Center for Public Health Preparedness

Center for Public Health Preparedness

A-CPHP Reverse Site Visit Atlanta, GA

March 10, 2004

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School Representatives and Partners in Attendance:

Peter J. Levin, ScD, MPH (PI)Guthrie Birkhead, MD, MPH (Co-PI)

Robert G. Westphal, MD, MPH (Director)

Joanne Cocozzoli, RN, MS (LHD Partner)Nancy Alfred Persily, MPH (SPH Assoc Dean, Academic Affairs)

Carol Young, PhD (SPH Director, Continuing Education)Margaret R. Watson (CPHP Program Coordinator)

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Partners Participating By Telephone:

• Dr. Michael Caldwell, MD, MPH (Commissioner, Dutchess County Health Department and current NYSACHO president)

• Sabrina Jaar Marzouka, JD, MPH (Education Director, Dutchess County)

• David Cote (Special Asst. to Commissioner, Vermont DOH) • Kelly Gordon, MA (Training & Development Manager,

Vermont DOH)

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Mission:

To strengthen public health preparedness for state and local public health professionals

and their community partners.

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Geographic Coverage:

New York State

(outside NYC)

Vermont

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• NYS has the 4th largest rural population in the country (Rural and School Community Trust Report, 2000)

• More rural Americans live in NYS than in Idaho, Montana, Nebraska, North and South Dakota, Utah, and Wyoming combined.

• Agriculture remains the leading industry and 32,000 farms cover a quarter of the total land area of the state (Farmland Information Library 1997).

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UAlbany CPHP Specialty Areas:

• Rural public health professionals and populations• Distance learning expertise and capability (satellite,

videostreaming, on-line coursework)

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“Leadership and Strategic Planning”

Public Health Training and Education Before and After CPHP

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Public Health Training and Education Infrastructure before UAlbany CPHP

NYS DOH - University at Albany SPH

Memorandum of Understanding

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Before CPHP

• Strong partnership NYSDOH• MPH on-site• Northeast Public Health Leadership Institute• Infrastructure for Continuing Education

a) Staffb) Distance learning (satellite broadcasts with

statewide focus)c) Accreditation CME, CEU – offered in NYS onlyd) Participant evaluations paper-based

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Funded Collaboration with NYS DOH Public Health Workforce

Development

• Public Health 101 and Basic Environmental Health Course

• Long-term care surveyor training • T2B2 - Third Thursday Breakfast Broadcasts• Women’s Health Grand Rounds • Preventive Medicine Residency

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• Funded September 2001• Partnership with

• Columbia Mailman SPH• UMDNJ SPH• U Albany SPH

• Competency-based continuing education plan


After CPHP

Distance Learning Infrastructure Enhanced• Satellite broadcasts• On-line courses• Automated evaluation system• NYSDOH investment in telecommunications

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Satellite Broadcasts

• Professional video producer hired (supported by several projects)

• National reach – 50 states• Web-streaming 24/7

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Capacity for On-Line Course Development

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Evaluation Capacity

• Automated analysis • Computer-generated reports• On-line evaluation, pre-test and post-test for

CME, CEU, CHES

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Year One Activities

July 2002 – July 2003

2,000-4,000 Public Health professionals reached

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Six 3-5 Day Courses(total participants = 349)

• Communicable Disease/Bioterrorism/Epidemiology (2-3 credits or non-credit) collaboration with NYS DOH

• Disease Forecasting with Geographic Information Systems: West Nile Virus (2 credits) collaboration with NYS DOH

• Infectious Disease Epidemiology: Zoonotic Diseases (2-3 credits) collaboration with NYS DOH

• NY SEMO Drill and Exercise Design (certificate of completion)• Preparing for Biological, Chemical & Radiological Threats

(certificate of completion) collaboration with NYS DOH

Year One (cont.)

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Six 1-day workshops across NYS(total participants = 150)

• Addressed PH core competencies, Basic ICS, “BT 101” and interactive scenario of an infectious outbreak

• Core competencies material shared by Columbia CPHP• Audience included local health department Directors,

Educators, BT Coordinators, Comm. Disease Nurses, Sanitarians

• 41 of 57 NYS counties participated

Year One (cont.)

