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Developing Internal Quality Improvement and Performance Management Training Modules

Developing Internal Quality Improvement and Performance Management Training Modules Training modules can enhance staff capabilities in quality improvement and performance management methodologies, improving organizational efficiency and effectiveness. Training modules can enhance staff capabilities in quality improvement (QI) and performance management (PM) methodologies, helping to improve organizational efficiency and effectiveness. Developed in partnership with the New Mexico Department of Health (NMDOH) and the Public Health Foundation, this guidance document outlines a structured approach to developing QI and PM training modules, based on NMDOH's experiences and lessons learned. By following the adaptable processes within, agencies can effectively plan and implement training initiatives tailored to their workforce's unique requirements. Get the full Policy Guide in English (PDF) » Descarga la versión completa de la guía en español (PDF) » website yes

Implementing Health in All Policies in the Climate Space

Implementing Health in All Policies in the Climate Space ASTHO, Association of State and Territorial Health Officials, HiAP lens, Health in all policies, climate change, climate space, flooding and rain, extreme weather, extreme heat, wildfire damage, seven strategies, Texas workgroup, national disaster operational workgroup, Washington state department of health, emergency preparedness and response, hiap implementation, Wisconsin department of health services, new mexico taskforce, interagency climate change taskforce, climate action teams, Climate and Health Capacity Survey, HiAP Task Force; Climate Change Commission, Resilience Initiative Kerry Wyss, Ali Aslam ASTHO | A Health in All Policies approach can help public health agencies better address the impact of climate change on population health and well-being. Each year, we face hurricanes, floods, extreme heat events, destructive wildfires, as well as other natural disasters and homeland security threats that test the resiliency of state, territorial, and freely associated state agencies and the communities they serve. To address the health threats posed by natural disasters and by climate change, more health agencies are integrating a Health in All Policies (HiAP) approach. This cross-sector approach can make these climate efforts more effective and impactful, and help promote health equity and optimal health. This report outlines strategies for health agencies to apply the HiAP lens and utilize cross-sector collaboration to optimize their climate and health responses. Get the Report (PDF) website yes

Investing in Indiana’s Public Health Infrastructure Through Community-Driven Policy Change

Investing in Indiana’s Public Health Infrastructure Through Community-Driven Policy Change public health infrastructure, community driven policy, indiana state health commissioner, public health system, indiana department of health, outpatient facilities, technical assistance, data and information integration, emergency preparedness, child and adolescent health, legislative action, state and local elected officials, health problems, health care, health system, health departments, federal agencies, essential public health services, centers for disease control, state and local levels, health outcomes, health organization, covid-19 pandemic, health infrastructure, promoting health, public health organizations, states public health, federal funding, astho, association of state and territorial health officials Maggie Davis, Keith Coleman Indiana enacts historic public health funding through community engagement and legislative support. In April 2023, Indiana passed bill SB 4, which was a historic investment in the state's public health funding and restructuring its public health system. This case study shares how the Governor's Public Health Commission and the Indiana Department of Health approached community listening sessions, formulated recommendations, and successfully built legislative support to reform the public health system in the state. Get the Report (PDF) website yes

Strengthening the Public Health and Health Care Workforce

In-depth analysis on state health policy surrounding the public health workforce. This is part of ASTHO's annual legislative prospectus series.

National Preparedness Month: Recognizing Public Health Preparedness

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Fortunately, looking at the ASTHO Directors of Public Health Preparedness (DPHP) peer group and seeing the great work of public health emergency preparedness and response programs across the nation, we recognize that there is much to be celebrated this month—but also much more work that needs to be done.

