I. Opening Business

Dr. Joshua Lipsman, chair, opened the meeting and welcomed all participants.  The minutes from the last Council meeting on July 17, 1997 were presented to Council members for approval.  Ms. Hazel Keimowitz, executive director of ACPM, requested some changes regarding the information related to ACPM’s GPHE funding consultant.  With incorporation of this correction, the minutes were unanimously approved.

 

II. Council Funding

Council funding under the HRSA’s special projects grant ended September 30, 1996.  Through prudent fiscal management, the Council has been able to continue with carry-over funds since that time.  Mr. Ron Bialek, project director, announced that new funds have been secured through ASPH’s cooperative agreement with HRSA. Effective October 1, 1997, the one-year contract between ASPH and the Public Health Foundation (PHF) fits well with ASPH’s main internal objective to promote linkages.  The Council and its activities will continue to be staffed both by the Public Health Foundation and The Johns Hopkins University Health Program Alliance in order to provide both practice and academic linkages.

 

III. Special Projects

Throughout its existence, the Council has lead the way in promoting linkages.  In turn, the Council has been sought out for involvement in continuing and emerging projects.

A. Public Health Practice Guidelines
In review, CDC’s task force on public health practice guideline has been moving forward. At recent Council meetings, key personnel have presented the task force activities and have continued to express interest in Council involvement in field testing the draft guidelines.  The Council had previously formed a subcommittee of practice members in order to further develop the Council role, draft a proposal, and present this information to the full Council for approval.  However, before the subcommittee had the opportunity to meet, Mr. Deane Johnson solicited an immediate proposal to qualify for end-of-year dollars.  After passing technical review, the proposal was ultimately denied funding.  This proposal along with the related proposal submitted by Dr. Lloyd Novick to the W.K. Kellogg Foundation (Kellogg) are still viable contenders for funding under the next fiscal cycle.

The CDC guidelines have been developed to be as broadly representative of the field and to help identify the best practices.  Over the next four to five years, CDC hopes to cover the entire field via subject modules.  The current draft proposal was developed under the assumption that the first draft of community preventive services guidelines would be available in early 1998.  Under this proposal, the Council would serve as advisory body for the field testing process through focus groups.  This first step would also involve developing tools and methods for field testing with input and expertise provided by Council members.  The focus groups would then be charged with reviewing the format, scientific validity, and content of the draft guidelines.

Dr. Lipsman suggested brainstorming on ways in which Council members or staff or member organizations might further participate in the project.  With the benefit of added time, it is possible to further develop the initial proposal and propose better ways of utilizing the unique resources of the Council for this activity.  Feedback from CDC has indicated that it would also be very useful for Council members to contact representatives in the Public Health Practice Program Office to advocate activity and confirm the Council’s belief in the usefulness and desirability of involvement.  It was agreed that Council members will follow up directly with CDC and will carefully review the current draft proposal to further generate ideas.

B. Competencies
Until general funding for the Council was secured, further pursuit of funding public health competencies activity was temporarily put on hold. Council discussion reiterated interest in pursuing the topic and the decision was made to resume discussions regarding potential Council involvement.

Ms. Nicole Cumberland, with the DHHS Office of Disease Prevention and Health Promotion, reviewed the activities of the Public Health Functions Steering Committee and workforce subcommittee on competencies.  As a subgroup of the Steering Committee, the workforce subcommittee drafted a report that was disseminated for comment and recently released.  The final report specifically names the Council as a unique and useful advisory group for further work regarding competencies.   After the next steering committee meeting, the list of public health partners and their proposed activities will be approved.

Council discussion focused on follow-up commitments regarding this report as well as general activity related to competencies.  The current list of competencies is just a compilation of information and was intended only to be a comprehensive collection of available lists from the wide range of public health fields.  The list still needs to be refined, better organized, and reviewed with more rigor.  Formal evaluation is also needed to ensure that no groups are excluded to develop the list as a useful reference document.

The Council subcommittee on competencies had formerly suggested hosting a two-three-day national meeting to specifically focus on competencies.  The proposed agenda would include part presentation but also real work on unifying competencies in order to produce a set of national, comprehensive documents.  As evidenced by increased activity by individual groups moving ahead to develop more competencies, there is high interest in the field.  The Council reconfirmed its interest and it was decided that the Council subcommittee would meet again to revisit this issue and discuss further ideas such as developing a planning committee and more specific agenda items for the national meeting.

During the discussion of competencies, Dr. William Keck raised the issue of accreditation.  A few years ago, APHA looked at the process of credentialing public health professionals but did not have the current resources and information available and was not able to conclusively resolve the issue.  Recently, NACCHO, CDC, and PHF began examining the feasibility and desirability of voluntary accreditation for local health departments.  It was decided to further explore this issue and its relevance to Council activities at a future Council meeting.

C. GPHE funding
Ms. Keimowitz reported that ACPM, in partnership with ATPM and ASPH, have realized some success in utilizing preventive medicine residencies in advocating funding for non-hospital based residencies.  ACPM’s contractual lobbyist has accomplished a tremendous amount of legislator education.  In addition, language was included in the 1998 balanced budget act that encouraged examination of providing support to preventive medicine residencies.  ACPM is currently re-evaluating their level of lobbyist activity as well as exploring other options such as partnering with teaching hospitals, serving as a consortium, and putting forth more legislative language.  ACPM has learned that it is vital for public health to substantiate how Medicare funds will actually benefit Medicare recipients.  Although several rationales exist, ACPM and its partners are developing a more rigorous methodology for identifying how the funds and recipients are related and how to present the information.

ACPM requested that the Council continue to endorse their activities in pursuing GPHE funding as needed, particularly tracking issues and providing letters of support for any proposed changes.  With the exception of AAHP and the QUAD Council, member organizations of the Council have been involved in the process and have been able to provide formal support without any conflict of interest.

 

IV. Linkages Activities

A. Promotion & Tenure Survey
Ms. Alison Wojciak, director of Practice Programs for ASPH, presented an update on the baseline information gathering survey on promotion and tenure conducted earlier in the year.  For the purpose of this study, ASPH defined public health practice as activities that involve teaching and research that responds to the specific public health practice needs of an organization and is performed alone or collaboratively with state, local, federal and community-based organizations to:

• assess public health problems;
• develop public health policies and programs;
• assure the delivery of public health services; and
• advocate for solutions to public health problems or workforce needs.

Approximately 75% of public health practice coordinators responded.  The results did not show a particularly "bright picture" about how public health practice is considered among tenure criteria at the represented schools.  It was discovered that a major barrier is the lack of a good working definition of public health practice and how to successfully accomplish activities within schools.  At the upcoming deans meeting, ASPH plans to present the survey results and advocate to continue pursuing change.  Faculty at various schools are currently developing a white paper and ASPH proposes to work extensively with the practice coordinators in order to initiate action by next summer.  The white paper will attempt to define public health practice in terms of strategic issues to help coordinators elevate practice within schools and build a consensus definition of academic public health practice.

B. Distance Learning:
Mr. Ron Merrill reported that as CDC’s Public Health Training Network (PHTN) is currently in transition. CDC and HRSA are jointly exploring the possibility of incorporating more fields into distance learning, such as rural health training, geriatrics, and telemedicine, and creating a uniform system of registration, credit, and credentialing.  Coordination of existing organizations and programs providing training is still tenuous and support from groups such as the Council would be helpful in furthering development.  After discussion of the draft letter of support, Council members decided that the letter needed to be more focused in content and intent such as a specific list of intended recipients.  Council staff will initiate discussions with CDC to clarify the issue(s) that the Council should support and prepare a revised letter to be disseminated to Council members for approval prior to the next Council meeting.

C. Public Health Meetings
Mr. Bialek reported that Council staff have been active in promoting linkages by creating more visibility and presenting information to the public health community.  Both Council members and staff made presentations at the annual NACCHO meeting and more recently at the Illinois/Missouri Public Health Association annual meeting.  In addition, the Council has been involved in developing and/or co-sponsoring sessions for the annual APHA meeting.  These sessions will provide opportunities for feedback related to collaborations with programs in state and work force competencies issues.  The Council endorsed continued involvement in presenting linkages information at these and other public health organizations’ meetings.

 

V. Organizational Updates

The following organizations presented updates focusing on linkages between their members and the "other side" (practice or academia) in addition to activities of individual organizational members and with national organizations.

ASTHO
Ms. Darcy Steinberg reported that ASTHO is actively working with the University of Illinois Chicago to conduct a survey focused on collecting information about ongoing linkages with state health departments and academia; ASTHO plans to highlight the results of the survey in their newsletter.  The Partnership for Children’s Health project involves working with universities and actively going into the community; a jointly sponsored conference will be held in Spring 1998 to highlight the related linkages activities.  ASTHO also recently supported the American Association of Health Education (AAHE) resolution regarding teacher’s preparation for health education, particularly elementary and middle school teachers.

SOPHE
As a potential member organization of the Council, the executive director of the Society for Public Health Education (SOPHE), Ms. Elaine Auld, presented a brief overview of the organization to the Council as well as relevant linkages activities.  The mission of SOPHE is to promote health through education and promotion of quality research, good quality practice, professional preparation, and advocacy on health education and public health issues.  Membership is comprised of academic researchers and practitioners.  Linkages are part of SOPHE’s strategic plan that has been operationalized beginning with a CDC-sponsored research agenda, which identified areas of linkages to be strengthened. SOPHE also supports and promotes linkages through a practice notes section in its journal (approximately 3-4 articles per issue) and a section in its newsletter called "tools of the trade" that provides ideas on how to provide ideas to research as well as involve researchers in practice.  Other activities include a joint HRSA/JHU project to look at graduate training needs in professional health education and a joint project with AAHE to publish graduate standards for health educators.

