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Joel L. Nitzkin, MD, MPH, DPA, FACPM
CEO, Principal Consultant, and sole member of JLN, MD Associates, L.L.C.
I am a public health physician, Board Certified in Preventive Medicine, with a doctorate in public administration and training as an Epidemic Intelligence Service Officer. My most highly specialized skills relate to control of infectious and communicable diseases and translation of medical and public health science into policy and effective and cost-efficient programming. My work has involved design, implementation and evaluation of public health programs, preventive services in healthcare and correctional settings, quality of care, and communicable disease control. Most recently, I have played major leadership roles in the teaching of management and policy skills to health professionals, workforce development and tobacco control.
Biographical Sketch
I was attracted to public health, while still in medical school, when I experienced the power of a simple community intervention to eliminate a major health problem. After hospital internship, I spent two years as a communicable disease control officer for the Centers for Disease Control, then secured a Master’s Degree in Public Health. In the early 1970’s, I broadened my focus to the full range of preventive services provided by a local health department, secured a Masters Degree and Doctorate in Public Administration, and Board Certification in Preventive Medicine. For the next 13 years, I served as Director of an urban health department (Rochester, NY). While local health director, I was an active member of boards of directors in health insurance, hospital, long term care and mental health entities. In 1989, I came to Louisiana as State Health Officer and Director of the Louisiana Office of Public Health. This was my second politically appointed job, and the second time I had been hired to “fix” a “broken” public health agency. Over the next 27 months, until the inauguration of the next governor, I energetically and successfully did the job I was hired to do. At that point, having fallen in love with New Orleans, I decided to stay, and started my career as a consultant. Since then, I have taken on a number of short-term full time assignments dealing with correctional health, leprosy, healthcare quality, telemedicine, home care and community outreach. In 1997, I incorporated as JLN, MD Associates, LLC, and have served in that capacity ever since.
I have served on multiple national advisory committees and commissions since the mid 1980s. I was President of the National Association of County and City Health Officials (NACCHO), 1988-89 and President of the American Association of Public Health Physicians (AAPHP), 1996-1998.
I have been actively involved in professional education and mentoring for my entire career. While in Miami in the early 1970’s I directed a Preventive Medicine Residency program and an unbroken string of Epidemic Intelligence Service (EIS) assignees. This supervision of EIS assignees continued while in Rochester and New Orleans. Miami and Rochester were two of only a very few local health departments with EIS assignees, with the assignments based on CDC’s perception of the quality of the mentoring available at the local level. Everywhere I have been located; I have been active in the teaching and research agendas of local medical schools and schools of public health. Since working as a consultant, I have maintained an assortment of academic affiliations, and have developed and implemented two educational curricula; one having to do with the early symptoms of heart disease and stroke, and the other relating to teaching policy, management and advocacy skills to doctors, nurses and other health professionals. During this period I have also made one or more educational and research presentations every year at state and national meetings.
On a voluntary basis, since 2000, I have played lead roles on behalf of AAPHP in workforce development and tobacco control. For detail see the www.aaphp.org web site.
On a personal basis, I am married, have two grown children, and enjoy jazz, scuba diving, travel, and genealogy. From 2004 through 2007, I also served as Captain of a Mardi Gras krewe.
Experience
JLN,
MD Associates, L.L.C.
New Orleans,
LA
1992-1994, and 1997 to Present
Health Policy Consultant
· Faculty appointment at the level of Associate Clinical Professor, Virginia Commonwealth University, School of Medicine, Department of Epidemiology and Community Health (Richmond, VA). This appointment is to enable me to function as part-time clinical faculty for purposes of providing both on-site and distance-based instruction in policy and management skills and help develop a translation research agenda. Appointment formalized December 2007.
· Principal Investigator on federally funded (CDC) project to develop and present seminar/workshops for clinicians and healthcare administrators on how best to expand and create new preventive services in healthcare settings and how best to partner with health departments and community groups to encourage and enable community-based preventive services. This is a four-year project initiated September, 2005.
· Principal Investigator on a locally funded project to develop Needs Assessment and Strategic Plan for the New Orleans Health Department, 2003.
· Principal Investigator on federally funded (SAMHSA) project to review the literature on preventive mental health services that should be implemented in healthcare settings. The final report includes over 500 bibliographic references and the evidence base, description of interventions and guidelines for planning and evaluation of 15 clinical preventive behavioral health services, covering all age groups. 2002 to 2004. This report was published as a 180 page “clinical update” monograph. It is accessible on the Internet and is now in its second printing.
