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Milne & Associates

Milne & Associates, LLC, (M&A), is a national consulting firm based in Portland, OR, that specializes in public health systems development and improvement, and in public health preparedness. The mission of the firm is to provide effective and meaningful contributions to improving organizational systems, capacity, and efficacy through insightful work, out-of-the-box thinking, and application of high performance experience. The firm works with national, state, and local public health agencies and associations, private not-for-profit organizations, academic institutions, and foundations.

M&A has assembled a team with national experience and deep public health expertise to fully address the significant challenges posed in the development of a public health operational master plan for King County . Led by the company's senior associate (Paul Wiesner, MD), M&A has organized a team experts into three subgroups: the core team which will have leadership responsibility for the project and the most direct interaction with the County; the resource team which will conduct intensive work in specific areas along with the core team; and the advisor team which provides periodic review and advice.

As can be seen in the brief synopsis of the team members' experience and expertise below, each team member brings a unique set of qualifications and expertise that, taken together, provides extensive national experience with major metropolitan health departments (MMHDs) as well as expertise in working with complex public health organizations. Most of the team members have had executive level experience in MMHDs.

Milne & Associates Team Members:

Core team: leadership responsibility for the project and the most direct interaction with the County

Paul Wiesner (Senior Associate for Milne & Associates) served for over 14 years as director of the health department in DeKalb County , Georgia , one of the two counties within which the city of Atlanta resides at the core of the Atlanta metropolitan region. During his tenure as public health director, he co-chaired the Health Collaborative of the regional Vision 2020 planning and was a founding member of the Atlanta Regional Health Forum, an ongoing multi-county public/private initiative to focus on improved health status across the metropolitan region. Many of the innovative ideas generated in DeKalb have been emulated in the region, in the state of Georgia , and nationally. Dr. Wiesner chaired the national NACCHO/CDC collaborative groups which developed the two most commonly used tools for assessing local health department performance in addressing community health issues: APEX/PH and MAPP. The latter is a state of the art strategic planning tool for public health practice developed and used by practitioners including leaders of major metropolitan health departments. As the leader in development of these tools, Dr. Wiesner experienced a wide variety of metropolitan health departments including his own in DeKalb County, in Chicago which was the prototype pilot/development site, and in several other cities including Nashville, Columbus, Ohio and San Antonio, all serving as demonstration sites of the new model.

Tom Milne brings extensive public health experience, having served as a member of the senior management team with the Multnomah County Division of Community Health Services (Portland, OR) for 10 years, and for 15 years as the executive director of the SW Washington Health District (Washington State), then a 3 county health department serving a population of 315,000. During his tenure in the latter position, he successfully organized a community collaborative to create a healthy Clark County , an effort that continues today, 11 years later. During his 5 year tenure as Executive Director of the National Association of County and City Health Officials (NACCHO), Milne worked with directors of the nation's largest public health departments, including those from Chicago, Houston, Los Angeles, Seattle, Atlanta, San Francisco, Kansas City, Boston, and Denver. Each of those leaders served on the NACCHO Board or in other leadership positions in the organization. Among his other responsibilities at NACCHO, Milne participated in the development of and signed off on provisions drafted for the Centers for Disease Control and Prevention (CDC) for the 2002 Federal Guidance for bioterrorism funding of local public health, including the provisions for the directly funded large, urban health departments (New York, Chicago, Los Angeles, and Washington, D.C.).

Patrick Lenihan served as deputy commissioner for the nation's third largest metropolitan health department for over 20 years, with major responsibilities for planning, policy, government relations, public information, and development functions, and served as the principal health policy advisor to the Daley administration. During his tenure, Dr. Lenihan developed the funding strategy for Chicago that allowed the city health department to triple is federal grant dollars and to reduce the reliance on local government funding to under 25% of the $160 million department budget. Beyond his Chicago experience, Dr. Lenihan has studied first hand the strategic operations of several large municipal health departments including those serving Nashville , Columbus , and St. Louis . During his tenure as the President of the National Association of County and City Health Officials, Dr. Lenihan was heavily involved in the development of national policy with direct ramifications on local public health practice.

