Jade is the Performance Improvement Director at KDHE’s Center for Performance Management​​ (Center) within the Office of the Secretary. In this role, she is tasked with overseeing strategic initiatives that span from the department’s strategic plan to state health improvement planning, quality improvement (QI), public health accreditation, equity, and community engagement initiatives. The Center is structured into three distinct programs: strategic initiatives, policy and accountability, and community involvement. Each program focuses on addressing community needs holistically, with an emphasis on incorporating community perspectives into decision-making processes. 

Jade has been a leader in promoting DEIJ in the state’s public health space. When the Center was established at KDHE, one of the initial steps taken by Jade and the former Health Equity Manager was to define guiding principles. Initially, their aspiration was to create a standalone office dedicated to health equity initiatives; however, navigating through challenges, including the evolving landscape shaped by events like the COVID-19 pandemic, presented difficulties. Despite this, their focus remained steadfast on grounding their work in health equity while integrating perspectives of performance management and QI. Understanding the significant return on investment in such endeavors, they ensured their initiatives were rooted in these principles. The Center operates alongside other departments within KDHE, emphasizing collaboration and inclusivity. Its objectives encompass building capacity, fostering community involvement, and ensuring that diverse perspectives inform decision-making processes, adhering to the principle of "nothing about us without us." Through this multi-pronged approach, they aim to address evolving health disparities and promote equitable outcomes across the state. 

Jade discussed with us the evolution of QI initiatives within the department, emphasizing the integration of an equity lens into QI practices. She noted that, initially, there was skepticism among staff regarding the efficacy of QI efforts, as similar approaches had been attempted in the past. According to tenured staff, these previous attempts left many feeling burnt out on the concept of continuous QI. However, the adoption of an equity framework transformed the way QI projects were conceptualized and implemented. Jade described a large-scale QI project focused on equitable resource allocation to communities. By incorporating guiding principles of equity and disaggregated data analysis, the project identified opportunities to scale resource distribution efforts. This transformative approach came as a result of community feedback and aimed to address persistent health disparities in historically under-resourced communities. This led to significant shifts in resource allocation and improved outcomes for many underserved populations. The success of this project underscored the importance of combining QI methodologies with a health equity lens. Jade highlighted the need to ask critical questions about why certain communities face barriers to success and to offer grace and support in addressing these barriers. This integrated approach has yielded tangible improvements in resource distribution and community outcomes, validating the effectiveness of QI efforts grounded in equity principles. 

KDHE has faced challenges in funding restrictions, particularly regarding the provision of food-related services through federal grants. However, the Center adopts a proactive and creative approach to overcome these obstacles. By seeking innovative solutions and proposing alternative approaches to funders, they ensure that crucial community needs, such as food insecurity, are addressed effectively. For example, they have leveraged partnerships with local grocery stores and insurance providers, using incentives like gift cards to educate and support unsheltered populations during the holidays. This effort extends to peak seasons when emerging health issues like influenza and RSV are major concerns, helping to spread awareness and address key health concerns effectively. Moreover, the Center actively shares experiences and strategies with other states and alliances, continuously fostering collaboration and knowledge exchange within the public health community. They consistently remain committed to creatively working through challenges to achieve their objectives and make meaningful impacts on community health and well-being. Through this approach, the Center has overseen several large-scale grants, totaling millions of dollars, aimed at addressing disparities in areas such as COVID-19 response, public health infrastructure, environmental justice, and social determinants of health. By directing funding where the work is conducted and providing technical assistance to communities, the Center strives to make tangible impacts on health outcomes and resource distribution. 

Jade also highlighted the importance of strategic partnerships with community organizations and local health departments as a key component of the Center’s success. Community health workers (CHWs) play a vital role in these partnerships, leveraging their deep understanding of local communities to identify inequities and areas of need. By fostering collaboration and localization, the Center has overcome challenges and implemented impactful initiatives. The Center helps fund two cadres of CHWs within the state. The first is a clinic-based model led by the KDHE CHW Section, where CHWs are housed in settings such as schools, federally qualified health centers, and other rural and primary care health clinics. The second cadre, in partnership with the University of Kansas Medical Center, is the Communities to Promote Equity (COPE) project, which includes Local Health Equity Action Teams (LHEATs). These teams drive community engagement based on democratic principles, ensuring everyone impacted has a say. The teams consist of CHWs who serve as the operational force supporting the implementation of 30-day action plans established in the 22 counties where LHEATs operate to address targeted health issues. This approach emphasizes meeting communities where they are and building trust through genuine engagement and support. 

One example of these principles in action is work that was done at meat packing plants in rural parts of Kansas during the COVID-19 pandemic. There are unique health challenges at these plants due to factors such as occupational hazards, high population density among workers, and limited access to healthcare services. These challenges can exacerbate public health issues, especially during events like the pandemic. To address these issues, Jade and her team at the health department collaborated closely with CHWs and LHEATs, among many other partners, as part of this effort to support communities. These teams were composed of individuals from the affected communities who understood the local context and had established relationships within the meat packing plant workforce. One notable initiative was the setup of mobile testing sites within the meat packing plant communities to provide COVID-19 testing and support services to workers. These mobile sites served as hubs for various services, including testing, vaccination, occupational health support, and educational resources on preventive measures. By bringing these services directly to the community, the department, alongside many collaborative partners and others, helped to ensure accessibility and addressed barriers to healthcare access faced by the meat packing plant workers. 

Jade offered that health departments can enhance their effectiveness by prioritizing community engagement and building partnerships with local organizations and leaders. By actively involving community members in decision-making processes and tailoring interventions to meet their needs, health departments can more effectively address public health challenges with a health equity lens. Adopting a regional approach allows for targeted interventions that consider the unique needs of different communities within a jurisdiction. Investing in CHWs and compensating them for their contributions can help bridge the gap between healthcare services and underserved populations. Moreover, health departments should remain flexible with funding sources and advocate for flexibility in funding restrictions to better address community needs. By prioritizing localization and engaging directly with communities through listening sessions, focus groups, and site visits, health departments can gain valuable insights and ensure that interventions are culturally appropriate and responsive. Sharing best practices and lessons learned with other health departments facilitates collective learning and improvement, ultimately advancing the goal of promoting health equity across communities.