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Lake Cumberland District Health Department

A healthy today for a brighter tomorrow.

The Ten Essential Services of Public Health

The 10 Essential Public Health Services (EPHS) were established 25 years ago as a framework for public health activities. The EPHS have been updated in 2020 to align with current and future public health practices. The framework is a recognized standard for public health missions.

The Three Core Functions

The three Core Functions of Public Health, as first identified in 1988 in the the Institute of Medicine’s (IOM) book, The Future of Public Health; and the Ten Essential Public Health Services provide a working definition of public health and a guiding framework for the responsibilities of local public health systems.

The Core Functions of Public Health of Assessment, Policy Development, and Assurance are sub-divided into the Ten Essential Public Health Services. All public or community health responsibilities (whether conducted by the local public health department or another organization within the community) can be categorized into one of these Ten Essential Services. Learn more about the Ten Essential Services here: Introduction to Public Health Video.

Assessment. Assurance. Policy Development.

Core Function: Assessment

Monitor Health status to identify community health problems.


Clinic/Epidemiology: We complete an annual immunization survey to determine rates for our community. We also monitor diseases and conduct outbreak investigations utilizing surveillance. We report the data reporting and provide treatment when necessary.

Diabetes: Annually, we review the rate of diabetes for our member counties, along with physical inactivity and obesity. We share this with an advisory committee and community partners who help with program planning.

Environmental: We receive and respond to complaints from the public regarding illness.

HANDS: We inquire as to the health of our mother’s and babies, and as to if they’ve had any recent doctor visits. We also watch for insect or rodent infestations and assist the family to resolve the problems; thus, keeping the home safe.

Health Promotion and Policy: Annually, we review data from our community health improvement plans to evaluate if the data has improved or gotten worse. In addition, we ask our coalition partners if they have updated data to share. After reviewing the data we decide as a coalition if we need to adjust or add activities to our community health improvements plans.

Diagnose and Investigate health problems and health hazards in the community.


Clinic/Epidemiology: We monitor diseases and conduct outbreak investigations utilizing surveillance.  We report the data reporting and provide treatment when necessary.  We also provide women’s health services in order to prevent and control cancer rates.

Environmental: We investigate food-borne outbreaks, and complaints regarding sewage, rodents and other sources of filth.

Epidemiology: Both our Epidemiologist and our Data Analysis Committee analyzes health data to discover negative health trends so that appropriate recommendations can be made.

Core Function: Policy Development

Inform, Educate and Empower people about health issues.


Clinic: We counsel patients on safe sex practices and risk reduction to prevent the spread of STIs. We educate women on self breast exam and the need for an annual physical exam. We provide education to WIC participants regarding proper nutrition, exercise, the importance of breastfeeding and smoking cessation.

Diabetes: We provide Diabetes Self-Management Education in all 10 counties; and, the Diabetes Prevention Program is available in all 10 counties. We submit diabetes related articles to newspapers monthly. We also work with community partners (i.e. hospital, extension offices, libraries, churches, etc.) to provide diabetes education in our community.

Environmental: We educate the public regarding hand washing, proper food handling and vector borne diseases.

HANDS: We are often asked for information regarding health problems that moms or babies are facing. Our staff seek information for the family and take it back at the next scheduled visit. We also refer families to agencies that can assist them with health concerns, such as developmental delays. We also refer parents to programs offering assistance with smoking cessation, diabetes, drug abuse, etc.

Health Policy and Promotion: We educate the community on numerous topics such as nutrition, dangers of tobacco, healthy heart, blood pressure awareness — “Know Your Numbers” — teen pregnancy prevention, sexually transmitted disease, drug use, safe sleep, secondhand smoke, communicable diseases and playground safety. We also provide smoking cessation classes, nutrition education and exercise management across our ten counties.

Mobilize Community Partnerships to identify and solve health problems.


Clinic: We participate in child fatality review teams to develop strategies in order to keep children safe and prevent fatalities. We partner with transportation, local law officials and fire departments to provide car seat safety checks in the communities. We work with local hospitals and medical providers to investigate and control the spread of disease.

