2024-08-15T14:50:42-05:00 2023-09-30 580692043 MAULDIN & JENKINS LLC 200 GALLERIA PKWY SE STE 1700 ATLANTA GA 303395946 990 2022-10-01 237410799 COUNCIL OF STATE AND TERRITORIAL EPIDEMIOLOGISTS INC COUN 7704583811 2635 CENTURY PARKWAY NE 700 ATLANTA GA 30345 JANET HAMILTON EXECUTIVE DIRECTOR 7704583811 2024-08-15 1 1 ALEISA HOWELL P00936721 7709558600 2024-08-14 2022 2024-08-08 14:25:15Z JANET HAMILTON 2635 CENTURY PARKWAY NE 700 ATLANTA GA 30345 36595836 0 X WWW.CSTE.ORG X 1992 GA DEVELOPMENT OF STATE SURVEILLANCE AND EPIDEMIOLOGIST TRAININGVISION STATEMENTTHE COUNCIL OF STATE AND TERRITORIAL EPIDEMIOLOGISTS IS COMMITTED TO IMPROVING THE PUBLIC'S HEALTH BY SUPPORTING THE EFFORTS OF EPIDEMIOLOGISTS WORKING AT THE STATE AND LOCAL LEVEL TO INFLUENCE PUBLIC HEALTH PROGRAMS AND POLICY BASED ON SCIENCE AND DATA. 13 13 94 1000 0 0 27322164 34207706 1660750 2358068 2124 9718 27686 20344 29012724 36595836 12217881 13116643 0 0 9072054 11647621 0 0 0 7528592 10708237 28818527 35472501 194197 1123335 7885631 12492068 3912127 7395229 3973504 5096839 X SEE SCHEDULE OCSTE PROMOTES THE EFFECTIVE USE OF EPIDEMIOLOGIC DATA TO GUIDE PUBLIC HEALTH PRACTICE AND IMPROVE HEALTH. CSTE ACCOMPLISHES THIS BY SUPPORTING THE USE OF EFFECTIVE PUBLIC HEALTH SURVEILLANCE AND GOOD EPIDEMIOLOGIC PRACTICE THROUGH TRAINING, CAPACITY DEVELOPMENT, AND PEER CONSULTATION, DEVELOPING STANDARDS FOR PRACTICE, AND ADVOCATING FOR RESOURCES AND SCIENTIFICALLY BASED POLICY. 0 0 SEE SCHEDULE OINFECTIOUS DISEASE:CSTE HELPS SUPPORT CDC'S RESPIRATORY VIRUS HOSPITALIZATION SURVEILLANCE NETWORKS FOR INFLUENZA, COVID-19, AND RESPIRATORY SYNCYTIAL VIRUS (RSV), COLLECTIVELY REFERRED TO AS RESP-NET. WE PROVIDE CDC FUNDING TO SELECTED STATE AND LOCAL HEALTH DEPARTMENTS TO COLLECT DATA ON LABORATORY-CONFIRMED RESPIRATORY VIRUS-ASSOCIATED HOSPITALIZATIONS AMONG CHILDREN AND ADULTS. FOR THE 2022-2023 RESPIRATORY VIRUS SEASON, CSTE FUNDED SEVEN SITES TO CONDUCT INFLUENZA HOSPITALIZATION SURVEILLANCE, FOUR SITES TO CONDUCT COVID-19 HOSPITALIZATION SURVEILLANCE, AND TWO SITES TO CONDUCT RSV HOSPITALIZATION SURVEILLANCE. DATA GATHERED FROM THE CSTE-SUPPORTED SITES ARE COMBINED WITH DATA FROM CDC'S EMERGING INFECTIONS PROGRAM. THIS FORMS A ROBUST NETWORK THAT PROVIDES KEY DATA FOR UNDERSTANDING THE BURDEN AND CHARACTERISTICS OF THESE VIRUSES IN THE POPULATION, WHICH HELPS PUBLIC HEALTH BETTER RESPOND TO AND PREVENT THESE SERIOUS INFECTIONS THAT CAUSE SUBSTANTIAL IMPACTS ON THE U.S. POPULATION EACH YEAR.DATA ARE SUBMITTED TO CDC WITH HOSPITALIZATION RATES PRESENTED ON THE RESP-NET INTERACTIVE DASHBOARD, WHICH CAN BE USED TO FOLLOW TRENDS AND COMPARE COVID-19, INFLUENZA, AND RSV-ASSOCIATED HOSPITALIZATION RATES IN DIFFERENT DEMOGRAPHIC GROUPS INCLUDING BY AGE, SEX, RACE AND ETHNICITY, AND ACROSS SEASONS. RESP-NET PROVIDES CRITICAL INFORMATION ON RESPIRATORY VIRUS-ASSOCIATED HOSPITALIZATIONS TO HELP PUBLIC HEALTH PROFESSIONALS UNDERSTAND TRENDS IN VIRUS CIRCULATION, ESTIMATE DISEASE BURDEN, AND RESPOND TO OUTBREAKS. COLLECTING DEMOGRAPHIC AND CLINICAL INFORMATION FOR HOSPITALIZATIONS ALLOWS CDC AND HEALTH DEPARTMENTS TO BETTER UNDERSTAND HOW WELL VACCINES ARE WORKING, WHICH PEOPLE ARE AT HIGH RISK, AND WHETHER A CERTAIN STRAIN OF A VIRUS IS RESULTING IN MORE SEVERE ILLNESS OR DEATHS. THESE FINDINGS CAN BE USED TO COMMUNICATE IMPORTANT PREVENTION INFORMATION TO THE PUBLIC TO HELP PEOPLE STAY HEALTHY AND SAFE. SEE SCHEDULE OENVIRONMENTAL HEALTH / OCCUPATIONAL HEALTH:EVERY YEAR, OVER 3.5 MILLION OF THE 167 MILLION WORKERS IN THE U.S. ARE INJURED ON THE JOB OR BECOME ILL AS A RESULT OF EXPOSURE TO HEALTH HAZARDS AT WORK. THESE WORK-RELATED INJURIES AND ILLNESSES RESULT IN SUBSTANTIAL HUMAN AND ECONOMIC COSTS FOR WORKERS AND EMPLOYERS AND FOR SOCIETY AT LARGE; IT HAS BEEN