I. Opening Business

Dr. Joshua Lipsman, chair, opened the meeting and welcomed all participants.  The minutes from the last Council meeting on June 8, 1998 were unanimously approved without comment.

The opening discussion reviewed the meetings and sessions attended by Council members and staff during the ASTHO-NACCHO annual meeting.  Sessions of note include those that discussed community competencies, Healthy People 2010, public health education and training, preventive medicine training, and SACHOs relationships with universities.

 

II. The Future of Public Health: 10 Years Later

Dr. Hugh Tilson provided the Council an update on activities related to the 10^th anniversary of the 1998 report, The Future of Public Health.  The Institute of Medicine (IOM) has planned two forums to examine the value and opportunities missed in the first report and what revisiting the report might accomplish.  The first meeting was held on September 24 as part of the ASTHO-NACCHO annual meeting.  The second meeting is scheduled for December 16 in Washington, DC.  It is hoped that all major constituent groups will have an opportunity to respond.

Discussion focused on how the Council could respond to the 1998 report.  One recommendation entailed developing a bare minimum for defining local health departments.  Another recommendation discussed ways to assess and model public health infrastructure in order to make recommendations for achieving Healthy People 2010.  A motion was made and adopted unanimously (with one abstention) for the Council to officially follow up to the 1998 report with a letter to IOM stating these recommendations.

 

III. National Public Health Research and Applications Agenda

Since the presentation made by Mr. Mike Gemmell, Executive Director of the Association of Schools of Public Health (ASPH), and the ensuing discussion during the March 6, 1998 Council meeting, Mr. Ron Bialek has been coordinating a subcommittee to begin work on developing a public health prevention research and application agenda.  The subcommittee is composed of interested individuals representing both government and private entities.  Through continued work with the subcommittee, it has been discovered that several other groups, including CDC have been working on developing research agendas.

After a second subcommittee conference call and presentation of the draft concept paper to the Public Health Functions Steering Committee, Mr. Bialek revised the concept paper.  This revised paper was presented to the Public Health Functions Working Group on September 17.  Working Group members felt that although the idea initially presented was attractive and a lot of groundwork has been laid, the concept has not been sufficiently explained.

During Council discussion, other examples of developing research agendas were identified. Dr. Doug Lloyd identified the National Institutes of Health’s (NIH) effort to develop a research agenda in behavioral health — NIH has scheduled a two-day conference in December to explore what is and is not known about behavioral research.  Mr. Neil Sampson, who is participating in this conference, suggested that the Council should be included on the agenda.  As another example, the Guide to Community Preventive Services was identified as a good start, but this guide is not intended to address many of the public health services research issues.  IOM has also called for a public health research agenda as well and has scheduled a small meeting in the latter half of October.  In addition, Dr. Satcher, as Surgeon General and Assistant Secretary for Health, has spoken about the importance of establishing a process for identifying the gaps in public health research.

The Council decided to form a core group of four to five individuals from the subcommittee to further develop the scope and framework in an in-person meeting.  Dr. Lloyd, Dr. Tilson, and Dr. Bill Barker volunteered to serve as part of this core group.  Mr. Bialek will also identify other appropriate individuals to work on refining the concept paper, drafting a table of contents, and developing a more detailed workplan for planning a public health research and applications agenda.

 

IV. Overview of Report: "Preparing Currently Employed Public Health Professionals for Changes in the Health System"

Dr. Kristine Gebbie, of Columbia University School of Nursing and consultant to the Office of Disease Prevention and Health Promotion, provided the Council an overview of the recently completed report, "Preparing Currently Employed Public Health Professionals for Changes in the Health System."

This project, funded by the Robert Wood Johnson Foundation (RWJ), examined five public health professions — administrators, educators, environmental health professionals, nurses, and physicians.  Dr. Gebbie’s presentation focused on a comparison of training needs based on the essential public health services.  The report found that although a strong desire exists to assemble a well-educated, qualified staff, it is a struggle to consciously develop workforce skills and competencies.  As the workforce continues to develop, there is need to identify commonalties and work across disciplines to better provide services to the public. RWJ remains very interested in advancing this initiative

Dr. Gebbie identified several ways that the Council could support this initiative:

1. Remain attentive to education programs for new and returning workers, which should help to move academic centers to meet these needs pragmatic.
2. Although the current list of public health competencies has been used for a lot of reasons, they need to be validated so they can be more useful for job descriptions and curriculum development.
3. Council organization need to be active partners in developing modules to meet needs identified in the report.
4. The Council can help identify ways of developing more effective educational teaching models — focusing on the method, more than just the content.

Council discussion focused on the need to integrate disciplines, such as units in schools of public health linked to units in schools of medicine. The Public Health Faculty/Agency Forum, from which the Council was derived, pushed change coming from schools.  Now, there needs to be pull from the practice field to structure teaching programs.  Programs have added courses and requirements, but there still remains a knowledge gap.  The Council could be helpful by documenting extreme gaps in training programs.  The discussion concluded with an agreement to endorse the goals of this report and to write a letter of commendation and interest in further work to Dr. Gebbie, with a carbon copy to Ms. Nancy Kaufman of RWJ.