ASTHO's 2024 Legislative Session Update: Part Two

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ASTHO's 2024 Legislative Session Update: Part Two Beth Giambrone, Maggie Davis, Christina Severin ASTHO's Public Health Legislative Update on Tobacco, Mental Health, Environmental Health, Workforce, and Containing Infectious Disease By the end of April, at least 36 states will have concluded their regularly scheduled 2024 sessions, with several states passing laws on important public health issues. Earlier this month, ASTHO provided a brief update on five of the top 10 public health state policy issues to watch during the 2024 state and territorial legislative sessions; this update examines the remaining five. Containing the Spread of Infectious Disease Public health agencies have a responsibility to keep their communities safe and healthy by maintaining foundational public health services including identifying, containing, and preventing the spread of communicable disease. ASTHO supports maintaining and guaranteeing robust public health legal authorities allowing public health leaders to meet their responsibilities for containing the spread of infectious disease. Following the COVID-19 pandemic, state and territorial legislatures considered many bills to change public health agency’s legal authorities to meet their responsibility, a trend that ASTHO anticipated continuing into 2024. So far, at least 28 states have considered, and at least two legislatures passed, bills relating to public health authority to address the spread of infectious disease in 2024. For example, the Hawaii legislature passed SB 3122, expanding public health authority by providing the state health official broad authority to issue standing orders for people 18 years and older to receive evidence-based services recommended by the U.S. Preventative Services Task Force. In March, however, Utah enacted HB 405, which limits local public health official’s authority to issue an isolation or quarantine order to specific conditions unless the local legislative body agrees that a new, drug resistant, or reemerging pathogen likely to cause high mortality or morbidity needs containment. Environmental Health Under the Safe Drinking Water Act, the EPA has the authority to set national standards for public drinking water. These standards establish legally enforceable Maximum Contaminant Levels (MCLs) and non-enforceable Maximum Contaminant Level Goals for public water systems. In April 2024, EPA released a final rule establishing legally enforceable MCLs for six PFAS compounds that occur in drinking water. Public water systems have until 2027 to complete initial monitoring and inform residents of the levels of PFAS in their water, and until 2029 to act if their drinking water levels exceed the MCLs. To date in 2024, at least four states have enacted or are considering legislation that would aid in monitoring and remediating PFAS in drinking water. Virginia recently enacted HB 1085/SB 243, which requires that the Department of Health notify the Department of Environmental Quality (DEQ) of any results from their monitoring of public water systems that show MCL exceedances, at which time requires DEQ to implement a plan to prioritize and conduct assessments of the public water system's raw water source(s). The Rhode Island House of Representatives passed H 7439, which would require the Department of Environmental Management to determine the maximum number of PFAS detectable by standard laboratory methods, and specifies the types of water systems that will be required to monitor untreated drinking water for those PFAS by June 1, 2025. Massachusetts is considering H 853, which would require the Department of Environmental Protection to maintain a list of municipalities where PFAS levels exceed the MCL and provide vouchers to homes in those municipalities to purchase home water filtration equipment. Strengthening the Public Health Workforce With several successes in 2023, ASTHO anticipated legislatures to continue considering legislation to strengthen the public health and health care workforces that represent the communities they serve during the 2024 legislative sessions. One strategy is establishing career pathway programs that provide students training and support to pursue public health careers. At