCR 1014-7 (10/19/2011), and include:

1. Assessment, Planning, and Communication 2. Vital Records and Statistics 3. Communicable Disease Prevention, Investigation, and Control 4. Prevention and Population Health Promotion Code of Colorado Regulations 1 5. Emergency Preparedness and Response 6. Environmental Health 7. Administration and Governance

2.4 "Essential public health services" means to:

A. Monitor health status to identify and solve community health problems.

B. Investigate and diagnose health problems and health hazards in the community.

C. Inform, educate, and empower individuals about health issues.

D. Mobilize public and private collaboration and action to identify and solve health problems.

E. Develop policies, plans, and programs that support individual and community health efforts.

F. Enforce laws and regulations that protect health and promote safety.

G. Link people to needed personal health services and assure the provision of health care.

H. Encourage a competent public health workforce.

I. Evaluate effectiveness, accessibility, and quality of personal and population-based health services.

J. Contribute to research into insightful and innovative solutions to health problems.

2.5 In addition, the definitions listed below shall apply to these rules.

A. "Standards" means a level of recommended achievement against which a local public health agency may compare its current activities, and may include, but is not limited to, performance standards, performance management standards, descriptive standards, and, or quality standards.

Section 3 – Minimum Quality Standards for Public Health Services:

3.1 Each county and district public local health department subject to Section 25-1-501 et seq., C.R.S., should meet the following Minimum Quality Standards through the ongoing process of continuous quality improvement:

A. Conduct and disseminate assessments focused on population health status and public health issues facing the community 1. Participate in or conduct a collaborative process resulting in a comprehensive community health assessment 2. Collect and maintain reliable, comparable, and valid data that provide information on conditions of public health importance and on the health status of the population 3. Analyze public health data to identify trends in health problems, environmental public health hazards, and social and economic factors that affect the public’s health Code of Colorado Regulations 2 4. Provide and use the results of health data analysis to develop recommendations regarding public health policy, processes B. Investigate health problems and environmental public health hazards to protect the community 1. Conduct timely investigations of health problems and environmental public health hazards 2. Contain/mitigate health problems and environmental public health hazards 3. Ensure access to laboratory and epidemiologic/environmental public health expertise and capacity to investigate and contain/mitigate public health problems and environmental public health hazards 4. Maintain a plan with policies and procedures for urgent and non-urgent communications C. Inform and educate about public health issues and functions 1. Provide health education and health promotion policies, programs, processes, and interventions to support prevention and wellness 2. Provide information on public health issues and public health functions through multiple methods to a variety of audiences D. Engage with the community to identify and address health problems 1. Engage with the public health system and the community in identifying and addressing health problems through collaborative processes 2. Promote the community’s understanding of and support for policies and strategies that will improve the public’s health E. Develop public health policies and plans 1. Serve as a primary and expert resource for establishing and maintaining public health policies, practices, and capacity 2. Conduct a comprehensive planning process resulting in a Tribal/State/Community health improvement plan 3. Develop and implement a health department organizational strategic plan 4. Maintain an All Hazards Emergency Operations plan F. Enforce public health laws 1. Review existing laws and work with governing entities and elected/appointed officials to update as needed 2. Educate individuals and organizations in the meaning, purpose, and benefit of public health laws and how to comply 3. Conduct and monitor public health enforcement activities and coordinate notification of violations among appropriate agencies Code of Colorado Regulations 3 G. Promote strategies to improve access to health care services 1. Assess health care service capacity and access to health care services 2. Identify and implement strategies to improve access to health care services H. Maintain a competent public health workforce 1. Encourage the development of a sufficient number of qualified public health workers 2. Assess staff competencies and address gaps by enabling organizational and individual training and development opportunities I. Evaluate and continuously improve health department processes, programs, and interventions 1. Use a performance management system to monitor achievement of organizational objectives 2. Develop and implement quality improvement processes integrated Into organizational practice, programs, processes, and interventions J. Contribute to and apply the evidence base of public health 1. Identify and use the best available evidence for making informed public health practice decisions 2. Promote understanding and use of research results, evaluations, and evidence-based practices with appropriate audiences K. Maintain administrative and management capacity 1. Develop and maintain an operational infrastructure to support the performance of public health functions 2. Establish effective financial management systems L. Maintain capacity to engage the public health governing entity 1. Maintain current operational definitions and statements of the public health roles, responsibilities, and authorities 2. Provide information to the governing entity regarding public health and the official responsibilities of the health department and of the governing entity 3. Encourage the governing entity’s engagement in the public health department’s overall obligations and responsibilities 3.2 Provision of the Minimum Quality Standards shall be in accordance with the Core Public Health Services as defined in 6 CCR 1014-7.

Code of Colorado Regulations 4 _________________________________________________________________________ Editor’s Notes History Entire rule eff. 03/17/2013.

Code of Colorado Regulations 5