Introduction

1. Introduction

2. Visitors from USC-CPHP PI : Charles Feigley, PhD, CIH Co-PI: Donna Richter, EdD, FAAHB Dir: Jane Richter, DrPH, RN

3. Visiting Partners • Max Learner, PhD – Director, Office of PH Preparedness, SC DHEC • LuAnne Ellison, MPH, CHES – Coordinator, BT Preparedness Training, SC DHEC • Stephen Morse, PhD – Director, Mailman School of Public Health, Columbia University • Geoff Scott, PhD – Director, Center for Coastal Environmental Health and Biomolecular Research, NOAA

4. Overview • Fall 2001 – Began to develop partnership with DHEC BT Team and other stakeholders • Summer 2002 – Contract from DHEC to assist with BT training needs assessment • May and July 2002 – Application written and submitted • Oct 1, 2002 – A-CPHP funded within the Arnold SPH

5. Overview Core Activities – reflects the philosophical foundation of Center • Building partnerships • Systems Change – infuse public health into emergency preparedness efforts • Rigorous evaluation

6. Overview • Supplemental Activities • Coastal Bioterrorism • Elected Officials – Building Knowledgeable Leadership • Lab Training in Dealing with BT Agents • Joint Appointments – Environmental Epid., Infectious Disease Epid., Risk Communication • January 2003 – March 2003 – most of staff hired, space renovated, and furnished

7. Overview Strengths of the Arnold SPH Though small in size, A-SPH is in the top 10 nationally for research funding • In USC, the School has 3% of the faculty, yet produces 20% of sponsored program support – highest research funding per FTE faculty • Full 7-year CEPH accreditation • Wide range of centers for public health research and service • The only major university with a public health president and a public health VP of Research and Health Affairs.

8. USC-CPHP Advisory Board • Scott Becker, MS – Executive Director, Association of Public Health Laboratories • J. Jarrett Clinton, MD, MPH – Regional Public Health Administrator, US Public Health Service, Region IV, DHHS (retired) • Lawrence Gostin, JD – Professor of Law, Georgetown U.; Professor of Public Health, Johns Hopkins U.; and Dir. CDC Collaborating Center for Law and Public Health

9. USC-CPHP Advisory Board • Lillian Mood, MPH, RN – Director of Risk Communication and Community Liaison, Environmental Quality Control, DHEC (retired) • Stephen S. Morse, PhD – Director, Center for Public Health Preparedness, Mailman School of Public Health, Columbia University

10. SOUTH CAROLINAPublic Health Workforce Development Survey A collaborative initiative of The Arnold School of Public Health/ USC CPHP and The South Carolina Department of Health and Environmental Control

11. Survey Characteristics SCDHEC Health Services employees surveyed Tailored to job classification Internet based with paper document available Assessed skill level and applicability to job Core public health competencies Emergency preparedness competencies Training preferences 102 total questions 27 minute completion time 7.3 Reading level Self assessment

12. Source Documents • from Core Competencies for Public Health Professionals by the Council on Linkages • ‘Emergency Preparedness’ from Columbia University School of Nursing, April 2001

13. Survey Response • 2629 of a possible 4025 total Health Services employees statewide (65.3%) • 2394 Internet responses • 235 paper responses

14. Core Public Health Competencies • Low ranking on basic public health may reflect lack of formal public health training • Clear need for training in basic public health

15. Emergency Preparedness • Emergency preparedness rated low in skill level and applicability to job • Clear need for training in emergency preparedness

16. SOUTH CAROLINAHospital Bioterrorism Preparedness Training Needs Assessment A collaborative initiative of The Arnold School of Public Health/ USC CPHP and The South Carolina Department of Health and Environmental Control

17. SC Hospital BT Preparedness Training Needs Assessment Survey questions based on 16 emergency preparedness competencies (skill level; applicability of skill to job) Also included questions on training preferences Surveyed emergency room, infectious disease, and infection control professionals 31 hospitals state-wide Hospitals stratified by size (# beds) 732 completed surveys

18. (1=lowest; 5=highest)

19. (1=lowest; 5=highest)

20. (1=lowest; 5=highest)

21. Public Health Laboratory Training

22. Clinical Lab Preparedness • SC DHEC Focus Area C – DHEC performed telephone survey of training needs of Class A clinical labs • Partnered with DHEC and USC School of Medicine to develop training workshop and piloted with DHEC lab staff • May 2003 - Revised and presented – open to laboratorians across the State

23. Clinical Lab Preparedness Lessons Learned • Labs so short-staffed that many could not send a representative • Asked for VHS tapes of the workshop, not CD-ROMs ________________________________________ - All 51 labs were sent notebooks and video tapes, plus all other course materials - Folded into Core

24. CT Needs Assessment – Labs • In September 2003, DHEC (Focus Area D) conducted needs assessment of SC LRN • Clinical chemistry assessment capabilities • Laboratory Information Management System (LIMS) • Training needs

25. Training Needs • Formation of DHEC / USC-CPHP committee • Exploration of training and toolkit opportunities • Contact with Association of Public Health Laboratories • Focus Area D Coordinators • Comprehensive dissemination approach for developed trainings (CD-ROMs, visits, etc.)

