State Sanitary Code Changes affecting Public Health Nursing

1
State Sanitary Code Changes affecting Public
Health Nursing

• Sylvia Pirani, MPH, MS
• Director, Office of Public Health Practice
• New York State Department of Health

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Presentation Outline

• Background Public Health Workforce Task Force
• Nurses in the Public Health Workforce
• Changes to the State Sanitary Code
• Developing Continuing Education Opportunities

3
Background

• 2001 NYS Public Health Council appoints Public
  Health Infrastructure Workgroup to assess states
  public health system
• 2003 Workgroup releases report on Strengthening
  New Yorks Public Health System for the 21st
  Century
• Focuses on workforce, organizations and systems
  and Information Technology
• Recommends that a statewide public health
  training task force be convened

4
Background

• 2005 NYS Public Health Workforce Task Force
  formed to focus on four issues
• Recruitment
• Retention
• Education and Training
• Leadership Development
• 2006 Task Force releases Roadmap and establishes
  nine key strategy areas

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Task Force Key Strategy Areas

• Strengthen academic/practice partnerships
• Strengthen workplace policies and procedures
• Assess leadership skills
• Define workforce competencies and gaps
• Market public health careers to college age
  students
• Market public health careers to adults and mid-
  career professionals
• Locate and advocate for new resources
• Hire staff with right skills and provide career
  development opportunities
• Implement workforce development programs

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Enumeration of Public Health Workforce

• Conducted by Center for Health Workforce Studies
  in collaboration with NYS DOH and NYSACHO in 2006
• 32/58 local health departments participated
• 18 full service, 14 without environmental health
• N 2078

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Formal Job Titles of LHD Employees (n1930)
Source University at Albany School of Public
Health Center for Workforce Studies Enumeration
of the Local Public Health Workforce in New York
2006.
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Formal Job Titles of LHD Employees Group
Figure 6 Center for Health Workforce Studies.
2007. New York State Public Health Workforce
Enumeration Survey
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Specific Job Titles of LHD Employees in Nursing
Jobs
Figure 7 Center for Health Workforce Studies.
2007. New York State Public Health Workforce
Enumeration Survey
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Recruitment

• 2007 survey of county civil service agencies
  found that 23 of 30 agencies responding reported
  recruitment challenges related to public health
  personnel
• Agencies expressed difficulty recruiting for 25
  of their positions.
• Highest concentration of recruiting difficulties
  found in nursing professions, esp. in four
  titles
• Registered professional nurse
• Public Health Nurse
• Community Health Nurse
• Supervising Public Health Nurse

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Recruitment

• Only 9 of 23 agencies provided reasons for
  recruitment difficulties. These are
• Salary
• Educational Requirements for Position
• Other Job Criteria including Experience
  requirement
• Location of Agency

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Retention

• Median age of local public health worker is 49,
  compared to median age of U.S. civilian worker of
  40.
• Public Health Nurses have median age of 50.
• 62 of local public health workers are between
  the ages of 45 and 64
• Almost 20 of local public health workers report
  plans to retire within next five years.
• Source Center for Health Workforce Studies.
  2007. New York State Public Health Workforce
  Enumeration Survey

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Marketing

• Strategies
• Establish comprehensive web-based clearinghouse
  on public health careers http//www.nyhealth.gov/p
  revention/public_health_works
• Conduct survey of public health students to guide
  future strategies in supporting the public health
  pipeline
• Conduct survey of recently hiring SDOH employees
  to guide future marketing efforts

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Public Health Works! Website
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Task Force Key Strategy Areas

• Strengthen academic/practice partnerships
• Strengthen workplace policies and procedures
• Assess leadership skills
• Define workforce competencies and gaps
• Market public health careers to college age
  students
• Market public health careers to adults and mid-
  career professionals
• Locate and advocate for new resources
• Hire staff with right skills and provide career
  development opportunities
• Implement workforce development programs

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State Sanitary Code Changes

• NYS DOH revised definitions and minimum
  qualifications for key public health
  professionals to ensure they
• Reflect up to date professional job descriptions
  and qualifications
• Address training needs
• Support career ladders

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SSC Code Changes

• Revise definition of Public Health Nurse and
  Supervising Public Health Nurse to reflect role
  in population health as well as individual
  patient care
• Maintain requirement for public health nurses to
  have BSN

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SSC Code Changes

• The term public health nurse 1 shall mean a
  nurse who plans, provides, directs and evaluates
  nursing care in a variety of settings with the
  goal of improved health outcomes and offers
  instruction and guidance in health practices for
  is actively involved in the planning,
  development, provision and evaluation of public
  health programs designed to prevent disease and
  improve the health of individuals, and
  families, specific populations, high risk groups
  and/or communities.

