1. Katie Sellers, DrPH Chief Science and Strategy Officer Association of State and Territorial Health Officials (ASTHO) March 9, 2014 ASTHO Governance Structure

2. Session Overview Issue  What is the best way to serve and have representation of ASTHO members in the territories and freely associated states? Session Goal  Obtain input from ASTHO’s USAPI members on what governance structure changes, if any, would allow for better representation on the ASTHO Board of Directors Overview  Overview of current governance structure and roles  Overview of past discussions about a potential board restructure  Discussion  Recommendation

3.  Shares best practices in health policy and programs  Advocates for our interests at the national level for state-based public health (i.e., Congress, the Administration, our national partners, etc) ASTHO Today  Provides access to 59 colleagues and agencies

4. ASTHO represents states, the District of Columbia, US Territories and Freely Associated States Cooperative agreement with CDC  Increased outreach and engagement with insular areas  Provision of technical assistance  Staff time and modest funds for consultants  Sub-award to PIHOA  July 1, 2013 – June 30, 2018 ASTHO and the US Insular Areas

5. 59 Voting Members Board of Directors ̶5 officers + 10 Regional Representatives ̶4 Ex-Officio Members ASTHO Governance Structure Terry Cline (OK) Immediate Past President Brenda Fitzgerald (GA) Secretary-Treasurer Ed Ehlinger (MN) President-Elect Jewel Mullen (CT) President José Montero (NH) Past President

6. Role of executive officers President President-Elect Immediate Past President Past President Secretary-Treasurer Executive Director

7. Regional Representatives Region 9 AS CNMI FSM Guam Palau RMI

8. Role of Regional Representatives Major functions  To serve as an ASTHO board member, providing leadership and support to the organization.  To represent the region and serve as a conduit for communication between member S/THOs and ASTHO Phases  Pre-election  Post-election  Ongoing

9. Role of Regional Representatives Gather input from region to bring to the board meeting Keep regional members informed of the work of the board Reinforce important communiques Serve a liaison role between board and regions Support ASTHO’s efforts during disasters (i.e. Gulf Oil Spill)

10. Unique Needs of Insular Areas ASTHO Board of Directors informally discussed insular areas representatives in 2014 Comments from 56 th PIHOA Board Meeting (August 2014)  Standing insular areas representative ensures insular areas have a voice on the board  Potential board structures ̶Add insular areas as a separate region ̶Ex-officio model in addition to representation by Region 9 representative ̶Representative rotates between Atlantic and Pacific  Considerations ̶How to represent both Atlantic and Pacific ̶Territories and freely associated states have different needs (i.e. Medicaid)

11. Proposal New, ex-officio seat for insular areas 6 USAPI vote for representative for one term, then 2 Atlantic territories vote for the next term Insular representative is expected attend 4 ASTHO board meetings per year  Read materials ahead of time  Obtain input from other insular area members before meeting  Represent interests of all insular areas at meeting

12. Questions and Concerns Please contact me at ksellers@astho.org if you have additional inputksellers@astho.org