As was discussed at the CPHP/PERRC Grantee Meeting and the October grantee call, ASPH has developed a workgroup website to allow CPHP and PERRC to share their H1N1 activities.  The workgroup website allows for document sharing, document collaboration, discussion forums, and announcements.  All CPHPs are encouraged to regularly update the workgroup website with their H1N1 activities.  This will help CPHPs to stay updated on what other centers are doing, and will provide ASPH and CDC with up to date information about the CPHP response to H1N1.  The Preparedness and Emergency Response Research Centers (PERRCs) will also be asked to join the workgroup.  For questions or comments, please contact Kristin Dolinski (kdolinski@asph.org).

Principal investigators, coordinators, and other key staff from the Centers for Public Health Preparedness (CPHPs) and Preparedness and Emergency Response Research Centers (PERRCs), attended their annual CDC Grantee’s Meeting on September 1st and 2nd in Atlanta, GA.  Approximately 110 representatives from the CPHPs and PERRCs attended the meeting.  The program was highlighted by a CDC panel of experts on H1N1, moderated by Linda Degutis (Yale).  Panelists included:        

·          Dan Sosin:  Acting Director, Coordinating Office for Terrorism Preparedness and Emergency Response

·          Martin Cetron:  Director, Division of Global Migration and Quarantine, National Center for Preparedness, Detection, and Control of Infectious Diseases

·          Edwin Trevathan:  Director, National Center on Birth Defects and Development Disabilities

·          Greg Burel:  Director, Division of Strategic National Stockpile, Coordinating Office for Terrorism Preparedness and Emergency Response

·          Marsha Vanderford:  Branch Chief, Emergency Communications, Division of Health Communication and Marketing, National Center for Health Marketing

Experts discussed several aspects of the CDC response to H1N1 influenza including lessons learned from the Spring outbreak and plans for the Fall flu season.  Meeting participants also had the opportunity to hear from Lara Lamprecht, from the Office of the Assistant Secretary for Preparedness and Response, who presented the draft National Health Security Strategy. 

A second H1N1 Panel, focusing on CPHP response and PERRC related research, followed the CDC Panel.  This panel was moderated by Christopher Atchison (Iowa); panelists included:  Ed Baker (UNC), Natalie Semon (Johns Hopkins), and Sandra Quinn (Pittsburgh) from the PERRCs, and Jane Richards Montealegre (UT Houston), Karen Levin (Columbia), and Jesse Bliss (Loma Linda) from the CPHPs.  Other meeting topics included a presentation from the Division of State and Local Readiness, and two presentations from Andrea Young (CDC/COTPER) regarding the CPHP evaluation and Preparedness and Response Core Competency Development Project.

PERRC participants discussed plans for research translation activities and communications. 

To learn more about the CPHP and PERRC programs, please visit http://preparedness.asph.org/.

Emergency Planning for At-Risk Groups: A Toolkit for Local Health Departments provides guidance to planners for identifying, engaging, communicating with, and providing services to at-risk populations during public health emergencies such as pandemic influenza.

Developed by the North Carolina Center for Public Health Preparedness (NCCPHP), part of the NC Institute for Public Health, at the UNC Gillings School for Global Public Health in partnership with the Office of Public Health Preparedness and Response at the North Carolina Division of Public Health, the toolkit covers five areas of preparedness for at-risk populations developed by the Association of State and Territorial Health Officials (ASTHO).

Each topic area includes Stories, examples of local initiatives that have strengthened disaster preparedness and response for at-risk populations.  A total of ten stories from communities around North Carolina are featured, with audio clips of key contacts who describe the activity and how it was implemented.  Each topic area also includes Tips and Suggested Planning Activities, Topic Spotlights, which provide in-depth analysis of key issues relevant to local planners interested in at-risk population planning, and Resources.  The toolkit also includes ready-to-use PowerPoint templates that may be customized for presentations to at-risk groups or partner organizations in the community to obtain support for planning activities.

