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How Washington State Leverages Data to Improve Emergency Preparedness

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How Washington State Leverages Data to Improve Emergency Preparedness Erin Laird Learn how Washington State has created a robust system for distributing public health and medical supplies during emergencies. When an emergency strikes, supplies like personal protective equipment (PPE) need to be deployed rapidly and strategically. Local, state, and federal partners must work together to identify and meet community needs—a process that requires timely access to actionable data about medical countermeasures and other vital public health supplies. State health agencies need to know how many public health supplies are on hand so they can make informed decisions and react to developing situations. In March 2024, ASTHO, with support from the Administration for Strategic Preparedness and Response (ASPR) and HHS Coordination Operations and Response Element, selected three state health agencies—Ohio, Massachusetts, and Washington—to identify and pilot scalable solutions to improve data and information sharing for public health response. ASTHO conducted a site visit to the Washington State Department of Health (WA DOH) in June 2024 to learn about their medical logistics center and observe the first in a series of regional tabletop exercises—Highly Efficient Local Logistics Operations Tabletop Exercise (HELLO TTX)—they conducted to better understand logistical considerations of requesting, receiving, and distributing PPE and medical countermeasures and tracking last mile distribution. Medical Logistics in Washington State: Moving Faster to Save Lives Key Term - Blog - How WA Leverages Data to Improve Preparedness The Washington State Medical Logistics Center plays a pivotal role in emergency response, supporting WA DOH’s ability to quickly distribute vital supplies and medical countermeasures before and during major incidents. Through the COVID-19 response, the WA DOH medical logistics effort expanded to include vehicles, systems, and a 198,000 sq. ft., temperature-controlled warehouse. This effort ultimately supported WA DOH’s ability to distribute over 150 million gloves, 66 million surgical masks, 30 million N95 respirators, and other vital supplies throughout the COVID-19 emergency response. This increased logistical capacity has allowed WA DOH to respond to many other events. In 2023, in response to wildfire smoke, WA DOH distributed 850 air cleaners across the state in just two days to support points of dispensing (PODs) in tribal communities. The Yakima Fire Department experienced an opioid overdose outbreak in September 2023 and WA DOH coordinated statewide to identify supply of naloxone and support mutual aid. Finally, in May 2024, WA DOH distributed 96 portable air cleaners and pallets of N95 respirators to the Benton Franklin Health District to support POD operations for communities with air quality impacted by the Lineage Cold-Storage Fire. Receiving, storing, and distributing medical countermeasures and other supplies requires strong data management systems and practices. WA DOH strives for a collaborative approach to enhance data management for logistics. By facilitating bidirectional data sharing among health care, emergency management, public health, and tribal partners, WA DOH aims to enhance its ability to track assets and “last mile” logistics. To this end, WA DOH conducted a series of in-person tabletop exercises (TTXs) with each region of the state. These TTX discussions focused on the logistical considerations of requesting, receiving, and distributing PPE and medical countermeasures using a scenario of a novel influenza outbreak. Leveraging TTX Discussions to Understand Local Logistics Washington Department of Health staff gathered for a tabletop exercise with ASTHO staff. The tabletop discussions were organized into two modules: Medical Logistics Requesting, and Medical Countermeasures Planning and Last-Mile Distribution. The tabletop discussions focused on understanding how local jurisdictions source, receive, and distribute supplies. Cory Portner, director of WA DOH’s Office of Emergency Medical Logistics, praised the discussions: “The HELLO-TTX series highlighted the power of collaboration and gave us actionable insights into refining our response strategies and logistics operations. Effective communication across agencies is key. As always, at the end of the day it comes down to relationships and knowing who to call.” Many jurisdictions indicated they do not have the space or staff to manage more than a small stockpile of supplies. Once requested from the state, local jurisdictions coordinate with local partners—such as libraries, foodbanks, fire departments, and immigrant assistance centers—to get materials distributed to the community, often using either PODs or using trusted partners to distribute to the population they serve. Space came up as an issue repeatedly, with some jurisdictions utilizing creative solutions such as leveraging storage available at fairgrounds, a county-owned airport, and even an old jail (a solution that raised some unique challenges for receiving). Last mile tracking depended on the type of asset. For example, tracking for PPE typically ended at the community partner level (the agency or site that received the supplies), while tracking for vaccines could show more data on number of vaccines administered by a provider. The focus of last mile tracking for local jurisdictions centered around using last mile information to ensure that the requestors received what was needed. Looking ahead, additional last mile tracking could shed light on equity and a better sense of whether community needs were met, rather than just whether orders were filled. Portner reflected, “HELLO TTX showcased that local partnerships vary widely: larger urban areas typically focus on health care and emergency management organizations, while smaller rural areas engage a broader range of local sectors like fire departments and veterinary services. Medical logistics operations also differ, with urban areas having greater storage capacity and more advanced data tracking, while rural areas face limitations in both. Additionally, local prioritization of PPE and medical countermeasures affects how each area tracks logistics and manages storage.” Looking Ahead This 198,000 sq. ft., temperature-controlled warehouse serves as the Medical Logistics Center for WADOH, housing PPE, medical countermeasures, and other supplies. Effective public health response requires an understanding of what supplies are needed, where they are needed, and to track whether those needs were met. To achieve this, coordination and communication across multiple levels of public health is critical. "Next up, we’re focusing on asset tagging and improving supply chain visibility through enhanced data readiness. Our goal is to create a more transparent and responsive logistics system, to make sure that we’re fully prepared for any future emergencies in support of communities in Washington state and beyond,” explained Portner. The strategies explored by these data readiness pilot sites can improve critical processes and demonstrate sustainable methods to meet the demand of bidirectional information sharing for public health agencies and their partners. article yes

