Slide decks presented during Day One sessions of the 11th Annual Stewards of Change National Symposium at Johns Hopkins University.

3. Welcome, Vision, Purpose and
Programs Overview
o Michael J. Klag MD, MPH
o Dean, John Hopkins Bloomberg School of
Public Health
o Daniel Stein
o President, Stewards of Change Institute
#SOCI16

4. Information-Sharing and the
Social Determinants, Today
and Into the Future
Moderator:
o Paul Wormeli, Executive Director Emeritus, IJIS Institute; Board
Member, SOC Institute
Presenters:
o Jessica Kahn, MPH, Director, Data and Systems Group, Centers for
Medicaid & CHIP Services, CMS, HHS
o Kshemendra Paul, Program Manager, Information Sharing
Environment
o Melinda J. Baldwin, PhD, LCSW, Senior Policy Advisor – Health and
Well-Being, Office of the Commissioner, Administration on Children,
Youth and Families, Administration for Children and Families
o Chris Traver, Senior Advisor for Information Sharing, Administration
for Children and Families, HHS
#SOCI16

5. SCOPE OF THE ISE
Diplomacy
Homeland Security
Intelligence
Defense
Law Enforcement
Frontline
• Investigators
• Analysts
• Operators
Federal
State
Local
Tribal
Private Sector
International
Communities
Information
Sharing
Environment
(ISE)
Information Technology Industry

6. NATIONWIDE CHALLENGES
18,000
LE Agencies750,000+
Officers
250,000
911 Operators
1.2million
Firefighters
2.2million
Security Officers
18 CI/KR Sectors
* Numbers are estimates
300+million
People
78Fusion Centers
28 HIDTAs
6 RISS Centers
FBI
NCIJTF ▫ CJIS ▫ FIGs ▫ JTTFs ▫ JRIGs ▫ TSC
DHS
I&A ▫ ICE ▫ CBP ▫ TSA ▫ DNDO ▫ NPPD
Maritime
Domain
NCTC
JCAT
Air
Domain
DoD
DOJ
ATF ▫ DEA ▫ USMS ▫ OJP
Protection of Privacy, Civil Rights, and Civil Liberties
Nlets
State
National Approaches to Interoperability
Common Operating Models
Consistent, Transparent & Distributed Policies
Integrated Capabilities & Shared Services
Evolving & Converging Threats & Risks
Collaboration Imperative
Strengthening Legitimacy
Enterprise Data Management

7. STATE & REGIONAL ISE SUMMIT
• Priorities:
◦ Create a collaboration environment – National ISE Matrix
◦ Coordinate federal agency efforts related to information sharing
◦ Develop rules for secondary use of data
◦ Explore the boundaries of the enterprise
◦ Develop outreach and education resources
◦ Create consistent security and control classification of
information
◦ Engage executive leadership
◦ Improve procurement practices
◦ Clarify roles and responsibilities on
cyber-related information
◦ Engage associations to spotlight ISE-related efforts
7

8. INFORMATION SHARING
FRAMEWORKS AND STANDARDS
• Established by PM-ISE, the Standards Coordinating Council
(SCC) is the forum to coordinate voluntary alignment, integration,
and adoption of information sharing and safeguarding standards
and frameworks.
• SCC has the role of coordinating alignment and supporting
adoption of
• Project Interoperability
• ISE Core Interoperability Framework, or “ICIF”
• Information Sharing and Safeguarding Playbook

9. ISE Core Interoperability Framework
(ICIF) Vision:
A Foundation for Interoperable ISEs
ICIF
ISE ISE
ISE ISE
ICIFProject Project
ICIF
COI
member
COI
member
COI
member
COI
member
ICIF
ISE
member
ISE
member
ISE
member
ISE
member
Mission Interest ISE
Tactical Information Sharing Project
State/Regional Information Sharing Environment
Federal Counterterrorism ISE
ISE Stakeholders
Participate in ICIF
Governance
ISEs Leverage ICIF
Components

10. PROJECT INTEROPERABILITY
Discover
Interoperable
Services
Build
Interoperable
Services
Extend
Interoperable
Services
Built upon…
Legal Authorities, Governance & Policy, Performance Management,
Communications and Outreach Tools
• Advocates standards & technologies
most likely to achieve the desired ISE
compatibility, performance, and scalability
• Connects partners with each other, and
with best-practices
• Mission agnostic
• Operational integration of the ICIF
• Promotes sharing and safeguarding of information at domestic nexus of
national security and public safety via development of ISEs
• Focused on “white-space” between agencies