While primarily designed for planners at local health departments, and with an emphasis on North Carolina, planners at other emergency response agencies and organizations may also find these materials useful.  “Emergency Planning for At-Risk Groups: A Toolkit for Local Health Departments” is available online at http://nccphp.sph.unc.edu/at-riskplanning/. For additional information about the toolkit contact NCCPHP Research Associate, Richard Rosselli, richross@email.unc.edu.

The Heartland Center for Public Health Preparedness (HCPHP) has played a key role in bracing local and regional partners for the 2009 Novel H1N1 Pandemic.  Since the first case of H1N1 in April, staff members at the HCPHP have driven plans into reality and offered expertise to elucidate the complex issues surrounding the pandemic.

Upon the initial outbreak of H1N1 in April 2009, Saint Louis University and the St. Louis City Department of Health (DOH) activated a memorandum of understanding; HCPHP was tasked to provide technical assistance to the St. Louis City DOH in the form of content expertise and planning support. In addition to the role with the City, an HCPHP staff member was appointed to the Saint Louis University Pandemic Preparedness Subcommittee and Response Team as a content expert to assist in the development and implementation of a response plan for the University community.

During the summer months, the HCPHP planned for what was expected to be a more than active influenza season, focusing primarily on the steps they would take to prepare the region for the H1N1 pandemic.  Upon the World Health Organization’s (WHO) declaration of the 2009 H1N1 virus as a pandemic, the HCPHP began providing technical assistance and content expertise to address issues and challenges that arose with its partner states, Missouri, Kansas, Oklahoma, and Kentucky and continued as key informants to the St. Louis City DOH and to Saint Louis University. 

The HCPHP staff member participated in discussions with the University on operational issues impacting medical screening, treatment, housing, risk communication, and academic business continuity issues surrounding the H1N1 pandemic.  In addition, the HCPHP staff members with the St. Louis City DOH facilitated an H1N1 Response Workshop for partnering agencies and organizations.  A report is expected to follow to outline issues and recommendations for challenges facing the response.

As their partners’ questions and concerns regarding the 2009 H1N1 pandemic multiplied, the HCPHP found a need for an outlet of frequent communication and updates.  An Internet H1N1 Portal culminated from hours of research and preparation and has become a key resource for partners.  This site, updated daily and several times throughout the day, has been utilized by many agencies and organizations throughout the region and has been linked as the H1N1 resource on their web sites.  The HCPHP H1N1 Portal allows contacts throughout the country to receive immediate updates through an RSS Feed and Twitter.  The HCPHP also has plans to include a secure page for a discussion board for local and regional partners.

With this novel pandemic, the HCPHP has acted promptly in defining their role in the region.  They remain a source of expertise and innovation in their approach and have equipped their partners with the necessary tools to tackle the challenges of the 2009 H1N1 Pandemic.

The H1N1 Internet Portal can be found at: http://www.heartlandcenters.slu.edu/h1n1/2009H1N1.htm.

On Wednesday, August 5, the University at Albany Center for Public Health Preparedness (UAlbany CPHP) and the New York State (NYS) Department of Health Office of Emergency Preparedness hosted a community forum designed to help emergency preparedness officials understand the special needs of three vulnerable populations—elderly adults, residents of isolated rural areas and persons with physical disabilities—during a large-scale emergency.  Representatives from organizations serving these populations met to discuss how people in these groups would access essential services in the event of a widespread public emergency such as a blizzard or pandemic flu.  In addition, On September 9th, the UAlbany CPHP participated in the NYS Preparedness Expo. The Expo was held the Empire State Plaza in Albany and provided preparedness information to NYS employees.  

UAlbany CPHP also conducted several in-person trainings:

·          July 29^th at the Albany College of Pharmacy—Preparedness, with a focus on H1N1, and the role of pharmacists in a pandemic.

·          August 25^th in Saratoga, NY for the “Back to School” Saratoga County School Nurse Meeting—Interactive training for school nurses on H1N1 and the current CDC guidance for K-12 schools.

·          September 30^th at the Guilderland Public Library—A general interest presentation in collaboration with the Albany County Department of Health on basic preparedness skills in the context of H1N1 pandemic influenza.

