NJDOH has identified, through the State Health Assessment, the State Health Improvement Plan, and the Department’s Five-Year Strategic Plan, the need to improve the public health workforce in the areas of access to care, quality improvement, systems integration, and population health management. MCH workforce development and capacity are also a priority for the Division of Family Health Services (FHS). Without an adequately trained MCH staff, vital Title V services and functions would not be provided to meet the needs of the current and future MCH population. Recognizing the value of experienced and trained staff, the FHS has taken action to improve the capacity of the MCH workforce despite a long-standing hiring freeze.

Most FHS staff concurred that training was needed to help them effectively conduct return on investment (ROI) analyses of MCH programs. FHS also recognized the need for incorporating the perspectives of families and family representatives into the MCH workforce under the broader umbrella of systems integration. Continued family involvement in health transformation is essential for effective program and policy development related to newly aligned systems. As a result, the NJDOH provided additional training to staff and equipped them with the skills needed to collect data appropriate for accountability documentation and to develop accountability metrics to calculate better the ROI for MCH programs tied to public health outcomes. Moreover, NJDOH collaborated with community partners through advisory boards, steering committees, and more. FHS also recognized the need for incorporating the perspectives of families and family representatives into the MCH workforce under the broader umbrella of systems integration. Continued family involvement in health transformation is essential for effective program and policy development related to newly aligned systems.

The FHS implemented the development of succession planning to ensure essential functions were considered in long-term planning. During this past fiscal year, cross-training of staff was implemented to provide the ability to maintain key roles in the event of short-term staffing shortages. Changes in the workforce funded by Title V reflect staff's long-standing MCH priorities and core functions.

Given the diversity of our state, cultural competency trainings continue to be provided to staff as an essential component of their continuing education activities. TVS also pursues other training opportunities through trainings offered at national conferences, including AMCHP, the MCH Epidemiology Conference, and the MCH Public Health Leadership Institute. Departmental trainings have been offered on ethics, grant writing, and grants management.

Opportunities to supplement staffing through student internships, special temporary assignments, fellowship programs, and state assignees have also been successful. Recruitment and Retention of qualified TVP staff are ongoing goals of NJ TVP.

In collaboration with TVP, FHS implemented succession planning to ensure essential staff roles were part of the long-term planning. During this past fiscal year, TVP continued to cross-train staff to ensure the ability to maintain key roles in the event of short-term staffing shortages. Changes in the workforce funded by Title V reflect the staff's long-standing MCH priorities and core functions. A focus on filling key positions and building the public health infrastructure is a key focus of NJDOH. NJDOH was recently awarded a CDC grant (CDC-OE22-2203) which will create an Office of Workforce and Professional Development whose main goal is to holistically forecast, plan, assess gaps, and determine ways to improve retention and invest in a diverse future talent pipeline.

Maternal/Women's/Reproductive Health & Perinatal/Infant's Health

MCH Workforce & Training

Rebecca Ofrane, MPH recently joined the NJ Dept. of Health as Executive Director of the Maternal and Child Health Services unit. She builds partnerships across sectors, having worked in healthcare, federal government, non-profit, and academic medicine. Rebecca is a DrPH candidate in Leadership, Practice, and Research at Rutgers School of Public Health, doing dissertation research on barriers to birth center access in NJ, and has an MPH in Environmental Health Sciences and Toxicology and a BS in Biochemical Engineering. She is also a certified full-spectrum doula.

Below is a list of the new staff who recently joined the Reproductive and Perinatal Health Team RPHS team to advance maternal and child health outcomes in NJ.