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SSC Code Changes

• Add new job definition Public Health Nurse 2
• In addition to working with individuals, groups
  and families to improve health in the community,
  a public health nurse 2 will administer programs,
  develop program budgets, and lead monitoring
  and/or quality care initiatives
• Provides career ladder to retain public health
  nurses with experience in LHDs

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SSC Code Changes

• The term public health nurse 2 shall mean a
  nurse who plans, provides, directs and evaluates
  nursing care in a variety of settings with the
  goal of improving health outcomes and is actively
  involved in the planning, development, provision
  and evaluation of public health programs designed
  to prevent disease and improve the health of
  individuals, families, specific populations,
  high-risk groups and/or communities. The public
  health nurse 2 is also involved in program
  administration and/or program budget development
  and monitoring and/or quality improvement
  initiatives, and/or acting as advocate and
  liaison for constituents.

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SSC Code Changes

• Require Public Health Nurse 2 and Supervising
  Public Health Nurse to complete 15 hours of
  continuing education in public health topics
  approved by the DOH within their first year of
  employment in each position.
• Topics can include education about supervision

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Developing CE Program for PHNs

• Discuss typical work activities for each PH Nurse
  title
• Identify most important core competencies for
  public health nurses in these titles
• Identify on-line and in person courses related to
  those competencies that public health nurses
  could complete to comply with this requirement.
• Create new programming to address gaps

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Quad Council Competencies

• 8 Domains
• Analytic Assessment Skills
• Policy Development/Program Planning Skills
• Communication Skills
• Cultural Competency
• Community Dimensions of Practice Skills
• Basic Public Health Science Skills
• Leadership and Systems Thinking
• Financial Planning and Management Skills
• 3 Levels
• Awareness
• Knowledge
• Proficient

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Typical Job Duties PHN 1

• Assesses health status, resources and risk
  factors of community/population to determine
  priorities for targeted interventions
• Works with communities to develop/deliver
  targeted health promotion and disease prevention
  activities
• Participates in assessing and evaluating health
  care services to ensure people are informed of
  programs and assisted in utilization of services
• Provides health education, care management and
  primary care to individuals and families

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Addl Typical Job Duties PHN 2

• Assists in development of policy and programs to
  address health concerns in community
• Recommends strategies to meet identified
  community needs
• Assists in preparation of program budgets
• Conducts studies and or evaluation of qualify of
  health department programs
• Acts as liaison with community groups

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Typical Job DutiesSupervising PHN

• PHN 1 or 2 duties, plus supervisory
  responsibilities

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How Well Prepared are BSN Nurses?
Source NYNJ Public Health Training Center
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How Important are These Competencies?
Source NYNJ Public Health Training Center
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Top Three Recommendations From Practice to
Academia

• Increase the amount of time students spend in the
  public health clinical arena
• 2. Stress with students the distinct difference
  between community health and public health
  nursing
• 3. Develop an educational component to the
  community health course that focuses on
  population-based practice and public health
  nursing in the LHDs

Source NYNJ Public Health Training Center
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Next Steps

• Identify already existing courses or on-line
  training that could be used to provide these 15
  hours
• Identify gaps
• Who can volunteer to review existing training?
• Who can volunteer to conduct new training?

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Contact Information

• Sylvia Pirani
• Director, Office of Public Health Practice
• New York State Department of Health
• Corning Tower, Empire State Plaza
• Albany, NY 12237
• sjp03_at_health.state.ny.us
• phworks_at_health.state.ny.us

http//www.nyhealth.gov/prevention/public_health_w
orks/