RESOURCE TEAM: conduct intensive work in specific areas along with the core team

Kathleen "Casey" Milne brings direct and indirect experience with large, urban health departments. While at Multnomah County, she lead a number of county wide programs, managed large clinics which provided personal health, field nursing, dental, and mental health services. She was also responsible for the operations and management of Multicare, a managed care program that served a large population of low income families. Casey was heavily involved in numerous public health policy issues through her involvement with the Conference of Local Health Officials and as Chair of the Association of Oregon Public Health Nursing Supervisors. She also successfully led a statewide effort to improve access to delivery services for low income pregnant women. She has successfully founded and directed the operation of two businesses and is a national expert in quality improvement.

Bobbie Berkowitz has had extensive experience working for and with large metropolitan health departments. From 1986 to 1993, Dr. Berkowitz served as the Chief of Nursing Services for Public Health Seattle King County. In that capacity, she was responsible for staff development, clinical practice policies and guidelines, program development and evaluation, and quality improvement including evaluation and improvement for practice and system-wide performance. During her tenure as Deputy Secretary for the Washington State Department of Health (1993-1996) she led the development and implementation of the Public Health Improvement Plan. This plan remains in statutory language and transformed the public health system in Washington , including increasing capacity of public health organizational structures, information technology, and workforce. Dr. Berkowitz continues to lead the national Turning Point initiative, funded by The Robert Wood Johnson Foundation. The aim of this initiative has been to strengthen the ability of public health at the state and local level in 21 states and hundreds of communities to improve health, prevent disease and injuries, and to protect the population from emergencies and hazards. The large metropolitan health departments included in Turning Point have been New York City , Chicago , Portland , New Orleans , and Tulsa.

Dave Joyner brings to the team a total of 33 years of public sector service at the state, local and public health district levels. He served as the Chief Administrative and Finance Officer for a major metropolitan health department for nine years. Prior to this, he served as Chief Financial Officer of two metropolitan county governments for a total of 14 years. This combination of experience has provided a broad perspective on the interaction of various governmental levels. He has a clear view of funding and service provision issues from both inside and outside the public health arena. Mr. Joyner has a wealth of experience in policy development, management and operational studies, structural reorganization, billing, facility management, operational standards, staff development, human resources administration, and information technology systems. His viewpoint from the "business" side of the organization provides an important complement to the professional public health practice expertise of other team members.

ADVISOR TEAM : provides periodic review and advice

Bruce Miyahara brings twenty-six years experience in public health management, budget, policy and finance in local and state government public health agencies and systems. Fourteen of those years include direct management experience in the Seattle/King County Department of Public Health at both Program and the Department level. He also has twelve years experience in direct management and development of state public health systems, and served as the Secretary of Health for Washington State from 1993 to 1998. His involvement in state public health system development has provided an in-depth understanding of the conflicting roles and financing/operational aspects of state, large metropolitan and small rural departments in improving and protecting the health of its residents. Mr. Miyahara has successfully dealt with the many competing policy/service demands at the interface of large, metropolitan health departments and state public health agencies as well as with the multiple local city and county jurisdictions with which metropolitan health departments must operate.

Jack Thompson is the Director of the Northwest Center for Public Health Practice at the University of Washington and a Senior Lecturer in the Department of Health Services. He is the Principal Investigator on the Northwest Center for Public Health Preparedness Program, a CDC-supported Academic Center for Public Health Preparedness. He has also served as a Senior Program Consultant with the Robert Wood Johnson Foundation Turning Point Initiative. Mr. Thompson has been on faculty in the School of Public Health and Community Medicine since November of 1994. At the national level, he chairs the Operations Committee of the National Public Health Training Center Leadership Council and also chairs a National Exemplary Group for the Centers for Disease Control and Prevention that focuses on Cross-Border Preparedness.

Barney Turnock is Clinical Professor of community health sciences and Director of the Center for Public Health Practice, University of Illinois-Chicago. He also serves as Director of the Illinois Public Health Preparedness Center. Dr. Turnock has worked for both the New York City and the Chicago Departments of Health. He served in the Bureau of Maternity of Services and Family Planning for the New York City Department of Health from 1976-1978, and as Medical Deputy Commissioner and Acting Commissioner of the Chicago Department of Public Health from 1982-1985. He was also Director of the Illinois Department of Public Health from 1985-1990. Dr. Turnock is the author of a widely read text on public health practice, Public Health: What It Is and How It Works, and is a highly regarded national expert in public health services organization and delivery.