PUBLIC HEALTH WORKFORCE DEVELOPMENT LOUIS ROWITZ, Ph.D MID-AMERICA REGIONAL PUBLIC HEALTH LEADERSHIP INSTITUTE

The Public Health Workforce (PHS) All those providing essential public health services, regardless of the nature of the employing agency. Promotion of individual and organizational excellence is the only standard acceptable to the public and decision makers who play a vital role in realizing the vision of Healthy People in Healthy Communities.

The Professional Obligations (Curry et al.) All professionals are obligated to both acquire and maintain the expertise needed to undertake their professional tasks and all are obligated to undertake those tasks that are within their competence.

Competence is a professional and moral obligation oriented to the highest standards of performance and not to a low minimal one.

The determination of high performance standards as well as the minimal ones must be determined by the public health professions, the policy makers, community needs, and societal values.

The Public Health Worker’s Social Responsibility Throughout the public health system, the social and moral responsibility of all individuals involved in the promotion of the health of the public is to put learning and experience into future practice. This is what competency concerns are all about.

Educators and Trainers Give the Public Health Worker the tools but the worker must take the responsibility of using these tools

Competency = Knowledge + Understanding + Practice

Public Health leaders need do be held to the highest standards of competency

National Public Health Leadership Network Created in 1994 Funded by CDC and housed at St. Louis University School of Public Health Supports the growth of state and regional public health leadership development opportunities in all 50 states Provide formal mechanisms for academic and practice to work together to promote leadership at all levels of the public health system

The Leadership Competency Project Began in 1994 Ongoing Identification of competency requirements for public health leadership due to multidisciplinary nature of public health Competencies are tied to performance standards Built upon the core public health functions/essential public health services

Four Major Leadership Competency areas were defined by NLN Transformational competencies Political competencies Transorganizational competencies Team Building Competencies

Core Transformational Competencies Visionary Sense of Mission Effective change agent

Core Political Competencies Understanding of political process Negotiation Ethics and Power Marketing and education

Core Transorganizational Competencies Understand organizational dynamics Interorganizational collaborating mechanisms Social forecasting and marketing

Core Team Building Competencies Develop team oriented structures and systems Facilitate development with teams and work groups Serve in facilitator and mediator role

Estimated 500,000 individuals currently employed by a range of organizations involved in public health practice and providing the ten essential services Public Health Workforce

Workforce Composition Percentage of local health departments having at least one full-time employee in the listed job classification, U.S.,

An estimated 80% of the workforce has no formal training in public health

GAP Current capabilities and future needs continue to widen

WHO IS MISSING ?

Present SOC Public Health Occupations Public Health Physician Public Health Nurse Public Health Dentist Public Health Dental Worker Public Health Veterinarian Public Health Nutritionist Public Health Pharmacist

Standard Occupations Continued Public Health Laboratory Scientist Public Health Laboratory Technician and Technologist Public Health Attorney or Hearing Officer Health Information System/Computer Specialist Public Relations/Public Information/Health Communications/Media Specialist Biostatistician

New Recommended SOC Public Health Occupations Epidemiologist Environmental Engineer Environmental Engineering Technician and Technologist Environmental Scientist and Specialist Environmental Scientist Technician and Technologist

Continued Occupational Safety and Health Technician and Technologist Health Educator Public Health Policy Analyst Health Service Manager/Health Service Administrator Public Health and Community Social Worker

Continued Mental Health and Substance Abuse Social Worker Psychologist, Mental Health Provider Alcohol and Substance Abuse Counselor, including Addiction Counselor Mental Health Counselor

BARRIERS Inventory of the workforce does not exist No consensus on the competencies or curricula needed for the workforce Integrated delivery system for lifelong learning does not exist Inadequate incentives for participation in training and continuing education

BARRIERS(2) No uniform approach or commitment to evaluation Financing of workforce development is unclear as well as a coherent training policy

PROBLEMS IN ENUMERATION Lack of clear public health professions classification/schemes An absence of consistent public health credentialing requirements A professional workforce educated in specific disciplines but without formal public health training

ENUMERATION(2) Standard occupation classifications based on population-based occupations

HRSA Action Steps National Leadership State and Local Leadership Workforce Composition Curriculum Development Distance Learning

National Leadership Action Steps Organize national forum of key stakeholders to examine human resource allocation and public health trends Develop Leadership modules for training to assess roles in a changing public health environment Involve frontline practitioners from all sectors in training

State and Local Leadership Action Steps Ensure that workforce planning takes place in all appropriate jurisdictions Work with other health professionals in the jurisdiction to achieve mutual goals in public health workforce development Develop partnerships with the State to quantify the supply and demand of public health personnel

Workforce Composition Action Steps Identify lead agency to provide leadership in determining workforce needs for implementing the essential services of public health Examine methods used by professional organizations to classify their respective workforces. DON’T REINVENT THE WHEEL

Workforce Composition(2) Develop a standard taxonomy based on essential services to qualitatively characterize the public health workforce Use the SOC to track shifts in the movement of the workforce in the public, private, and voluntary sectors Ensure cultural and ethnic diversity in the workforce

Curriculum Development Competencies(Action Steps) Verify that identified competencies are necessary for efficient and effective P.H. practice Identify competencies critical to all P.H. practice and those critical to practice in specific settings Improve long range planning to update competencies

Curriculum Action Steps Ensure that the practice community has a substantial role in curriculum development Determine the current status of competency of the workforce Develop measurable performance indicators for identified competencies Survey P.H. training centers to ensure that competencies are part of the curriculum

Curriculum Action Steps(2) Conduct analysis of competency statements and make revisions in curriculum Identify gaps between high priority competencies that are needed and those already present in the workforce Translate competencies into discrete didactic and field-based learning experiences

Curriculum Action Steps(3) Create a matrix of addressed and unaddressed competencies based on public health organizational needs Support a curriculum development process that is sensitive to the needs of the local community Recommend to CEPH that competency-based approaches be included in academic programs

Distance Learning Action Steps Utilize DL in training, education, and communications Directly link DL systems and program development Routinely gather input from key partners regarding training needs and technological capabilities

Distance Learning (2) Develop agency expertise in DL Provide access to information about public health DL programs Organize a mechanism for pooling and accessing resources and expertise on DL across all of public health

CDC/ATSDR STRATEGIC PLAN FOR WORKFORCE DEVELOPMENT

VISION A competent workforce able to perform the essential public health services

Premise Use the essential services as a framework for identifying workforce competency requirements Assume a multidisciplinary, multisector, diverse and geographically dispersed public health workforce

Premise(2) Design a cohesive learning system to develop and deliver a comprehensive P.H. practice curriculum which build basic, cross cutting(core) competencies and technical skills

Six Strategic System Elements Monitor workforce composition Identify competencies/Develop curriculum Design integrated learning system Use incentives to assure competency Conduct evaluation and research Assure financial support

Implementation(Guiding Principles) Build upon existing resources of CDC and partners Focus on the needs of the front line public health worker Strengthen competency certification and credentialing system

Focus Areas Centers for Public Health Preparedness Global training development and delivery system using state of the art technology Certification and credentialing systems in public health Applied research and evaluation

KNOWLEDGE IS THE SECRET TO FUTURE SUCCESS