The Supporting Role of Healthcare Coalitions for Local Health Departments in Emergency Preparedness

By Nicole Dunifon, MS, Program Analyst, NACCHO, and Daniel Reategui, MHS, NACCHO Policy and Practice Scholar

This post originally ran on NACCHO’s Preparedness Brief blog. For more preparedness news and information, visit

The Hospital Preparedness Program (HPP), administered by the Office of the Assistant Secretary for Preparedness and Response (ASPR), provides grant funding to states in order to support sustainable community healthcare coalitions (HCCs), improve medical surge capacity, and enhance community and hospital preparedness in the event of a public health emergency. With the development of ASPR’s Healthcare Preparedness Capabilities: National Guidance for Healthcare System Preparedness, local health departments (LHDs) across the country have now begun to partner with HCCs and healthcare organizations on emergency preparedness planning, training, and exercises. Most recently, coalitions have played a pivotal role in coordinating with LHDs and healthcare systems during the Ebola response.  Continue reading

How One Award-Winning LHD Successfully Expanded Services for Homeless Veterans

Interview by Ian Goldstein, Web and New Media Specialist, NACCHO

NACCHO’s LHD of the Year Award recognizes and honors outstanding accomplishments of local health departments (LHDs) across the country for their innovation, creativity, and impact on communities. Whatcom County (WA) Health Department is the winner of NACCHO’s 2014 Local Health Department of the Year Award in the medium-sized jurisdiction category for its initiative to house and expand services for homeless veterans. The following is an excerpt from a recent podcast in which NACCHO interviewed Regina Delahunt, MS, REHS, Director, Whatcom County Health Department.

NACCHO: Tell us about your policy and why you wanted to apply for NACCHO’s LHD of the Year Award.

Delahunt: We applied because the award’s focus was on policy development. About five years ago, we made conscious decision in our health jurisdiction to focus on more upstream policy-level change, especially policies that affect the social determinants of health. We applied because we have had quite a bit of success with the policy-level change. We wanted to showcase one of our biggest successes and recognize all of our partners because we could not do this on our own. We also wanted to share our experience with other health jurisdictions so that maybe their road to policy development would be a little bit easier. Continue reading

Safe Storage of Firearms Prevents Suicide

By Tony Gomez, BS, RS, Manager, Violence and Injury Prevention, Public Health Seattle & King County; Clinical Faculty Instructor, University of Washington, School of Public Health

There is an urgent public health need to reduce suicide rates in the United States. There were 40,600 suicides in 2012, making suicide the tenth leading cause of death.1 Increases in suicide rates among Americans ages 35 to 64 across the country are cause for alarm; suicide in this age group rose 28.4% from 1999 to 2010.2 The greatest increases in suicide rates occurred in people 50 to 54 years old, which increased by 48.4%, and 55- to 59-year-olds, which increased by 49.1%.2 Among the most common methods of  dying by suicide are firearms, the use of which increased by 14.4% from 1999 to 2010.1 In the United States, over half of suicide deaths are due to firearms; another 17% are due to poisoning by prescription medicines and other substances. Continue reading

Local Health Official Interview: Winifred M. Holland of the Florida Department of Health in Clay County

Holland, WWinifred M. Holland, MPH, MA, LMHC, Health Officer, Florida Department of Health in Clay County, has spent more than 30 years in public health. In this interview, Holland discusses her career path, the challenges of maintaining the fiscal viability of her LHD, and the rewards of working on teen pregnancy prevention programs.

  • Please tell us about your professional background and how you got to where you are today.

I have been a public health professional for over 30 years. My initial degree is in secondary education but once I was exposed to public health, it became my passion. Continue reading

Working with Local Health Departments to Support PrEP for HIV Prevention

World AIDS Day. December 1. By Gretchen Weiss, MPH, Senior Program Analyst and Alyssa Kitlas, Program Analyst

Yesterday was World AIDS Day, a day to remember those who have lost their lives to HIV and AIDS; recognize the challenges that remain in ending the epidemic and improving the lives of those living with HIV; celebrate the progress we have made in curbing the epidemic; and unite in commitment to an AIDS-free generation. Over the past few years, incredible progress has been made across the HIV care continuum. Among the key achievements and successes has been pre-exposure prophylaxis, or PrEP. PrEP, which involves taking a pill a day to prevent HIV, represents a breakthrough in biomedical HIV prevention.

