Southwest Center for Public Health Preparedness

1. Southwest Center for Public Health Preparedness Review and Practice Evaluation David L. Johnson, PhD, Director College of Public Health, University of Oklahoma February 26, 2004

2. 2004 Review and Practice Evaluation Part A: Introduction

3. Southwest Center for Public Health Preparedness Mission Provide education and training to help prepare the public health workforce and others for response to terrorism, emerging infectious diseases, and other public health disasters http://www.swcphp.ouhsc.edu/

4. SWCPHP Specific Objectives • Accurately assess competencies in core public health skills and bioterrorism preparedness • Design, develop and deliver education and training to enhance agency preparedness to respond to bioterrorism events • Perform best practices evaluations related to emerging public health issues • Assist in sustaining and enhancing the public health workforce

5. Metrics for Success Effectiveness Efficiency Productivity Accountability

6. Effectiveness • Tailored to the audience • Relevance: course content tailored to the specific audience through needs assessment • Credibility: utilize local subject matter experts (SMEs) when possible and appropriate • Value: relate the material to everyday practice needs and overall disaster preparedness as well as bioterrorism preparedness; credential with continuing education credit (CME, etc.) • Competency-based training • Focus on both core public health competencies and bioterrorism preparedness competencies • Match the competencies to the functional role • Enhance and evaluate organizational as well as individual competencies

7. Efficiency • Avoid redundancy and waste • Close coordination with CDC Focus Area G and HRSA Hospital Bioterrorism Preparedness Program training efforts • Contract with SMEs to minimize overhead • Leverage resources • Partner whenever possible to expand audience access and leverage funding • Utilize Train-the-Trainer approach where appropriate

8. High Productivity • Broad variety of training modalities • Seminars, workshops, short courses, drills & exercises, graduate courses & degree programs • On-site in-person training • Synchronous distance education (graduate courses) • Streaming video • DVD / CD-ROM-based (in development) • Aggressive schedule of offerings (see pg. 28, 1 qtr FY04 report) • Intensive and continuous course development effort • Wide variety of topics and audiences • Broad geographic coverage • Originally Oklahoma and New Mexico • North Texas (Tarrant County) via NACCHO’s Project Public Health Ready • Colorado added in FY 2004 geographic expansion

9. Accountability • To trainees • Critiques obtained for every training course • Continuous quality improvement process • To our partners and client organizations • Advisory Board of practice partners and clients • Quarterly review and coordination meetings • To CDC & ASPH • Monthly conference calls, quarterly reports, annual meetings • To Congress

10. 2004 Review and Practice Evaluation Part B: Evaluation Criteria

11. 2004 Review and Practice Evaluation Part B-I Leadership and Strategic Planning

14. Public Health Education and Training Infrastructure BEFORE the SWCPHP • No formal individual needs assessment process • Few preparedness training opportunities • Infrequent drills and exercises • No Certificate program in core public health • Only discipline-specific MPH programs (biostatistics, epidemiology, health promotion, etc.) • No access to graduate public health education outside two major metropolitan areas • No distance education (DE)

15. Public Health Education and Training Infrastructure AFTER the SWCPHP • Objective needs assessment • Broad spectrum of training opportunities • Drills and exercises keyed to the Response Plan • Aggressive and expanding Distance Education program • New graduate public health education curricula tailored to health agency personnel • New specialty MPH in Terrorism Preparedness

16. 2004 Review and Practice Evaluation Part B-II Customer and Market Focus

17. Products and Clients • Products • Short courses, seminars, workshops, drills & exercises • Graduate coursework leading to a Master of Public Health (MPH) degree in Preparedness and Terrorism • Clients • Public Health Leaders & Managers, Professionals, and Support Staff (80%) • First Responders, Educators, Media, First Receivers (ER, EMS, etc.), others (20%) • Multiple Levels • Senior Leaders and Managers • Practice Professionals • Support Personnel

18. SWCPHP Core Partners • College of Public Health • New curricula tailored to public health agency personnel • Course scheduling to accommodate working students • Active involvement of the Dean, Chairs, and senior faculty • Distance Education infrastructure investment • Oklahoma State Department of Health • Tuition support • Employees allowed time off to attend classes • Advancement incentives tied to advanced education • Active involvement of the Commissioner and senior leaders • Distance Education infrastructure investment

19. SWCPHP Core Partners (cont.) • Tulsa City-County and Oklahoma City-County Health Departments • Objective needs assessment methods development • Training methods development • Quantitative evaluation methods development

