PUBLIC HEALTH ASSOCIATIONS’ COLLABORATIVE EFFORT (PHACE) COLLABORATORS New Jersey Association of County & City Health Officials New Jersey Environmental Health Association New Jersey Public Health Association New Jersey Local Boards of Health Association New Jersey Society for Public Health Education New Jersey Association of Public Health Nurse Administrators 15 June 2020 Dear Governor Murphy, Commissioner Persichilli, and NJ Legislature: Healthcare, public health practices and smart legislative policies have waged war against a contagion that has impacted, but could have devastated the residents of New Jersey. The efforts of our political and legislative representatives in understanding and acting on interventions necessary to keep citizens safe is greatly appreciated. Accolades are warranted for the front-line health care personnel and first responders who are heroes in fighting the disease head on. We are grateful for all that has been accomplished. At the same time healthcare professionals have managed the sick, thousands of public health professionals from all Local Health Departments (LHDs) have diligently worked around the clock to limit the spread of disease throughout their communities. Since March of this year local health departments in New Jersey have admirably and successfully responded to the extraordinary challenges associated with the spread of COVID-19. They have identified and reported the numbers of cases and the resulting deaths, counseled persons diagnosed, and managed cases on how to quarantine or isolate themselves. They have conducted contact tracing and educated the public on social distancing to prevent the spread of the disease. To date, we have investigated over 165,300 positive cases of COVID-19, which includes tens of thousands more contact tracing calls to advise people on quarantine and isolation procedures, where to find testing, and how to manage other challenges related to loss of work and quarantine restrictions. Clearly, COVID-19 prevention has been and continues to be a LOCAL response. However, we have grave concerns regarding the overall lack of communication with local health departments related to the ongoing response. While the New Jersey Department of Health, Office of Local Public Health has strived to communicate with us, they are often unable to provide responses due to constraints beyond their control. We are particularly concerned about the future integration and execution of contact tracing, the void of communications from the NJ Department of Health to local public health, and the absence of involvement by local public health professionals in the planning and guidance development. Local health departments are the “boots on the ground” workforce with centuries of collective expertise and experience and this knowledge is not being utilized in response to the greatest public health event in our lifetimes. It is our diversity of backgrounds, cultures, thought, knowledge, and expertise that allows our communities to thrive. Our vast knowledge and experience have allowed us to advance and improve the public’s health practice. It is imperative to have open and transparent communication with the individuals who advance the practice of public health in our communities. Some view the diverse structures of municipal, regional, contractual and county based public health departments as unique to the State of New Jersey, a barrier to public health action, particularly contact tracing, and a confusing system to work with. The reality is none of the above is true and there is a simpler way to view our governmental public health system – local, state and federal. This system must be considered when crucial public health matters are explored for implementation statewide. 111 Greenbrook Road, Green Brook, NJ 08812 Phone: 732-968-5151 - Fax: 732-968-5331 Email: ksumner@middlebrookhealth.org Communication can and must seamlessly and equitably flow amongst all agencies that exist within this system such that everyone is able to quickly, efficiently, and effectively respond to the many anticipated issues. These issues include linking individuals with local social and health services, privacy concerns, establishing and investigating epidemiological data, local oversight and authority, transparency, liability, and building trust within our communities. At such a crucial time, we should be working on stabilizing and enhancing our local public health departments and their workforce, to match the needs of the future. This is an opportunity to increase the visibility and value of public health throughout the State. Recently, the Governor announced plans to create a statewide contact tracing program. As noted, local health departments have been providing contact tracing throughout this pandemic. We have built our teams and have earned the trust of the communities we serve. We have asked the Commissioner and the programmatic leads at the NJ Department of Health to provide us with funding so that we could enhance our systems which are established and effective. Instead of responding to suggestions from local public health professionals regarding the process and providing the resources we desperately need, we are being told of a system that will take time to implement, disrupt current activities, and utilizes a software application, CommCare, that is reportedly not suited to New Jersey, all of which potentially puts local health officials at risk of liability by compromising their statutory authority and responsibilities. We have continuously stressed the need for a municipal based system yet another system was chosen. Finally, local public health has always been understaffed and underfunded and we are now in a state of crisis, since New Jersey’s local governments, who fund nearly 100% of local public health budgets are now also suffering severe financial constraints. Monies have been allocated by the Federal Government to specifically assist local public health. CDC Director, Robert R. Redfield, MD stated, “Increasing the capacity of our nation’s public health infrastructure is critical to stopping the spread of COVID-19 in communities across this country.” Unfortunately, the amount to be distributed to local health is especially small compared to the amount allocated to the State. If more resources were provided to our local health departments we could be even more effective in our response. Please support our vital function and assure we maintain a competent workforce to continue battling the ongoing pandemic. Every local health department needs sufficient funds to maintain current staff and to hire additional resources as needed for continued case investigations and inevitable mass vaccination campaigns. We respectfully request that local public health departments be viewed and considered as a full partner in our public health system, that our expertise and experience is brought to bear against this and future public health events, and that resources should be generously distributed to local public health departments to support their heroic efforts during these trying times. In addition, plans should be developed and implemented to support the future of local health departments, as COVID-19 will not be the last public health emergency we must respond to. As we have demonstrated, we are here to help! Respectfully, PHACE - Representing New Jersey’s public health professionals Megan Avallone, President, NJACCHO Lynette Medeiros, President, NJEHA Donald Weinbaum, President, NJPHA Christine Harris, President, NJLBHA Samantha Bunsa, President, NJSOPHE Juliet Leonard, President, NJAPHNA 111 Greenbrook Road, Green Brook, NJ 08812 Phone: 732-968-5151 - Fax: 732-968-5331 Email: ksumner@middlebrookhealth.org