Diabetes: We are active in health coalitions in all 10 counties — especially the 8 counties that have diabetes specific coalitions (Adair, Casey, Clinton, Cumberland, Green, McCreary, Russell, Wayne). We are active in the state Kentucky Diabetes Network Coalition.

Environmental: We partner with the food service industries for food safety; and, with other agencies to address various environmental concerns.
Health Policy and Promotion: We have health coalitions across our ten counties. We facilitate these meeting and help implement Mobilizing for Action through Planning and Partnerships (MAPP), a community-driven strategic planning process for improving community health. This framework helps communities apply strategic thinking in order to prioritize public health issues and identify resources to address them.

Preparedness: The Preparedness Department cultivates partnerships with emergency responders and healthcare organizations across the district to ensure plans and training are conducted that will increase preparedness to public health threats and emergencies.

Develop Policies and plans that support individual and community health efforts.


Environmental: We develop plans regarding vector borne illness.

Health Policy and Promotion: We have worked with our community coalitions to develop policies and plans to improve the health status of our communities. These plans include environmental strategies and polices such as Tobacco Free School, Smoke Free Restaurants (volunteer), Tobacco Free Daycare, Certified Trail Towns, Walking Programs, Exercise Programs (such as, 5K events), Farmer’s Markets, Bicycle and Pedestrian Plans and Syringe Exchange Programs.

Core Function: Assurance

Enforce Laws and regulations that protect health and ensure safety.


Clinic: We follow ACIP guidelines to provide immunizations to prevent the spread of disease.

Environmental: We enforce environmental health laws regarding nuisance, garbage, vectors, school safety, public facility hygiene and safety, food safety and sewage.

HANDS: If our home visitors discover or suspect abuse of the mother or baby, we take safety measures as required by the law.

Health Policy and Promotion: Our Child Care Health Consultant Program assists with corrective plans of actions within the daycare that have violated regulations.

Link People to needed personal health services and Assure the Provision of Health Care when otherwise unavailable.


Clinic: We provide case management for persons living with HIV. We provide payment assistance through contracted providers to ensure continuation of care for women’s health services. We refer patients to The Department of Social Insurance, local physicians, hospitals, or Federally Qualified Health Centers (FQHCs), as needed.

School Program: We link students/parents to needed personal health services and assure the provision of health care when otherwise unavailable.

Health Policy and Promotion: Through our health coalitions and website, we provide a resource guide for our community that serves as a to needed services.

Assure a Competent public health and personal health care Workforce.


New Employee Orientation: New employees receive a 3-part orientation including General Information, On-Site Orientation, and an Agency Overview.
Job Specific Training: This can range from weeks to months in a variety of formats and includes a performance evaluation after probationary period of 6 months.

Workforce Development: We focus on the “Core Competencies for Public Health Professionals” from the Council on Linkages Between Academia and Public Health Practice (2009), and the Public Health Preparedness Capabilities from U.S. Department of Health and Human Services and Centers for Disease Control and Prevention.

Ongoing Training: Trainings include General Staff Meetings, Annual Trainings, and Continuing Education as applicable.

Employee Morale and Support: LCDHD provides programs to promote Employee Recognition and Incentives.

Future Workforce: LCDHD provides education/student opportunities to post-secondary students and participates in annual events for secondary education.

Evaluate effectiveness, accessibility and quality of personal and population-based health services.


Diabetes: We conduct ongoing CQI with our Diabetes Education (i.e. increasing frequency of foot checks).

Health Policy and Promotion: Annually, we review and evaluate all of our programs offered across the counties. Then, various suggestions are taken into consideration for ways to improve our services and programs.

Research for new insights and solutions to health problems.


Clinic: We participated in the Centering Research Project.

Environmental: We adopt new types of sewage disposal systems. We also incorporate the latest food service science into our inspection process.

HANDS: We are participating in the UK/HANDS Study evaluating Kindergarten school entry readiness of students who have participated in the HANDS Program.

Health Policy and Promotion: We are continually looking for new solutions to our health problems in our communities. Some of our health coalition are a part of research projects such as Clinton County EPHECT, where they are addressing obesity in their county.