The UAlbany CPHP sponsored a student essay contest which was open to all UAlbany SUNY School of Public Health graduate students. Students were asked to answer the question “What is public health preparedness and why should Public health practitioners be concerned with emergencies and disasters?”

Finally, staff from the center presented to the School of Public Health’s master level seminar on Student Preparedness Skills. The students were provided training based on the nationally approved core competencies of the Medical Reserve Corps, including Incident Command System, Personal Preparedness, Points of Dispensing, and Psychological First Aid to enable them to serve as volunteers in the event of a pandemic.

The following articles were developed in collaboration with a number of partnering organizations, and with funding support awarded to the Harvard School of Public Health Center for Public Health Preparedness under cooperative agreements with the US Centers for Disease Control and Prevention (CDC) -- grant numbers 5P01TP000307-01 (Preparedness and Emergency Response Research Center) and U90 TP124242-05 (Centers for Public Health Preparedness). The content of these publications as well as the views and discussions expressed in these papers are solely those of the authors and do not necessarily represent the views of any partner organizations, the CDC or the US Department of Health and Human Services.

Papers

“Altered Standards of Care during an Influenza Pandemic: Identifying Ethical, Legal, and Practical Principles to Guide Decision Making.” This article was published ahead of press in Disaster Medicine and Public Health Preparedness on September 14, 2009.

Levin D, Cadigan RO, Biddinger PD, Condon S, Koh HK; on behalf of the Joint Massachusetts Department of Public Health-Harvard Altered Standards of Care Working Group.

Although widespread support favors prospective planning for altered standards of care during mass casualty events, the literature includes few, if any, accounts of groups that have formally addressed the overarching policy considerations at the state level. This paper describes the planning process undertaken by public health officials in the Commonwealth of Massachusetts, along with community and academic partners, to explore the issues surrounding altered standards of care in the event of pandemic influenza. Throughout 2006, the Massachusetts Department of Public Health and the Harvard School of Public Health Center for Public Health Preparedness jointly convened a working group comprising ethicists, lawyers, clinicians, and local and state public health officials to consider issues such as allocation of antiviral medications, prioritization of critical care, and state seizure of private assets. Community stakeholders were also engaged in the process through facilitated discussion of case scenarios focused on these and other issues. The objective of this initiative was to establish a framework and some fundamental principles that would subsequently guide the process of establishing specific altered standards of care protocols. The group collectively identified 4 goals and 7 principles to guide the equitable allocation of limited resources and establishment of altered standards of care protocols. Reviewing and analyzing this process to date may serve as a resource for other states.  

“Public Health Emergency Preparedness at the Local Level: Results of a National Survey.” Health Services Research, 2009 Oct; 44 (5 Pt 2):1909-24. E-published 2009 Aug17.

Savoia E, Rodday AM, Stoto MA.

The objective of this study was to examine the relationship between elements of public health infrastructure and local public health emergency preparedness (PHEP).Using cross-sectional data sources from the National Association of County and City Health Officials 2005 National Profile of Local Health Departments (LHDs), the authors found that LHDs serving larger populations are more likely to have staff, capacities, and activities in place for an emergency. By adjusting for population size, the presence of a local board of health and the LHDs' experience in organizing PHEP coalitions were associated with better outcomes. The results of this study suggest that more research should be conducted to investigate the benefit of merging small health departments into coalitions to overcome the inverse relationship between preparedness and population size of the jurisdiction served by the LHD.  

“Public Health Systems Research in Emergency Preparedness: A Review of the Literature.” American Journal of Preventive Medicine 37(2): 150-156.

Savoia E, Massin-Short SB, Rodday AM, Aaron LA, Higdon MA, Stoto MA.

Despite the acknowledged promise of developing a public health systems research (PHSR) agenda for emergency preparedness, there has been no systematic review of the literature in this area. The purpose of this study was to conduct a systematic literature review in order to identify and characterize the PHSR literature produced in the U.S. in the past 11 years in the field of public health emergency preparedness. Articles were searched in MEDLINE and EMBASE, as well as in the gray literature. Two independent reviewers classified the articles according to study design and IOM public health emergency preparedness (PHEP) research goal areas.

