Preparing the MidAtlantic Public Health Workforce Johns Hopkins Center for Public Health Preparedness March 17, 2004

2. Preparing the MidAtlantic Public Health Workforce Johns Hopkins Center for Public Health Preparedness March 17, 2004

3. Key Personnel • Robert Lawrence, MD Principle Investigator • Lynn Goldman, MD Co-Investigator • Ayanna Fews, MBA Coordinator • Andrew Lentz, MPA Coordinator • Cindy Parker, MD MPH Trainer Liaison • Dan Barnett, MD MPH Trainer/Liaison • Jonathan Links, PhD Curriculum Advisor • Cliff Mitchell, MD MPH Curriculum Advisor • Margo Edmunds, PhD Program Evaluator • Diane Zerbe, MHA Academic Coordinator

4. CDC’s Vision • Every health department fully prepared; every community better protected • Public Health workforce prepared to deliver essential services Maureen Y. Lichtveld,November 8, 2002

5. JH-CPHP Mission To provide the necessary training that will enhance the ability of public health professionals to respond to bioterrorism and other emerging public health threats

6. CDC’s Vision Goal: An integrated national network of Centers for Public Health Preparedness to ensure frontline public health workers have the skills and competencies required to respond effectively to current and emerging health threats, including terrorism

7. Centers for Public Health Preparedness (CPHP) http://www.phppo.cdc.gov/owpp

8. Competency-based Performance - driven Governmental public health workforce Individual and agency competency *Developed in collaboration with state, local and academic partners (October 21, 2002) Guiding Principles* (Lichtveld cont.)

9. Role of CPHPs (Lichtveld cont.) • Support local/regional education training needs • Develop “products” for potential national use • Strengthen the science base locally, regionally, and nationally

10. CDC anticipated outcomes in the next 6 months Training products database of federal, state and local health training efforts Toolbox of learning offerings Direct training for key state and local BT health officials Terrorism Preparedness andResponse Training Matrix

11. Key Training Content Areas • Biological/chemical agents-diagnosis, treatment, consequences • Unified and incident command systems • Communications/notifications systems • Risk communications • Worker safety • Legal authorities • Epidemiology/surveillance; laboratory systems • Information technology • Psycho-social consequences • Maureen Y. Lichtveld,November 8, 2002

12. Key JH-CPHP Content Areas • Weapons of Mass Destruction (Barnett, Parker: numerous) • Incident command (Alcorta, 2/03) • Communications/notifications systems • Risk Communication (Burke, 8/02) • Worker Training in a New Era (Mitchell 10/02) • Legal Issues (Sapsin, Teret 2/04) • Forensic Epidemiology/surveillance; • Control of biohazards/laboratory systems • Information technology • Mental Health & Disaster Preparedness (Everly 10/03)

13. Baker Barnett Bollinger D. Burke T. Burke Catlett Chotani Cosgrove Everly Faden Frick Geyh Glass Goldman Halsey Henderson Hodge Lawrence Links Mitchell Parker Sapsin Sommer Teret Treuth Participating Hopkins Faculty

14. Allegany County HD Baltimore City Fire Baltimore City Health Baltimore City Police Boston U. School of Law Delaware O.A.G. DC Health DHMH Legal Counsel JH Health System Center for Health & Homeland Security MD Office of Attorney General Maryland Pesticide Network MedChi U. of MD Medical System Worcester County HD Wicomico HD Participating Practice Partners

15. Helping States Create Contingency Plans

16. What we do… JH CPHP Preparedness Certificate Program (Web Based) JH CPHP Suitcase Course Train the Trainer Program JH CPHP Special Programs Onsite Training Symposiums JH CPHP State and Local HD Technical Assistance JH CPHP Liaison Activities W/ HD & other agencies Courses developed by Faculty Consultants Courses to be adapted from Preparedness Certificate Courses Risk Comm. ~ Smallpox ~ Worker Training ~ Dirty Bomb Training ~ Grand Rounds Others Work with State and Local Public Health Agencies on BT Training Plans Attend BT Planning Meetings within MidAtlantic Region

17. Key Partnerships Area Health Education Centers (Western/Eastern Shore) Baltimore City Health Department Baltimore City Medical Reserve Corp Emergency Health Management Services Administration (DC) Delaware Department of Public Health Maryland Association of County Health Officers (24 Local Health Departments Maryland Department of Health & Mental Hygiene Metropolitan Washington Council of Government Montgomery County Health Department Safety Council of Maryland Washington DC Department of Health Western Maryland Medical Reserve Corp

18. Partnerships within JHU Center of Excellence in Community Environmental Health Practice Center for Law and the Public’s Health Critical Events Planning and Response (JHMI) Education & Resource Center in Occ. Health & Safety Environmental Health Tracking Center General Preventive Medicine Residency MidAtlantic Public Health Leadership Institute MidAtlantic Public Health Training Center Public Health Scientists Working to Address Terrorism Urban Health Institute

19. Washington, DC

20. Maryland

21. MD Department of Health & Mental Hygiene • Board of Physicians • BT Preparedness and Response Planning & Advisory Committee • Bioterrorism Education & Training Team • Public Health Response Team • BT Preparedness Certificate/scholarship program • Proximity to SPH for Grand Rounds etc.

