• Cross-training and sustainability in environmental health-based mosquito control programs

      Kelly, Rosmarie; Georgia Department of Health (Georgia Public Health Association, 2017)
      Background: In Georgia, only a few county environmental health programs still do mosquito surveillance and control. This is partly due to a lack of sustainability in these seasonal programs and a pressure to move personnel from mosquito control to programs that are mandated by the state. There is also a lack of training available for mosquito control workers. Methods: Richmond County Mosquito Control (RCMC), a program within the Richmond County Environmental Health office, is one of the sustainable programs, and the RCMC program has dealt with these issues in some innovative ways. It is sustainable because it partners with other agencies to provide an integrated mosquito management (IMM) approach to local mosquito control. Because training and education are important components of an IMM program, RCMC provides annual training for all mosquito control personnel. Because mosquito control is largely a seasonal program in Georgia, Richmond County has hired retired people to do mosquito control work during the mosquito season. These employees are seasonal workers; one person is kept on full time to manage the program. Richmond County Mosquito Control collaborates with the Phinizy Center for Water Sciences to provide surveillance and mosquito identification. Richmond County Mosquito Control approaches training in several ways. First, RCMC is active in the Georgia Mosquito Control Association. Second, by collaborating with the Phinizy Center for Water Sciences both students and mosquito control employees can learn from one another to the benefit of both programs. Finally, there is a yearly training for all employees with guest speakers providing information on various topics of interest, including: a review of the data that have been collected, information on new and existing treatments and practices, a review of the National Pollutant Discharge Elimination System (NPDES) pesticide discharge management plan procedures, and an overview of business decisions to improve the program and update procedures. Results: Recently, the RCMC program has expanded to deal with the potential threat of Zika virus transmission in Georgia. In addition to its swimming pool remediation project and its goats in retention basin enclosure project, the special projects group has added another project, maintaining retention/detention ponds to help reduce local mosquito breeding. In order to train the mosquito control employees and Phinizy Center students to do this job, they are working with the county engineer to learn the inspection requirements for an MS-4 permit. Finished inspection forms are provided to the county and to the Environmental Protection Division of the Georgia Department of Natural Resources. In addition, employees are training at the Phinizy Center to learn mosquito identification and surveillance, and to look at the fate of stormwater after it exits the ponds.
    • Effect of Medicaid status on up–to-date vaccination rates among two-year-old children in Georgia, 2015

      Machado, Fabio; Tuttle, Jessica; Drenzek, Cherie; Georgia Department of Health (Georgia Public Health Association, 2017)
      Background: The annual Georgia Immunization Study (GIS) employs a retrospective cohort design to determine the up-to-date (UTD) immunization rate of 24-month-old children in Georgia. Previous results have shown lower vaccination rates in the second year of life, particularly for DTaP. We sought to determine if a discontinuation of Medicaid coverage after the infant year contributed to lower immunization rates in the second year. Methods: A stratified random sample of 2,002 Georgia children born in January 2013 was drawn from electronic birth records. Immunization history and Medicaid status were obtained from the Georgia Registry of Immunization Transactions and Services (GRITS). Parents and providers of children inadequately immunized according to the Advisory Committee on Immunization Practices’ (ACIP) immunization schedule were contacted for additional information. UTD immunization rates were compared among participants based on Medicaid status (Medicaid both years, first year only, second year only, never on Medicaid). The relationship between Medicaid status and specific immunizations was also explored. Reasons for loss of Medicaid among children who were not UTD were sought via parent interview. Significance testing was performed using Chi-Square tests in SAS version 9.4. Results: Children covered by Medicaid both years or never covered by Medicaid were more likely to be UTD by 24 months (90.4% and 84.5%, respectively) than children no longer covered by Medicaid in their second year of life (49.2%). These children also demonstrated a significantly lower immunization rate for the 4th DTaP dose (p<0.0001). Conclusions: A discontinuation of Medicaid coverage after the first year of life was associated with a lower UTD immunization rate among 24 month old children, particularly the 4th DTaP dose. Although reasons for discontinuation of Medicaid were beyond the scope of this study, lower vaccination levels among this group may reflect a lack of understanding of vaccine support services, and deserves further examination.
    • Mock Me! A guide to developing a first rate training tool on a second rate budget

      Baxter, Galen; Georgia Department of Health (Georgia Public Health Association, 2017)
      Background: Working closely with county Environmental Health Specialists through the Standardization Process, a critical need was identified. Assistance was needed in prioritizing inspections based on risk levels identified in restaurant kitchens during inspections. Additionally, more training was needed to help them identify other areas in food service establishments that require further assessment. Methods: Tight budget constraints prevented the purchase of expensive training equipment; however, with a little creativity and team work, a mock kitchen made entirely out of cardboard, tape and a couple of aluminum pans was created as a portable, hands-on training tool that could be easily transported around the state. Results: Overwhelming positive feedback was received from the districts that experienced training using the tool. Environmental Health Specialists suddenly had an opportunity to practice and apply what they had learned within a controlled environment and increase their confidence in assessing and prioritizing during inspections. Conclusions: Solutions to problems can sometimes be found using a very simple approach. A little bit of creativity and a willingness to literally “think outside the box” can go a long way in providing viable, alternative solutions to common roadblocks in government. The key to creating an effective training tool is to accurately identify training gaps in the intended audience.
    • Recruitment, retention, and succession planning for district health directors

      Rudd, Lee; Georgia Department of Health (Georgia Public Health Association, 2017)
      Background: Since the District Health Director (DHD) leads the district health organization, plans must be put in place to ensure that we retain current directors and anticipate the future when the DHD retires from the position. Methods: Best practices in the areas of recruiting, retention, and succession planning are used to present resolutions to the problems. Results: By following the steps identified in the best practices, there is a reasonable chance that the district will be prepared for any change in leadership. Conclusions: Using the best practices identified by human resources professionals combined with the unique characteristics of public health districts will ensure success.
    • A unified integrated public health approach: Zika response

      Kagey, Betsy; Burkholder, Jennifer; Georgia Department of Health (Georgia Public Health Association, 2017)
      Background: Zika virus planning in Georgia has involved many units within the Georgia Department of Public Health (GDPH). Their roles and responsibilities include identifying potential vectors, alerting and educating the public on how to ‘tip n toss’, preparing and testing for Zika virus infection at the Georgia Public Health Laboratory (GPHL), monitoring travelers, including pregnant women, infected with Zika virus, direct messaging for pregnant women, mothers of newborns and women who are considering pregnancy, and education on sexual transmission for men and women. Methods: With no locally transmitted case of Zika virus infection within Georgia, the focus has been on public messaging and answering the myriad calls about Zika virus from health care providers and the public. This unified response involves numerous GDPH units: Epidemiology, Maternal and Child Health, GPHL, Emergency Preparedness and Response (EPR), Environmental Health, Risk Communication, WIC, and others. Conclusions: The Office of Public Health Emergency Preparedness and Response is one member of this multi-unit team. This session will identify the roles and responsibilities of each of these units in the unified response to Zika virus within Georgia both at the state and district level. Lessons learned from this approach build upon GDPH’s overall capacity to provide an integrated respond to public health threats and emergencies within the state.