 

V. Initiatives in Public Health Education

A. Population Medicine and Public Health in Medical Schools
Dr. Barker provided information to the Council about a current initiative by ATPM to promote medical schools and health departments working together.  There is a need for stronger undergraduate connections to preventive medicine.  Mr. Sampson indicated that HRSA would be interested in supporting efforts that looked toward medical school residencies incorporating public health concepts into the curriculum.  A motion was made and passed to support medical school residency programs bringing together principles of public health and medicine.  Council staff will provide Dr. Barker with a list of Council e-mail addresses so they can receive electronic updates about this initiative and other projects of ATPM.

B. Academic Public Health Agencies
Per discussions during previous Council meetings, the Council has agreed to support Dr. Bill Keck and his work to promote academic health departments.  A special session during the APHA annual meeting has been scheduled for Wednesday, November 18, 2:00-4:00, to bring together leaders from the field to discuss the development and nurturing of academic health departments.  Letters of invitation will be sent to the presidents, executive directors, and Council members (if applicable) to organizations involved in both public health and medicine practice and education.  Council members were encouraged to attend as well as to garner organizational support from the organizations they represent.

Beyond already identified programs, Mr. Sampson suggested that the Council look at HRSA’s "Models that Work" program for more examples. In addition, Mr. Sampson volunteered to work with Council staff about potentially establishing an annual award for teaching health departments.

 

VI. Update of Council Activities

A. Public Health Competencies
Mr. Bialek updated the Council about the current work of the Public Health Functions Project to further develop the competencies of the public health workforce.  The Council was specifically identified in the 1997 report, Preparing the Public Health Workforce for the 21^st Century.  Once resources are identified, the Council plans to implement the proposed workplan developed by the Council in early 1998. HRSA, with the support of its Administrator Dr. Claude Earl Fox, would like to take a more active role in moving this work forward and monies in the Year 2000 budget have been requested.

B. Council Objectives and Strategies
As a regular agenda item, the Council reviewed its objectives and strategies, last updated in June 1998.  Council members made several additional suggestions before finalizing the updates for the coming year:

• Objective 6: needs to be updated to reflect more effective dissemination and use of the Guide to community Preventive Services. Suggested language: "Ensure practice-sensitive development and intelligent dissemination of practice-based guidelines."
• Objective 3: should include "Public Health Professionals" report (see IV.)
• Objective 5: The Link should be mentioned in the objective, not just the strategies.

C. 1998 Report Card
Ms. Marie Flake provided the Council an update on progress toward completing the 1998 Report Card of the Council.  The working outline of the report includes: 1) what the Council has accomplished; 2) case studies on three Council projects; and 3) case studies of successful linkages activities.  Council discussion focused on planning for future report cards and better ways of measuring Council objectives and strategies.

D. Council Membership and Participation Agreement
Dr. Lipsman reported that signed participation agreements have been received from all but one Council organization.  Council staff will follow-up with this organization as well as keep apprised of organizations that have changed leadership and/or Council member to keep the agreements up-to-date.

E. The Link
Ms. Michon Béchamps provided the Council with the publication schedule for Volume 13 of The Link.  The upcoming issue (Volume 12, No. 4) will focus on the public health research and applications agenda. The focus of Volume 13, No. 1 will be the 1998 Report Card (see Item VI. C.).  The following issue will focus on leadership in public health.  Dr. Lipsman suggested that an update of organizational linkages activities be included in one issue for 1999.  Ms. Béchamps requested that Council members provide updates to the mailing list.

F. Council Web Site
Ms. Béchamps informed the Council that the web site is in process of being updated to include project descriptions, current membership and staff, and articles from The Link. In the coming months, a letter will be sent to Council organizations to facilitate a direct link to the Council web site.

G. Council Brochure
The draft brochure provided to the Council was approved for design.  The content needs to be updated to include the revised Council objectives.  Dr. Tilson suggested that the logo used on the brochure, with some modifications, be copyrighted and included on Council letterhead.  The motion to adopt the logo and brochure with modifications was adopted.

 

VI. Administrative Business

Dr. Lipsman announced that HRSA has promised an additional $20,000 to be added to the Council’s subcontract with ASPH.  Ms. Liz Weist of ASPH confirmed that these monies have been approved and finalized.  These additional funds will be used to add the Society for Public Health Education (SOPHE) and the National Environmental Health Association (NEHA) as Council members.  At the next meeting, on November 19, the Council will invite Art Bloom to represent NEHA and adopt a motion to officially add SOPHE to the membership.

Dr. Lipsman also announced that beginning in the next quarter, Marie Flake and the Johns Hopkins University Health Program Alliance staff will no longer provide staffing to the Council.  PHF will assume responsibility for those tasks previously coordinated by Johns Hopkins staff.

The meeting was adjourned to the NACCHO Awards Luncheon.

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