For the past few years, NACCHO has been engaged in dialogue with local health departments and its federal and industry partners about achieving the full promise of PrEP, how PrEP will be rolled out in the “real world” (i.e., implemented outside of clinical trials and demonstration sites), and what the role of local health departments will be. In late 2013, NACCHO received funding from Gilead Sciences, Inc., the manufacture of Truvada, which is currently the only FDA approved medication for PrEP, to develop an educational program about PrEP as a component of comprehensive HIV prevention. NACCHO launched its Web-based PrEP and Local Health Departments educational series in October 2014. The series is composed of three modules, the third of which was released yesterday:

  • Module 1: The Science of PrEP for HIV Prevention and the US Public Health Service Clinical Practice Guidelines for PrEP
  • Module 2: Who Might Benefit from PrEP? Assessing Benefit at a Population and Individual Level
  • Module 3: Thinking About Incorporating PrEP into Your HIV Prevention Programs? Examples and Models from Local Health Departments

The goal of NACCHO’s educational series is to increase awareness and knowledge of PrEP among local health departments. To achieve this goal, NACCHO undertook a number of activities to explore, identify, and define the various roles that local health departments can play in supporting PrEP as part of a comprehensive HIV prevention strategy. Module 3 highlights the findings of these activities by detailing the various roles for local health departments and providing examples of what local health departments across the country are doing, such as providing PrEP through health department clinics; referring clients to providers for PrEP; creating online resource directories for providers and community members; and offering direct provider education and training opportunities. Similar to the previous two modules, Module 3 includes two webcasts (pre-recorded lectures), a discussion guide, and supporting resources and tools.

Recognizing that PrEP poses a number of questions and that implementation will look different across the country, NACCHO has hosted live webinars with series instructor Dr. Mark Thrun, Director, HIV/STD Prevention and Control, Denver Public Health. The webinars provide an opportunity for participants to ask questions, share information about their PrEP-related activities, and learn from colleagues and partners across the country. We hope that you will join us for our upcoming webinar on Dec. 16, 12:30–2:00 PM EST. Register here and come prepared to ask questions and share what your health department is doing to support PrEP in your jurisdiction.

We want to thank all the health departments that have provided input and guidance on NACCHO’s PrEP activities and look forward to engaging more of you in this important work. NACCHO is currently developing a PrEP Story Bank to document, share, and support local health department efforts. Please e-mail Gretchen Weiss on NACCHO’s HIV/STI team at if you would like to share how you are supporting PrEP delivery in your jurisdiction.

Ready vs. Project Public Health Ready

By Leigh Wilsey, Preparedness Coordinator, Florida Department of Health in Clay County

This article was originally published in NACCHO Exchange. To read the entire issue, download the newsletter from NACCHO’s online bookstore (login required).

PPHR-Logo-2006-300x203As a local health department (LHD), the Florida Department of Health in Clay County (DOH-Clay) has had many opportunities to respond to emergencies and disasters that impact public health. Large statewide public health response activations have included the following:

  • Hurricane Andrew, 1992;
  • Wildfires, 1998;
  • Hurricane Floyd, 1999;
  • Hurricanes Bonnie, Charley, Francis, and Jeanne, 2004, known in Florida as “The 4 of ’04”; and
  • Local activations for tropical storms, flooding, and wildfires.

