Public health emergencies require a quick, decisive, and coordinated response—but the federal funding machine is too slow and sporadic to support a permanent emergency response workforce. How can we address this challenge and prepare our workforce for the next crisis?
Ongoing training and technical assistance
Training and technical assistance to help the public health workforce prepare and respond to emergencies are but two of the essential elements necessary to avoid a roller coaster approach.
It might be helpful to delve a little deeper at one often overlooked but essential part of emergency preparedness, namely, training of the workforce. We saw the urgent need for that during the multi-year COVID-19 pandemic. For example, at the CDC, there just weren’t enough full-time, well-trained emergency personnel to manage the communication, policy, programmatic, and logistical COVID-related matters. That meant the agency had to rely on others to assist, including those who were experts in tobacco, diabetes, motor vehicle safety, and infant mortality. These employees took time away from their “day jobs” to do stints in the incident command structure. Because their positions were funded by non-emergency line items, they could only stay in the response for a limited time, leading to a revolving door of leaders. In most instances, the only emergency preparedness training they had was what they got on the job.
Even if the emergency workforce were enlarged, it would be wise to train most if not all of those in the public health workforce for the likelihood they will be drawn into a future emergency response again. The CDC admirably has already indicated an interest in doing just that.
In past instances, ICF has seen the benefits of specialized workforce training particularly when new issues have arisen. For instance, the Substance Abuse and Mental Health Services Administration (SAMHSA) contracted with ICF to support the evaluation of the Garrett Lee Smith National Suicide Prevention Program—which was responding to the increasing numbers of youths aged 10 to 24 years with suicidal ideation. The grantees have provided training through in person, self-directed, online, and facilitated group events to gatekeepers across the nation to prevent youth suicide.
Closely connected to training is technical assistance or TA; that is, targeted and timely support, sometimes one-on-one from someone with expertise. This can assist the employees as they grapple with the day-to-day challenges and urgent, time-sensitive matters that arise. Technical assistance may involve having ready access to individuals who have very specialized subject matter expertise or providing well-developed resources or toolkits. An example of ICF’s development of a customized TA initiative is the Child Welfare Capacity Building Center for States, which provides hands-on guidance on such matters as reducing the length of stay of children within facilities and responding to tragic events.
And sometimes a combination of the two is required to address an urgent situation. As public health agencies increasingly grappled with the opioid crisis, some for the first time, the CDC contracted with ICF to design and implement a comprehensive training and technical assistance center (DOP TA Hub) to support state and local public health personnel. The technical assistance includes an online resource library of evidence-based practices, access to one-on-one, group, and peer-based technical assistance, as well as other support tools.
In summary, training and technical assistance to help the public health workforce prepare and respond to emergencies are but two of the essential elements necessary to avoid a roller coaster approach. Before all the COVID-19 funding runs out, it would be wise to learn the lessons from the past and ensure we are prepared for the next emergency and the one after that. Like it or not, those emergencies will occur.