1. RPHS recently welcomed a new Project Coordinator, Karen Farrior. She oversees the Fetal Alcohol Syndrome, Postpartum Depression and Mood Disorders, Family Planning, and Colette Lamothe-Galette Institute. Ms. Farrior is a Certified Public Manager (CPM) with a Master's Degree in Business Management, a concentration in Organizational Leadership, and a Bachelor's Degree in Sociology.
2. Cynthia Armand serves as a Program Management Officer (PMO) for the RPHS Team. Cynthia manages multiple state and federal grants, including Fetal Alcohol Syndrome, Postpartum Depression, and Mood Disorders. Ms. Armand. holds a master's degree from Rutgers University in Public Health and is a Certified Health Education Specialist (CHES).
3. Ngozi Okafor serves as a Program Specialist. She is a 2021 graduate of Rutgers University on the New Brunswick campus. She holds a Bachelor of Science in Public Health, a Certificate in Health Disparities, and minored in French. She has been involved in several professional activities within the New Jersey Department of Health, Division of Family Health Services, and has experienced an increased involvement with the Maternal Child Health team following a shift in responsibilities
4. Noelle Abbott serves as a PMO. She assists with implementing and managing the Healthy Women Healthy Families grant. Noelle also serves as a TVS co-lead overseeing the Connecting NJ Initiative in 14 counties and partnering with the Department of Children and Families to support this centralized intake referral system in every county. Noelle is also a member of the NJ Breastfeeding Strategic Plan Steering Committee since its inception this past fall. It aims to provide a roadmap to foster systemic changes to increase breastfeeding amongst NJ birthing individuals. Noelle graduated from the Edward J. Bloustein School of Planning and Public Policy at Rutgers University in 2021, earning her Bachelor's in Public Health.
5. Sumantha Banerjee, MPH, CHES, serves as a Public Health Consultant 2. She graduated with my MPH at the University at Albany’s School of Public Health with a concentration in Community Health and Behavioral Health Sciences. She has extensive expertise in managing public health preparedness grants. Before joining RPHS, she also served as grant coordinator for a regional hospital preparedness grant and, most recently, managed homeland security grants for county and state agencies. As the newest RPHS team member, Sumantha supports MCH-related projects as needed until a project is assigned to her in the coming months.

TVP continues to utilize the vulnerable populations plan created at the COVID-19 pandemic's peak. The team has revised the plan to adapt it to the current needs. It encompasses epidemiology in high-need areas, areas where individuals are more susceptible to contracting COVID-19. Additionally, the NJ COVID-19 vulnerable populations plan includes a list of populations deemed vulnerable to COVID-19, that includes racial and ethnic populations, immigrants, limited English proficiency, homebound, seniors, homeless, disabled populations, migrant workers, pregnant and nursing mothers, underinsured and uninsured, undocumented workers and substance abusers.

Many of these vulnerable populations face an increased risk of exposure to COVID-19 as many experiences higher rates of unemployment. They are more likely to work in essential, low-income jobs that do not allow telework; and do not have health insurance or paid sick leave through employers. Racial and ethnic minority groups, seniors, people with low socioeconomic status, the homeless, those with SUD, pregnant women, and/or those with certain underlying medical conditions such as heart disease, diabetes, obesity, and smoking are also at increased risk of contracting COVID-19 and/or experiencing severe illness from COVID-19. Other populations such as immigrants, migrant workers, undocumented workers, limited English proficiency, homebound and disabled populations traditionally do not access health care on a routine basis, thereby increasing their risk for severe disease. In addition, distrust of medical and governmental entities, anti-vaccination sentiments, and disparities in vaccine coverage may impact the achievement of high COVID-19 vaccination rates in these population groups. Knowing the value of CHWs along with their long-term use in NJ TVP programming, their limited training, lack of a standardized curriculum, and difficulty recruiting, retaining, and advancing in their careers, NJ TVP decided to invest, establish and build the NJDOH Colette Lamothe-Galette Community Health Worker Institute,

https://www.nj.gov/health/fhs/clgi/

In May 2020, NJDOH created the Colette Lamothe-Galette Community Health Worker Institute (CLG-CHWI), a program to train and certify CHWs. NJDPH secured a grant from the NJ Department of Labor's Growing Apprenticeship in Non-Traditional Sectors (GAINS) Program, the Institute's primary funder. The Institute is named in honor of Colette Lamothe-Galette, the former NJDOH's 1st Population Health Director, who went on to the Nicholson Foundation, where she served as a Senior Program Officer and led The Nicholson Foundation's CHW efforts until she passed away from COVID-19 on April 4, 2020.

Often, CHWs are frontline public health workers who are trusted by the people they serve because of their intimate understanding of the cultures, languages, and challenges of their neighborhoods. NJ TVP has made the expansion of CHWs in NJ a strategy to address inequities in our healthcare system. One of the ways the NJ TVP has worked over the past several years to improve the health of vulnerable populations within the state is to support and help sustain initiatives that involve CHWs. This work has included efforts to establish standardized training, build CHW capacity, and expand the number of CHWs statewide.

Through the CLG-CHWI, CHWs are hired as apprentices, allowing them to experience classroom and on-the-job training. Training includes 144 hours of related classroom technical instruction covering 13 core competencies supplemented by 1000 to 2000 on-the-job hours, with reflective supervision. This CHW apprentice occupation is registered with the US Department of Labor (USDOL).