From January 1, 1997, through December 31, 2008, there were 547 articles that met the inclusion criteria that were published. It was possible to classify 314 (57%) articles into at least one of the four IOM PHEP research goal areas. Of these, 61 (11%) addressed Research Area 1 (usefulness of training); 39 (7%) addressed Research Area 2 (communications in preparedness and response); 193 (35%) addressed Research Area 3 (sustainable preparedness and response systems); and 39 (7%) addressed Research Area 4 (criteria and metrics to measure effectiveness and efficiency). Twenty-one studies (4%) could be classified into more than one category. The majority of the articles (81%), including commentaries/reviews and case studies, were based on qualitative analysis. Commentaries/review articles were the most common study types (62%). Since 2001, the PHSR literature on PHEP issues has grown at about 33% per year. However, most studies lack a rigorous design, raising questions about the validity of the results.  

“Impact of Tabletop Exercises on Participants’ Knowledge of and Confidence in Legal Authorities for Infectious Disease Emergencies.” Disaster Medicine and Public Health Preparedness 2009 v. 3, p. 104-110.

Savoia E, Biddinger PD, Fox P, Levin D, Stone L, Stoto MA.

Legal preparedness is a critical component of comprehensive public health preparedness for public health emergencies. The scope of this study was to assess the usefulness of combining didactic sessions with a tabletop exercise as educational tools in legal preparedness, to assess the impact of the exercise on the participants’ level of confidence about the legal preparedness of a public health system, and to identify legal issue areas in need of further improvement. The exercise scenario and the pre- and post-exercise evaluation were designed to assess knowledge gained and level of confidence in declaration of emergencies, isolation and quarantine, restrictions (including curfew) on the movement of people, closure of public places, and mass prophylaxis, and to identify legal preparedness areas most in need of further improvement at the system level. Fisher exact test and paired t test were performed to compare pre- and post-exercise results.

The analysis shows that a combination of didactic teaching and experiential learning through a tabletop exercise regarding legal preparedness for infectious disease emergencies can be effective in both imparting perceived knowledge to participants and gathering information about sufficiency of authorities and existence of gaps. The exercise provided a valuable forum to judge the adequacy of legal authorities, policies, and procedures for dealing with pandemic influenza at the state and local levels in Massachusetts. In general, participants were more confident about the availability and sufficiency of legal authorities than they were about policies and procedures for implementing them. Participants were also more likely to report the need for improvement in authorities, policies, and procedures in the private sector and at the local level than at the state level.  

“Engineering Responses to Pandemics.” This article is in press and will be published in Volume 3 of the Tannebaum Institute Series on Enterprise Systems and in a special issue of the journal Information, Knowledge Systems Management. It will also appear as a chapter in a book of the same title in a series of studies in healthcare technology and informatics.

Larson R, Nigmatulina RK.

Focusing on pandemic influenza, this chapter approaches the planning for and response to such a major worldwide health event as a complex engineering systems problem. Action-oriented analysis of pandemics requires a broad inclusion of academic disciplines since no one domain can cover a significant fraction of the problem. Numerous research papers and action plans have treated pandemics as purely medical happenings, focusing on hospitals, health care professionals, creation and distribution of vaccines and anti-virals, etc. But human behavior with regard to hygiene and social distancing constitutes a first-order partial brake or control of the spread and intensity of infection. Such behavioral options are “non-pharmaceutical interventions.” (NPIs) The chapter employs simple mathematical models to study alternative controls of infection, addressing a well-known parameter in epidemiology, R0, the “reproductive number,” defined as the mean number of new infections generated by an index case. Values of R0 greater than 1.0 usually indicate that the infection begins with exponential growth, the generation-to-generation growth rate being R0. R0 is broken down into constituent parts related to the frequency and intensity of human contacts, both partially under our control. It is suggested that any numerical value for R0 has little meaning outside the social context to which it pertains. Difference equation models are then employed to study the effects of heterogeneity of population social contact rates, the analysis showing that the disease tends to be driven by high frequency individuals. Related analyses show the futility of trying geographically to isolate the disease. Finally, the models are operated under a variety of assumptions related to social distancing and changes in hygienic behavior. The results are promising in terms of potentially reducing the total impact of the pandemic.  