11. 11
Project Interoperability 2.0
ISE Core Interoperability
Framework (ICIF)
Assertions-Based
Architecture (ABA)
Assertion
Definitions
Assertions
Assessor
Operational
Infrastructure
Specs
Standards
ISE Integration Library
IS&S
Playbook
(Rev.)
Planner’s
GuidetoISEs
Reference
Architectures
Governance
Documentation
Implementing
Guidance
Performance
Scenarios
Common
Lexicon
Common
Profile
• Users save time and money in aligning their
architectures and establishing ISEs; barriers to
entry fall
• Reduces implementation risk by making
available interoperability examples, a common
vocabulary, etc.
PROJECT INTEROPERABILITY
COMPONENTS

12. www.standardscoordination.org
9
STANDARDS
COORDINATING COUNCIL

13. VISIT ISE.GOV
@shareandprotect

14. Kshemendra Paul
Program Manager, Information Sharing Environment
National Security
Through
Responsible
Information Sharing

15. Interactive Session:
Questions of Consequence
o Facilitators: Daniel Stein and the
Stewards of Change Institute Team
#SOCI16

16. SOCI Voices of Social Determinants of
Health and Wellness Video
• Click here to view on our YouTube channel -
https://www.youtube.com/watch?v=d1ypPZlaKFY&
index=1&list=PLeI2juMpKM4O1A6m0XrCfKtmITs_S
7_45

17. Learning from Network Domains,
Moving toward Health Equity
Moderator:
o Bill Hazel, MD Secretary Health and Human
Resources, Commonwealth of Virginia
Presenters:
o Margo Edmunds, Ph.D., Vice President, Evidence Generation and
Translation, AcademyHealth
o Paula Soper, MS, MPH, PMP, Senior Director, Public Health
Informatics, Association of State and Territorial Health Officials
o Emily Kulick, Privacy Fellow, U.S. Department of Education
o Rafael Diaz, Chief Information Officer, U.S. Department of Housing
and Urban Development
#SOCI16

18. Paula Soper, MS, MPH
Senior Director, Public Health Informatics
Association of State and Territorial Health Officials
June 13, 2016
Public Health 3.0: Upgrading our Approach to
Address Health Equity and the Social
Determinants of Health

19. Versioning Public Health in the US
• Full Accreditation
• Enhanced leadership
and workforce
• Lifespan/
generational
Population-based
prevention
• New partners to
focus on social
determinants
• Technology, tools
and data
• New metrics of
success
• Network model
Public Health 3.0
Future
GOAL: Optimal health for all
FOCUS: Achieving optimal health
Public Health 1.0
Late 19th Century - 1988
• Variation in health
department capacity
• Germ theory
• Short time-frames
• Medical care
• Vaccines
• Antibiotics
• Expanded
capabilities in
epidemiology and
laboratory science
• Industrial model
GOAL: Reducing deaths
FOCUS: Acute and infectious diseases
• 3 core functions/10
Essential Services
• Accreditation taking
hold
• Multiple risk factors
• Longer time frames
• Health equity, social
determinants of
health
• Chronic disease
management and
prevention
• Pre-paid benefits
• Corporate model
Public Health 2.0
1988-Present
GOAL: Prolonging disability-free life
FOCUS: Increased focus on chronic disease

20. Public Health 2.0 Public Health System
Public health system commonly defined as “all public, private, and
voluntary entities that contribute to the delivery of essential public
health services within a jurisdiction.”
Intended to ensures that all entities’ contributions to the health and
well-being of the community or state are recognized in assessing the
provision of public health services.
Focus on public health as the convener
The public health system includes
 Public health agencies at state and local levels
 Healthcare providers
 Public safety agencies
 Human service and charity organizations
 Education and youth development organizations
 Recreation and arts-related organizations
 Economic and philanthropic organizations
 Environmental agencies and organizations
An improvement, but still a limited focus

21. Public Health 3.0: Why is this an imperative?
ACA drivers to change: SIM, social determinants,
prevention
ZIP codes remain a more accurate determinant of health
than genetic codes.
Collective societal responsibility to create conditions that
allow all members of our communities to make healthy
choices.
 Public health programs often
still developed and
implemented in silos that
result in missed opportunities
to leverage critical knowledge
of communities to improve
health at the local level.

