Master of Public Health (MPH)

OBJECTIVES AND NEED:

 

1a. Description of the Program: Aprogram of interdisciplinary graduate study leading to the Master of Public Health (MPH) is proposed for the School of Pharmacy and Allied Health Sciences (SPAHS). Although organized within the SPAHS, the program will also have faculty from the College of Arts and Sciences, the School of Education, and the School of Business.

The discipline of Public Health deals with health issues affecting an entire community or population rather than those of individual persons. Today, the people of the United States and Montanans in particular are in greater need of public health professionals than at any time since the beginning of the 20th century. The range of public health problems now facing our country and state includes infectious diseases such as AIDS, West Nile Virus, and SARS, bioterrorism, environmental and toxic waste hazards like those in Butte and Libby, population health problems affecting Native Americans including diabetes and obesity and the lack of health insurance by 20% of Montanans. These issues and others are front-page health problems facing our nation and our state.

Currently at The University of Montana there exist strong programs in Environmental Health Sciences, Biological Sciences, Psychology, Political Science, Business Administration, Health Education, Social Work, and Environmental Studies. These programs embrace all the core competencies required for the Master of Public Health. With its existing specialized programs in environmental health sciences, community health education and Native American studies, The University of Montana has unique opportunities to create areas of emphasis for public health professionals. Utilizing these existing capabilities and applying distance learning technology will enable many health care practitioners around the state of Montana to obtain the knowledge and skills needed to address the growing public health problems in our state and nation.

1b. Program Goals and Objectives: The Master of Public Health program will seek to achieve three primary goals: first, to educate and prepare professionals for public health practice in Montana, around the nation and internationally; second, to serve the State of Montana needs for public health and public health policy through University Community collaboration; third, to conduct research to meet state needs for information and advance knowledge and expertise in the field of public health. The initial objectives of the program will be to graduate 25 or more professionals with the MPH degree within 3 years, to select an effective program chair, to offer all core courses and the capstone seminar at least once within the first two years, to secure positive program assessments from enrolled students and their employers and to obtain CEPH accreditation in the fourth year of operation.

1c. Intellectual Basis for the Curriculum: Practitioners in public health work to improve the health of a population or community rather than that of the individual. The basic public health degree is the Master of Public Health (MPH). 1 The first graduate program in public health was started in 1918 at Johns Hopkins University and today there are about 34 accredited schools and approximately 45 accredited programs of public health offering the MPH. This program is unique in that it aims to graduate practitioners who are competent to address the challenges resulting from the intersection of rural and global health issues.

1d. Course of Study: The University of Montana Master of Public Health will require 36 graduate credit hours of instruction. All students will be required to take these MPH core courses:

         Fundamentals of Biostatistics 3 Cr.

         Fundamentals of Epidemiology 3 Cr.

         Environmental and Rural Health 3 Cr.

         Community Based Research 3 Cr.

         U.S. Healthcare System and Policy 3 Cr.

         Social and Behavioral Sciences in Public Health 3 Cr.

         Professional paper or portfolio 3 Cr.

To insure that students graduate with an understanding of the contemporary and changing global determinants of rural health, a three credit capstone course titled "Rural Health Issues in a Global Context" will be required.

 

Students will be able to select an area for concentration including:

         Environmental and Rural Health

         Community Health Education

         Native American Population Health

In addition to the MPH degree, the program will also offer a Certificate in Public Health for individuals who earn 12 graduate credits from among the core courses.

The full curriculum including electives and core courses is found in attachment 1.

1e. Instructional Methods: Because it is anticipated that the Master of Public Health program will be of greatest interest to individuals now employed in healthcare occupations who cannot leave their jobs, all required courses and some electives will be provided by distance learning using primarily the asynchronous Blackboard medium. All courses required for the MPH degree will be appropriate for distance learning. Students will be required to come on campus for one week on three occasions, at the beginning of the program, between years one and two, and at the end of the program.