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Preparedness Grand Rounds Series:

Included Five Live Presentations(total attendees at SPH = 240)

Three Satellite Broadcasts:• 446 New York State participants reported• 136-144 sites registered • 28-33 states participated • 200 videotaped copies of programs distributed to all

NYS LHDs, VT DOH, etc.

Year One (cont.)

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Preparedness Grand Rounds Series Topics:

Dec 02: The Role of the Media During Public Health Emergencies*

Jan 03: Challenges in the Detection & Identification of Biologic Events**

Jan 03: Smallpox Vaccination Plan and Implementation* (presented in collaboration with T2B2)

Feb 03: Terrorism Preparedness: Chemical & Radiological Threats **

* Satellite broadcast ** Live presentation at SPH

Year One (cont.)

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Preparedness Grand Rounds Series Topics:

Mar 03: Terrorism Preparedness: Effecting Local Response from a National Plan*

Apr 03: Public Health, Emergency Preparedness & Ensuring Civil Rights During Crisis (collaboration with the Northeast Public Health Leadership Institute)

Apr 03: Surveillance Systems for Biological and Other EventsMay 03: Enteric Diseases: Real Threats to our Public’s Health

* Satellite broadcast ** Live presentation at SPH

Year One (cont.)

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“Customer and Market Focus”

CPHP Impact on Public Health Training

and Education Infrastructure

Partnership Building

SPH Capacity Building

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Purpose• to understand organizations and systems that make up

New York State’s public health infrastructure• to identify strategies to strengthen its capabilities• to make appropriate recommendations for

improvement

Public Health Council Infrastructure Work Group

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Enumeration of PH Workforce

• More than 12,700 FTE public health workers in NYS• 43% in New York State Department of Health/Health

Research Incorporated• 57% in local health departments

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Composition of NYS Work Force in Local Health Departments

Education/Outreach10%

MDs1%

Nursing22%

Support Personnel28%

Administration7%

Other2%Other Clinical

5%

Scientif ic/Investigation

20%

Epi/Comm Disease/Disease Control

5%

Source: 2000-01 PH Leadership Institute Project Survey

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Survey of Public Health Workforce by Public Health Council

• Representative sample counties surveyed• LHDs reported substantial need for continuing

education• Emerging public health issues consistently identified

as of great need

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Survey of Public Health Workforce by Public Health Council

Access to training constrained by:• Limited resources • Poorly designed training • Competing priorities• Inaccessible times and locations

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CPHP Needs Assessments• Surveys• Focus groups • Program evaluations • All feedback collected during Year One

reinforced Year Two plans to focus resources on building distance learning capacity and products to enhance preparedness efforts.

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CPHP Focus Groups

• Focus group from 3 LHDs reviewed proposed on-line BT outline and objectives.

• Focus group from 5 LHDs defined training needs for the Spring ’04 course for LHD staff


Activities Year TwoAugust 2003 - present

Preparedness Grand Round Series: monthly satellite broadcast

Terrorism, Preparedness and Public Health: An Introduction: on-line course Emergency Preparedness in Schools: Prevention, Response and Recovery: course developed in collaboration with UAlbany School of

Education (Summer Session 2004, 3 credits)


Preparedness Grand Rounds Series:

• Complete series offered via satellite broadcast • Rebroadcast each 9 a.m. program at 4 p.m. (effective January 2004) to promote site registration outside EST• All broadcasts available via our web-site as Real Player web-streaming files• Re-distributing all programs via videotape (free)

Year Two (cont.)

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Broadcast Month Program Title

Number Sites Registered

Number States Viewed

Estimated # Viewers Reported

Oct. 2003 Food & Agricultural Terrorism 81 27 769

Nov. 2003 Community Response 135 27 1014

Dec. 2003 PH Law and Terrorism 252 43 1935

Jan. 2004 BT & Zoonoses 400 49 3312

Feb. 2004 Water Contamination Threats 330 43 3076

Mar. 2004 Psych Aspects of Terrorism 404 45 3032

Satellite Broadcast Audience Report

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Broadcast Month Program Title

