I. Opening

Dr. Joshua Lipsman, chair, opened the meeting and welcomed all participants.

 

II. Public Health Practice Guidelines

Mr. Ron Bialek presented a progress review of the public health practice guidelines panel.  As discussed during the last Council meeting, the guidelines related to motor vehicle accidents and cardiovascular disease are currently being finalized.  Mr. Deane Johnson announced that the next CDC task force meeting would be held in Washington, DC, April 28-29; the following meeting will be in Los Angeles in September.

By the nature of the Council and its access to facilitating partnership and collaboration, logical roles for the Council would be to assist in evaluation and field testing.  The Council explored alternative funding sources to fund such roles and other continued work in the area.  Presenting a topic-specific proposal to CDC or other funding agency or incorporating these activities as a component of general funding for the Council were the two alternatives considered.

As a result of the discussion, Council staff will follow through and approach Kellogg as a potential funder.  It was also suggested that the Council liaison, Dr. Lloyd Novick, contact Bobbie Berkowitz, University of Washington, for further discussion of this project and possible related activities for the Council.

 

III. Public Health Education: Teaching Public Health Departments

Mr. Michael Gemmell presented the information and viewpoints proposed by ASPH and officially supported by Council regarding graduate public health education funding (GPHE) to Ms. Colleen Tynan, point person for GME in the legislative office of HCFA.  Ms. Tynan was sent upon the bequest of Ms. Barbara Wynn, Deputy Director of the HCFA Bureau of Policy Development, to whom the Council sent a letter earlier in the month stating the Council’s support of the ASPH GPHE funding proposal.  With the exception of AAHP, all Council member organizations approved support for this letter.

As reviewed by Mr. Gemmell, publication of the Institute of Medicine’s Future of Public Health in 1988, forced a realization that only one-third of the public health workforce were trained at the graduate level with skills based on practice competencies.  Many in the field agreed that these students should be given the same opportunity as medical students for supported learning experiences through using public health departments as training centers. Schools of public health have been encouraged to establish partnerships with health departments for such a use.  However, to formally build the public health infrastructure and develop a well-trained cadre to deliver services adequately, some type of additional funding is needed.  It has been suggested that the GME Medicare funds, currently used only to train clinical physicians in hospital settings, be tapped to train preventive medicine residents and eventually other public health professionals in public health departments.

In response, Ms. Tynan expressed general support for idea.  However, there are several issues that must be addressed prior to proceeding and HCFA providing official support.  Medicare is concerned about access for beneficiaries, quality and costs.  As written in the legislation, GME funds can only fund hospitals to pay providers to Medicare beneficiaries.  At the present time, there is no such direct link of public health to Medicare services.  To further this proposal, the Council and ASPH would need to demonstrate specific benefits to the Medicare population.  In addition, only hospitals, not public health schools or departments can be accredited.

Future needs identified by Council discussion included the need to educate legislative branch about the role and function of public health.  Advocates of this position also need to demonstrate links to services and show benefits to Medicare recipients.  The Council and its partners should be strategic about pursuing and supporting each tenet of the proposal; it would be prudent to explore incorporating public health into training already funded.  ASPH is currently reviewing lobbying efforts, educating their colleagues in the field, and building further justification for this endeavor.

The next step will be to convene a meeting of Mr. Gemmell, Mr. Bialek, Dr. Mary Davis, Ms. Hazel Keimowitz, Ms. Diane Downing, and Mr. Ron Merrill with Ms. Tynan and other HCFA representatives to further discuss the ASPH proposal and ideas presented.

 

IV. Public Health Training Network

Mr. Dennis McDowell of CDC’s Public Health Training Network (PHTN) presented information regarding CDC activities in distance learning.  He also explored possible Council roles in such activities.

With traditional learning institutions being increasingly taxed and the lifelong learning needs in public health, CDC has begun more rigorous strategic planning.  The need for distance learning is far too great for complete financing from one organization.  Through strategic partnership development and maintenance, collaboration, and shared resources, program offerings can be expanded to help create a more informed and competent workforce.  The overall goal is to provide seamless distance learning, regardless of the source organization, and to coordinate at all levels of participation.