2. Need for Program: In November 2002, The Institute of Medicine issued a report titled "The Future of the Public's Health in the 21st Century." The report included seven recommendations specifically focused on the need for workforce training and public health research. These recommendations to Congress as well as state and local governments urge greater resource allocation to the education of public health workers and to faculty development and research.2

In January, 2004, Georges C. Benjamin, Executive Director, American Public Health Association said "What is clear is that the public health work force must be revitalized if we hope to avert a looming crisis." "With improvements in technology, we should expand distance learning opportunities and online training to better equip workers already in the field."3

Currently in the state of Montana there are more than 1400 individuals employed in public health agencies at the city, county, state or federal level. Of these, only 22% hold a graduate degree or higher; 58% hold a baccalaureate degree. In a 2004 survey of public health workers in Montana, 50% of the 1400 respondents indicated a high or moderate interest in university course work. Contacts to selected city/county public health agencies as well as the Montana Department of Public Health and Human Services and the Indian Health Service, Billings found that between 25% and 40% of the public health personnel in these agencies will retire within the next 5 years. Leaders of these agencies are very supportive of an MPH program at UM to train replacements (see attachment 2 for letters of support).

Because many individuals now working in public health do not know if they should pursue the MPH degree, the program will offer a Certificate in Public Health consisting of 12 graduate credits in core MPH course offerings. Montana public health leaders learning of this option were very enthusiastic about the idea.

There is today an unprecedented need for research into the public health problems in Montana, the US, and internationally. Research in public health is primarily conducted by faculty members in the nation's MPH programs. As much as 85 % of the entire budgets for schools of public health are derived from grants and contracts.4 The University of Montana has the capability to participate in this research and thereby benefit not only the University but also the state, the nation, and the world.

3. New Courses: The Masters of Public Health will add these new 3 credit, graduate courses to the curriculum:

Fundamentals of Biostatistics

Fundamentals of Epidemiology

Environmental and Rural Health

Community Based Research

US Healthcare System and Policy

Social Behavioral Sciences in Public Health

Rural Health Issues in a Global Context

The requirements for the Masters of Public Health degree (MPH) will be 36 credits including 21 from the core curriculum above, at least four elective courses, and either a professional paper (up to 3 credits) or a professional portfolio (1 or 2 credits).

New elective courses will include:

Community Health Education

Environmental and Occupational Epidemiology

Seminar in Epidemiology

The full curriculum including core and elective courses is included in attachment 1.

ADEQUACY, ACCREDITATION, AND ASSESSMENT ISSUES

1. Adequacy of faculty, facilities, and other resources compared to accreditation standards: Recent additions of faculty in Biostatistics and Epidemiology provide The University of Montana with all of the disciplines required for the Master of Public Health. With an anticipated enrollment of between 25 and 35 graduate students and 15 to 20 certificate program students in this primarily on-line program, existing facilities and equipment are capable of supporting the MPH program. Library holdings will need to be augmented at an estimated cost of approximately $100,000. These expenses are included in the program budget, at the rate of $15,000 each year.

2. Accreditation: Graduate programs in public health are accredited by the Council on Education for Public Health (CEPH). The category of accreditation to be sought by the University of Montana program is in Community Health/Preventive Medicine. This is the generalist degree in public health. The initial step in the accreditation process is to seek Applicant Status with CEPH. A self-study process and report is the second step and must occur before Accredited Status can be achieved. The self-study report must be submitted within two years of becoming an Applicant. If the self-study report is found satisfactory, then the third step is an accreditation visit.

3. Assessment plan: The assessment of students and program outcomes will be accomplished in this way:

Intermediate Assessment: Student performance will be evaluated on-line in the manner now customary with Blackboard. These procedures include the utilization of passwords and time limits on test availability. At the discretion of the instructor, proctored exams can be arranged if necessary.

End of Instruction Assessment: The defense of a professional paper or professional portfolio will be required.

