Leading the Transformation of the Public Health System: Are “We” Prepared? Dennis Lenaway, PhD, MPH Office of the Chief of Public Health Practice Centers for Disease Control and Prevention November 4, PHLS Annual Program

Public Health Challenges

Emerging Diseases (SARS, Pandemic Flu) Re-emerging Diseases (XDR-TB) Food Safety Bioterrorism Natural Disasters Obesity Aging Population Health Disparities Global Warming

Health Care Crisis

Aging Population Re-emerging Diseases Emerging Diseases Obesity Health Disparities Access to Quality Health Care Health Insurance Costs Uninsured and Underinsured

Federal, State and Local Silos Public Health Care Emergency Management EducationLaw Enforcement

Rebalancing Health Priorities Safer Healthier People Vulnerable people Affected people without complications (undiagnosed asymptomatic) Affected people with complications General protection Targeted protection Primary prevention Secondary protection Tertiary protection Death from Complications

Traditional Healthcare Safer Healthier People Vulnerable People Affected People without complications (undiagnosed asymptomatic) Affected People with complications Traditional Healthcare Disease Care

Traditional Public Health Safer Healthier People Vulnerable People Affected People without complications (undiagnosed asymptomatic) Affected People with complications Public Health System

Healthcare Delivery System Disease Care Need to Rebalance Health Priorities Public Health Network Health Protection: Health Promotion, Prevention, and Preparedness Safer Healthier People Vulnerable People Affected People without complications (undiagnosed asymptomatic) Affected People with complications

“Given the significant public health and health care challenges we face, are Public Health Leaders adequately prepared to address these issues?” “What are the requisite leadership competencies needed to address these challenges?” “Do we have a system of leadership development that can meet this challenge?” Questions

Transforming the Public Health System

Setting Agency Standards Public Health Accreditation Board Setting System Standards National Public Health Performance Standards Establishing Public Health Laws and Policies Community Engagement MAPP Local – State – Federal interaction (SMOs) Structure and Functions

Transforming the Public Health System

Competencies for Public Health professionals Epidemiologists Environmental Health Nursing Credentialing and certification National Board of Public Health Examiners (2005) Existing programs in nursing, environmental health, laboratorians Workforce

Transforming the Public Health System

The “Strategic Influence” of Public Health Leaders Policy PH Leaders Community Experience Politics Resources Programs

Transforming the Public Health System

National-level Goals and Priorities CDC’s Health Protection Goals Healthy People 2010 State and Community-level Goals MAPP State and Local Health Departments Goals and Priorities

Leadership is Essential to Success Improved Performance Improved Performance Agency Standards System Standards Laws and Policies Community Engagement Portfolio Management Improved Health Outcomes Improved Health Outcomes + + Leadership Workforce

Leadership Development at CDC National Public Health Leadership Institute Regional Public Health Leadership Institutes National Public Health Leadership Development Network Association of Public Health Laboratories National Center for Environmental Health Emerging efforts

DRAFT – For Discussion Purposes Only 23 Components: Development Offerings Foundation CDC Leadership Development Framework Architecture Initiative for Leadership Enhancement and Development (I LEAD) Leadership Development efforts are most effective when they are strategic, coordinated and measurable. CDC Health Protection Goals and Organizational Excellence Assessment Four-Tier Leadership Competency Model Evolving High Performing Leaders Tier 1 Leader Development Map Leadership Assessment and Consultation Center (LACC) Tier 2 Leader Development Map Tier 4 Leader Development Map Tier 3 Leader Development Map Learning Management System (LMS) Outcome Strategic Human Capital Management Plan Evaluation

Leadership Development at CDC Office of Workforce and Career Development Crisis Leadership Competencies Communication Conflict management Credibility Decisiveness Flexibility Initiative Influence Partnering

Thoughts about Leadership Competencies Foresight Insight Action (Johansen, 2007) Anticipate needs and sense emerging trends Forecast what “might” happen Provoke new thoughts and ideas Move from problem-solving to tackling dilemmas Early action Better results

Issues Surrounding Leadership Development Continuum Dilemma – Leadership vs. Management competencies – Basic vs. Advanced – Regional vs. National Crisis Leadership Integrated or single program? Discipline specific Leadership How to build effective networks Fragmentation Develop a “system” for Leadership Shared vision, shared funding, common purpose

“Leaders are visionaries with a poorly developed sense of fear and no concept of the odds against them” (Robert Jarvik) “Success is the child of audacity” (Disraeli) Final Thoughts

Leading the Way to Better Health