Program Management Tool (New Awardees) Form

EHTB Program Management Tool

Grantee Name: XXXXXXXXXXXXX

Reporting Period: FY 2015, Quarter 3

Form Approved

OMB No. 0920-xxxx

Exp. Date xx/xx/201x

This document is provided by the Environmental Health Tracking Branch (EHTB) to capture the information needed to demonstrate the effectiveness of the National Environmental Public Health Tracking (EPHT) Program. Each question aligns with a performance measure set for the EHTB in their Performance Plan for Fiscal Years 2005 – 2010. The EHTB and its grantees will be held accountable for meeting the performance measures and performance may affect availability of program funds in the future. Therefore, it is critical that this tool is completed accurately and in a timely fashion.

Instructions:

The Program Management Tool (PMT) contains 7 questions; one for each performance measure listed on the next page, and will be sent out quarterly (January 1^st, April 1^st, July 1^st, and October 1^st). Each quarter you will be asked to return this tool which contains your contributions to the performance measures during that reporting period. Not all questions will be applicable to you. Each question lists who needs to respond (e.g., State Health Department, Local or City Health Department, Academic Partner, or the EHTB). For further clarification, a short description has been provided below each question.

Please complete and return to your Project Officer by 8/3/2015 for the April 1, 2015 – June 30, 2015 reporting period (FY 2015, Quarter 3). If you have any questions, please contact your Project Officer.

The template for you to forward to your programs is attached please feel free to contact me if you have any questions or concerns.

Thank you for your participation.

CDC estimates the average public reporting burden for this collection of information as 20 hours per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-xxxx).

CDC estimates the average public reporting burden for this collection of information as xxx minutes/hours per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0853).

CDC estimates the average public reporting burden for this collection of information as xxx minutes/hours per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0853).

CDC estimates the average public reporting burden for this collection of information as xxx minutes/hours per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0853).

EHTB Performance Measures
Performance Measure 2:	By 2010, increase the number of statewide Environmental Public Health Tracking networks that meet EPHT/PHIN standards by 17.
Performance Measure 3:	By 2010, integrate environmental and public health data from 33% of states and the New York City into the National Environmental Public Health Tracking Network.
Performance Measure 4:	By 2010, increase the number of health and environmental workforce trained in Environmental Public Health Tracking principles and practices by 1000 people.
Performance Measure 5:	By 2010, increase by 100% the number of environmental and public health professionals demonstrating an awareness of Environmental Public Health Tracking.
Performance Measure 6:	By 2010, increase the number of states with established Environmental Public Health Tracking risk communication strategies that meet EHTB guidelines by 17.
Performance Measure 7:	By 2010, complete 15 studies to determine the harmful effects from environmental hazards.
Performance Measure 8:	By 2010, increase by 800% the number of public health actions, developed using Environmental Public Health Tracking data, that prevent or control potential adverse health effects from environmental exposures.

Question		Response	Clarification (This section should be used for additional information or clarification and to describe how each response was derived. Please limit your responses to 250 words.)
1	PM2: Do you have a statewide EPHT Network that meets EPHT/PHIN standards, where controlled access to EPHT environmental and health data can be provided? Criteria to meet this performance measure: 1. Infrastructure is in place to access data for core nationally consistent measures and data, and 2. Relationships/agreements with necessary data owners have been established and data necessary to calculate core measures have been received, and 3. Core nationally consistent measures and data are available through role-based access on the State Tracking Network For example, state X has the infrastructure to support the exchange of EPHT environmental and health data for core measures between data partner X and state X. State X has access to the necessary data from the data owner and has processed the data to allow controlled access to EPHT environmental and health data for core measures. Complete by: State, Local
2	PM3: Is your state currently sharing data with the National EPHT Network? Are core nationally consistent measures and data (environmental, health effects, and exposure data used to generate core measures as part of your State Tracking Network) readily available to multiple organizations through the National EPHT Network? For example, state X has the infrastructure to exchange core measures and the data for core measures through the National Tracking Network. This allows the National Tracking Network to provide a national picture of core measures. Complete by: State, Local
3	PM4: How many health and environmental professionals have you trained on EPHT principles and practices in this reporting period? Training can be provided through established training programs, workshops, EPHT 101, or other forms of workforce development. Principles and practices include public health surveillance, risk communication, GIS, etc. Complete by: EHTB
4	PM5: What percentage of environmental and public health professionals have demonstrated an awareness of the National EPHT Program in this reporting period? This awareness will be calculated through surveys or other mechanisms to the environmental and public health professional population by the EHTB and should represent the percent increase to the awareness over the Reporting Period. Complete by: EHTB
5	PM6: For the current reporting period, do you have a risk communication strategy that meets EHTB guidelines? Please list or describe it under the clarification column. Your risk communication strategy should help you translate scientific data into information that is understandable, relevant, and usable by the public. If you have previously reported this information in a past progress report or cooperative agreement template, please reference the name and date of the report. Complete by: State, Local
6	PM7: Please list the number of specific epidemiologic studies done to determine the association between a health effect and an environmental factor in this reporting period. Please include a very brief description of the study population, methods, results, and conclusions for each. If you have previously reported this information in a past progress report or cooperative agreement template, please reference the name and date of the report. Complete by: State, Local, Academic Partners, EHTB		Please indicate the following for completed studies only: Completion date: Title: Publication/Conference/Meeting Title: Author: Abstract or Background Information: (Please briefly summarize the hypothesis, methods, and conclusions) Please provide project officer with submitted abstract and/or manuscript.
7	PM8: How many public health actions during the current reporting period can be directly associated with your activities and findings? Please include a title and a brief description of the action and how the action was influenced by your project activities. Any of the following are examples of components of a public health action: action to identify populations at risk, respond to outbreaks, clusters and emerging threats; establish the relationship between environmental hazards and disease; guide intervention and prevention strategies; identify, reduce and prevent harmful environmental risks; improve the public health basis for policymaking; enable the public’s right to know about health and the environment; inform legislators, policy makers, communities, and/or individuals regarding potential environmental health risks. If you have previously reported this information in a past progress report or cooperative agreement template, please reference the name and date of the report. Complete by: State, Local, Academic Partners, EHTB		There is NO WORD LIMIT is this Section. Please disregard the “250 words limit” in the Clarification section above! Title: (Specific enough to allow reader to understand what the action was) Please address each of the following by including your response under each question: What was the problem/situation? How was Tracking involved? What action was taken to resolve the problem? If possible, quantify the impact of the resulting action on the health of the population.

Page 7 of 7