Using the essential services as a foundation for performance measurement and assessment of local public health systems.

Efforts are under way to develop a performance measurement monitoring system for state and local public health systems and to develop a strategic planning tool for local public health systems. The development of these measures is being based on the Essential Public Health Services. This article provides the rationale for why the Essential Services offer a good framework for identifying, analyzing, and evaluating public health activities. The article also reviews the history of local public health and the development and application of the Essential Public Health Services and their predecessor frameworks such as the core functions, the organizational practices, and the essential elements.

Assessing the impact of Medicaid managed care on TB activities in local health departments.

Three in-depth case studies were conducted to explore the impact of Medicaid managed care on local health department prevention activities. Tuberculosis (TB) was selected as a sentinel issue because TB includes both clinical treatment and population-based public health considerations (such as surveillance and contact tracing). Overall, study results indicated that there has been a minimal impact on TB prevention and control services, primarily because few TB patients are served by managed care. However, the sites offer many suggestions for areas to monitor, possible collaborative opportunities, and mechanisms to assure continued TB prevention and control.