Recent Abstracts

Do current surveillance systems provide valid and credible statistical information on 2009-H1N1?

Michael A. Stoto, Ying Zhang, and Melissa A. Higdon

Poster to be presented at the International Conference on Health Policy Statistics, Washington DC, January 2010

The outbreak and rapid world-wide spread of novel A (H1N1) influenza in 2009 came after almost a decade of enhancements to global disease surveillance systems.  Yet even with these systems there is reason to question the validity – and the credibility – of the statistical information they provide.

Although establishing a standard case definition is a critical step in an epidemiological outbreak investigation, definitions of suspected, probable, and confirmed cases varied from country to country and changed as the virus spread.  Some changes reflected an evolving understanding of the epidemiology, limitations in laboratory capacity and requirements of public health practice. For some of the same reasons, case ascertainment processes varied, but typically focused on more severe cases.  As a result, there was substantial uncertainty about virulence and transmissibility of the novel viral strain.

One of the most commonly held assumptions about the novel A (H1N1) virus is that children and young adults are at especially high risk.  The data, on which this assumption is based, however, are not reliable, and it is possible that the differential risk for children and adolescents is an exaggeration.  In particular, higher age-specific rates for A (H1N1) incidence as well as hospitalizations and deaths, regardless of the source, are biased upwards for children and young adults and downwards for older adults.  The degree of this bias is unknown, but comes from a combination of younger patients being more likely to present themselves for medical attention and older patients not having samples sent for laboratory testing.  These patterns seem to be due to both patients and physicians responding to what they believe are the facts about the risk of A (H1N1), as well as physicians responding to public health recommendations (based on the same assumptions) regarding who should be tested.

The tendency of public health officials and the media to report cumulative case counts adds to the confusion.  Cumulative numbers reflect when cases are reported or confirmed in the laboratory rather than the time of onset.  As a result, they reflect patients’ decisions about when to seek care, reporting requirements, laboratory capacity, and statistical processing rather than the incidence of disease in the population.  Furthermore, by definition, cumulative numbers can only increase, even when incidence is waning, contributing to a false impression about the pandemic.  

School Closures in Response to A/H1N1: Issues for Decision-Makers

Tamar Klaiman, John Kraemer, and Michael A. Stoto, Georgetown University

This abstract will be an oral presentation at the American Public Health Association, Philadelphia in November 2009.

Because schools can be amplifiers of the spread of influenza and children seem to be particularly vulnerable to its complications, hundreds of U.S. schools closed in response to the 2009 A/H1N1 outbreaks in the spring of 2009.  This experience surfaced a number of challenges that can have important implications for the capability of the broader public health system to respond to pandemics and other public health emergencies.  In an in-depth case study based on media reports, observations of public health meetings, and discussions with decision-makers, we will address: the goals of school closure, what closure means in practice, whether to close schools, who makes the closure decision, and when schools should re-open. Implications of these various challenges will be reviewed and considerations for decision-makers in future public health emergencies will be presented.

On May 6, 2009, the Yale Center for Public Health Preparedness (YCPHP) held the second in a series of collaborative trainings to the Disaster Field Manual for Connecticut Environmental Health Specialists. Two years prior, YCPHP led a team of state agency subject matter specialists and local health practitioners in the adaptation of the California Conference of Directors of Environmental Health’s disaster manual to meet Connecticut needs. The resulting field manual has been used by YCPHP as the foundation for a number of well received trainings for front-line environmental health professionals. These trainings have been cosponsored by the CT Department of Health, CT Department of Environmental Protection, CT Department of Emergency Management and Homeland Security and the Connecticut Environmental Health Association.

“The collaborative process used to adapt the field manual really opened the door to develop these trainings,” said Dr. Linda Degutis, YCPHP Director. “A number of state agencies had developed response plans for natural disasters that involved local environmental health professionals, but did not know how to reach out to them.”