20. Additional Partners • New Mexico Department of Health • Oklahoma Department of Mental Health and Substance Abuse Services • Oklahoma City Area Indian Health Service • Oklahoma City Area Inter-Tribal Health Board • Indian Health Resource Center of Tulsa • Albuquerque Area Indian Health Board • Oklahoma Department of Environmental Quality • Oklahoma Department of Emergency Management • Oklahoma State Medical Association • Oklahoma Hospital Association • University of Oklahoma at Tulsa • University of North Texas • Los Alamos National Laboratory • Tulsa AHEC • University of New Mexico • Central Colorado Area Health Education Centers (AHECs)

21. Partnerships Resulting from SWCPHP Efforts • NACCHO - Public Health Ready Project • Working closely with Tulsa City-County Health Department and Tarrant County (Texas) Health Department, as well as the Cherokee Nation to assess preparedness for bioterrorism and emergency response • Memorial Institute for the Prevention of Terrorism (MIPT) • University of Texas School of Public Health, Academic Center for Public Health Preparedness

22. New Partnerships (cont.) • HRSA - Bioterrorism Hospital Preparedness Program • Best practices evaluation and technical assistance related to expedient engineering techniques for patient isolation in bioterrorism and epidemic disease response • Working with the MIPT and UTSPH to develop integrated first responder / public health preparedness training

23. Graduate Public Health Education: Maintaining the Public Health Workforce • Active collaboration between the University of Oklahoma College of Public Health, Oklahoma State Department of Health, and the Southwest Center for Public Health Preparedness • Tailor public health curricula to health agency needs • Improve access to graduate public health education • Stimulate current health department employees to pursue formal public health education • Promote interest among non-employee students to seek public health agency careers

24. A Collaborative Effort • College of Public Health • New curricula tailored to public health agency personnel • Course scheduling to accommodate working students • Active involvement of the Dean, Chairs, and senior faculty • Distance Education infrastructure investment • Oklahoma State Department of Health • Tuition support • Employees allowed time off to attend classes • Advancement incentives tied to advanced education • Active involvement of the Commissioner and senior leaders • Distance Education infrastructure investment • Southwest Center for Public Health Preparedness • Develop curricula and courses in Preparedness topics • Provide technical support to preparedness instructors

25. New Product: Graduate Certificate in Public Health • Specifically tailored to public health agency personnel • 18 semester hours • Core didactic public health education in biostatistics, epidemiology, health promotion, health administration & policy, and environmental health; • Integrated public health practice course via case studies and problem based learning involving bioterrorism scenario

26. New Product: MPH in Public Health Practice • 44 semester hours, of which 18 are from the Certificate program • Broad-based preparation in all core areas • 9 hours of electives to allow additional focus • Particularly suited to public health agency leaders and managers

27. New Product: MPH in Preparedness and Terrorism • Specifically designed for public health preparedness and response planners • 44 semester hours, • Broad-based preparation in all core areas • Focus on preparedness for bioterrorism, emerging infectious diseases, and other public health disasters

28. New Graduate Courses Developed for the MPH in Preparedness and Terrorism CPH 7113 Current Topics in Preparedness CPH 7223 Policy and Legal Aspects of Terrorism CPH 7433 Mental Health and Psychological Aspects of Terrorism CPH 7533 Emergency Risk Communications CPH 7940 Field Practice in Public Health Preparedness

29. 2004 Review and Practice Evaluation Part B-III Information and Analysis

30. Productivity Statistics for 5 Quarters (Oct 2002-Dec 2003) • Continuing Education • 3,300 persons trained (~700/qtr average) • 57 training events (~10/qtr average) • 21,200 person-hours of training (~4000/qtr average) Average cost ~ $37/hour or $296/day

31. SWCPHP Y1 Q1 Training

32. SWCPHP Y1 Q2 Training

33. SWCPHP Y1 Q3 Training

34. SWCPHP Y1 Q4 Training

35. SWCPHP Y2 Q1 Training

36. Productivity Statistics for 5 Quarters (Oct 2002-Dec 2003) (cont.) • Graduate Education • 43 health department professionals trained • 596 semester hours of coursework • 8,940 classroom hours