least six states have considered, and three have passed, bills creating or strengthening a career pathway program during the current legislative sessions. At least two states have enacted programs to address health care provider shortages in April. Maine’s legislature passed LD 2268, which would allow internationally trained physicians to receive a limited license to practice medicine and address provider shortages in rural areas of the state. Washington enacted SB 5582, directing community and technical colleges to develop a plan in consultation with local workforce development councils and health care employers to train more nurses over the next four years. In May, Hawaii’s legislature passed HB 1827 appropriating funds to support public high school health care workforce certificate programs to support graduates seeking entry-level positions in the health care industry. Supporting Mental Health Children and adolescents continue to experience mental health issues, with teen girls reporting significant challenges. Schools can play an important role in supporting the mental health of all students through direct services or policies that address prevention, education or coordination. In 2024, a number of jurisdictions considered legislation related to youth mental health, through training requirements for staff and students, and support for treatment flexibility in the school setting. At least six jurisdictions considered bills related to mental health education for students, including specific suicide and violence prevention content. Virigina enacted HB 603, which requires school health instruction to include information about common mental health challenges, helpful coping strategies, the importance of seeking help from a professional or other adult, and available school resources. Several jurisdictions, including Virginia (HB 224), Minnesota (HF 4363) and Missouri (HB 2471), also considered establishing or amending suicide prevention and related mental health training programs for teachers and other school staff. Finally, several jurisdictions considered legislation to explore or otherwise support using telehealth services in schools for mental health services. Minnesota is considering legislation that would create a pilot program to determine whether the availability of telehealth services in schools increases mental health access (SF 4236) as well as a requirement to provide space at secondary schools for students to receive telehealth mental health services (HF 3542). New York is currently considering S 8976, which would authorize telehealth services in schools to be delivered by licensed providers, while Maryland enacted HB 522 in April, which requires school districts to develop guidelines to allow telehealth appointments at schools starting in the 2025-26 school year. Tobacco and Nicotine Products According to the American Lung Association, 22 states do not have comprehensive smoke-free laws that help protect against the dangers of second-hand smoke in a variety of settings (e.g., multi-family homes, public spaces, restaurants), or reduce the number of people who start smoking. At least 16 states have introduced legislation aimed at creating, promoting, or expanding smoke-free environments. Connecticut recently enacted SB 132, which expands their clean indoor air act to prohibit vaping at dog race tracks. The Maryland legislature passed HB 238/SB 244, which would update their Clean Indoor Air Act to prohibit vaping in public indoor areas, indoor places of employment, and mass transportation. In addition, the Alabama Senate recently passed SB 37, which would prohibit vaping in public places. In addition, at least 14 states have introduced legislation to either prohibit or further restrict the sale of flavored tobacco products, including menthol products. For example, bills introduced in Hawaii (HB 2441/SB 3130), Minnesota (HF 2177/SF 2123), and New Jersey (S 1947) would prohibit the sale of flavored tobacco products, including menthol, within their jurisdiction. In addition, a bill in New York (A 699/S4477) would ban the sale of flavored smokeless tobacco products within five hundred feet of a public or private school. ASTHO’s state health policy team continues to monitor these important public health issues and will provide relevant updates. website yes

