In today’s ever-evolving public health landscape, effective performance management is not just a goal—it’s a necessity. The Manitowoc County Health Department (MCHD) has risen to this challenge by integrating the Foundational Public Health Services (FPHS) framework as the backbone of its Performance Management System (PM System), ensuring a strategic, adaptable, and community-centered approach to public health improvement.
By integrating performance management with quality improvement, public health departments can drive better results and serve communities more effectively. Designing or re-designing the agency’s PM System structure can be daunting. Organizing the PM System by program area has been an approach that has been repeated in many agencies. However, the Public Health Accreditation Board (PHAB) Standards and Measures call for a PM System that encompasses “establishing and evaluating the achievement of goals, objectives, and improvements or actions across programs, policies, and processes.” Shifting the PM System to move beyond a program-focused structure helps highlight how various programs collectively support agency and community health goals.
Why the FPHS Framework?
The FPHS framework outlines foundational capabilities and areas essential to every public health department, from protecting communities from infectious diseases to advancing health equity. As described by PHAB, “The Foundational Public Health Services (FPHS) framework outlines the unique responsibilities of governmental public health and can be used to explain the vital role of governmental public health in a thriving community.” The FPHS framework provides common language and narrative as well as a framework to guide transformation and modernization efforts. Building FPHS into a PM System is a relatively new approach. By rooting its PM System in this framework, Manitowoc County has ensured alignment with national standards while addressing the unique needs of its community.
Example:
MCHD has developed six goals. For each goal there are objectives and measures that are crosscutting when multiple programs work toward the same goals.
Driving Impact:
This alignment has allowed MCHD to move beyond program-specific silos, fostering a broader understanding of how multiple initiatives collectively advance community health. Manitowoc County Health Director Korina Aghmar stated: “By breaking free from program-specific silos, we’ve cultivated a holistic view of community health. Aligning our Performance Management System with the Foundational Public Health Services reveals the interconnectedness of initiatives, amplifies impact, and empowers us to advance the health and well-being of those we serve.” The FPHS framework provides a shared language and focus, enabling staff and stakeholders to work cohesively toward measurable outcomes.
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