Measuring public health services: The impact of a Colorado ruling on minimum core services

The 2012 Institute of Medicine (IOM) Report For the Public's Health: Investing in a Healthier Future recommends that all public health departments should provide a minimum package of public health services. Currently, little is known either about the level of core public health services provided or about public health agency's ability to change the services they provide. Through implementation of the Public Health Act of 2008, the State Board of Health was mandated to create a list of core services that should be provided across Colorado. Baseline data was collected on what services were currently provided prior to Board rulemaking in October 2011. The purpose of the study is to examine the effect of core service requirements on the adoption and delivery of core services by local governmental public health agencies (LPHAs); to examine LPHA-level structural capacity factors related to change in the level of adoption of core services by LPHAs; and to examine changes in health outcomes related to change in the level of adoption of core services by LPHAs. The study design is a longitudinal pre-post analysis of agency-level changes in core services provision among all 54 LPHAs in Colorado. We found that prior to the implementation of the core services requirement, core services were provided in a basic way in 7 of the 9 core service areas in most LPHA jurisdictions. Follow up data collection will be completed this spring to show change in LPHA services and describe structural capacity factors that may impact service change.