Student/Alumni Satisfaction: Standard student assessments will be collected. Additionally, the alumni will be surveyed to determine the degree to which their course of education was found relevant to their needs and responsibilities on the job.

Program Review: In the first operational year, application will be made for accreditation by the Council on Education for Public Health (CEPH). By the end of the third year, and after the submission of a self-evaluation, an accreditation visit will be scheduled. The outcome of the site visit can be a decision to accredit, to continue pre-accreditation or denial of accreditation.

IMPACT ON FACULTY, FACILITIES, COSTS, STUDENTS, AND OTHER DEPARTMENTS AND CAMPUSES

1a. Additional Faculty Requirements: The MPH program will require the recruitment of two new full time faculty; one to serve as Program Chair/Director. The individuals sought should hold a Ph.D. or Dr.Ph in public health and have significant experience in a school of public health and with distance learning, administration and grant development. The availability of such candidates is satisfactory at an anticipated salary with benefits of $112,700 for the Director and $93,750 for a full time faculty member.

1b. Names and Qualifications: The current faculty who desire appointment in the MPH program are listed in Attachment 3. Funds for course instruction are included in the budget under Personal Services.

2. Impact on Facilities: Additional library resources will be required, as indicated above. Funds needed for these acquisitions are included in the program budget.

Master of Public Health students will be required to complete a professional paper or portfolio which will be supervised by a University of Montana faculty member with appointment to the MPH faculty. The student may have a visiting faculty member involved with the research in the place where the research is being conducted. At the conclusion of the student's course work, the capstone course in combination with a final interview will insure the student has performed the research.

Space required for the new personnel needed for the program is available in the Skaggs Building.

3. Costs: The "Budget Analysis/Enrollment Estimates" schedule below displays the forecasted revenues and expenses for the program and include the following:

3a. FTE estimates are based upon part-time enrollment of 10 MPH and 6 certificate students in FY 06, 25 MPH degree students in FY '07, 50 in FY '08, 85 in FY -09, and 95 thereafter. Also included in this estimate are 15 MPH Certificate students in FY -07, and 20 certificate students each year thereafter.

3b. Incremental tuition revenue based upon resident Graduate I tuition rate ($3812.40) x FTE.

3c. Program fees represent super tuition at $150 per SCH (144 in FY '06; 555 in FY '07; 990 in FY '08; 1515 in FY '09; and 1665 in FY '10).

3d. Personal services include one new FTE faculty in FY '06 ($93,750) and one new FTE faculty in FY '07 ($112,700); an Administrative Assistant (.50 FTE) at $20,614; and course instruction each year. In FY '09 and '10, the Administrative Assistant will be increased to 1.0 FTE.

3e. Equipment expenses include library acquisitions of $15,000 each year of the proposed budget.

4. Impact on Enrollment: Based upon interviews with Montana public health agencies and practitioners, it is estimated that the MPH degree program will have 25 students enrolled in FY 2006, approximately 30 new students in the next year, and in the next year of operation and thereafter, about 35 new students. The student targeted for enrollment in the MPH program is a health care practitioner now working in a public health agency. These individuals include registered nurses, physicians, pharmacists, and medical technologists

For entry into the MPH degree program applicants will need at least a baccalaureate degree and the GRE or other professional school exam. A cumulative undergraduate grade point average of 3.0 and prior experience as a healthcare provider or in public health are guidelines to be applied as well.

All of the core courses will be provided by distance learning. No difference in profile is expected between students on and off campus. Individuals pursuing the MPH degree on a full time basis will be able to complete the course work in two years by taking 18 credits per year. However, it is anticipated that the majority of students will be health care practitioners needing to continue to work. For these students, it is anticipated that three years will be required to complete all of the course work (averaging 12 credits per year). Based on these estimates, at any given time after the second year of operation, between 50 and 90 students will be enrolled. By the end of the third year, the program should graduate about 35 students per year.

The MPH certificate program is expected to enroll about 20 students per year beginning in FY 2008.