ESTIMATED THAT THE DIRECT AND INDIRECT COSTS OF WORK-RELATED INJURIES AND ILLNESSES EXCEED $170 BILLION ANNUALLY.IN PARTNERSHIP WITH CDC'S NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH (NIOSH) AND STATE OCCUPATIONAL HEALTH PROGRAMS, THE CSTE OCCUPATIONAL HEALTH SUBCOMMITTEE HELP TO QUANTIFY THE BURDEN OF SUCH INJURIES AND ILLNESSES THROUGH THE OCCUPATIONAL HEALTH INDICATORS (OHIS). OHIS ARE 25 MEASURES OF HEALTH (WORK-RELATED DISEASE OR INJURY) OR FACTORS ASSOCIATED WITH HEALTH (WORKPLACE EXPOSURES, HAZARDS, OR INTERVENTIONS) THAT ALLOW A STATE TO COMPARE ITS HEALTH OR RISK STATUS WITH THAT OF OTHER STATES AND EVALUATE TRENDS OVER TIME. THE CSTE OCCUPATIONAL HEALTH SUBCOMMITTEE PROVIDES ONGOING REVIEW, GUIDANCE AND COLLABORATION FOR ANNUAL STATE REPORTING OF OHIS. DATA FROM THE 29 STATES THAT CALCULATE OHIS FOR THEIR STATE ARE POSTED ON THE CSTE WEBSITE AT HTTPS://WWW.CSTE.ORG/PAGE/OHINDICATORSTABLE. THIS YEAR'S REVIEW INCLUDED A NEW, UPDATED DOCUMENT, "OCCUPATIONAL HEALTH INDICATORS: A GUIDE FOR OBTAINING AND TRACKING OCCUPATIONAL HEALTH CONDITIONS AND THEIR DETERMINANTS, AN ANALYSIS OF 2020 OHI DATA," TO HELP STATES CONTINUE TO DEVELOP PRIORITIES FOR WORKPLACE INJURY AND ILLNESS PREVENTION. THIS "HOW-TO" GUIDE ASSISTS STATES IN BUILDING CAPACITY FOR OCCUPATIONAL HEALTH SURVEILLANCE."THE HOW-TO GUIDE PROVIDES DETAIL OF HOW TO COLLECT AND ANALYZE THE DATA, AND THE REQUIRED INTERACTION WITH OTHER STATE/FEDERAL PARTNERS SHOWS THE HEALTH DEPARTMENT THE PARTNERS IT NEEDS TO ASSURE THE SUSTAINABILITY OF THE EFFORT," SAID KEN ROSENMAN, MD, CHIEF, DIVISION OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE AT MICHIGAN STATE UNIVERSITY, AND CO-CHAIR OF THE CSTE OCCUPATIONAL HEALTH SUBCOMMITTEE.THE INDICATORS COMPLEMENT OTHER STATE AND NATIONAL GOALS TO IMPROVE POPULATION HEALTH AND ARE INTENDED TO BE USED IN CONJUNCTION WITH OTHER GUIDELINES FOR STATE-BASED SURVEILLANCE OF OCCUPATIONAL INJURIES AND ILLNESSES, SUCH AS THE GUIDELINES FOR MINIMUM AND COMPREHENSIVE STATE-BASED PUBLIC HEALTH ACTIVITIES IN OCCUPATIONAL SAFETY AND HEALTH (HTTPS://WWW.CDC.GOV/NIOSH/DOCS/2008-148/PDFS/2008-148.PDF).THE PROCESS OF OBTAINING THE DATA FOR THESE INDICATORS IS INTENDED TO RAISE AWARENESS AND BUILD CAPACITY FOR USING AVAILABLE DATA AND TO OPEN DIALOGUE AMONG OCCUPATIONAL HEALTH PARTNERS WITHIN THE STATE."THE OCCUPATIONAL HEALTH INDICATORS ARE A GREAT WAY FOR A STATE HEALTH DEPARTMENT TO BEGIN TO ASSESS THE BURDEN OF OCCUPATIONAL INJURIES AND ILLNESSES IN THEIR STATES," SAID ROSENMAN. SEE SCHEDULE OSURVEILLANCE / INFORMATICS:THIS YEAR SAW THE LAUNCH OF CSTE STORIES FROM THE FIELD, A MULTIMEDIA PROJECT HIGHLIGHTING THE GREAT WORK OF CSTE MEMBERS AND OTHER EPIDEMIOLOGISTS ACROSS THE COUNTRY WHO'VE EFFICIENTLY LEVERAGED DATA MODERNIZATION FUNDING AND PRINCIPLES TO IMPROVE PUBLIC HEALTH AT THE JURISDICTIONAL LEVEL THROUGH MEANINGFUL AND INNOVATIVE USE OF DATA.CSTE LAUNCHED THE WEBSITE, STORIES.CSTE.ORG, IN MARCH AS A ONE-STOP SHOP TO VIEW AND READ NEARLY 180 TALES OF EPI INNOVATION. THE STORIES SHOWCASE INNOVATIVE WAYS PUBLIC HEALTH DEPARTMENTS ARE WORKING TO GET BETTER, FASTER, ACTIONABLE INSIGHTS FOR DECISION-MAKING AT ALL LEVELS OF PUBLIC HEALTH. THE PROJECT HIGHLIGHTS NOT ONLY TECHNOLOGICAL INNOVATIONS BUT ALSO THE EPIDEMIOLOGISTS WHO HAVE RESEARCHED AND IMPLEMENTED DATA MODERNIZATION SOLUTIONS IN AREAS SUCH AS ELECTRONIC CASE REPORTING (ECR), INTEROPERABLE DATA SYSTEMS, SYNDROMIC SURVEILLANCE, AND MORE.MUCH OF THIS WORK WAS DONE UNDER GREAT STRESS AND PROVIDES EXAMPLES OF "TRIUMPH IN THE FACE OF ADVERSITY" DURING THE GLOBAL RESPONSE TO THE COVID-19 PANDEMIC, WHILE THE U.S. PUBLIC HEALTH INFRASTRUCTURE AND WORKFORCE WERE STRETCHED TO THE LIMIT.THE INITIATIVE WAS FUNDED BY CDC'S OFFICE OF PUBLIC HEALTH DATA, SURVEILLANCE, AND TECHNOLOGY (OPHDST). CDC DIRECTOR DR. MANDY COHEN PRAISED THE PROJECT AND FEATURED EPIDEMIOLOGISTS, SAYING "PUBLIC HEALTH IS A TEAM SPORT AND THIS IS A GREAT EXAMPLE OF US WORKING TOGETHER TO PROTECT HEALTH AND IMPROVE LIVES. THESE STORIES HIGHLIGHT CRITICAL COMPONENTS OF HOW COMMUNITIES ARE IMPROVING THEIR READINESS TO INVESTIGATE AND RESPOND TO DISEASE THREATS. CDC AND PUBLIC HEALTH PARTNERS SUCH AS OUR STATE EPIDEMIOLOGISTS ARE PUTTING DATA AND EVIDENCE INTO ACTION TO HELP PEOPLE AND COMMUNITIES STAY HEALTHY."ADDITIONAL THEMES OF THE STORIES INCLUDE LABORATORY DATA EXCHANGE, PUBLIC HEALTH DATA SCIENCE WORKFORCE, PARTNERSHIP AND INNOVATION, INTEROPERABLE DATA SYSTEMS, AND ENTERPRISE APPROACH TO DATA SYSTEMS MODERNIZATION. THESE DATA MODERNIZATION EFFORTS REPRESENT A SIGNIFICANT RETURN ON THE INVESTMENT OF FUNDING, STAFF, TIME AND RESOURCES INTO DATA MODERNIZATION TO IMPROVE PUBLIC HEALTH IN JURISDICTIONS ACROSS THE COUNTRY. AND THAT IMPACT IS NOT OVER; MANY OF THE INITIATIVES FEATURED IN CSTE STORIES FROM THE FIELD WILL CONTINUE, BE EXPANDED OR GENERATE OTHER EFFORTS GOING FORWARD AND IN PREPARATION FOR FUTURE THREATS. WORKFORCE:THIS YEAR, CSTE'S DATA SCIENCE TEAM TRAINING (DSTT) PROGRAM HELPED GIVE THE MADISON & DANE COUNTY HEALTH DEPARTMENT IN WISCONSIN A MAJOR "UPGRADE" IN DATA COLLECTION SKILLS. DSTT IS A TEAM-BASED, ON-THE JOB TRAINING PROGRAM TO PROMOTE DATA SCIENCE UPSKILLING AT STLT PUBLIC HEALTH AGENCIES AND PARTICIPANTS WORK COLLABORATIVELY ON A PROJECT THAT ADDRESSES A CURRENT AGENCY NEED RELATED TO DATA MODERNIZATION. WHEN KAT GRANDE, PUBLIC HEALTH SUPERVISOR AT PUBLIC HEALTH MADISON AND DANE COUNTY, SAW AN EMAIL PROMOTING THE DSTT PROGRAM, SHE IMMEDIATELY THOUGHT OF A PROJECT THAT WOULD MAKE A GREAT FIT. AT THE HEIGHT OF THE COVID-19 PANDEMIC, GRANDE AND HER TEAM BUILT A COVID DATA DASHBOARD THAT WAS WELL RECEIVED BY THE PUBLIC AND WAS VIEWED OVER HALF A MILLION TIMES. "WE FRAMED A DSTT PROJECT ON HOW TO EXPAND [THE DASHBOARD] TO INCLUDE THE BREADTH OF RESPIRATORY ILLNESSES AND MAKE IT EASY TO UNDERSTAND," SHE SAID. "YOU DID NOT NEED EXTENSIVE TRAINING IN EPIDEMIOLOGY TO INTERPRET IT. WE USED PLAIN LANGUAGE, SIMPLE VISUALIZATIONS STRATEGIES FOR COMMUNICATING TO THE POPULATIONS MOST IMPACTED." TO HELP WITH BUILDING THIS NEW DASHBOARD, THE DSTT PROGRAM ALLOWED GRANDE AND HER TEAM TO TAKE COURSES IN SOFTWARE LIKE R AND SAAS. INSTEAD OF GOOGLING AND WATCHING YOUTUBE VIDEOS, THE TEAM ATTENDED A FORMAL CLASS WITH LIVE INSTRUCTORS. THE COMPREHENSIVE TRAINING ALLOWED GRANDE'S TEAM TO BUILD NOT JUST A STANDARD DASHBOARD, BUT AN INNOVATIVE ONE THAT PULLS IN MULTIPLE DATA STREAMS. "ONE THING THAT SETS OURS APART IS THAT WE USED THE TRADITIONAL PUBLIC HEALTH DATA THAT YOU SEE ON THE CDC AND OTHER HEALTH DEPARTMENT DASHBOARDS," SHE SAID. "BUT ALSO MADE SOME REALLY DELIBERATE PARTNERSHIPS WITH OUR UNIVERSITY RESEARCHER PARTNERS AND TRIED TO APPLY SOME OF THE RESEARCH THAT THEY WERE DOING ON THINGS LIKE AIR SURVEILLANCE."IN ADDITION TO AIR SURVEILLANCE, ANOTHER INNOVATIVE FEATURE OF THEIR DASHBOARD WAS TO INCORPORATE SCHOOL ABSENTEEISM INTO FLU SURVEILLANCE. "THE ABILITY TO HAVE THE TIME, THE SPACE, AND THE CREATIVE ENCOURAGEMENT FROM THE DSTT STRUCTURE SO THAT WE COULD MAKE SOME OF THOSE INNOVATIONS, ON TOP OF A TRADITIONAL DISEASE-RELATED DASHBOARD, WAS REALLY ADDITIVE," GRANDE SAID. PUBLIC HEALTH LAW:DURING THE COVID-19 PANDEMIC, CSTE'S LEADERSHIP IN SOME AREAS WAS QUITE VISIBLE, FROM UPDATING EPIDEMIOLOGISTS NATIONWIDE ON THE LATEST INFORMATION FROM CDC SOMETIMES MULTIPLE TIMES A DAY TO SUPPORTING VIRTUAL GATHERINGS FOR BEST PRACTICE SHARING WHILE MANY AREAS WERE STILL IN LOCKDOWN. HOWEVER, ANOTHER AREA IN WHICH WE ALSO OFFERED GUIDANCE AND SUPPORT WAS LESS VISIBLE AND IS PERHAPS LESS WELL RECOGNIZED AS PART OF CSTE'S EXPERTISE: PUBLIC HEALTH LAW.CREATED IN 2021, THE CSTE PUBLIC HEALTH LAW SUBCOMMITTEE PROVIDES A FORUM FOR EPIDEMIOLOGISTS, PUBLIC HEALTH ATTORNEYS, AND OTHER HEALTH AND LEGAL EXPERTS TO COLLABORATE ON LEGAL ISSUES RELATED TO SURVEILLANCE, EPIDEMIOLOGY, AND PUBLIC HEALTH PRACTICE.THE SUBCOMMITTEE OFFERED MUCH NEEDED EXPERTISE TO PUBLIC HEALTH OFFICIALS AND EPIDEMIOLOGISTS IN RESPONSE TO LEGAL QUESTIONS AND CHALLENGES ON ASPECTS OF THE COVID-19 PANDEMIC, INCLUDING VACCINES, QUARANTINE, AND OTHER ISSUES. THE CONTROVERSIES SURROUNDING THESE ISSUES, AS WELL AS RAPIDLY CHANGING PUBLIC HEALTH NEEDS, MEANT THAT APPLYING RELATED LAWS WAS NOT ALWAYS CLEAR.TO PROVIDE INFORMATION AND GUIDANCE, THE SUBCOMMITTEE PRESENTED A THREE-PART WEBINAR SERIES ON LEGAL ISSUES RELATED TO THE PANDEMIC, HELPING ADVISE PUBLIC HEALTH OFFICIALS OF THEIR LEGAL STANDING IN THESE AREAS. THE FIRST DISCUSSED STUDENTS RETURNING TO SCHOOL AFTER WIDESPREAD SCHOOL CLOSURES, QUARANTINE AND OTHER K-12 LEGAL ISSUES, INCLUDING WHETHER SCHOOLS COULD REQUIRE QUARANTINE OF INFECTED STUDENTS. THE SECOND FOCUSED ON THREATS TO THE AUTHORITY OF PUBLIC HEALTH AND THE LEGAL AVENUES AVAILABLE TO ENSURE THAT SOUND PUBLIC HEALTH GUIDANCE WAS PROVIDED IN RESPONSE TO THE PANDEMIC. THE THIRD WEBINAR PROVIDED A LEGAL ANALYSIS OF INDOOR AIR QUALITY AND THE MEASURES BEING TAKEN TO MANAGE THAT TO PREVENT THE SPREAD OF COVID-19.IN ADDITION TO THIS SERIES, THE SUBCOMMITTEE IS WORKING TO PRESENT QUARTERLY WEBINARS GOING FORWARD, TO CONTINUE ADVISING AND SUPPORTING CSTE MEMBERS AND PUBLIC HEALTH ORGANIZATIONS ON PERTINENT LEGAL ISSUES. THE SUBCOMMITTEE WILL CONTINUE IN ITS MISSION TO DESIGN AND IMPLEMENT PRACTICAL LEGAL SOLUTIONS TO COMPLEX PUBLIC HEALTH CHALLENGES AND USE THE TOOLS OF LAW AND POLICY TO ADVANCE PUBLIC HEALTH EFFORTS. CHRONIC DISEASE / MATERNAL AND CHILD HEALTH:FACILITATING THE CREATION, APPROVAL, AND IMPLEMENTATION OF STANDARDIZED CASE DEFINITIONS AND RECOMMENDING WHICH CONDITIONS SHOULD BE ON THE NATIONALLY NOTIFIABLE CONDITION LIST ARE CORE FUNCTIONS OF CST. EACH YEAR AT OUR ANNUAL CONFERENCE, THE CSTE MEMBERSHIP VOTES ON POSITION STATEMENTS DESCRIBING THESE DEFINITIONS AND RECOMMENDATIONS. THIS PROCESS IS ESSENTIAL FOR IMPACTING STANDARD PRACTICES AND POLICY TO IMPROVE PUBLIC HEALTH NATIONWIDE.IN JUNE 2023, THE POSITION STATEMENT "UPDATE TO THE NEONATAL ABSTINENCE SYNDROME (NAS) STANDARDIZED CASE DEFINITION" WAS APPROVED, ADDRESSING A GROWING ISSUE IN MATERNAL AND CHILD HEALTH. THE OPIOID CRISIS IN THE UNITED STATES HAS CONTINUED TO INTENSIFY IN PAST YEARS, INCLUDING INCREASED OPIOID AND POLYSUBSTANCE USE DURING PREGNANCY, WHICH CAN RESULT IN WITHDRAWAL SIGNS IN NEWBORNS, KNOWN AS NAS. THIS CRITICAL POSITION STATEMENT UPDATE IS BUILT FROM YEARS OF COLLABORATIVE WORK TO IMPROVE THE ORIGINAL 2019 NAS DEFINITION, CLARIFYING INTERPRETATION AND CONSISTENCY IN REPORTING ACROSS JURISDICTIONS AND ADDRESSING CONCERNS IDENTIFIED BY PUBLIC HEALTH ORGANIZATIONS.AFTER THE ORIGINAL DEFINITION WAS ADOPTED, CSTE FUNDED SIX JURISDICTIONS TO PILOT IMPLEMENTATION FROM 2020-2023 AND PROVIDE DATA AND FEEDBACK ARIZONA, FLORIDA, GEORGIA, MASSACHUSETTS, TENNESSEE, AND PHILADELPHIA. THEY FOUND THAT THE ORIGINAL DEFINITION WAS SOMETIMES DIFFICULT TO IMPLEMENT IN A STANDARDIZED MANNER AND SIMPLIFICATION WAS NEEDED IN THE CASE CLASSIFICATION STRUCTURE."TO HAVE A COMMON SURVEILLANCE CASE DEFINITION FOR NEONATAL ABSTINENCE SYNDROME ALLOWS FOR MEASURES THAT CAN BE COMPARED MORE ACCURATELY AND TO EVALUATE THE IMPACT OF SURVEILLANCE AND INTERVENTION PROGRAMS," SAID LUIGI GARCIA SAAVEDRA, MPH, BIRTH DEFECTS EPIDEMIOLOGIST SUPERVISOR FOR THE NEW MEXICO DEPARTMENT OF HEALTH AND CO-CHAIR OF THE CSTE MATERNAL AND CHILD HEALTH SUBCOMMITTEE. "I THINK THE REVISIONS WERE VERY USEFUL TO IMPROVE THE CASE DEFINITION."TO ADDRESS THE LESSONS LEARNED AND RECOMMENDATIONS FROM THE PILOT, CSTE CONVENED A LEADERSHIP GROUP TO SPEARHEAD REVISIONS, WHICH INCLUDED PILOT PROJECT TEAMS, OTHER JURISDICTIONS THAT HAVE BEEN CONDUCTING NAS SURVEILLANCE, SUBJECT MATTER EXPERTS FROM CDC'S NATIONAL CENTER FOR BIRTH DEFECTS AND DEVELOPMENTAL DELAYS, THE CSTE MATERNAL AND CHILD HEALTH SUBCOMMITTEE, AND THE CSTE NAS WORKGROUP.CSTE HAS NOW FUNDED FOUR OF THE PILOT SITES TO CONTINUE, USING PILOT DATA TO CONDUCT ANALYSIS PROJECTS TO EXPLORE THE FEASIBILITY OF LONGITUDINAL SURVEILLANCE AMONG INFANTS BORN WITH NAS AND SUPPORT REFERRAL SERVICES TO FAMILIES IMPACTED BY THE CONDITION. THE NAS WORKGROUP IS ALSO DEVELOPING AN IMPLEMENTATION GUIDE TO SUPPORT JURISDICTIONS THAT ARE BEGINNING NAS SURVEILLANCE AND WILL CONTINUE TO ASSESS RESPONSES NEEDED TO IMPROVE THE HEALTH OF MOTHERS AND CHILDREN IN COMMUNITIES NATIONWIDE. INJURY, SUBSTANCE USE, AND MENTAL HEALTH:IN THE LAST TWO DECADES, THE NUMBER OF DRUG OVERDOSE DEATHS IN THE U.S. HAS QUADRUPLED, RISING FROM 16,849 IN 1999 TO OVER 70,000 IN 2019 MORE THAN 840,000 IN TOTAL. TO ADDRESS THIS CRISIS, PUBLIC HEALTH MUST COORDINATE WITH FIRST RESPONDERS, COMMUNITY HARM REDUCTION PROGRAMS AND TREATMENT PROVIDERS. HOWEVER, DEFINING AN UNUSUAL INCREASE IN OVERDOSE DEATHS SUCH AS AN OUTBREAK OR CLUSTER CAN VARY AND DEPENDS ON CIRCUMSTANCES IN THE LOCAL COMMUNITY. THIS CAN MAKE IT DIFFICULT TO DETERMINE AND MOUNT A PUBLIC HEALTH RESPONSE.IN AUGUST 2022, THE CSTE OVERDOSE SPIKE ALERT ADVISORY WORKGROUP LAUNCHED THE CSTE OVERDOSE ANOMALY TOOLKIT TO HELP COMMUNITIES MEET THESE COMPLEX AND EVER-GROWING CHALLENGES. WITH FUNDING THROUGH CDC'S OVERDOSE DATA TO ACTION (OD2A) COOPERATIVE AGREEMENT, WORKGROUP MEMBERS FROM CDC, STATE AND LOCAL HEALTH DEPARTMENTS, CSTE STAFF AND CONSULTANTS CREATED THE TOOLKIT TO PROVIDE PUBLIC HEALTH RESPONSE TEAMS WITH A COMPREHENSIVE APPROACH TO CONDUCTING A TIMELY AND EFFECTIVE INVESTIGATION INTO NOTABLE INCREASES IN A CITY, COUNTY OR REGION.THE TOOLKIT HELPS COMMUNITIES IMPROVE THE USE OF THEIR OVERDOSE SURVEILLANCE DATA TO EMPOWER PREVENTION AND RESPONSE. WITH GUIDANCE, TOOLS AND TECHNIQUES FROM THE TOOLKIT, THEY CAN DETERMINE AND DEFINE WHAT NEEDS A RESPONSE AND AT WHAT LEVEL THAT SHOULD BE MADE TO DELIBERATELY REACT TO CHANGES IN THE COMMUNITY. THIS HELPS COMMUNITIES PLAN AND UTILIZE THEIR RESOURCES MORE EFFECTIVELY.THE TOOLKIT IS ORGANIZED AROUND THREE ACTIVITY AREAS IN AN ITERATIVE MODEL: PLAN, ACT AND EVALUATE. THESE FEATURE REAL EXAMPLES OF JURISDICTION-BASED ACTIVITIES THAT CAN BE USED TO HELP PUBLIC HEALTH RESPONDERS BETTER PREPARE FOR, DETECT AND RESPOND TO DRUG OVERDOSE OUTBREAKS.AT THIS STAGE IN THE OVERDOSE EPIDEMIC, COMMUNITIES UNDERSTAND THERE IS A BASELINE OF EVENTS IN THEIR JURISDICTIONS AND HAVE IMPLEMENTED PREVENTION PROGRAMS. BUT THEY OFTEN NEED TOOLS TO UNDERSTAND WHAT CHANGES IN OVERDOSE LEVELS WARRANT ADDITIONAL ACTION AND WHAT STEPS CAN BE TAKEN WHEN THAT ACTION IS REQUIRED. THE CSTE OVERDOSE ANOMALY TOOLKIT PROVIDES GUIDANCE FOR COMMUNITIES THAT MAY NOT HAVE THE EXPERIENCE, RESOURCES OR TIME TO CREATE THE NEEDED RESPONSE WHEN AN OVERDOSE SPIKE OR CLUSTER OCCURS. TRIBAL EPIDEMIOLOGYWHAT BEGAN AS A WORKGROUP PROJECT IN 2020 TO UNDERSTAND THE CHALLENGES MANY NATIVE AMERICANS FACED IN ACCESSING COVID-19 VACCINATIONS, TESTING AND PERSONAL PROTECTIVE EQUIPMENT (PPE) ULTIMATELY EVOLVED INTO A 2023 MANUSCRIPT PUBLICATION IN THE JOURNAL OF HEALTH DISPARITIES RESEARCH AND PRACTICE. ALONG THE WAY, THE EFFORT ILLUSTRATED HOW COMMUNITIES ARE BETTER SERVED WHEN BETTER QUALITY DATA IS USED, AS WELL AS HOW CSTE, OUR SUBCOMMITTEES AND OUR WORKGROUPSUSE THE POWER OF EPIDEMIOLOGY TO FOSTER THOSE TYPES OF IMPROVEMENTS.THE MANUSCRIPT, "COVID-19 SEVERITY AMONG AMERICAN INDIANS AND ALASKA NATIVES IN 16 STATES - JANUARY 1, 2020, TO MARCH 31, 2021," IS THE SECOND ARTICLE TO BE PUBLISHED BY THE CSTE TRIBAL SUBCOMMITTEE. THE COLLABORATIVE GROUP OF OVER 20 TRIBAL EPIDEMIOLOGY CENTER (TEC) AND STATE PUBLIC HEALTH STAFF MEMBERS INITIALLY PUBLISHED FINDINGS IN A CDC MORBIDITY AND MORTALITY WEEKLY REPORT IN 2020 AND FOLLOWED THAT UP WITH ADDITIONAL DATA COLLECTION IN 2021."WE KNEW THE LIMITATIONS OF THE MMWR, WHICH FOCUSED ON THE BURDEN OF DISEASE, AND WE WANTED TO DO SOMETHING DEEPER," SAID JESSICA ARRAZOLA, CSTE DIRECTOR OF EDUCATIONAL STRATEGY AND ONE OF THE MANUSCRIPT'S AUTHORS. "SO, WE LOOKED MORE AT SEVERITY OF DISEASE, CO-MORBIDITY, HOSPITALIZATIONS AND DEATHS. THE DISPARITIES WERE NOT RELATED JUST TO HAVING THE DISEASE, BUT THE OUTCOMES WERE MUCH WORSE FOR THE NATIVE AMERICAN POPULATION."MANY STATES WERE COLLECTING DATA ON NATIVE AMERICAN COMMUNITIES DIFFERENTLY, AND SOME DIDN'T HAVE SEPARATE DATA FOR THIS COMMUNITY OR INCLUDED THOSE IDENTIFYING THEMSELVES AS MULTIRACIAL ONLY AS HISPANIC. THROUGH COLLABORATION WITH TECS, THE CSTE SUBCOMMITTEE HAD MORE COMMONALITY IN CASE REPORTING DEFINITIONS AND DATA, ALLOWING FOR BETTER AND MORE RIGOROUS ANALYSIS. BEING ABLE TO UTILIZE IMPROVED DATA HELPED LEAD TO ONE OF THE MAIN CONCLUSIONS OF THE ARTICLE, THAT "COVID-19-RELATED HEALTH BURDENS AMONG AI/AN PERSONS WARRANT IMPROVED ACCESS FOR AI/AN COMMUNITIES TO MEDICAL COUNTERMEASURES AND HEALTHCARE RESOURCES."SINCE PUBLICATION, THE MANUSCRIPT HAS BEEN DOWNLOADED MORE THAN 110 TIMES, ILLUSTRATING THE IMPORTANCE OF THE RESEARCH AND FINDINGS. "THIS COLLABORATION IS A GREAT EXAMPLE OF PEOPLE WHO TRULY CARE ABOUT THEIR COMMUNITIES USING DATA TO INFORM ACTION THAT WILL PROTECT AND CARE FOR THOSE COMMUNITIES," SAID ARRAZOLA. 0 1 0 1 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 1 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 52 0 1 94 1 0 0 0 0 1 1 0 0 0 X 13 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 GA X X JANET HAMILTON 7704583811 2635 CENTURY PARKWAY NE SUITE 700 ATLANTA GA 30345 ANGELA DUNN MD MPH PRESIDENT (OUTGOING) 5.00 X X 0 0 0 SARAH LYON-CALLO MA MS PHD PRESIDENT (INCOMING) 10.00 X X 0 0 0 CATHERINE BROWN DVM MSC MPH PRESIDENT - ELECT 5.00 X X 0 0 0 KATHRYN TURNER PHD MPH VICE PRESIDENT 2.00 X X 0 0 0 RUTH LYNFIELD MD SECRETARY/TREASURER 4.00 X X 0 0 0 BENJAMIN CHAN MD MPH MEMBER-AT-LARGE 5.00 X 0 0 0 SHERRI L DAVIDSON PHD MPH MEMBER-AT-LARGE 8.00 X 0 0 0 MARY-MARGARET A FILL MD MPH MEMBER-AT-LARGE 1.00 X 0 0 0 KATE GOODIN MS MPH MEMBER-AT-LARGE 2.00 X 0 0 0 MELISSA JORDAN MS MPH MEMBER-AT-LARGE 5.00 X 0 0 0 SARAH KEMBLE MD MEMBER-AT-LARGE 2.00 X 0 0 0 KEN KOMATSU MPH MEMBER-AT-LARGE 2.00 X 0 0 0 ERICA PAN MD MPH MEMBER-AT-LARGE 2.00 X 0 0 0 JANET HAMILTON EXECUTIVE DIRECTOR 48.00 1.00 X 290153 0 42468 SHELIA SCOTT SENIOR DIRECTOR OF FINANCE 42.00 3.00 X 169543 0 20853 MARCELLE LAYTON CHIEF MEDICAL OFFICER 41.00 X 264282 0 25424 ANNIE FINE CHIEF SCIENCE/SURVEILLANCE OFFICER 43.00 X 259981 0 38173 BEVERLY CHRISTNER SENIOR DIRECTOR OF OPERATIONS 44.00 X 212317 0 31038 JENNIFER LEMMINGS SENIOR DIRECTOR OF GSS 42.00 X 195700 0 42035 DHARA SHAH SENIOR DIRECTOR OF PROGRAMS 44.00 X 185254 0 33539 1577230 0 233530 19 0 1 0 HIGHWOODS REALTY LIMITED PARTNERSHIP 3100 SMOKETREE COURT STE 600 RALEIGH NC 27604 PROPERTY RENTAL 650564 HLN CONSULTING LLC 9 PEMBERLY MISSION VIEJO CA 92692 CONSULTING 332000 CAVAROCCHI RUSCIO DENNIS ASSOCIATES LLC 600 MARYLAND AVE SW SUITE 220 EAST WASHINGTON DC 20024 EDUCATION/ADVOCACY 208046 MELISSA KAY IVEY 80 WALKER LOOP SPRINGVILLE TN 38256 CONSULTING 186250 KAHUINA CONSULTING LLC 40 CONISTON ROAD ROSLINDALE MA 02131 CONSULTING 150644 6 94822 33883656 229228 34207706 ANNUAL MEETINGS 611430 2045024 2038505 6519 MEMBER FEES 611430 313044 313044 2358068 9718 9718 20254 20254 FEES 900099 90 90 90 36595836 2351549 0 36581 X 7189186 5927457 543564 8653530 434019 1365811 650697 82372 23400 17190 5420745 713 373011 745676 602407 2429022 775095 64408 30376 TELEPHONE 61793 DUES AND SUBSCRIPTIONS 25237 PRINTING AND REPRODUCTI 18042 TRAINING 16882 21868 35472501 4436511 6941494 2938262 2122988 66685 60209 192854 99261 866980 735863 195525 131117 55794 3136999 7885631 12492068 3282286 3742007 108846 124211 520995 3529011 3912127 7395229 X 3973504 5096839 3973504 5096839 7885631 12492068 1123335 0 X X 0 1 X 1 1 1 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 162545 17190 17190 105654 -88464 50094 34089 16005 816886 701774 115112 131117 SECURITY DEPOSITS 49718 INTERCOMPANY RECEIVABLE 25094 RIGHT OF USE ASSET 3062187 3136999 TENANT IMPROVEMENT ALLOWANCE 55687 OPERATING LEASE 3473324 3529011 X PART X, LINE 2: THE ORGANIZATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH ACCOUNTING STANDARDS THAT PROVIDE GUIDANCE ON WHEN UNCERTAIN TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND HOW THE VALUES OF THESE POSITIONS ARE DETERMINED. NO LIABILITY HAS BEEN RECORDED AS OF SEPTEMBER 30, 2023 OR 2022 DUE TO UNCERTAIN TAX POSITIONS. EUROPE (INCLUDING ICELAND & GREENLAND) - ALBANIA, ANDORRA, AUSTRIA, BELGIUM 0 0 PROGRAM SERVICES FLU SURVEILLANCE 48541 EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES FLU SURVEILLANCE 48749 SOUTH AMERICA 0 0 PROGRAM SERVICES FLU SURVEILLANCE 54639 0 0 0 0 0 0 151929 0 151929 0 0 0 0 0 0 PART III ACCOUNTING METHOD: 1 ARIZONA DEPARTMENT OF HEALTH SERVICES 150 NORTH 18TH AVENUE SUITE 530 PHOENIX AZ 85007 866004791 65865 0 EPI & SURV BASE 1 ARIZONA DEPARTMENT OF HEALTH SERVICES 150 NORTH 18TH AVENUE SUITE 530 PHOENIX AZ 85007 866004791 90289 0 FLU AUSTIN ANIMAL CENTER 7201 LEVANDER LOOP BLDG A AUSTIN TX 78702 746000085 64000 0 FLU BROWN UNIVERSITY BOX 1997 69 BROWN STREET 2ND FL PROVIDENCE RI 02912 050258809 37499 0 FLU COBB & DOUGLAS PUBLIC HEALTH ATTN JERE EAWLINGS 1650 COUNTY SERVICES PKWY MARIETTA GA 30008 581517015 40910 0 FLU COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 4300 CHERRY CREEK SOUTH DENVER CO 80246 840644739 87148 0 FLU COLUMBIA UNIVERSITY PO BOX 29789 GENERAL POST OFFICE NEW YORK NY 10087 135598093 83936 0 FLU DALLAS COUNTY HEALTH AND HUMAN SERVICES 2377 N STEMMONS FRWY DALLAS TX 75210 756000905 138159 0 FLU FRED HUTCHINSON CANCER RESEARCH CENTER PO BOX 19024 SEATTLE WA 98109 237156071 52969 0 FLU GEORGIA DEPARTMENT OF PUBLIC HEALTH 2 PEACHTREE ST NW STE 25-455 ATLANTA GA 30303 900676388 128918 0 FLU HENNEPIN COUNTY HSPHD 300 S 6TH ST MC 129 MINNEAPOLIS MN 55487 416005801 13947 0 EPI & SURV BASE 1 HENNEPIN COUNTY HSPHD 300 S 6TH ST MC 129 MINNEAPOLIS MN 55487 416005801 757011 0 FLU INDIANA STATE DEPARTMENT OF HEALTH 2 NORTH MERIDIAN STREET INDIANAPOLIS IN 46204 356000158 373808 0 FLU INNOVATIVE ENERGY MANAGEMENT INC 2801 SLATER ROAD SUITE 200 MORRISVILLE NC 27560 721045884 125000 0 FLU IOWA DEPARTMENT OF HEALTH AND HUMAN SERVICES LUCAS BLDG 6TH FLOOR 321 E 12TH STREET DES MOINES IA 50319 426004523 374802 0 FLU JOHNSON COUNTY DEPARTMENT OF HEALTH 11875 S SUNSET DR SUITE 300 OLATHE KS 66061 486034760 125000 0 FLU KANSAS DEPARTMENT OF HEALTH AND 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HEALTH 108 CHERRY STREET PO BOX 70 BURLINGTON VT 05420 036000264 12043 0 COVID-19 OUTBREAK TOOLS VIRGINIA DEPARTMENT OF HEALTH ATTEN 11TH FLOOR-S PETERSON 109 GOVERNOR ST 109 GOVERNOR ST RICHMOND VA 23218 546001775 116237 0 COVID-19 OUTBREAK TOOLS STATE OF FLORIDA DEPARTMENT OF HEALTH 4052 BALD CYPRESS WAY BIN B-02 TALLAHASSEE FL 32339 159350284 64000 0 FLU 51 0 CSTE/CDC APPLIED EPIDEMIOLOGY FELLOWSHIP 123 5927457 PART I, LINE 2: CSTE EXECUTES A LEGALLY BINDING AGREEMENT WITH ALL GRANTEES. THIS AGREEMENT DESCRIBES THE DETAILED TERMS AND PERMISSIBLE USES OF GRANT FUNDS. FUNDED ENTITIES ARE REQUIRED TO SUBMIT REGULAR PROGRESS REPORTS DETAILING THE USE OF FUNDS 2 - 4 TIMES PER YEAR. PROGRESS REPORTS ARE REVIEWED INTERNALLY AND SHARED WITH STAKEHOLDERS IF NEEDED AND/OR REQUESTED. FUNDED ENTITIES ARE REQUIRED TO SUBMIT BUDGETS DETAILING ESTIMATED COSTS AND EXPENDITURES OF THE AWARD BEFORE ANY FUNDS ARE DISBURSED. ANY CHANGES MADE BY THE GRANTEE FROM THE APPROVED BUDGET MUST BE PREAPPROVED BY CSTE. A FINAL REPORT IS DUE AT THE END OF THE PROJECT. X 1 1 X X X X X 0 0 0 JANET HAMILTON EXECUTIVE DIRECTOR 289853 0 300 0 0 0 17409 0 25059 0 332621 0 0 0 ANNIE FINE CHIEF SCIENCE/SURVEILLANCE OFFICER 259681 0 300 0 0 0 15599 0 22574 0 298154 0 0 0 MARCELLE LAYTON CHIEF MEDICAL OFFICER 263982 0 300 0 0 0 15857 0 9567 0 289706 0 0 0 BEVERLY CHRISTNER SENIOR DIRECTOR OF OPERATIONS 202017 0 10300 0 0 0 12739 0 18299 0 243355 0 0 0 JENNIFER LEMMINGS SENIOR DIRECTOR OF GSS 188270 0 7430 0 0 0 11742 0 30293 0 237735 0 0 0 DHARA SHAH SENIOR DIRECTOR OF PROGRAMS 170704 0 14550 0 0 0 11115 0 22424 0 218793 0 0 0 SHELIA SCOTT SENIOR DIRECTOR OF FINANCE 160673 0 8870 0 0 0 10173 0 10680 0 190396 0 0 0 PART I, LINE 1A EMPLOYEES HAVE A WELLNESS BENEFIT OF UP TO $25 PER MONTH. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS ACTIVE MEMBERSHIPS AND ASSOCIATE MEMBERSHIPS FOR PERSONS ENGAGED IN THE PRACTICE OF EPIDEMIOLOGY. PERSONS CURRENTLY ENROLLED FULL TIME IN AN UNDERGRADUATE OR GRADUATE PROGRAM WHO ARE ACTIVELY PURSUING A DEGREE IN PUBLIC HEALTH OR RELATED FIELD ARE ELIGIBLE FOR STUDENT MEMBERSHIP. IN FY23, THERE WERE 3,364 MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE ELECTION OF THE EXECUTIVE BOARD, POSITION STATEMENTS THAT DO NOT AFFECT STATE OR TERRITORIAL PUBLIC HEALTH LAW, AND OTHER SIMILAR MATTERS AS SPECIFIED IN THE BYLAWS OR DESIGNATED BY THE EXECUTIVE BOARD SHALL BE DETERMINED BY A VOTE OF THE ACTIVE MEMBERS BY ELECTRONIC BALLOT AT A TIME BEFORE THE ANNUAL MEETING OR AS DESIGNATED BY THE EXECUTIVE BOARD. FORM 990, PART VI, SECTION A, LINE 7B OFFICIAL COUNCIL DECISIONS, SUCH AS POSITION STATEMENTS THAT AFFECT PUBLIC HEALTH LAW, ARE MADE BY VOTE WITH ONLY ONE VOTE PER STATE OR TERRITORY CAST BY THE STATE EPIDEMIOLOGIST OR AN OFFICIAL ACTIVE MEMBER REPRESENTATIVE FROM THE STATE OR TERRITORY DESIGNATED BY THE STATE EPIDEMIOLOGIST. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PREPARED BY MAULDIN & JENKINS, LLC, AN INDEPENDENT CERTIFIED PUBLIC ACCOUNTING FIRM. FORM 990 IS THEN PROVIDED TO THE ORGANIZATIONS'S BOARD FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C POLICY REQUIRES IMMEDIATE NOTIFICATION OF CONFLICTS AND WE HAVE ANNUAL ACKNOWLEDGEMENT THAT ALL HAS BEEN DISCLOSED. FORM 990, PART VI, SECTION B, LINE 15 EVERY THREE TO FIVE YEARS AN INDEPENDENT CONTRACTOR IS HIRED TO DO A SALARY AND WAGE REVIEW. COPIES OF THE REPORT ARE GIVEN TO THE EXECUTIVE BOARD TO USE AS A TOOL FOR SETTING THE EXECUTIVE DIRECTOR'S SALARY, AND A COPY IS GIVEN TO THE EXECUTIVE DIRECTOR FOR SETTING THE EMPLOYEES' SALARIES. FORM 990, PART VI, SECTION C, LINE 19 SOME INFORMATION IS POSTED ON THE CSTE WEBSITE FOR THE GENERAL PUBLIC TO ACCESS. SOME INFORMATION IS POSTED ON THE CSTE WEBSITE FOR MEMBER ACCESS ONLY. ANY INFORMATION THAT A REQUESTOR COULD NOT ACCESS THEMSELVES, UPON REQUEST, IS PROVIDED EITHER BY FAX OR EMAIL. FORM 990, PART IX, LINE 11G OTHER CONSULTANTS & CONTRACTS 5,420,745. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. CSTE FOUNDATION INC 2635 CENTURY PARKWAY NE SUITE 700 ATLANTA GA 30345 474094953 SUPPORT CSTE GA 501(C)(3) LINE 12A, I CSTE INC 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 CSTE FOUNDATION INC C 94822 COST