State and Federal Efforts to Bolster the Behavioral Health Workforce

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Learn about state and federal efforts to bolster the behavioral health workforce in response to the growing demand for behavioral health services.

Colorado's New Online Mentorship Initiative Supports Local Public Health Agencies

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Colorado's New Online Mentorship Initiative Supports Local Public Health Agencies Elise Moore Learn how CDPHE developed an online mentorship program to enhance local public health leadership, with tips for other health departments. The Colorado Department of Public Health and Environment (CDPHE) launched their Athena Success Partnering program, an online staff mentorship initiative for local public health agencies. CDPHE's Office of Public Health Practice, Planning, and Local Partnerships (OPHP) developed the program as part of its Executive Director Learning Pathways project, which supports those leading local health agencies in Colorado—especially after many of those leaders faced intense scrutiny during the pandemic. CDPHE used Public Health Infrastructure Grant (PHIG) funds to procure the software to support its online mentorship programs. Several different entities in CDPHE are now using the software for mentoring initiatives, including programs for new hires, human-centered leadership, and peer support. In addition to the Athena Program, OPHP uses the software for a peer connection program for Colorado Chief Medical Officers. Development and Launch of the Mentorship Program An Executive Director Advisory Group helped guide OPHP’s thinking around the options and elements to include in its online mentorship program for local health agencies. The Athena Program provides new and experienced executive directors and emerging leaders the opportunity to form supportive peer relationships for skill development, confidence building, networking, effective agency leadership, and supporting retention efforts. OPHP started by focusing on local public health agency executive directors and has recently opened the program to all Colorado local public health agency staff. The program offers a series of steps or prompts to guide mentors and mentees, with content to last for a year of regular meetings. Some of the automated prompts include ice breakers and questions about communication, goal setting, and leadership. Additionally, the platform has a learning section where users can find articles and resources related to professional development. Participants use the platform for traditional mentoring, and to connect with colleagues with expertise in specific areas. Users can ask questions or request mentorship for specific time-sensitive problems or learning needs. They can also join role-specific groups, such as planners and emergency preparedness and response and resiliency staff. OPHP notes that it took time for staff to develop new habits for using the platform for questions and resource sharing and that some executive directors did not feel qualified enough to become mentors to other executive directors. To address some of these challenges, OPHP created resources and opportunities for users to understand the program's benefits, including a monthly newsletter. In one edition, OPHP outlined reasons to become a mentor—addressing the benefits, time investment, preparation guidance, and qualifications to be a mentor. Program Receives Positive Response Both mentors and mentees in the Athena Program have expressed positive outcomes and benefited from their relationships. Broomfield County Executive Director Jason Vahling shared that he benefitted from the mentor experience. “Initially, I was signing up to be a mentor, but I feel like, at times, we switch back and forth between being the mentor and mentee and learn from each other. It has been great to have a partner outside the metro area to get insights and learn from." Mentorship Platform Evaluation Plans As the program continues, OPHP is using quantitative and qualitative data (e.g., participation counts, user surveys, and key informant interviews) to assess participant engagement. Program administrators are also assessing supports and barriers to participation and whether participation in the mentorship program is helping build essential knowledge and skills in implementing best practices for core public health services and foundational capabilities, management and leadership, and staff support and retention. OPHP’s Advice on Planning an Online Mentorship Program For health departments seeking to build their mentorship platform, OPHP shared a few tips: An advisory group was valuable for program planning. Talk to potential participants about their needs, as these may vary. Be patient and take the long view. Demonstrate how the program benefits both mentors and mentees. Provide various options for engaging with mentoring, peer support, and group interaction opportunities. Future Plans for Strengthening Staff Expertise CDPHE plans to continue leveraging PHIG funding, as well as their academic health department partnership with the Colorado School of Public Health, to offer a program to prepare participants to successfully take the Certified in Public Health (CPH) exam and earn certification with a pilot beginning in January 2025. PHIG recipients interested in learning more about Colorado’s experience can reach out to the team at ophp@state.co.us. Special Thanks-Blog - Colorado's New Online Mentorship Initiative Supports Local Public Health Agencies OE22-2203 PHIG website yes

Leading Health Security Efforts Through Strategic Collaboration and Innovation

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Leading Health Security Efforts Through Strategic Collaboration and Innovation Margaret Nilz This blog post illustrates how health agencies' strategic plans can improve health security and emergency preparedness. Strategic planning is a cornerstone of effective public health systems, guiding organizations in preparing for and responding to health threats. Three pivotal documents—the CDC Office of Readiness and Response (ORR) Strategic Plan, the ASTHO Strategic Plan, and the ASTHO Environmental Scan—are part of the foundation of ASTHO’s work. Each plays a critical role in shaping public health policies and practices. Understanding their synergies and differences is beneficial and crucial for enhancing our collective efforts in safeguarding public health. ASTHO’s Environmental Scan tracks U.S. public health concerns and trends. Through qualitative analyses of select health agency materials and health official feedback, this blog identifies state, territorial, and freely associated state health agencies’ (S/THAs) top current and emerging priorities across public health programs, infrastructure, and health equity and agency strategies to address them. Across 2023 and 2024, S/THAs consistently identified emergency preparedness and response as a critical priority. Callout 1-Blog - Leading Health Security Efforts through Strategic Collaboration and Innovation It is essential to align strategic plans and address emerging public health priorities in order to effectively respond to new health challenges. The ORR and ASTHO Strategic Plans share several common goals, such as implementing equitable, evidence-based practices, partnering for sustainable infrastructure improvements, and focusing on operational excellence while providing technical assistance. However, each plan also has unique missions. Callout 2-Blog - Leading Health Security Efforts through Strategic Collaboration and Innovation ASTHO’s Health Security team has a unit mission and vision that align with ORR goals and focus on supporting the needs of ASTHO members, as identified in the Environmental Scan. Callout 3-Blog - Leading Health Security Efforts through Strategic Collaboration and Innovation Aligning these strategic goals with current public health priorities is crucial in addressing existing and emerging health threats. Values The ORR and ASTHO plans express shared values like collaboration and innovation. These values guide strategic decisions and foster a cohesive public health community. Table-Blog - Leading Health Security Efforts through Strategic Collaboration and Innovation Competencies and Priorities Both organizations focus on developing competencies like leadership and technical expertise. ORR concentrates heavily on competencies specific to preparedness, including planning, response, and research for public health emergencies. ASTHO emphasizes competencies to support S/THAs, such as technical assistance, communication, capacity building, and advocacy. Building and aligning these competencies is essential for improving public health outcomes and ensuring workforce preparedness. With that in mind, ASTHO’s competencies are specifically aimed at aiding and supporting its members, and consequently the nation, in achieving the ORR competencies. Environmental Scan Observations The ASTHO Environmental Scan thoroughly evaluates current public health trends, challenges, and opportunities. Key highlights from the 2023 and 2024 Environmental Scans include: Focus on emerging threats such as infectious diseases and the impact of climate change. Changes in public health funding and resource availability. Technological advancements and their implications for public health practice. Common trends identified include a heightened focus on health equity, the importance of data-driven decision-making, and the need for increased interagency collaboration. Organizational competencies, including performance management and quality improvement, were listed as current priority areas for public health infrastructure and capacity-building. Focus issues include financial infrastructure, business processes, including procurement, recruitment, and grants management, policy development, and public health governance structures. Workforce development was listed as a priority for public health infrastructure and capacity building. Focus issues include recruitment and retention, local academic pipelines and training opportunities, staff compensation, and staff salary gaps. Data modernization and informatics are priority areas in states with state health improvement and strategic plans and were listed as current public health infrastructure and capacity-building priorities. Accountability, performance management, and quality improvement are priority areas in states with state health improvement and strategic plans and were listed as current public health infrastructure and capacity-building priorities. Implementation While ORR and ASTHO aim to achieve similar overarching goals of supporting health agencies, their implementation strategies vary. The ORR Strategic Plan focuses on four primary strategies that directly address the emerging threats and challenges highlighted by S/THAs, including: Modernizing and integrating data and systems across multidisciplinary public health entities to support data readiness and interoperability. Advancing readiness and response science to improve public health practice, including maturing and implementing evidence-based research in preparedness. Building and enhancing the response capability of CDC and state, tribal, local, and territorial health departments and driving collaboration among partners to enable rapid and effective response to public health emergencies through improved capabilities, partnerships, and funding mechanisms. Conducting rapid and ongoing readiness and response evaluation to inform continuous improvements across the detection of public health threats, readiness science, and emergency operations. While ASTHO’s Strategic Plan is less explicitly focused on preparedness, its guiding mission in supporting, equipping, and advocating for S/THOs and their agencies with a focus on leadership development highlights several strategic priorities critical to improving public health preparedness and addressing emerging priorities. Health and Racial Equity: A state and territorial public health system that prioritizes implementing policies and programs advancing health and racial equity to achieve optimal health for all. Workforce Development: A diverse state and territorial public health workforce that is engaged, well-resourced, well-trained, and connected to the communities it serves. Data Modernization and Interoperability: A state and territorial public health system supported by an enterprise-level data infrastructure in which public health data systems are interoperable, secure, and supported by a well-trained workforce. Collaborative Opportunities Maximizing the impact of these strategic plans involves leveraging the strengths of each organization through collaboration and innovation. There are numerous areas where ORR and ASTHO can collaborate to enhance public health outcomes: Joint programs leveraging CDC’s national scope and ASTHO’s state-level connections. Shared research initiatives pooling resources and expertise from both organizations. Coordinated emergency response efforts that create a unified front addressing public health emergencies. By continuing to communicate, these organizations can effectively address complex public health challenges and enhance overall public health resilience. Future Outlook Looking ahead, the strategic efforts of ORR and ASTHO will play a crucial role in shaping the future of public health infrastructure and preparedness. Engaging with and supporting these initiatives is essential for all stakeholders. To adapt to the changing health security threats, future iterations of all documents must be routinely updated to meet the needs of the nation and ASTHO’s members. A collective effort is required to improve public health resilience and response capabilities, ensuring we are well-prepared for future challenges. Ultimately, the synergy between ORR and ASTHO’s strategic plans presents a powerful opportunity to enhance public health outcomes. We can create a more resilient and effective public health system by fostering collaboration, building competencies, and addressing emerging trends and challenges. website yes