26. Chemical Lab Training • Success • USC-CPHP / DHEC Collaboration • Challenges • Unequal capabilities among SC LRN • Connecting with target audience • Next Steps? • Visit NCEH today • CDC training in late Summer 2004

27. BIOTERRORISM TRAINING FOR GOVERNMENTAL ADMINISTRATIVE OFFICIALS

28. Overview • Why selected as supplemental activity? • What did USC-CPHP set out to do? • Needs Assessment • Literature Review • Pilot Training • Training Curriculum

29. Needs Assessment • Methodology • Informal discussions with national and state officials • Focus groups (USC-CPHP) • Interviews (CHSPR and USC-CPHP) • Findings • Barriers • Training needs • Training strategies

30. Accomplishments • Literature review • Brief online review of national and state organizations addressing issue (CHSPR) • More in-depth review done by USC-CPHP • Pilot Training • 15 of 22 invited actually attended • Three-hour seminar • Speakers from DHEC and SLED

31. Pilot Training • Evaluation results • Organization (e.g., clarity of goals) and quality (e.g., handouts) rated positively • 100% agreed that seminar provided them with useful info that would benefit them in their jobs • 100% agreed that they had learned about the SC and County Emergency Management and Response System and about the roles of lead agencies

32. Next Steps • New trainings • Legislative issues • SC Framework/roles and responsibilities • Grant funding/resources • Risk communication • Continued relationship building • Municipal Associations • Councils of Government • Disseminate Best Practice & Lessons Learned

33. Lessons Learned • Delivery method is as important as content • Solicit the assistance of a champion • Speakers should be recognized and accepted by elected and appointed officials • Training content should reflect issues unique to the chosen locale • Incentives should be provided for attending

34. COASTAL BIOTERRORISM: Developing Capacities for Protecting Ports and Communities October 1-2, 2003 Francis Marion Hotel

35. Workshop Development • Collaboration with NOAA Center for Coastal Environmental Health and Biomolecular Research • Steering Committee • Included key stakeholders from Coast Guard, DHEC, Savannah River Training Center, Ports Authority, NOAA, SC Sea Grant • Scenario-based discussion led by co-facilitators from US Coast Guard and DHEC

36. Workshop Objectives • To facilitate communication & interagency networking • To familiarize key stakeholders with protocols in: • public health/medical response • public safety, law enforcement, and security • information management and public relations • To determine how multijurisdictional agencies will be coordinated under an incident command structure

37. Workshop Objectives • To identify assets and opportunities in current: • capabilities and resources; • communication strategies; and • training and research needs The identification of the training and research needs served as needs assessments for NOAA and USC-CPHP.

38. “Cajun Cruise Crisis” Scenario involves a cruise ship entering port of Charleston after many passengers become ill • Discussion questions followed along discipline lines • Healthcare / Public Health • Security / Law Enforcement • Communication / Public Affairs • Opportunity for key agencies to discuss and present multiple options and possible solutions • Crystallized competing needs of public health versus criminal investigations

39. Discussion Groups Facilitators led four breakout groups (12-15 people) through three 45-minute sessions • Mixed disciplines for better interaction • Sessions • Capabilities • Communications • Training and Research Needs • Reporting of discussion groups

40. Needs Assessment Findings • Charleston Scenario • Training Needs • Interagency coordination and operability • Exercise design and evaluation, ICS • Research Needs • Technology—ie. Bio-analytical toolbox • Communications

41. Coastal Successes • Collaboration between USC-CPHP & NOAA • Interagency networking • Enthused stakeholders • Ample Opportunities

42. Workshop Products & Next Steps • Phase 1: Stakeholder dissemination • Summary of the scenario • Research and Training Needs • Lessons learned • Phase 2: National dissemination • Scenario-based needs assessment • A-CPHPs with ports

43. ACADEMY for PUBLIC HEALTH EMERGENCY PREPAREDNESS (APHEP)

44. PURPOSE • Provide a mechanism to facilitate a cohesive community response between public health and first responders to a CBRNE event. • Lay the groundwork for the establishment of a progressive community exercise program. • Enhance public health infrastructure through networking and sharing best practices andlessons learned.

45. GOAL Build local community capacity to respond to acts of terrorism through: • Acquisition of knowledge that will help teams develop, implement, and evaluate a tabletop exercise. • Development of relationships and partnerships between the agencies and facilities involved.

46. FORMAT Each public health district developed APHEP teams with 6 – 8 members. Teams were required to have representation from public health, hospitals, fire service, law enforcement, and emergency management. Three sessions held in Columbia over a period of six months with activities in between. Each team required to conduct a tabletop and present a summary and after action report during session III.

47. CURRICULUM Public Health Role in Incident Command - NACCHO Exercise Design and Evaluation - ODP Risk Communication – Vincent Covello Forensic Epidemiology – DOJ, CDC

48. OUTCOMES Addressed training needs of key public health staff and community partners within short time frame utilizing existing curricula. Allowed grantees to collaboratively address need to exercise and evaluate existing plans and policies thereby reducing duplication of efforts.

49. OUTCOMES Provided opportunity for shared learning and efficient use of funding. Enhanced working relationship with public health agency. Established partnerships with hospitals and the response community.

50. South Carolina Hospitals: At the Crossroads of Bioterrorism Preparedness and RealityConference October 21 & 22, 2003