· Consultant to Ochsner Health Plan, New Orleans – disease management and quality assurance in preparation for NCQA site visit. All materials generated by JLN secured “full” acceptance by the NCQA review team. 2001.
· Principal Investigator on four federally funded projects, on behalf of Engineering Management & Economics, Inc.: Interactive Guide to Community Preventive Services, Centers for Disease Control, September 2000; Geographic Information System Enhancement of Community Planning for Cardiovascular Diseases, Centers for Disease Control, June 1999; Listen to Your Heart Project (computer and web-based educational materials and administrative decision-support simulator to get patients experiencing symptoms suggestive of a heart attack into definitive medical care more rapidly) National Library of Medicine/NIH, November 1998; Automated Simulation Analysis Platform for Health Care Project (computer simulation program to project costs and benefits of implementation of preventive programming for adult onset diabetics) Centers for Disease Control, September 1997.
· Policy consultant to Merck & Co. relative to development of innovative risk assessment based wellness programming for selected municipal and corporate clients, 2000
· Policy advisor for development of integrated set of management information systems for the El Paso County Department of Health, Colorado Springs, CO, 2000
· Medical Director, LifeStyle Directions, Inc., Monaca, PA, 1996 to 2000 – provision of medical, epidemiological and policy guidance to LDI relative to their family of health risk assessment questionnaires, report forms and program components.
· Telemedicine – initiation of program, medical and project direction, development and implementation of research protocols
· Medicare quality assurance - helped develop Health Care Quality Improvement Initiative for Louisiana Health Care Review (Louisiana’s Peer Review Organization)
· Hansen’s Disease Center, Carville, LA - program evaluation, strategic planning and successful advocacy for addition of $1.4 million for 1993 budget and $3 million for 1994 budget
· Correctional Health Liaison- development of new medical and mental health policies and procedures within the Louisiana State prison system, and improved communications with the Charity Hospital system
Expert Witness
I have served as a substantive or expert witness for most of my career, with many depositions and a handful of court appearances. Much, but not all of this, was in the context of my public health work, or voluntary activities in the field of tobacco control. From January 1 of 2000 through October of 2009, I served as expert witness in 75 cases or related sets of cases. Of the 75, 18 were food poisoning cases, 18 nosocomial (hospital related) infections, and 18 prison/jail health. Twelve related to other community-acquired infections, 7 to other aspects of health care quality (including 4 deaths in critically ill patients who were not evacuated for Hurricane Katrina, and two were tobacco-related. I served the plaintiff in 51 of these cases, defense in the other 24. During this period, in addition to record review and relate research, I provided 17 depositions and 11 court appearances.
Louisiana State University School of
Medicine
New Orleans,
LA
1994-1997
Associate Professor
· Principal Investigator, Louisiana TELEMEDicine Research Project. This involved initial development of LSU telemedicine program, development of a management information system, and working with stakeholders to expand the system. 1993-1996
· Medical Director, University Home Care. 1994-1997
· Consultant to Medical Center of Louisiana at New Orleans (Charity and University hospitals) on disease and demand management, continuity of care, and compliance with JCAHCO and HCFA guidelines 1995-1997
· Medical Director and Management Consultant to, Daughters of Charity Neighborhood Health Partnership (DCNHP) 1995-1996
Louisiana Office of
Public Health
New Orleans, LA
1989-1992
State Health Director:
Medical Director, Health Officer (official responsible for enforcement of State Sanitary Code), and Chief Executive Officer of state agency with headquarters, nine regional offices, 62 local health departments and three laboratories. I was hired to “fix” a “broken” and demoralized public health agency that had drifted for 18 months without top-level leadership, following a period in which major cuts, but no enhancements were made. With that as a mandate, I provided the administrative and political leadership that resulted in agency growth from 1,800 to 2,100 staff positions and from $136 million to $172 million annual budget during my 27 month tenure in this position. Of the $36 million in new annual revenues, $25 million was in recurring federal funding, most of which has continued to this day. One major political victory resulted in six million dollars in new funding (also annual and recurring) was from a single act of the state legislature to dramatically upgrade the safe drinking water program. Another legislative victory was adoption of Louisiana’s first clean indoor air (anti-smoking) legislation.