Best Practices to Leverage Partnerships to Support Health Equity: An Implementation Cheat Sheet

Formal partnerships between health agencies and private companies can lead to resource sharing, expertise exchange, and improved health services delivery. The strategies outlined in this resource provide a comprehensive approach to enhancing health equity through public-private collaboration.

Healthy People Coordinator Description Template

Healthy People Coordinator Description Template This template was designed to help health agencies craft job descriptions for staff that can effectively incorporate Healthy People 2030 frameworks into public health initiatives. Healthy People is a national framework that fosters a shared vision of public health across the United States. It establishes national priorities every 10 years to guide jurisdiction planning and data collection, which is supported by the HHS Office of Disease Prevention and Health Promotion (ODPHP). The goal of this template is to create a description for the role of Healthy People Coordinator that is adaptable and flexible to meet the needs of health departments and help them identify candidates. This template was designed with the reality in mind that this is an unfunded position, and for many jurisdictions the position itself may be embedded within another position within the department/division or bureau. This description details the knowledge, skills, and abilities for a successful candidate that can be used on their own or added and adapted to fit into an existing and aligned role. The Healthy People Coordinator role has historically had connections to funding for block grants, performance improvement, or other public health infrastructure related projects. How ODPHP Defines HP Coordinators: “The Healthy People State and Territorial Coordinators make Healthy People happen every single day across the United States. Each state or territory has a Healthy People Coordinator who serves as a liaison with the Office of Disease Prevention and Health Promotion (ODPHP). ODPHP works with Coordinators to identify areas of alignment in their work and the Healthy People 2030 goals and objectives. They also collaborate with the HHS Office of the Assistant Secretary for Health (OASH) Regional Offices.” Suggested Position Description and Overview This position will ensure adequate oversight, management, and efficient and effective implementation and integration of the Healthy People framework within jurisdiction-wide, programmatic-specific, and organizational planning efforts. It will also provide support to state block grant programming and accreditation efforts. Suggested Position Duties Support both program managers and division heads in vision and strategy to align their work with the Healthy People 2030 framework. Help to assess and align planning efforts (CHA/SHA, CHIP/SHIP, Strategic Planning) and programmatic work with Healthy People 2030 objectives. Promote the adoption of data-driven and evidence-based interventions and strategies while working to adapt them to jurisdictional needs. Foster collaborative approaches through increased communication and engagement across programs, departments, and local jurisdictions. Engage leadership, community-based and non-governmental organizations, trusted leaders, and the community across multiple sectors to initiate action and educate key stakeholders around the current public health evidence base to inform policies in alignment with the Healthy People 2030 framework. Serve as the liaison to local/regional/state health departments to better align local level planning efforts with state/territory/freely associated state planning efforts. Participate in Healthy People opportunities offered by ODPHP. Suggested Qualifications for Employment Knowledge, Skills, and Abilities Knowledge of national frameworks like Healthy People 2030, as well as social determinants of health, health literacy, and health equity. Skills in performance and quality improvement and planning. Familiarity with use of evidence-based interventions and practices. Ability to manage multiple timelines and projects. Insight, general understanding, and knowledge in strategies to advance equitable health outcomes. Suggested Requirements for Education, Experience, and Competencies Master’s Degree or higher in Public Health or a closely allied field, preferred but not required. Qualifying