5. Relationship to Other Programs on Campus: The Master of Public Health is a highly interdisciplinary degree and consequently the program relies on the contributions from biological sciences, business, environmental studies, environmental health sciences, health and human performance, pharmacy, psychology, political science, and social work. The Chairs from all of these programs have been consulted in the development of this proposal and have submitted letters of support. (See attachment 4.)

To best insure an effective interrelationship between the many departments and programs contributing to a Master of Public Health program, an Advisory Committee comprised of the Deans of the schools of Education, Business, and Arts and Sciences will meet with the Chair of the Master of Public Health Program and the Dean of School of Pharmacy and Allied Health Sciences three times a year to advise and recommend on operational elements of the program, including budget, resource allocation, curriculum, accreditation and strategic direction. In addition, the faculty committee involved with the formulation of the MPH program has recommended the Organization and Management Characteristics found in attachment 5.

6. Relationship to Other Institutions: In the northwest, there are currently only two accredited programs in Community Health/Preventive Medicine. These are at Portland State University and at the University of Utah. The School of Public Health at the University of Washington offers specialized degrees in each and all of the public health specialties. There are no MPH programs in states adjacent to Montana and none in the Rocky Mountain west offer a curriculum that is primarily available via distance learning. Furthermore, there are no US programs that specifically address the rural-global health interface that is a focus of this proposed program.

Within the Montana University System, there are currently on-line, elective course offerings of value to MPH candidates provided at Montana Tech in the Industrial Hygiene program and at Montana State University- Billings in the Healthcare Administration program. The Directors of these programs are supportive of the creation of a Master of Public Health and have so indicated in their letters in attachment 4.

Patricia Wahl, Dean of the School of Public Health at the University of Washington, when contacted about the prospects of a MPH program at The University of Montana was very encouraging and supportive.4

Process Leading to Submission of Proposal

The opportunity for a Master of Public Health program was formally investigated and deliberated by a faculty committee involved with the Health Sciences and Human Services Planning Cluster during 2001 and 2002. Their report to the Provost in May 2003 recommended that The University of Montana explore the possibility of establishing a MPH in Community/Global Health.

In September 2003, a consultant, Lawrence L. White, Jr. MHA, began a feasibility study to determine the need, capability, and cost for a MPH program. Early in the project, the Deans of the schools involved were asked to suggest faculty members to comprise a MPH Program Committee (see Attachment 7). The committee, consisting of ten faculty representing all of the disciplines involved in the core curriculum met on 12 occasions between January 2004 and July 31, 2004. This committee involved itself first with the formulation of a mission statement, goals and objectives (see attachment 6) and then with the formulation of the core and electives curriculum. The Deans and Program Chairs affected and involved were periodically apprised of the status of the project by faculty members and by the consultant.

Between September 2003 and July 2004 seventeen individuals representing ten employers were interviewed in person to gain their opinions regarding the need for a MPH program at The University of Montana, the size of their public health work force and their assessment of the demand for workers with the MPH degree. Each and every individual was very positive and encouraging that the program be developed. The letters of support in Attachment 2 are from some of those interviewed.

As stated previously, in Montana there are at least 1400 individuals employed at the professional level by city, state or federal public health agencies. The turnover due to retirement in these agencies in the next five years will be between 25% and 40%. The estimated starting salary for an individual with the MPH degree in a supervisor position at an urban city/county health department is $40,000. A department head starting salary is approximately $50,000.

 

End Notes

1." Who Will Keep the Public Healthy?- Educating Public Health Professionals for the 21st Century", Institute of Medicine, 2003, p.4,8.

2. "The Future of the Public's Health in the 21st Century", Institute of Medicine, National Academies Press, 2003

3. "We Must Strengthen Our Public Health Work Force", American Public Health Association, January 9, 2004

4. Personal conversation with Dean Patricia Wahl, University of Washington School of Public Health, April 19, 2004.