CDC/HRSA/ASPH Meeting Preparedness Education and Training: Where We Are September 20, 2004 Lynn Rothberg Wegman, M.P.A. Director, Division of State, Community, & Public Health (DSCPH) Bureau of Health Professions (BHPr) Health Resources and Services Administration (HRSA) Department of Health and Human Services (DHHS)
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CDC/HRSA/ASPH Meeting Preparedness Education and Training:
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CDC/HRSA/ASPH MeetingPreparedness Education and Training:
Where We Are
September 20, 2004
Lynn Rothberg Wegman, M.P.A.Director, Division of State, Community, & Public Health
(DSCPH)
Bureau of Health Professions (BHPr)Health Resources and Services Administration (HRSA)
Department of Health and Human Services (DHHS)
HRSA’s Bioterrorism Training and Curriculum
Development Program (BTCDP)
Education and Training Activities at the State and Local Levels
Public Health Security and Bioterrorism Preparedness and Response Act of 2002
Public Law 107-188, Section 319F (g) Signed June 12, 2002 for FY 2003-2006 Bioterrorism Training and Curriculum
Development Program (BTCDP)
Bioterrorism Training and Curriculum Development Program
Recognize
Alert
Treat
Participate
Purpose
Development of a health care workforce that possesses the Knowledge Skills, and Abilities (KSAs) to:– Recognize indications of a terrorist event
– Treat patients and communities in a safe and appropriate manner
– Participate in a coordinated multi-disciplinary community response
– Alert the public health system rapidly and effectively
Two Separate BTCDP Components
Provision of Continuing Education for Practicing Providers
Curricular Development/Enhancement in Health Professions Schools
Courses/Training Offered Number of CE Awardees: 19 Number of CE Respondents: 14 Most Popular Topics (Descending order) Basic Preparedness Bioterrorism Chemical Radiological Nuclear Incendiary NIMS Infrastructure Stockpile Hospital Emergency Communications
BTCDP FY 2003 Available funds: $26.5 M
– Total CE: $22.2– Total CD: $4.3
Awards: 32– Total CE: 19 Avg. Award: $1.2 M– Total CD: 13 Avg. Award: $351, 000
Estimated Trainees*: 193,314– Total CE: 173,786– Total CD: 19,528*Estimates are from entire two-year project period
CE = Continuing EducationCD = Curriculum Development
Continuing Education Linkages
Linkage with: Number:HRSA Hospital Preparedness Program 17
States with both CE States with both CE and CD Awardeesand CD Awardees
PRTXTX
ARARTNTN
VAVA
OHOH
NYNY
NENE
MTMTWAWA
CACA
ILIL
HIHI
NJNJ
NMNM
COCOKSKS
OKOK
NDND
SCSC
PAPA CTCT
WVWVKYKY
Needs Assessment
Funded programs are refining the initial needs assessment by carrying out the following:– Collaborate with other DHHS Programs
• Centers for Disease Control and Prevention (CDC) Public Health Preparedness and Response for Bioterrorism Program
• HRSA Bioterrorism Hospital Preparedness Program
– Utilize BHPr data sources regarding licensed health professionals in state
– Identify gaps: • Disciplines/trainees that have not received CE• Disciplines which have not developed core competencies for
bioterrorism preparedness training
Evaluation
Tied explicitly to project objectives
Will specify what data will be collected and the method for collection
Utilize existing discipline-specific competencies for bioterrorism preparedness training to:– Measure and evaluate the objectives and outcomes presented in
curricula and training courses– Measure and evaluate the demonstrated knowledge, skills, and
abilities of trainees in response simulations/drills/exercises
Topics/Subjects Most Frequently Offered by CE Awardees
Face-to-Face Self-Paced Web-Based Tabletop Drills and Exercises
TOTAL CE/CD PARTICIPANTS
Target ProfessionsEstimate of Total
CE TraineesEstimate of Total
CD Trainees
Health Center Administrators 624
0
Allied Health Providers 11,887 6,731
Nursing 68,660 3,385
Medicine 36,375 4,818
Nurse Practitioners 7,508 593
Physician Assistants 2,773 574
Dentists 3,317 693
Pharmacists 5,982 1,624
Mental Health Providers 7,392 0
Public Health Providers 2,091 430
EMS 16,043 285
Veterinarians 508 0
Others 10,626 395
Total 173,786 19,528
Total Trainees 193,314
Bioterrorism and Emergency Preparedness Training in Aging
(BTEPA)Curriculum Development Projects
HRSA’s Geriatric Education Centers Initiative on Bioterrorism
Bureau of Health ProfessionsDivision of State, Community
and Public Health
Geriatric Education Centers
Geriatric Education Centers strengthen interdisciplinary training of health professionals to diagnose, treat, and prevent disease and other health problems that older people face
FY 2004 $19 million
47 Geriatric Education Centers
Geriatric Education CentersStatutory Purposes Improve the training of health professionals in
geriatrics Develop and disseminate curricula on the
treatment of health problems in elderly individuals Train and re-train faculty to provide instruction in
geriatrics Support continuing education for health
professionals who provide geriatric care Provide clinical geriatrics training in nursing
homes, chronic and acute care hospitals, ambulatory care centers, and senior centers
Need for Education and Training of Health Professionals in Bioterrorism and Aging
9/11/01, anthrax scare, and IOM report on BT Internet search produced 314,000 references on bioterrorism Citations focused almost solely on the 6 Class A Agents
identified by CDC Few mentioned the special needs of frail elders living alone or
in long-term care facilities <50% HCPs have had BTP training, only 1 in 10 have
geriatrics-related BTP HCPs, administrators, 1st responders and ED staff need
training in treatment and geroethics of triage
Physiological changes in older people = increased risk of illness / injury with attention to down-regulation of immune system
Altered presentation of illness – e.g., infection, myocardial infarction, and temperature regulation
Public health principles such as herd immunity, vectors of disease, spread and containment
Environmental settings in which older persons reside – weaponized flu and SARS
Key Principles and Components to BTEPA Approach
Surveyed older adults as to their levels of concern and knowledge
What they would do if they felt ill or heard of an attack
Whether they have ever discussed this with their health care providers
What they want from their health care providers to prepare
Needs Assessment: Bioterrorism and Emergency Preparedness in Aging
N = 55, average age 71 High level of concern and knew about anthrax and
smallpox 75% would go to hospital or ED or see MD if they
felt ill None had discussed this with their HCP’s Majority would rely on HCP’s to give them the
information they need on bioterrorism preparedness
Results of Needs Assessments of Older People
Surveyed health care providers as to:
Adequacy of profession’s/community’s preparedness to care for older people in times of bioterrorism and natural disasters
Their formal training in bioterrorism and whether there was aging-specific content
Education/training they need
Who they would call for help
Needs Assessment: Bioterrorism and Emergency Preparedness
N = 50 Profession’s/community’s preparedness for
bioterroism
-- 3.53 (1=inadequate, 9=fully adequate) Profession’s/community’s preparedness for a