States Assessing and Mitigating Risks of Agencies Using Artificial Intelligence

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This blog post discusses mitigating risks of AI use in government agencies, emphasizing privacy, transparency, and ethical concerns.

Leading from the Inside: Advancing DEI at the State Level

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Leading from the Inside: Advancing DEI at the State Level astho, association of state and territorial health officials, workplace cultures, financial performance, creates a positive, diversity equity and inclusion dei, united states, work life balance, hiring process, human resources, organizational culture, top talent, team members, employee engagement, recruiting process, long term, public health worker, socioeconomic status, races ethnicities, retain employees, company s culture, diversity equity inclusion, public service, recruitment retention development, public health workforce, work culture, organizational values, diversity matters James Bell III Three steps on how to implement DEI strategies at the organizational level. Campaigns for racial justice have grown throughout our country, and parallel conversations focusing on diversity, equity, and inclusion (DEI) have increased, especially in public service. We experience this effect through the lens of facilitating more equitable and responsive service delivery. Our programming, policies, and data must be culturally informed and relevant. But DEI must also be valued internally in how we contribute to employee recruitment, retention, and development. Today’s workplace is complex, and DEI is vital for improving outcomes for all the populations we serve. Most modern organizations have come to terms with the critical need for DEI initiatives. The evidence highlighting how these efforts can improve an organization’s productivity, creativity, retention, and financial success has been clear for some time. But, honestly, is that enough? And why haven’t we made the earth-shattering changes we all know are possible? Perhaps it could be traced back to the changes we hope to seek being assigned outside of our organization when it should be us who are leading and implementing change. Breaking down siloes for diversity requires new ways of working with fewer barriers among and across teams and their unique people. To remove these perceived barriers, I propose that a few key steps must take place. 1. Put the people first. I have been in too many meetings where employees are considered “resources” or “FTEs,” and it’s so unfortunate. As advantageous as it may be for some, the lure of DEI as a return on investment cannot be the sole purpose for pursuing such initiatives. We lose the essence of humanity and unique individuality that makes diversity so special when we limit people to a box on an organizational chart. If governments want to attract and retain the best possible talent, the actual business case to make is talent itself. Building a diverse and inclusive culture cannot only be a human resources function or a top-down effort. All people across departments should see themselves reflected in this work and be able to identify a path to make it their own. As leaders, we should work relentlessly toward understanding the needs of others while building a safe environment for the type of collaboration needed to solve complex problems better. This means constantly learning and embracing new concepts, ideas, and ways of doing things. Each of us has the power to create a more substantial, fairer workplace where everyone can contribute their strengths, talents, and ideas while being treated with dignity and respect. 2. Back your program with a budget. Organizations have shouted their pledges and promises to foster more diverse, equitable, and inclusive environments from any rooftop they could find for at least three years. Although determining which groups are walking the walk is challenging, a strong indication of one’s commitment is to look at budget line items. A lack of or limited budget is an immediate red flag that conveys that DEI is not a priority. Just like anything else, if something is important to you, you will spend the money required to implement it properly. One of the best ways to demonstrate your commitment to DEI is through sustainable, tangible financial investment. This allows our DEI initiatives to be continuous and to evolve over time based on the immediate need. We are not in a position to check the box or allow one implicit bias course to cover all the broad gaps we are experiencing. There is also the benefit of a broad supply of qualified DEI practitioners and consultants who are experienced in guiding organizations through complex DEI issues. Should we continue to face complicated and longstanding DEI issues, it isn’t up to our staff to try to resolve them. We must assign monthly, quarterly, or annual monies to address these problems. 3. Hold yourself and your organization accountable. Regardless of agency or size, DEI efforts within organizations often lack strategic follow-through and accountability. These endeavors are often reactive, episodic, or only prioritized after a public relations crisis. We can’t only respond when we are required to respond. The communities we serve—and our employees—expect that we will carry out our responsibilities and fulfill our promises. We have not consistently been diligent in creating mechanisms for feedback, and if we have, we fail to implement them. To truly embed DEI into our culture, we need meaningful metrics and the willingness and courage to use the data to hold ourselves accountable. How will we ever know if we are going in the right direction or making desired changes if we never discuss the data? And that isn’t to say results must be perfect because we know changes take time. But it communicates clear goals and allows for solid focus and discussion for alignment. This disclosure is necessary to drive change and inspire others by demonstrating that progress is possible. The future of state government must fully embrace diversity, equity, and inclusion both as an aspiration and as a responsibility. We must create a sense of belonging and environment for organizational justice, even if this means resisting the status quo that we have nurtured and become far too comfortable letting stand. We should be celebrating rather than marginalizing employees because of their individuality. We should be challenging business practices that undermine our organizational values and fail to treat employees equitably. Author card spacing 1 Related Content-Blog - DELPH Magazine 2 website yes

Building Public Health Leaders: Voices from Public Health AmeriCorps

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Voices from Public Health AmeriCorps (PHA) offer insights into the benefits gained at PHA and detail the program's experiential learning and professional development opportunities.

What to Know About the American Rescue Plan

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One of President Biden’s first actions just before being sworn into office was to draft up the American Rescue Plan, a sweeping proposal that ASTHO has committed to working with the Biden Administration on. The proposal offers a national vaccination plan, a promise to address COVID-19 health disparities, and efforts to prioritize the expansion the public health workforce. This post details some of the high-level takeaways, as they relate to public health.

How State and Territorial Health Departments Can Navigate Recent Executive Actions

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One of tools presidents have to implement and drive their strategy are executive actions. Executive orders and presidential memoranda carry the force of law and allow presidents to move quickly, deliver a clear message, organize the functioning of the executive branch, and spotlight critical issues with declarations of commemorative observances.

A New Approach to Breaking the Cycle: Creating a Shift in Emergency Medical Services to Address Substance Use Disorder

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If EMS can change the perception of patients with Substance Use Disorder, they will see that building rapport and encouraging the patient to seek help from resources they provide can be mutually beneficial. For EMS, it reduces the call volume, and often the financial cost, of repeated responses for the same patient—and the patient gets the help they need to break the cycle of substance dependence.

Congressional Efforts to Bolster Contact Tracing Workforce

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As the response to COVID-19 transitions from response to recovery, advocacy efforts continue to intensify on Capitol Hill, to help shape negotiations on the fifth emergency supplemental package.