MULTI-JURISDICTIONAL DISEASE INVESTIGATION TRAINING IN THE STATE OF CALIFORNIA Norman Jackson, MS Education Specialist II California Department of Health Services Immunization Branch

Multi-jurisdictional BT Training  What it is  Why it is unique  How you can adapt it  How we’re going to evaluate it California Department of Health Services Immunization Branch 02/05

Multi-jurisdictional Training Presentation Objectives: You will be able  To name two advantages of a collaboration (state/local) approach to bioterrorism training.  To list three organizational steps needed for a just-in-time training.  To name a web resource where the disease investigation webcast is available in Spanish and English. California Department of Health Services Immunization Branch 2/05

High Points  Disease Investigation Training & Exercise Concept  Role of Disease Investigation in Emergency Preparedness  Highlight Collaboration across Focus Areas and Branches  “Just-In-Time” Training Organization  How you can use the Satellite Broadcast California Department of Health Services Immunization Branch 2/05

Multi-jurisdictional Training Our Challenges  Meeting the demands of the various DCDC branches  Communicating effectively across multiple disciplines, focus areas  Improved dialogue and rapport with stakeholders at LHJ  CA geographic characteristics and linkage with smaller LHJ California Department of Health Services Immunization Branch 2/05

 A bioterrorism cross-training for state and local health department staff that may be called on to serve as case investigators.  LHDs are helping develop the training and will conduct the event locally. Advance work done via 4 conference calls/web slides.  Partnering with academic school of public health: SDSU and the California Distance Learning Health Network. Project Features California Department of Health Services Immunization Branch 2/05

Project Rationale The project developed from an informal LHJ statewide needs assessment:  To build capacity to respond to a BT event.  To allow LHDs to test their organizational structures and personnel for field investigation.  To provide basic and practical skills through existing programs. California Department of Health Services Immunization Branch 2/05

DCDC Infrastructure California Department of Health Services Immunization Branch 2/05 Our partners

California LHJ Participation California Department of Health Services Immunization Branch 2/05 To date

State Level  Statewide training and exercise packaging for local FA-G facilitation  State satellite broadcast on basics of disease investigation (90 minutes)  Presentation and local disease-specific training by local CD controller or FA-B lead  Tabletop exercise with role play California Department of Health Services Immunization Branch 2/05

What disease to test? All partners agreed to “Influenza-like illness”  Pandemic cross-cutting  ILI is not a BT event, so….  Law enforcement, FBI partners not needed for this one California Department of Health Services Immunization Branch 2/05

CDHS Activities & Responsibilities  Design, content development and produce satellite broadcast  Modeling a “just in time” training involving local and state officials and content.  Packaging for FA-G training site managers including tabletop exercise, Plain Language household hand-out materials, just-in- time training tips, and PowerPoint for local CD trainer  Job action sheets for training lead, chief investigator and disease investigator  Media toolkit with sample press release templates and feature story angles  Glossary of common infectious disease symptoms in 14 languages  Personal protective equipment guide  CE for nurses  Pretest-Posttest design, format for process and impact evaluation. California Department of Health Services Immunization Branch 2/05

Local Level  Implementing a just-in-time training to prepare staff to investigate suspected cases  Presenting a combination of distance learning and traditional face-to-face training  Collaboration between Focus Area B, F and G staff with CD staff, and distance learning facilitator.  Collaboration with CDHS branches California Department of Health Services Immunization Branch 2/05

Satellite Broadcast 90-Minute Satellite Program Content  Feature national or state experts  Short historical perspective - disease investigation yesterday and today  Basic steps in outbreak investigation  Field demos including client notification, reporting, case interviewing, field safety  Q&A facilitated by local training lead.  Archived as webcast in Spanish and California Department of Health Services Immunization Branch 2/05

Tabletop Exercise  Flu-like illness is disease to be investigated  Local outbreak starts with a symptomatic bus driver who still decided to work (despite symptoms) and who just finished a two-week vacation in country X.  Participants will be divided into groups of three or four and will role-play written scenarios California Department of Health Services Immunization Branch 2/05

Information that can be immediately accessed by PH professionals and clinicians when presented with suspect or known persons affected by terrorism events:  Based on “just in time” business model.  Delivery Real-time  Continuous updates  Quick communication  Immediacy of state/CDC content “Just-in-time” Model California Department of Health Services Immunization Branch 2/05

 Willingness and aptitude for spontaneity  Prepared communications (i.e., binders, media)  Local content/advisors in place for support  Local CD Controller involvement with planning and implementation; health officer authority in place  All Focus Area Leads notified first.  Staff notified via or phone to report for training immediately or next morning. “Just-in-time” Training California Department of Health Services Immunization Branch 2/05

California Department of Health Services Immunization Branch 2/05

How You Can Use Our Project  Final package of all material will be on line in advance of event and after at cdlhn.com  Satellite program can be downlinked live for viewing then or taping for later training opportunity; register at cdlhn.com  Satellite program will be archived as a webcast in English and Spanish at cdlhn.com continued California Department of Health Services Immunization Branch 2/05

 Multi-language symptom glossary will be available as a finished product or as artwork.  Just-in-time guidelines can be used or adapted  Plain language flyer about ILI can be used or adapted. How You Can Use Our Project, cont. California Department of Health Services Immunization Branch 2/05

Symptom Glossary California Department of Health Services Immunization Branch 2/05

Multi-jurisdictional Training How we’re going to evaluate it:  Local process evaluation by FA-G lead  Course evaluation by participants  Post-exercise DI competency checklist summary by FA-B lead  Conference call and reports by FA-G leads  Wrap up of DCDC partners  (Hope) UCLA Impact Evaluation California Department of Health Services Immunization Branch 2/05

California Department of Health Services Immunization Branch 2151 Berkeley Way, Room 712 Berkeley CA, Phone: (510) Fax: (510) California Distance Learning Health Network 9245 Sky Park Court, Suite 100 San Diego, CA Program Office: Phone (619) Fax (619) Emergency Preparedness Office California Department of Health Services P.O. Box , MS 7002 Sacramento, CA Phone: (916) Fax: (916) THANK YOU Resources: