PU501 Unit 5 Essential Services County Audit Example

Ten Rows, One County, a Verdict on Each: An Essential Services Audit Checking a Composite Rural County Against the 2020 Revision of the Ten Essential Public Health Services, With a Document Cited Behind Every Rating

[Student Name]

Purdue University Global

PU501: Fundamentals of Public Health and Health Systems

Unit 5 Essential Services Audit

[Instructor Name]

[Date]

The county, its documents and every rating are composite and bracketed for the writer's own data; the framework is real.

Method

Rating rules. Full: documented delivery by the department or a named contractor across the county. Partial: delivery limited in reach, time or population. Absent: no documented delivery. Evidence: documents a reader can open, namely the department's annual report, the adopted budget, the community health improvement plan, board of health minutes and the state's local performance reports. Interviews with the health officer and two program managers were used to locate documents, not to replace them. The framework places equity at the center of all ten services rather than as an eleventh (Castrucci, 2021). The audit therefore notes, for each service, whether delivery reaches the two areas the community snapshot identified as carrying the most burden.

Audit Table

1. Assessing and monitoring population health. Who: department, with state epidemiology. Evidence: [year] community health assessment. Rating: partial; the assessment is five years old and has no tract-level data.

2. Investigating and addressing health problems and hazards. Who: department. Evidence: communicable disease logs and inspection reports. Rating: full.

3. Communicating to inform and educate. Who: department. Evidence: annual report and social media plan. Rating: partial; no materials in Spanish beyond immunization notices.

4. Strengthening and mobilizing community partnerships. Who: department with the hospital coalition. Evidence: coalition minutes. Rating: partial; the coalition met twice last year.

5. Creating and championing policies, plans and laws. Who: board of health. Evidence: board minutes. Rating: partial; no new policy in three years beyond fee updates.

6. Using legal and regulatory action. Who: department and board. Evidence: food, septic and body art enforcement records. Rating: full.

7. Assuring equitable access to care. Who: partners, mainly the health center and hospital. Evidence: health center service area plan. Rating: partial; the northern tracts lack regular primary care.

8. Building a diverse, skilled workforce. Who: department. Evidence: budget and training logs. Rating: partial; no epidemiologist and high nurse turnover.

9. Improving through evaluation and quality improvement. Who: department. Evidence: none current. Rating: absent since the quality coordinator's grant ended.

10. Maintaining organizational infrastructure. Who: department and county. Evidence: budget, information systems inventory. Rating: partial; aging data systems, stable governance.

The county is strongest where it holds legal power and weakest where it needs data, people and time to plan.

Patterns Across Rows

Full ratings cluster in services 2 and 6, investigation and regulation, which are funded by fees, required by law and visible when they fail. Partial and absent ratings cluster in assessment, evaluation and workforce, the services that depend on discretionary funding. Equity runs weak across nearly every row: services seldom reach the northern tracts or Spanish-speaking residents on equal terms.

Two Ratings That Were Hard to Call

Service 7, assuring access to care, was the hardest. The department does not deliver primary care, and arguably need not, since the health center and hospital do. But the framework asks whether the system assures equitable access, and the northern tracts have no regular clinic. The audit rated it partial because the health center's service area plan names the northern tracts as a priority, a document the department helped write. Service 4, partnerships, was first rated absent because the coalition had no recent action, then raised to partial when the health officer produced a signed agreement with the school district for a shared health fair. Recording these judgment calls lets a reader disagree with a rating while trusting the method.

Who Should Read the Audit

The board of health, which sets priorities; the county commission, which approves the levy; and the coalition partners, who deliver several of the services rated partial. Each will read it for a different reason, so the table is kept on one page and the patterns section written for nonspecialists.

What the Patterns Mean

The original core functions argued that public health needs assessment, policy development and assurance working together (Institute of Medicine, 1988). This county can enforce rules but cannot easily see where to apply them or judge whether its work succeeds. National calls for a modernized public health system make the same point: departments need data capacity and partnerships, not only regulatory tools (DeSalvo et al., 2017).

Priorities Suggested by the Audit

Update the community health assessment with tract-level data; restore a quality and evaluation function, even part-time; translate core materials into Spanish; and bring the coalition back to regular meetings with a focus on the northern tracts.

Limits

Documents may not capture informal work, such as a nurse's outreach that never reaches a report. Ratings are the auditor's judgment, checked with the health officer, who disagreed with two and provided additional evidence for one, which changed service 4 from absent to partial.

Conclusion

The county delivers the services the law requires and struggles with those that require planning and data. The audit gives the board a list of where to start.

References

Castrucci, B. C. (2021). The "10 Essential Public Health Services" is the common framework needed to communicate about public health. American Journal of Public Health, 111(4), 598-599. https://doi.org/10.2105/AJPH.2021.306189

DeSalvo, K. B., Wang, Y. C., Harris, A., Auerbach, J., Koo, D., & O'Carroll, P. (2017). Public Health 3.0: A call to action for public health to meet the challenges of the 21st century. Preventing Chronic Disease, 14, E78. https://doi.org/10.5888/pcd14.170017

Institute of Medicine. (1988). The future of public health. National Academy Press.