37. Public Health Employee Education Gains Achieved to Date • 43 OSDH students currently enrolled • 25 expected to complete the Certificate by Dec 2004 • Broad and balanced representation • Oklahoma City OSDH employees (22 students) HIV/STD Service Injury Prevention Immunization Special Services Financial Management Child Abuse Prevention Emergency Medical Service Nursing Service Maternal and Child Health Laboratory Service Family Health Administration Internal Audit Unit Community Health Administration Tobacco Use Prevention Acute Disease Epidemiology • County health department employees (17 students representing 12 departments) • Other (4 students formerly with OSDH)

38. Areas of Special Expertise • Objective scenario-based evaluation • Disaster mental health aspects of public health preparedness • Policy and legal aspects of terrorism preparedness • Water supply security • Technical assistance in expedient engineering methods for hospital and health department isolation surge capacity • Cultural issues in working with Native American and Hispanic populations

39. Objective Evaluation • SWCPHP staff have been active in developing and validating objective techniques for preparedness evaluation • Current projects: • NACCHO Project Public Health Ready assessment, training, and evaluation support to the Tarrant County, TX Public Health Department and Tulsa City-County Health Department • Several publications submitted or in preparation, participation in panel discussions at national ASPH/CDC and NACCHO meetings

40. Disaster Mental Health • SWCPHP staff are nationally active in disaster mental health preparedness efforts, particularly regarding the protection of children • Current activities: • P-FLASH and K-FLASH mental health practitioner training (direct and as Train-the-Trainer) – courses on-going • Disaster mental health planning for school administrators, counselors, and nurses – in development • Best practices survey of state mental health disaster plans – in progress • Developing graduate course in disaster mental health

41. Policy and Legal Assets • SWCPHP staff and practice partners with combined public health and law backgrounds Peter Budetti, MD,JD; Betty Pfefferbaum, MD, JD; Madeline Robertson, MD,JD; Les Beitsch, MD JD; Ken Levit, JD ; Gary Cox, JD David L. Boren, JD; President, University of Oklahoma and former Chair, United States Senate Intelligence Committee

42. Current Public Health Law and Policy Related Activities • Developing model public health policy and preparedness workshop format and curriculum • Pilot workshop scheduled for April 2004 in partnership with the Oklahoma Public Health Association

43. Water Supply Security • SWCPHP staff and partners are providing both preparedness planning and hands-on emergency response training in drinking water supply security • Active partnership with Los Alamos National Laboratory trainers • Current projects: • Water treatment plant operator preparedness • Chlorine release emergency response • Chapter on water security for new bioterrorism text in final draft by SWCPHP personnel

44. Isolation Surge Capacity • SWCPHP staff are leading a national effort to evaluate expedient engineering methods for isolating potentially infectious patients in hospitals and health department during natural or bioterrorism-related outbreaks • Current projects: • Preliminary evaluation of free-standing HEPA filtration units and HEPA-filtered exhaust-ventilated patient enclosures (completed) • Detailed case study evaluation of real-world applications of various system designs, and development of a guidelines document – in partnership with the HRSA Hospital Bioterrorism Preparedness effort

45. Cultural Issues • SWCPHP staff are working with Oklahoma tribes, New Mexico tribes and pueblos, and regional Latino populations • Current projects: • Disaster crisis communications development under the CDC Pre-Event Message Development project • NACCHO Project Public Health Ready – Cherokee Nation • Indian Health Service Incident Command System training (approximately 50% of all IHS hospitals, health centers, and field clinics fall within the SWCPHP support area)

46. 2004 Review and Practice Evaluation Part B-IV Systems Development

47. Education and Training Delivery Methodologies • Traditional in-class delivery • Synchronous video teleconferencing • Asynchronous streaming • Digital capture for Internet streaming or CD-ROM distribution • Hard-copy materials

48. Large Geographic Support Region • SWCPHP supports three states • 300,000 square miles • 10,000,000 population • 9,200-member public health workforce (excluding Indian Health Service and Tribes) • Geography is a driver for innovation and an enhanced distance education infrastructure • Collaboration between OSDH and SWCPHP has made possible significant expansion in DE capabilities

49. Distance Education Initiative • State-of-the-art synchronous video teleconference delivery statewide, with interstate compatibility • Evening and weekend course scheduling, video capture, and on-line streaming to accommodate working students • DE infrastructure funding provided by OSDH and COPH $ 220,844 OSDH $ 175,000 COPH

50. Oklahoma State Department of HealthH.323 Videoconference Sites OSDH H.323 Videoconference Sites OCCHD OSDH