Videotapes Distributed

Videostream Hits

Oct. 2003 Food & Agricultural Terrorism 79 454

Nov. 2003 Community Response 86 259

Dec. 2003 PH Law and Terrorism 104 310

Jan. 2004 BT & Zoonoses 126 378

Feb. 2004 Water Contamination Threats 120

Post-Broadcast Distribution Report

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CPHP Partnership Building

• BT Training Partnership • Community Partners (e.g., Iroquois Healthcare Alliance, Hudson

Headwaters Health Network, Oneida Nation) • NYS DOH Offices (e.g., Bureau of Communicable Disease Control,

Emergency Preparedness Training Office, Center for Environmental Health, EMS)

• VT DOH• Governor’s Office of Public Security• Local Health Department Professionals• New York State Association of County Health Officers • National Guard• NY State Police• NY NJ Public Health Training Center• UAlbany School of Education

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Role of New York State Department of Healthin developing and assisting collaborations and

partnerships

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NYSDOH Preparedness Training Advisory GroupKey partners for collaboration and integration

Academic Partners• University at Albany CPHP• Columbia CPHP• NYU• NY/NJ Public Health Training Center

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Professional Organizations• New York State Association of County Health

Officials• Medical Society of the State of New York• New York State Nurses Association• Health Care Association of New York State• Greater New York Hospital Association

NYSDOH Preparedness Training Advisory GroupKey partners cont.

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NYSDOH Preparedness Training Advisory Group Key partners cont.

Professional Organizations • New York State Public Health Association• New York State Dental Society• Association of Homes and Services for the Aging• Community Health Centers Association of New York

State• Home Care Association of New York State

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Other State Agencies• Division of Criminal Justice Services• Office of Alcohol and Substance Abuse Services• Office of Mental Health• State Emergency Management Office

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Other Organizations• American Indian Health Care Facility• New York City Department of Health and Mental

Hygiene• Onondaga County Health Department

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NYSDOH Training for Local Health Departments

Training to complement UAlbany CPHP mission to enhance preparedness of the public health workforce• Training for all roles associated with smallpox

vaccination clinics • Joint training on Forensic Epidemiology for law

enforcement and local health departments• Packaging and shipping of infectious clinical

specimens

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Training to complement University at Albany CPHP mission to enhance preparedness of the public health workforce• SARS

• Laboratory issues• Contact tracing and epidemiology• Isolation and quarantine• Data reporting and management• Clinical diagnosis, treatment and management• Standard respiratory precautions

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Training to complement University at Albany CPHP mission to enhance preparedness of the public health workforce• Training for Public and Environmental Health

Response Teams• Development and implementation of drills and

exercises• Risk Communications

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Local Health Department Partnerships and Collaboration

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LHD FeedbackJoanne Cocozzoli, RN, MS

Assistant Director of Prevention and Patient Services/BT CoordinatorSchenectady County Public Health

• Week-long Communicable Disease Course• Focus groups• Satellite broadcasts• On-line course development

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“Information and Analysis”

CPHP Impact on Development and Dissemination

of Education and Training


Certificate In Public Health

• Designed for local, state and national public health workers interested in formal public health training• Builds on SPH goal to provide professional public health education (MD, RN, Pharm D)• Serves to attract public health professionals into advanced degree programs (MPH, DrPH) • Courses offered by distance learning and traditional classroom-based format


Graduate Certificate Program (MPH core = 18 hours)

• EPI 501: Principles and Methods of Epidemiology I

• EPI 503: Principles of Public Health

• STA 552: Principles of Statistical Inference I

• HPM 500: Health Care Organization, Delivery & Financing

• HPM 525: Social & Behavioral Aspects of Public Health

• EHT 590: Introduction to Environmental Health

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Specific Preparedness Topics Covered within MPH Core:

• Epidemiology 501: 2 ½ hr session on syndromic surveillance

• Epidemiology 503: assignment to review and comment on CPHP Preparedness Grand Round Series program

• HPM 525: Paper on stress and coping post- 9/11• Environmental Health 590: 2 ½ hr session on BT and

PH Preparedness, with lecture, discussion and groups working through an emergency scenario


CDC/ASPH Cooperative Agreement for Academic Health Departments

One Year Grant: Pilot project based on UA SPH/NYS DOH model with goals to:

• Encourage SPH students to intern at LHDs• Encourage LHD staff to pursue formal academic

training• Develop model for replication in LHDs across NYS and the nation

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Emergency Preparedness in Schools:Prevention, Response and Recovery

Collaborative course developed with UAlbany School of Education

Topics include: • infectious diseases/bioterrorism• natural/industrial disasters• development of comprehensive school crisis plans• violence and child abuse• creation of safe and healthy classrooms and schools• legal and ethical issues

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“Information and Analysis”

Technical Assistance

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Hudson Valley Regional Health Officers’ Network Emergency Preparedness Website

A collaboration among 7 NYS county health departments, the NYS Department of Healthand the UAlbany CPHP


Syndromic Surveillance & Other Applications



Communications Directory


Geographic Information System


Syndromic Data Systemsin collaboration with NYS DOH

(under development)

• Emergency Department syndromic data• Medicaid pharmaceutical sales• Analysis of 911 data in selected counties

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HVRHON Next Steps

• Develop new system for northeast New York region based on HVRHON model

• Provide technical assistance to two other New York regions interested in developing similar systems

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“Systems Development”

A-CPHP Collaboration/Network Development Through:

• Shared Learning• Information Dissemination• Best Practices• Reduced Duplication

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Shared Learning

National Dissemination

• Participation in A-CPHP PI, Coordinators’ and Evaluators’ conference calls and meetings

• Distance learning coordinators network• Free distance learning reaching 50 states + Puerto Rico• PH Training Calendar• PH Foundation distribution of materials• TRAIN

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TRAIN-New YorkTRAIN-New York• Learning Management

System for state and local public health work force

• Comprised of national www.train.org site and participating state sites

• Supported by CDC, NYS BT grant and UAlbany SPH

• BT grant deliverable

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Shared Learning

NYS Systems of Dissemination

• NYS TRAIN partner• SPEED Rounds• Local Health Department videoconferencing

network

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Shared Learning:

Columbia University CPHP

University of Medicine and Dentistry of New Jersey

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CPHP Distance Learning Capacity

and Product Growth Since Year One

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Marketing Outreach System

• Interactive email system• Provides web-based database • Technology benefits Office of Continuing Education

and SPH

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Subscriber Growth Since Inception of Interactive Email Marketing System

0

200

400

600

800

1000

Jul-03 Aug Sept Oct Nov Dec-03 Jan-04 Feb Mar-03


Web-based Product Development

• On-line courses (core and BT)• On-line evaluation system• On-line continuing education process• Web-streaming

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On-line Course:Terrorism, Preparedness and Public Health:

An Introduction

Six lesson, interactive course (1-hour per lesson) For certificate with option for CEU, CME, or CHES For public health workforce and community partners Includes objectives, quizzes, final exam, learning center and links for

additional educational resources Completed beta-testing and currently ‘piloting’ course in NYS and VT

thru March 31, 2004. Public release in April 2004

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Web-streaming capacity added(now standard for all programs)

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On-line Evaluation Process

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On-line Evaluation Form

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On-line Post-test & Continuing Education Application

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“Business Focus”

Use of Resources to Reach Goal

of Supporting Life-long Learning

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Supporting Lifelong Learning:

• Local Health Department BT grants• Academic Health Departments• NYNJ PHTC Orientation to PH• Evaluation system development across the board

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Summary of CPHP Progress to Date:

• Developing on-line course material and distance learning products

• Providing expert broadcast topics nationwide• Working with all partners to meet regional needs for

our public health workforce• Sharing all information across the country

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Our Future:

Add to our on-line course: Terrorism, Preparedness and Public Health:

• Psychological considerations in disaster planning

• More depth on agents of BT, CT, RT and responses

Adapt Emergency Preparedness in Schools course on-lineComplete on-line versions of remaining core MPH Make spring course available state-wideReach 50 states and 500 sites each broadcast

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Our Future:

Conduct Preparedness Research:• Sample of upstate NY ER staff• Sample of public school teachers & nurses• Sample of NYS community response teams:

determine to what degree school system and public health staff are integrated into preparedness efforts

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Our Motto:

“Chance favors the prepared mind.”

Louis Pasteur 1822-1895

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