Monroe
County Health Department
Rochester,
NY
1976-1989
County Health Director:
Medical Director, Health Officer and Chief Executive Officer of local government agency with 450 staff and a $12 million budget. Major accomplishments included the following:
· Developed and implemented new data systems.
· Quadrupled home health agency revenues in first three years.
· Played major role in Emergency and Disaster Planning relative to Ginna Nuclear Plant, bomb threats and possible bioterrorist attacks.
· Played major leadership roles on the Boards of Directors of health insurance, hospital, long term care and mental health entities
· Served as President of one local, one state, and one national organization.
· Worked closely with the Monroe County Jail and the Jail Health Project of the American Medical Association in the initial development of the health standards that later became the National Commission on Correctional Health Care (NCCHC) standards for accreditation of prison and jail health programs.
Supervised a continuous string of EIS Officers assigned to the MCHD under my supervision. Prior to my arrival, there had never been an EIS assigned to this local health department. After my departure, no others were assigned.
Dade County
Health Department
Miami, FL
1970-1976
Chief, Office of Consumer Protection:
· Directed communicable and chronic disease control programs, immunization, tuberculosis and sexually transmitted disease clinics, vital records and nursing home inspection.
· Supervised a public health residency program and a continuous string of federally-assigned physician Epidemic Intelligence Service officers.
· Played lead role in designing and managing health-related anti-terrorism programming for 1972 Democratic and Republican National Conventions in Miami Beach.
· My most dramatic accomplishments were investigation and control of a large outbreak of typhoid fever in a migrant labor camp and development of an innovative childhood immunization program that eliminated local transmission of diseases preventable by routine childhood immunization for the final four and a half years of my six year tenure in Miami.
US Public
Health Service
Frankfort,
KY
1967-1969
Epidemic Intelligence Service Officer (Assigned from the Centers for Disease Control to Kentucky Department of Health, Frankfort, KY):
· Trained by CDC in epidemiology, biostatistics, surveillance, communicable disease control, bioterrorism and in family planning program design
· Communicable disease investigation and control – this included investigation and control of multiple outbreaks, including a large epidemic of infectious hepatitis, rebuilding state surveillance systems, and rewriting much of the state sanitary code
· Sixty day assignment to Northern Nigeria to assist and help assess the regional smallpox eradication program
Post Sophomore Fellowship
Jerusalem and Kiryat Shmoneh,
Israel
1963-1964
Post Sophomore Fellow:
This experience, between my sophomore and junior years of medical school, diverted my career from clinical medicine to public health. I started as a hematology research fellow studying an “epidemic” of megaloblastic anemia of pregnancy in a small town in northern Israel. With assistance and mentoring from Professor Sidney Kark (Social Medicine), I determined the behavioral determinants of this illness and recommended that lunch served at language school for these Moroccan immigrants. This simple, but previously not considered, intervention eliminated the anemia.
Formal Education
Public Health Leadership Institute, Berkeley, CA, Participating Scholar, 1991-1992
Nova University, Fort Lauderdale, FL, Doctor of Public Administration, 1977-1978
Nova University, Fort Lauderdale, FL, Master of Public Administration, 1975-1977
Dade County Health Department (Miami, FL) Residency in Public Health/General Preventive Medicine 1970-1974
University of California, Berkeley, CA, Master of Public Health, 1969-1970
Centers for Disease Control; Epidemic Intelligence Services: Basic and specialized training in prevention and control of infectious and other diseases, bioterrorism and family planning; 1967-1969
Parkland Memorial Hospital, Dallas, TX, Internship, 1966-1967
Wayne State University, Detroit, MI, School of Medicine, Medical Doctor, 1961-1966
Wayne State University, Detroit, MI, School of Liberal Arts, 1958-1961
Current Certification and Licensure
American Board of Preventive Medicine, since 1974
Medical Licensure: Louisiana since 1989
(I have been licensed to practice medicine since 1967 and have held licenses in Michigan, California, Kentucky, Florida and Louisiana at various stages in my career. I am maintaining only Louisiana in an active mode at this time.)
Current Professional Affiliations
American Association of Public Health Physicians American Public Health Association
American Medical Association American Society for Public Administration
Publications and Presentations
Over 80 publications. One to five presentations at major national meetings almost every year since the mid-1980’s.
More complete curriculum vitae with current and past academic and other appointments, awards, publications and presentations available on request.
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