The first training session, held on April 25, 2008, was used to disseminate the manual to practitioners and introduce them to the content and possible uses of the manual. YCPHP invited as keynote speakers two environmental health practitioners from Iowa who had adapted the California manual. One speaker presented on how the manual was used by Iowa environmental health strike teams to respond in Louisiana after Katrina. The other speaker spoke about how the manual was used on a more routine basis to respond to flooding, fires and other emergencies within her county. Following this, subject matter experts that had contributed sections of the manual provided guidance on how to use the information in the field, and as well as key state contacts for emergencies.

The second training addressed different areas in the manual and included Captain Mark D. Miller, RS, MPH, is a Senior Environmental Health Officer with the Centers for Disease Control and Prevention, who presented on mass sheltering. He co-taught on mass sheltering with the training director from the South Central Connecticut Chapter of the American Red Cross. The pair also conducted an interactive exercise on conducting rapid health assessments of shelters. The Salvation Army brought one of their emergency response vehicles to the event and attendees were able to go inside and view the food preparation and storage areas. A representative from the State Department of Environmental Protection provided attendees with an overview of the state’s Disaster Debris Management Plan. For most attendees, this was their first introduction to the potential roles that environmental health practitioners might play in the implementation of the plan.

Continuing education (CE) credits in the form of Food Service Contact Hours were offered at both events.

Since the emergence of H1N1 last spring, the Yale Center for Public Health Preparedness (YCPHP) has been working with its partners on a broad array of educational and technical assistance activities related to the H1N1 virus. Partners include the Connecticut Department of Public Health, Connecticut Department of Higher Education, Connecticut Emergency Management Regions, local health departments and Yale University.

“We already had strong, established relationships with our internal and external partners,” said Dr. Linda Degutis, YCPHP Director. “When the need arose, they knew just where to look.”

Many activities have focused on assisting Yale University’s Health Plan and Department of Emergency Management on preparing for the re-emergence of H1N1 when students returned to campus in the fall. The Center was a part of university-wide planning, which began early in the summer. YCPHP educational activities included development of a H1N1 guide for Yale employees as well as H1N1 podcasts for employees and students. The Center also participated in H1N1 presentations to new students at the medical and public health schools. YCPHP provided technical assistance to the University Health Plan in redesigning their seasonal influenza vaccine clinics to increase throughput and then conducted a series of evaluations at the clinics to measure the impact. At this time, the Center is also providing guidance to the University on the analysis and appropriate interpretation of influenza surveillance data.

Community partners have also reached out to YCPHP for assistance on a variety of projects. A statewide conference on H1N1 and Higher Education was spearheaded by YCPHP, in collaboration with the State Department of Health and Department of Higher Education. On the regional and local levels, the Center has helped in the creation of a library of risk communication resources for local public health practitioners can be utilized as part of their public education campaigns on H1N1. And last, but not least, YCPHP had dedicated three issues of its monthly newsletters to H1N1 virus topics. These newsletters are disseminated to the public health workforce and the general public.

On Tuesday, September 2, a group of faculty, staff and students from schools of public health, as well as Centers for Disease Control and Prevention (CDC) experts, met to discuss Graduate Student Epidemiology Response Programs (GSERPs) in Atlanta, GA. GSERPs provide an opportunity to engage students directly in public health practice, specifically in preparedness and response activities, through partnerships with local and state health departments.

This group was established to promote the work of the GSERPs and encourage the formation of new GSERPs in schools of public health. In addition, the group established at this meeting will look at response activities to determine best practices and also to link the activities of GSERPs to the Applied Epidemiology Competencies, and other competency sets.

GSERPs have played a role in state and community response to H1N1 by staffing call centers, contact tracing and conducting exposure assessments.

For more information about GSERPs or this group, contact Ms. Dorothy Biberman at dbiberman@asph.org.

For more information about H1N1 response from schools of public health, visit http://www.asph.org/document.cfm?page=1089.

The Preparedness & Response Core Competency Development Project has made considerable progress since the first meeting in June. Over 260 subject matter experts from around the country volunteered to participate and received Delphi Round 1, a tool for receiving feedback on draft domains. Results from Delphi Round 1 will be analyzed and used to refine the draft domains. Then, workgroups will meet to determine a preliminary list of competencies, objective and measurable behaviors and skills, which will go into Delphi Round 2 for feedback from the participants.