Prior to 2006, DOH-Clay’s role in public health response was limited to staffing special medical needs shelters. Even though a basic written plan existed, staff had experience running the shelter and rarely referred to it. While staff always had a “we will get the job done” attitude, the lack of coordinated planning and training presented many challenges in the back-to-back activations during the 2004 hurricane season.  Continue reading

Stories from the Field: Food Safety Calendar Educates Entire Community

food-safety-calendar-storyThe following story was submitted to NACCHO’s Stories from the Field website by Jeanne Garbarino from Vineland City (NJ) Health Department on Sept. 17. NACCHO’s Stories from the Field website provides a means for local health departments (LHDs) to share their experiences and demonstrate the value of public health. Stories from the Field can be used to support advocacy, peer learning, and collaboration with state and federal partners. Share your story at

When the Vineland City Health Department (VCHD) in Vineland, NJ, discovered that a lack of education around proper hand washing was the number one public health offense in the city’s retail food establishments, local health department (LHD) and Food Safety Council staff thought up an unusual solution: let students do the teaching. Through a contest with cash prizes, the department tasked K-12 students to contribute drawings illustrating best practices related to hand washing; the winning art was then published in the VCHD’s inaugural “Serving Safe Food Calendar,” distributed to every retail food establishment in the city.

The calendar project began in 2005, after the VCHD conducted its first risk-factor study with the U.S. Food and Drug Administration’s voluntary standards program and identified poor personal hygiene as the biggest health issue present in the city’s restaurants. A lack of hand washing spreads the viruses and bacteria that can lead to a number of foodborne illnesses, such as norovirus and salmonella. The LHD wanted to combat this issue in a creative, original way in hopes of gaining more attention from the food service community, and raising a higher level of awareness surrounding hygiene issues. Along with the Food Safety Council, the VCHD began brainstorming education campaigns and someone suggested enlisting local students to draw posters; the idea quickly evolved into a calendar.

The original production focused only on hand washing, but in subsequent years, the VCHD has expanded its focus to also cover proper food temperatures and foodborne illnesses. It isn’t a regular series – in total, the project costs about $4,000, so the department only produces them when funds are available – but when the opportunity arises students, parents, teachers and food service industry workers jump at the chance to take part, whether that means contributing a drawing or just pinning a calendar on a wall. Calendars have since been produced in 2009, 2011, 2012, and 2014. Artwork is selected through a contest that offers 12 winners a $50 Visa gift card and the opportunity to receive their prize during a televised city council meeting. Surprisingly, it’s the brief TV appearance that really drives kids to participate, and not the cash.

To garner enough submissions, the VCHD reached out to local teachers – a challenge in itself, as catching teachers when they weren’t busy was not always achievable – and asked that they promote the contest to their students. Some biology teachers even turned contest participation into a graded classroom assignment; they studied the various foodborne illness that can arise due to improper hand washing or refrigeration and students incorporated their lessons into their drawings. Simple outreach efforts expanded the scope of the VCHD’s original project; students and teachers were able to engage with public health education in a more meaningful way, and came away from the project with a strong personal understanding of the issues.

Once published, every licensed retail food establishment in the city, from top-tier restaurants to coffee carts, receives a copy of the calendar. The VCHD even provides them to the supermarket departments that handle and prepare raw foods. And though there are no established, direct links between calendar production and changed habits, risk factor studies conducted in the nine years since the project began have shown an improvement in personal hygiene practices among the city’s food service professionals. Additionally, VCHD staff have heard anecdotal evidence about community members whose children have taken to monitoring their family’s hand washing habits, or contest winners who now manage restaurants. And, perhaps most poignantly, retail food establishments sing the praises of the calendars and greatly appreciate the educational opportunity they provide.

Despite the clear successes, the calendar project has not been without struggles. Every new production cycle the VCHD undertook illuminated new strategies they needed to follow in order to ensure a useful product. For instance, one of the biggest challenges was timing their initial outreach campaign with a break in teachers’ schedules. If teachers were too busy to deviate from their planned curriculum, the calendars didn’t receive the classroom promotion the VCHD relied on for success. The department has since identified May as the best month to solicit artwork from students and teachers. Another important step was ensuring students had quality information to inform their projects. The VCHD found that it was often necessary to provide resources directly to the teachers; as schools do not typically teach food safety, classrooms really relied on the health department to educate them about proper behaviors.

Any LHDs interested in replicating Vineland’s calendar project, or initiating their own food safety education campaign, should remember the importance of including the whole community in the process. By involving students in the calendar, the VCHD was able to educate children, parents, and teachers in addition to the food service establishments originally targeted. Food safety became education became the whole city’s mission, not just the health department’s.

Read more LHD stories from the field at