Planning and implementation of this program progressed concurrently: partnerships to sustain it were built overnight. As a microcosm of the local community response to COVID, the combination of students, public health professionals and educational institutions created a formidable collaboration that created a new student internship framework in only a few weeks.
Strengthening Student Capacity. Not unsurprisingly, students are the core program participants. In Summer 2020, CCIB piloted the program with seven (7) Azusa Pacific students who were at risk of failing their degree requirements without internships. Their input and feedback helped shaped the program and aligned it with the students’ remote work and learning needs. For example, based on student feedback:
□ Their contact tracing shifts were scheduled for weekends so the internships did not compete with classes, family needs and/or jobs;
□ Teams were scheduled and worked in 15-week cycles to meet the average number of hours necessary to fulfill most schools’ internship requirements.
While mentorship is usually an important feature of student internships, DPH could not afford such a personalized time commitment to the students during the pandemic. As a result, CMS/CCIB:
□ paired the schools’ teams with DPH divisional teams doing the same work (e.g., DPH Chronic Disease fielded a team of Disaster Service Workers [DSWs] for CCIB work), and
□ created on-line webinars on topics such as work/life balance, public health careers, giving the interns a chance to meet and dialogue with their professional counterparts.
Relying on University Partners. Because so many DPH staff were deployed as DSWs in the COVID response—or those remaining in their home public health programs were so overworked assuming additional responsibilities from those who had been reassigned—there were few DPH staff who could supervise the interns. For the new student internship program to advance, CCIB had to adapt an internal DPH “team” structure (each division managed its own team of callers) which allowed for collective management of the interns and necessitated greater partnership and involvement from the schools and universities.
The resulting system relied on the schools to identify “teams” of 7 to 21 interns, who would be assigned days to work and scheduled by their school internship manager (a staff person, faculty member or graduate student). The internship manager would handle absences, scheduling modifications and performance issues due to insufficient DPH staff to provide those services. Likewise, DPH did not have adequate staffing to write individual evaluations or reports—also common in the past. If the school needed that written work, they had to alter their internal requirements or perform that work themselves. Those schools who ultimately participated understood that the pandemic required DPH to revisit past agreements, to evolve to meet pandemic-driven change, and to develop new scopes of practice during COVID.
In total, CMS staff met with 40 colleges and universities across the country. Twenty-nine (29) schools were able to adapt to the new internship framework and joined CCIB. Besides the students themselves, the schools have been essential partners in this program. As Attachment B details, starting with the Azusa pilot in Summer 2020, this program will have fielded 866 student internships in the span of two years. For those schools that requested it, CMS worked with DPH Contracts & Grants to craft entirely new MOUs and agreements (Attachment C).
Internal Collaborative Problem-Solving. When planning for the student internship program, its complexity had not been fully envisioned. To address the process innovation eventually required for the initiative, professionals from throughout DPH devoted themselves to program solutions:
□ Onboarding: Students had to be onboarded differently than staff and volunteers—classifications which are not accurate for this subset of workforce members. Together with LAC Department of Human Resources (DHR), DPH Human Resources (DPHHR), and Public Health Information Systems (PHIS), CMS rewrote and re-formatted new intern manuals and onboarding materials and provided the students with DPH electronic addresses with which to access to necessary CCIB systems. Onboarding—a process that often takes a month—was collapsed into less than a week, facilitated by the work of an onboarding task force at the start of every term. Multiple, extraneous processes that were not pertinent to students, non-paid workers or remote staff were eliminated.
□ Training: Led by DPH’s Organizational Development and Training (ODT) unit, training had to be redesigned to fit into a single week and to consolidate different training modules and methods (e.g., some recorded, some live, etc.) from varied sources. Additionally, half of the training had to be converted into self-education so that students could complete their training without interrupting their class schedules. Likewise, the students had to be credentialed in HIPAA and other workforce requirements, necessitating expedited training that enabled them to immediately start their work without minimizing or loosening public health standards.
New training modules to address unique student skills-building needs were also developed, including interactive webinars from DPH Nursing Administration, the Department of Children and Family Services (DCFS) and the Department of Mental Health (DMH), on essential topics such as de-escalation tactics, customer service, and how to navigate a fear-based conversation. Practice calling with supervision was incorporated into the curriculum, and live observation was introduced and managed by CMS. Eventually, DPH hired a temporary DSW Manager (paid by federal COVID funds) to oversee students and other DSWs on the weekends, and to personally manage the interactive training elements.
□ IT Infrastructure: Perhaps the biggest lift internally was shouldered by PHIS, which developed the CRM-based CCIB technology from scratch, and then has issued, to date, 70+ iterations of IT improvements and script revisions. As part of its collaboration with CCIB, it integrated additional features that enabled full intern participation, such as, but not limited to:
- authorizing external access to the system within the confines of HIPAA-protected firewalls;
- integrating third-party calling to support direct observational supervision and to facilitate access to translation/interpretation services; and
- introducing browser-based phone services and messaging features linked to assigned emails so students were not required to use their own phones for contact tracing.