The 11 draft domains, which went into Delphi Round 1, were:

1.     Crisis and Emergency Risk Communication

2.     Crisis Leadership

3.     Hazard, Vulnerability, and Risk Assessment

4.     Information Management

5.     Investigation

6.     Legal Preparedness and Ethics

7.     National Incident Management System

8.     Preparedness Planning and Improvement

9.     Public Health Interventions

10.  Surveillance

11.  Safety and Health Protection

Expected Outcomes of the Model

It is intended that the competency model will provide a proposed national standard of behaviorally-based, observable skills for the workforce to prepare for and respond to all-hazards scenarios. In keeping with the National Response Framework and Target Capabilities List, all-hazards includes terrorist attacks, natural disasters, emerging infectious disease, health emergencies, environmental threats, and/or other major events such as chemical, biological, radiological, nuclear, high-yield explosives (CBRNE), and food and agriculture events.

 The model will:

·          Supplement existing core competencies for the general public health workforce (e.g. Council on Linkages Core Competencies for Public Health Professionals).

·          Be targeted toward a mid-tier public health professional which is defined as “an individual with an MPH (or related degree) and at least five years experience working in the public health field, or an individual without an MPH and at least 10 years experience working in the public health field.”

·          Represent the array of individual, mid-tier worker competencies that organizations can use to assure readiness. Each individual will not need to be competent for all behaviors and skills in the model. Rather, organizations can have the flexibility to use the model to ensure that personnel are trained to the competencies while still allowing for local, state and regional differences in organizational structure.

Project Website

For more information about the Public Health Preparedness and Response Core Competency Development Project, please visit: www.asph.org/competency.

The week of September 4^th, 2009, ASPH, the Centers for Disease Control and Prevention (CDC), the Association of State and Territorial Health Officials (ASTHO) and the National Association of County and City Health Officials (NACCHO) welcomed three new ASPH/CDC Public Health Preparedness Fellows during a two-day orientation held in Washington, DC.  Over the next few weeks, the fellows will begin their assignments at state and local public health agencies funded under CDC’s Public Health Emergency Preparedness (PHEP) cooperative agreement. 

For a period of one-year, the new fellows will undertake projects of their own design, with the guidance of host-agency mentors.  The projects will contribute to the critical preparedness mission of that particular state/city, and the CDC, while providing the fellows with practical experience in addressing burgeoning public health threats. 

ASPH is proud to welcome the following members of the Class of 2009 ASPH/CDC Public Health Preparedness Fellows: 

• Ms. Anna Lea Burchfield, (MPH, MHA-South Florida),  Ohio Department of Health, Office of Health Preparedness, Columbus, Ohio;
• Ms. Heather Narciso (MPH-Berkeley), New York City Department of Health and Mental Hygiene (DOHMH), Division of Disease Control, Bureau of Emergency Management (BEM), New York, New York; and
• Mr. Kumengoy D. Koko-Ngando (MPH, TM-Tulane), New England Center for Emergency Preparedness, Dartmouth Medical School, Lebanon, New Hampshire.

For more information on the ASPH/CDC Public Health Preparedness Fellowship Program, please contact ASPH staff at TrainingPrograms@asph.org.

The Ohio Center for Public Health Preparedness is now accepting applications for it’s new preparedness-focused Continuous Quality Improvement Institute, or CQI². Funded through the CDC Centers for Public Health Preparedness cooperative agreement, this project will bring together teams of participants in a seven month cohort-based training institute. The cohort of teams will plan and launch quality improvement projects within their agency or community that will seek to improve public health emergency response processes. This will be a critical opportunity to utilize previously collected data from after action reviews, exercises and actual response efforts and complete the cycle by implementing effective corrective actions.

The goal of CQI² is not only to improve specific, measureable response outcomes among participating organizations, but to continue to build capacity within these organizations around the concepts of quality improvement. CQI² teams will receive content and coaching that will assist in project development and implementation, as well as team dynamics and leadership development. The ultimate goal of the project is to prepare agencies to institute a “culture of quality” within their organizations.