According to Mr. McDowell, CDC would like Council support of developing one coordinating body for federal distance learning activities. The proposed name for this group is the Distance Learning Coordinating Council (DLCC).  It would also be useful for the Council to help advocate and promote the vision of centralization of resources for strengthening partnerships in distance learning.  Due to the range of activities and organizations currently involved in distance learning, there needs to be coordination at the federal level to develop a comprehensive database of activities and registrants.

Other topics raised by Council members included the need to increase marketing efforts specifically directed toward managed care organizations.  Many agreed that a possible role for the Council could be to help educate academics (and practitioners) about distance learning and its importance in public health.  Quality assessment is another possible avenue of pursuit.  With both academic and practice connections, Council members can facilitate researching and collecting information about distance learning activities happening within their organizations and contacts.  Mr. McDowell concurred with the Council opinion that evaluation was very important.

As a next step, Mr. McDowell agreed to draft a letter which Council members could then take to their constituents.  Mr. McDowell also agreed to write a feature article, focusing on the issues related to distance learning, for a subsequent issue of The Link.  It was also suggested that staff monitor funding sources for distance learning.

 

V. Competencies Issues

Mr. Bialek presented the report of the competencies ad hoc committee to the Council.  As stated, the subcommittee has discussed and explored the next steps for Council work on public health competencies.  The subcommittee feels that finding a topic-specific funding source would be ideal.  The Robert Wood Johnson Foundation has expressed interest in sponsoring the proposed workshop.

As approved by the Council members, Council staff will work on securing funding, developing a program agenda, and identifying deliverables of such a conference to share with the subcommittee.

Other endeavors mentioned were the Public Health Functions Steering Committee report, which applies to the workforce as a whole and work on validation models being developed at Emory University.

 

VI. Survey of Tenure and Promotion Criteria

As reported by Ms. Alison Wojciak of ASPH, the draft of the survey on tenure and promotion criteria is under development.  After review and consultation with the advisory committee, the survey is scheduled to be sent in early June to public health practice coordinators at ASPH member schools.  ASPH also plans to hold a workshop in June where they will discuss vigor in practice and work toward developing guidelines for further activity.

Some concern was expressed about the limited scope of the survey.  It was concluded that there are some unique issues for schools of public health and that this one survey may not fit all purposes.  An ideal future endeavor would be to develop a model survey and methodology that could be easily adapted for other purposes.

 

VII. NACCHO Annual Activities

As developed and discussed at past meetings, the Council is planning to further linkages by holding its next meeting in Houston in conjunction with the annual NACCHO meeting, July 16-19, 1997.  In addition to the meeting, the Council is also sponsoring two programs — a roundtable on academic/practice cultures and a panel on publishing and publicizing practice results.  Summaries of both programs are marked Attachment A.  Another scheduled activity will be presentation of the annual Linkage Awards during the Awards Luncheon.

In an effort to further develop the roundtable discussion, the Council discussion focused on generating ideas and additional questions related to academic/practice cross-cultural communications.  This information will be summarized and provided to the session moderators.  As suggested, active teachers were added to the roundtable. Drs. Tilson and Novotny will co-moderate the sessions with NACCHO members Drs. Keck and Lipsman.  After the conclusion of the NACCHO meeting and programs, Council staff will develop the materials presented and discussed during the panel and roundtable into articles for The Link and possibly a "Guidance Document on Academic Partnerships."

 

VIII. The Public Health Workforce: An Agenda for the 21st Century

Ms. Kristine McCoy of ODPHP presented a summary and activities update from the Public Health Functions Steering Committee.  An updated draft summary of the Committee report was prepared for Council review and was included in the meeting materials packet.  In developing a Council response, it was decided that an appropriate role would be to advance issues and activities related to public health competencies.  Ms. Downing was appointed the Council representative for future Committee meetings as the Council role is more specifically identified and written into the report.

 

IX. Administrative Business