experience (demonstrated by certificate, course work, or practical experience) in performance and quality improvement frameworks, evaluation, and data interpretation. Extensive written and oral communication skills coupled with demonstrated experience communicating complex topics or issues both verbally and in writing to diverse internal and external audiences across a broad spectrum of managerial, administrative, and professional staff, especially executive-level leaders. Demonstrated experience in the following subject areas: Organizational development. Working with diverse groups, interacting with the community or community partners. Strategic planning. Facilitation and decision-making. Coaching preferred but not required. Demonstrated competencies in the following areas: Self-awareness, self-management, and continual growth and learning. Decision making—the ability to identify issues; develop analyses of alternative positions and impacts; make data-driven, defensible recommendations; take calculated risks based on logical ratio decision-making processes; make timely/responsive decisions; assume responsibility for decisions made; and involve others appropriately in decision-making processes. Working openly and transparently with colleagues and partners, fostering trust and serving as a resource in challenging work environments. Utilizing quality improvement tools and processes in accomplishing work activities and in support of the agency’s mission and goals; this includes seeking opportunities to participate in process improvement activities and initiating efficiencies in how work is accomplished. Showing a commitment to inclusivity, encompassing cultural, racial, ethnic, and gender sensitivity and competency. Organizational and political awareness. Ability to inspire. Practicing ethics and integrity. Utilizing tools for effectively collaborating with a multigenerational workforce. Suggested Preferred/Desired Education, Experience, and Competencies Understanding, skill, and experience in data interpretation/visualization. Proficiency in co-creating organizational strategies and building shared commitments with executive-level leaders and partners. Certification(s) in facilitation, leadership development, change management, quality improvement, or other related topics. Experience working in a public health-related or governmental organization. website yes

Legislative Prospectus: Public Health Workforce

Legislative Prospectus: Public Health Workforce 2022 ASTHO Legislative Prospectus: Public Health Workforce astho, association of state and territorial health officials, association of state and territorial health officials astho, public health officials, state health officials, territorial health officials, island jurisdictions, state health, public health, leading cause of death, mental illness, 10th leading, center for disease control, united states, national suicide prevention lifeline, save lives, suicide prevention resource center, disease outbreak, disease control and prevention, national institute of mental health, preparedness plans, centers for disease control and prevention, mental health conditions, preparedness and response, attempting suicide, mental health problems, health care, evidence base, covid-19, mental health, suicide prevention, pandemics preparedness, behavioral health Years of underinvestment in public health left a fragile public health system to respond to COVID-19 in early 2020. The public health workforce overcame extraordinary conditions responding to the pandemic—working long hours, risking exposure to the disease, and withstanding threats and abuse from the public—which negatively effected the mental health of many public health workers. A Spring 2021 survey of over 26,000 public health workers found that 52.8% experienced symptoms of anxiety, post-traumatic stress disorder, or suicidal ideation. States and territories are considering several policies to support the public health workforce, including efforts to increase the number of public health workers, strengthening protections for workers privacy and safety, and ways to sustain public health funding. Download the Prospectus website

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

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.

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

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