The application process for CQI² will be selective with each team receiving a mini-grant to help defray project and participation costs. More information, including an application packet can be found on the Center’s website at:

http://cph.osu.edu/practice/activeprojects/cqi2.cfm

The deadline for applications is November 16, 2009. For inquiries regarding CQI² contact Adam Negley, anegley@cph.osu.edu.

On October 1, 2009, NACCHO will award $3.3 million to eight Advanced Practice Centers (APC) selected to help the public health community prepare for, respond to, and recover from public health emergencies and other disasters.  Five new health departments will join the Montgomery County Health Department (MD), Public Health-Seattle and King County (WA), and Tarrant County Public Health (TX), which have been part of the APC network since its inception in 2004. The newest APCs are the Lucas County Regional Health District (OH), the Mesa County Health Department (CO), the Multnomah County Health Department (OR), the San Francisco Department of Public Health and the South Carolina Department of Health and Environmental Control – Region 7.

Since 2004, the APCs have developed highly acclaimed, practical tools and resources that have been successfully adopted in communities across the nation.  They have addressed critical areas in public health preparedness, from building partnerships with the business community, addressing vulnerable populations, and planning for mass vaccination to mass fatalities management, development of mutual aid agreements, and food safety management.  Some of the tools developed over the years include:

·          No Ordinary Flu, comic book that illustrates a compelling story through the eyes of a survivor of the 1918 pandemic and connects to the present-day threat,

·          Master the Disaster!, an interactive, customizable, emergency preparedness tabletop exercise builder featuring seven public health emergency scenarios,

·          Pictogram-based Signs for Mass Prophylaxis Services, designed to promote universal access to emergency dispensing sites services,

·          Plan to Be Safe Campaign, a toolkit with a poster, take-away brochure and tri-fold brochure that emphasize  preparing a disaster kit  with at least nine essential items, and

·          Speak First: Communicating Effectively in Times of Crisis and Uncertainty, a crucial training for staff who may have to speak to the public during a crisis.

Approximately 90 tools have been developed for local health departments nationwide.  These resources are available in a variety of formats, allowing for easy duplication and customization. 

Although individual focus areas will vary depending on individual department strengths, the new network of APCs will concentrate on providing health departments with tools to improve public health workforce preparedness; prepare for real-life responses through training exercises; communicate internally and with the public; collaborate with stakeholders; strengthen biosurveillance capacities; improve response capabilities to chemical and biological agents;  develop stockpiling and distribution strategies; optimizing medical surge capacity; improve strategies for outreach to vulnerable populations; enhance mass fatality management;  improve understanding of the intersection of law and public health; strengthen the public health infrastructure and establishing plans for ensuring that the public has access to disaster mental health services.

NACCHO received 42 applications from local health departments across the country.  This network of APCs was chosen through a competitive proposal process and will be funded through September 2010.  For more information on the APC Program, visit www.naccho.org/apc.

During the ASPH Annual Meeting, Dean Audrey Gotsch and Dr. C. William Keck, co-chairs of the Preparedness & Response Core Competency Development Project, will hold a public Town Hall meeting on Sunday, November 8 from 2:30 – 4 p.m. The goals of the Town Hall will be to disseminate updates from the project and answer questions and hear ideas from the audience. All interested individuals are welcomed.  

Location:

Ritz-Carlton Hotel

Ten Avenue of the Arts

Philadelphia, PA 19102

Telephone: (215) 523-8000

For more information about the ASPH Annual Meeting, please visit: http://www.asph.org/document.cfm?page=930.

For more information about the Public Health Preparedness and Response Core Competency Development Project, please visit: www.asph.org/competency.

Join your friends and colleagues at this important Food Safety Education Event!   

March 23 - March 26, 2010

Hyatt Regency Atlanta

265 Peachtree Street, NE

Atlanta, Georgia 30303-1294

800.233.1234

Register now!  Visit the conference website at http://www.fsis.usda.gov/Atlanta2010/.