22. Challenges Area G funding

23. Baltimore City

24. Baltimore City • The nation's oldest city health department. • Embedded liaison with JH-CPHP • HarborB.A.S.E. Executive, Evaluation, Volunteer Committees • Assisted in department-wide training • Proximity to SPH for Grand Rounds, etc

25. Preparing for Surge Capacity

26. Primer II Tabletop exercise JH Applied Physics Lab

27. Delaware

28. Baltimore City Health Department model • Targeted to meet job-related information needs of respective employee training level audiences (senior staff, clinical staff, bureau chiefs & managers, clerical & support staff) • Includes Introductory Courses in: • Bioterrorism Preparedness and Response • Chemical Terrorism Preparedness and Response • Radiological Terrorism Preparedness and Response • Incident Command • Risk Communication

29. Baltimore City Health Department model (cont.) • Level 1: Senior Staff • Senior health department leadership staff • Level 2: Clinical Staff • Includes physicians, nurses, epidemiologists • Level 3: Bureau Chiefs and Managers • Mid-level managerial staff • Interface between Level 1 and Levels 2 & 4 • Level 4: Clerical and Support Staff • Includes secretarial staff, facilities management staff, animal control employees, environmental sanitarians, etc.

30. Baltimore City Health Department model (cont.) Evaluation of Training Activities • JH CPHP • MPH Preparedness Track Student Involvement

31. Wicomico County model Independent study • Used JH CPHP Roadmap to Preparedness • January 15th – March 1st • Complete 8 of 13 preparedness modules on your own • JH-CPHP will conduct four half-day trainings

32. Allegany County BPQA II June 6, 2003 SARS Symposium March 12, ‘04

33. Montgomery County BPQA I February 6, 2003 BPQA/AAP Special Needs of Children – June 26, 2003 Public Health Ready pilot site

34. Roadmap to Preparedness • Creative way for health departments to get their staff trained • Based on CDC-adopted “Bioterrorism & Emergency Readiness Competencies for all Public Health Workers” • Includes a combination of activities that employees can do on their own, agency-sponsored activities, and Center-sponsored activities • Incentive-based • Addresses employee concerns about responding to a disaster • First developed in conjunction with Montgomery County HD for Public Health Ready, then adapted for use in other health department settings. • Uses “experiential learning” techniques whenever possible

35. Roadmap (cont.)

36. Roadmap (cont.)

37. Roadmap to Preparedness • Wicomico County Health Department as a model for other counties: • Completed the first 9 of 13 activities on their own • Using online programs, self-study materials, and agency-led discussions • Set very aggressive timetable for employees to complete activities 1 -9 (about 6 weeks) • Offered 4 hours administrative leave for all employees completing these activities within the time period specified • Scheduled us to do the final 3 of 4 activities • Over a period of 3 days, we did 4 back-to-back half-day sessions, each session included approximately 25% of their workforce. • Last activity is an exercise

38. Roadmap to Preparedness – Next Steps • Implementation of Roadmap to Preparedness model in other State and local health departments. • In development: • Cecil County • Garrett County • Allegany County • Delaware • Share model across network

39. Garrett County Maryland

40. Cecil County Maryland

42. Inservices/Orientation Online training modules Leadership institute Train-the-trainer Academic courses Certificate programs Degree programs Summer institute “just-in-time” Conferences Board of Physicians Incident Command MidAtlantic scholars Forensic Epidemiology Terrorism & Public Health Preparedness Certificate MPH preparedness track HPM summer institute Guest speakers Day long events each quarter A Variety of Learning Styles

43. Recent Training Events • SARS Symposium (March ’04) • Legal Issues (Feb ‘04) • Mental Health & Disaster Preparedness (Oct ’03) • Pesticides & Public Health (Sep ’03) • Dirty Bomb Symposium (March ’03)

44. JH-CPHP Website

45. Online Training Modules

46. Online Instructional Design Approach • Design for broad public health personnel audience • Slide design and layout designed for minimum 800x600 screen • Base of 56 K modem • Scaffolding structure • Topics begin with fundamental terminology to establish baseline of understanding • Evaluation Method • Interactive exercises • Short objective quizzes

47. Currently Online • Incident Command – Alcorta • Law, Public Health and Terrorism – Sapsin • Strategies for Prevention of Bombing Injuries -Baker (JHU) and Runyan (UNC) • Radiation Terror – Topic 1 – Links • Economic Evaluation of Preparedness Programs – Frick • Bioterrorism and Food Safety - Hager

48. Future Online Training Modules April 2004 • Psychology of Terrorism – Everly • Risk Communication – Edmunds • Radiation Terror – Topic 2 - Links • Bioterrorism and Food Safety – Topic 2 – Hager • Emergency Response Planning – Blodgett • Introduction to Weapons of Mass Destruction – Barnett and Parker

49. Future Online Training Modules May 2004 • Personal Preparedness Planning for Public Health Workers – Barnett • Psychology of Terrorism – Topic 2 and 3 – Everly • Emergency Preparedness Training Approaches – Singleton • Bioterrorism and Food Safety – Topic 3 - Hager

50. Legal Bases in PH Emergency