ATPM
ATPM continues to promote linkages by training health professionals (mainly nurses and physicians) in public health practice.  Under a 5-year cooperative agreement, ATPM will work with HRSA to explore curriculum development for health practitioners.  A second cooperative agreement with HRSA and USDA requires a joint effort with the EPA to improve diagnosis and pesticide exposure.  ATPM also reported that the organization had rented three booths at the APHA meeting to highlight and promote membership, the immunization project (joint medical and nursing education), Internet-based courses, and the Council of Graduate Education in Public Health.

APHA
Although APHA has not established formal linkages, its Public Health Innovations Project funded by CDC is working to provide public health practitioners with information, tools, and skills.  A workshop held in September was designed to help practitioners and academicians in translating data.  APHA is also developing a second workshop for late winter and conducting several related sessions at the 1997 annual meeting.

ASPH
The linkages activities of ASPH include:

• working with West Virginia and Vermont to develop certification standards based on core public health concepts;
• continuing to sponsor the graduate internship program with CDC.
• implementing another graduate internship program — the first year of this program will be based at the Bureau of HIV/AIDS;
• coordinating the Council of Public Health Practitioners — specifically, planning a summer workshop in Ann Arbor; and
• sponsoring a session at Prevention ’98 to highlight prevention/research linkages and developing these talks into papers for inclusion in an American Journal of Preventive Medicine supplement.

QUAD Council
The QUAD Council is actively working on linking schools of public health and schools of nursing, particularly as related to environmental health.  During the past year, an advisory committee was convened to identify areas in environmental health where assistance is needed. Through collaboration with the Robert Wood Johnson Foundation (RWJ), the QUAD Council plans to invite nursing representatives to examine how the move into the community is affecting nursing education curriculum.  Other future plans include conducting an invitational summit to identify the unique offerings of nursing and to invite non-nursing professionals such as Council members, to facilitate discussion of related field issues.  According to a 10-year cycle to revise the scope of practice, the American Nurses Association is developing a white paper to examine separating public health from home health and long-term care.

ACPM
ACPM continues to work towards developing competencies in medical management to help physician specialists.  The organizations is also planning a workshop for preventive medicine program directors along with its 5th annual workshop (Prevention ’98) to look at a variety of issues including linkages.  In addition, ACPM has been involved in developing and refining a curriculum on indoor air pollution.

HRSA
Recent HRSA activities have almost exclusively focused on promoting organizational and contextual linkages.  One example is the development of a public health dentistry program. More information will be provided in HRSA’s written linkages update.

NACCHO
Please see attached handout.

CDC
Along with HRSA, RWJ, and Kellogg, CDC has focused recent efforts on examining the feasibility of a management institute similar to the Public Health Leadership Institute (PHLI).  The program would target mid-level staff working in areas such as grants or human resources to provide practical ways and skills for improving management. More information will be provided in CDC’s written linkages update.

 

VI. Council Objectives

The Council briefly discussed the current goals and objectives approved October 1996. Besides noting minor revisions to dates and timelines, it was agreed that a fuller discussion should be held at the next meeting so that more Council members can be present and actively contribute to the updating process.

A related topic discussed was providing copies of the Public Health Infrastructure Workgroup draft report to Council members for comment. After individual members have had a chance to review the material, the Council may develop a group paper/opinion, possibly suggesting criteria for weighing the objectives proposed.

The Council also discussed the value of an accredited degree in public health.  Dr. Keck suggested adopting a strategy such as looking at practice agency components in formulating criteria.  It was also suggested to further examine the accreditation of public health programs, agency accreditation, and CEPHE criteria and discuss at a future Council meeting.  As previously noted, relating public health competencies to the accreditation process may warrant further Council discussion and involvement.

VII. Administrative Business

A. Upcoming Meetings
As a point of discussion, Dr. Lipsman proposed scheduling the Council’s next year’s meetings in conjunction with Prevention ’98 (San Francisco) and the annual ASTHO/NACCHO (St. Louis) and APHA (Washington, DC) meetings.  Council staff will follow-up with individual members to solicit information regarding interest in coordinating with these three meetings, availability of staff to attend, and potential external funding sources for travel to these meetings.

B. Travel Policy
The draft distributed with the meeting materials will become the de facto policy until further revision is warranted.

C. The Link
In addition to announcing the contents of the upcoming issues of The Link, meeting participants discussed possible themes for future issues.  The list of potential topics include: competencies, accreditation, field testing public health practice guidelines, Healthy People 2010 infrastructure, and publishing practice-based articles.  Using The Link as a vehicle for publishing opinion-based work was also discussed.

D. Promotion/Marketing
In order to create a more distinct and known identity for the Council, plans are in place to develop a website as well as some print materials.  Both APHA and Public Health Functions Working Group volunteered to permit the Council to use space on their web sites.  It was also decided that once the web site is operational, member organizations would provide links from their web sites.  In addition, posting The Link on-line was discussed as another possibility.