22. Public Health 3.0: How to effect change?
Emphasize cross-sectoral environmental, policy, and
systems-level actions that directly affect the social
determinants of health and advance health equity.
Challenge to business leaders, community leaders, state
lawmakers, and Federal policymakers to incorporate health
into all areas of governance.
More expansive partners to address:
Economic development
Education
Transportation
Food
Environment
Housing
Safe neighborhoods

23. Public Health 3.0: Technology, Tools and Data
Modernized information systems to support new standards
and technology
Interoperability to facilitate multi-sectoral data and
information sharing for analysis, coordination and decision-
making at micro and macro levels
Modern tools
Analytic tools to support sophisticated analysis of multi-sector data
Visualization tools to support impactful communication of analyses to
stakeholders, funders and communities
Predictive modeling tools to support prioritization, resource allocation
and other decision-making by communities, service providers, elected
officials, government agencies, foundations and others
Funding, policies and standards to support modernization
and interoperability

24. Public Health 2.0: “Interoperability” Case Study
Healthy Communities Access Program funding
Health and Human Services Coalition undertaking regional Community
Health Assessment and Community Health Improvement Plan
Opportunities to look at data in new ways
Blood lead poisoning, looked at data from multiple agencies differently
Blood lead results at county, sub-county level, not region
Home address
Housing stock age
Housing stock ownership records
Rental property lead testing/abatement records
After several months and many challenges with data access and data
matching, able to identify rental company at root of widespread
problem
Community able to develop multi-pronged approach to address short-
and long-term interventions
Imagine how to do this more efficiently in a Public Health 3.0 context

25. Thank you!
Paula Soper
Senior Director, Public Health Informatics
Association of State and Territorial Health Officials
Email: psoper@astho.org
Phone: 571-318-5412
http://www.astho.org/Programs/Informatics/

26. Individual Care
- Coordinating care/Electronic human
services record
- Decision support tools/predictive risk
modeling
Management Decision Making
- Trends in need and service utilization
- Outcome evaluation
- Cost/benefit analysis
- Performance based contracting
- Research
Community Use
-Open government/open data
-Research partners
Allegheny County Department of Human Services
Using Integrated Data Systems

27. Weekly Email Alert to Caseworkers (Pilot)Child Welfare Case Management System
Data Where It’s Needed: Up-to-date education information (where legal)
Action Research Model
Analysis
Perform integrated
analysis to assess specific
nature and dynamics of
targeted issue.
Critical Reflection
Carefully examine analyses to develop
effective strategies to improve both
organizations’ way of working with
children and families.
Action
Create, implement
and evaluate
strategies and
interventions.
Allegheny County Department of Human Services
Education Partnerships
Case ID Client ID Client Name School Attended School Contact IEP Attendance Suspension Withdrawal
1111 11111 Client 1 Pittsburgh Public - Schiller 412-555-5555 Y X
2222 22222 Client 2 Clairton - Middle School 412-555-5555 N X
3333 33333 Client 3 Pittsburgh Public - Carrick 412-555-5555 N X X
4444 44444 Client 4 Pittsburgh Public - King 412-555-5555 N X
Days Missed in
Prior Week
Days Missed this
Academic Year Attendance Category
Days Tardy in
Prior Week
Days Tardy This
Academic Year
Client 1 1 27 Chronic 5 22
Client 2 5 9 At-Risk 7 11
Client 3 4 45 Severely Chronic 5 12
Client
Name
Days
Suspended in
Prior Week
Days Suspended
This Academic
Year
Client 3 4 16
Client
Name
Date of
Withdrawal
Reason for
Withdrawal Date of Enrollment New School
Client 4 12/20/2015 Left District
ATTENDANCE
Days Absent
Client
Name
DETAILS
SUMMARY OF EDUCATION CONCERNS
SUSPENSIONS
WITHDRAWALS
Tardies

28. Office of the Chief Privacy Officer
Technical assistance, policy development, enforcement & internal
data management
Upcoming Guidance For Cross-Agency Data Sharing
 Integrated Data Systems and FERPA
 WIOA Performance Reporting (joint guidance with Dept. of Labor)
In discussions with other agencies to identify joint guidance opportunities
U.S. Department of Education

29. External Sources
 Allegheny County Housing Authority
 Allegheny County Jail
 Birth Records
 Allegheny County Medical
Examiner’s Office
 Department of Public Welfare
 Housing Authority City of Pittsburgh
 Physical Health Claims (Medicaid)
 Juvenile Probation
 Pittsburgh Public Schools + 17
additional County School Districts
 Pre-trial Services
 Adult/family court
Internal Sources
 Aging
 Child Welfare
 Community Service Block Grant
 Drug & Alcohol
 Early Intervention (partial)
 Family Support Centers
 HeadStart (partial)
 Homeless
 Housing Support
 Mental Health
 Intellectual Disabilities
Potential Data Sources
 Early Childhood
 Post Secondary Education
 Employment & Training
 Place and Incident Based Data
Allegheny County Department of Human Services (Pittsburgh, PA)
Integrated Data Systems

30. Affinity Table Discussions
Table 1: Margo Edmunds / HealthCare
Table 2: Paula Soper / Public Health
Table 3: Emily Kulick / Education
Table 4: Rafael Diaz / Housing
Table 5: Sixto Cancel / Think of Us
Table 6: Chris Traver / ACF Interoperability
#SOCI16