Considering the SUD crisis in NJ, NJ TVP has been working on expanding CHW core competencies to include SUD training that offers specialized tracks in the form of additional training on primary actions of state and/or local public health-led efforts to address underlying conditions of SUD. Moreover, additional training will be included to focus on the integration of CHWs in novel settings that include prisoner re-entry programs, mental health, and substance use disorders, Certified Community Behavioral Health Clinics (CCBHCs), and FQHCs who have never utilized CHWs. These novel settings have been selected due to the challenges facing these vulnerable populations. These novel settings will be a part of innovative demonstration projects where we test the Return on Investment (ROI) of CHWs and explore sustainable funding strategies with Medicaid.

Adolescent Health

Adolescents are best served by providers and professionals with an understanding of adolescent development and trending health issues. For those working with adolescents, like other special populations, skills matter. Therefore, CAHP is dedicated to assisting the NJ adolescent workforce in being prepared to address the complex needs of this age group. Education of the adolescent workforce is essential to the provision of high-quality health education and services for adolescents that are accessible, developmentally appropriate, effective, inclusive, and equitable. At all levels of professional education, providers in all disciplines serving adolescents need to be equipped to work effectively with this age group. They must be attuned to the nature of adolescents' health problems and have a range of effective strategies for risk assessment, disease prevention, care coordination, treatment, and health promotion in their clinical repertoire.

Currently, CAHP is staffed by four master's level professionals, one master's candidate, and an administrative assistant. Staff expertise consists of sexual health, counseling, public health, health science administration, education, and social work with a range of backgrounds, including direct service provision, program management, public school education, and community-based services. Over the past two years, we have recruited 3 of the four professionals working in the program. Training is an essential part of CAHP. In addition to training in the EBMs implemented through programs, staff also received training in subject matter including but not limited to youth mental health, social and emotional learning, positive youth development and mentoring, and parent/caregiver engagement.

Current assessments of the adolescent workforce participating in NJDOH programs suggest the knowledge and skills of some providers/professionals working with adolescents lack essential skills and knowledge needed to serve this vulnerable population effectively. As an example, self-reported data on perceptions of professional competencies related to youth mental health collected via surveys of staff at eight school districts prior to the implementation of Lifelines Trilogy suggested that members of the crisis team were unaware of or had misinterpretations of school policies regarding mental health including which tools to use for screenings, where to refer for services and when to include parents/caregivers. In addition, self-reported data from pre- and post-survey trainings provided to NJDOH grantees indicated a similar lack of knowledge and skills related to subjects such as birth control and other contraceptives, STIs, and social and emotional learning, prior to training. In our survey of adolescents, over 85% indicated they do not feel understood or supported by the adults in their lives (professionals, parents, and caregivers. Given the current landscape of adolescent health education, support, and service needs, continued training and education of adolescent health professionals and providers is an important goal for the Child and Adolescent Health Program and the professionals/providers who work with the adolescent population.

Children with Special Health Care Needs

Within the SCHS unit, we have been focusing on workforce development in several ways. We envision what our organizational chart needs to look like in the future and build the positions to get to that vision. This year, we developed a group of staff known as the Data Systems and Emerging Threat Response program. Within this program are data staff, who sit within our other programs but report to a single data coordinator who ensures that the data work across the programs is met. By cross-training and having staff work on multiple data systems, they can ensure that we can meet our data demands even when staff is out, leaving, or retiring. Additionally, the Coordinator runs a monthly data group across the division to bring staff from MCH, WIC, EIS, and SCHS together. These training meetings expose staff to new ideas and information.

Meeting the needs of emerging threats such as COVID, ZIKA, and natural disasters has often happened in an ad hoc manner. This team is designed to look at ways more prospectively to address developing issues. The focus has been on bringing in different types of staff that are able to write and execute funding opportunities, work with medical records, and organize and manage projects with quick turnaround times. Having the staff means we can be more strategic and timelier in collecting data and producing results and recommendations for changes. Along with bringing in new staff, we are looking for more opportunities to capitalize on existing staff expertise. We conducted a survey asking staff about needs for training, desired areas they want to expand, and hidden “talents.” One staff person let us know that she had learned SAS in her Master’s program and would be interested in more data work. We were able to reallocate data tasks to her and paired her with a colleague who was struggling with her data tasks.

Another area of workforce development is hiring more early-career staff and exposing them to meetings, stakeholders, and project management. As in medicine’s “see one, do one, teach one” philosophy, we have started a grant group that exposes junior staff to the grant writing process, including having staff conduct “Grant 101” training, linking staff with mentors, and allowing staff to take the lead on grants with the more experienced staff acting as mentors and reviewers. Our philosophy is “see a few, be work on some, write one.” Additionally, we are bringing junior staff to board meetings, workgroups, and stakeholder meetings and letting them take on these roles over time.