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In May 2021, President Biden released full details of the fiscal year 2022 budget. Overall, the budget request combines President Biden's American Jobs Plan, his American Families Plan, and funding priorities for the Pentagon and domestic agencies, for a projected total of $6 trillion. Read more about what the president is proposing in this post.

As the U.S. continues to undertake the largest vaccination campaign in almost a century, it has required government at all levels to surge workforce capacity. The federal government, states, territories, and local jurisdictions are acting to meet the immediate demand for vaccination as well as expand the long-term vaccination workforce. Looking ahead, expansion of the vaccination workforce long-term will help support potential COVID-19 booster shots and expand vaccine access broadly.

Many states have experienced considerable challenges in recruiting and retaining HAI/AR staff, in this interview, public health officials from Kansas discuss their successes and lessons.

What We Learned at the Public Health TechXpo and Futures Forum ASTHO | Our staff's top takeaways from the TechXpo. astho, association of state and territorial health officials, public health techxpo and futures forum, public health leaders, u.s. public health system, public health policy, data sharing and modernization, population health, governmental health agencies, public health infastructure, workforce resilience, public health workforce, techxpo and futures forum, public health infrastructure, build workforce resilience, future of public health, health techxpo and futures, health leaders and experts, experts across the technology, health workforce, health outcomes, futures forum, health leaders, health departments, public health professionals, today and the future, public health services, public health techxpo Dylan Reynolds Marcus Plescia and Garfield Clunie present "The Future of Measuring Health Equity - A World of Evolving Data." Last month, ASTHO kicked off the Public Health TechXpo and Futures Forum in Chicago, an opportunity for some of the world’s top leaders in technology and to engage public health leaders on challenges and solutions for successfully modernizing the U.S. public health system. Over 600 participants were in attendance, with 200 more attending virtually from around the world. It was a packed three days. Our speakers demystified the world of public health policy, opened doors to new funding streams, and gave us a glimpse into the glittering future of data sharing and modernization. Heavy hitters from Amazon and Google weighed in as well, showing us how they’re working hand-in-hand with health agencies to change the way they approach population health and well-being. So as we look back on a busy week—and look ahead to our virtual follow-up event on June 15—here are some of the messages that stuck with us the most: "Standards are like toothbrushes. Everyone has one, and no one wants to use some else’s." The line from Gabriel Seidman, director of policy at the Ellison Institute for Transformative Medicine, was met with a belly laugh from a crowded room during one of the week’s most well-attended sessions, a panel conversation on the future of measuring health equity. However, Seidman’s comparison was an apt one. There is certainly much to be said for a public health data system that is engineered to meet the specific needs of its target community. However, for public health experts to do their best work, they must be able to speak a common language—at a local, state, territorial, and national level. When each level of public health is operating with different standards in place and with a different definition of success, data gets lost and people get left behind. One of the loudest calls to action from the week was for governmental health agencies to break down these data siloes and establish common standards between agencies. The "Next Pandemic" is a Priority—But It's Not the Only One There is—understandably—mounting national attention on preparing for what many public health experts believe will be the inevitable "next pandemic." The COVID-19 pandemic showed us what a lack of preparedness could mean for population health, and there is so much unknown about what the future of pandemics has in store. However, experts at the TechXpo reminded us that public health is about more than responding to a singular crisis. "I think many of the conversations we're having are so focused on COVID-like pandemics," said John Auerbach (alumni-MA) "But if we look at the things that are still killing people, for the most part it's not infectious disease." Instead, Auerbach cited challenges that have long been a part of the public health story, such as diabetes, the fentanyl overdose crisis, and climate change. Before COVID-19 entered the national spotlight, public health’s day-to-day work was largely centered on chronic disease and behavioral health. Auerbach reminded us that amid all of the unknowns of our future, there is plenty we do know—and plenty we can be doing to address it. "Modernizing data systems is more than buying a big computer." While there were many versions of this message over the course of the forum, Auerbach perhaps said it most concisely of all. In other words, it doesn’t matter if a public health agency has a chrome-plated exterior and a cloud-based data system, so long as the underlying infrastructure isn’t sustainably and thoughtfully built. Whether it’s a matter of restricted funding, antiquated processes, or siloed thinking, health agencies and their leaders must have a plan to address these challenges before assuming that “buying a big computer” will catch their data dashboards up to speed. This was one of the ironies of this future-forward event: Amid so many exciting innovations and inventions, many of the challenges boiled down to basic, equity-centered questions about the best way to get this new technology in the right people’s hands. If public health is going to take a technological leap at a national level, then it must also be able to make a leap at a community level—in communities of color, in territorial health agencies, and in our policies. Jumping lightyears ahead doesn’t count if entire populations are still being left lightyears behind. Workforce Resilience Cannot Be Taken for Granted We cannot separate the future of public health from the future of its workforce. The COVID-19 emergency response has left many public health workers feeling burned out and harboring traumatic levels of toxic stress, pushing many of them to seek out jobs outside the field. In fact, according to a recent analysis of data from the Public Health Workforce Interests and Needs Survey, 46% of state and local public health employees left their jobs between 2017 and 2021. For public health to reach its full potential in the future, we must begin investing in that workforce today. Over the course of the week, we heard often from mental health experts and senior health officials to learn about their priorities, challenges, and paths to improve workforce well-being in their health agencies. This included the unveiling of the PH-HERO Workforce Resource Center, which arms health agencies with the resources and knowledge they need to support their workforce. Whatever the future of public health holds, it begins with a workforce who is motivated to make that future a reality. More than anything, the TechXpo was a reminder that public health’s future is as multiple as it is uncertain. We are working toward a future that is more adaptable than ever before—with thought innovators and health experts who are constantly reflecting, pivoting, and adjusting to the moment. There are so many conversations yet to be had. For those who have not done so already, we invite you to register for our fully virtual TechXpo follow-up forum on June 15, and add your voice to the growing chorus. website yes

Understanding boundary spanning principles helps public health practitioners recognize the types of boundaries that come naturally when navigating relationships that may involve managing up, down, and across.

Legislative Prospectus: Public Health Workforce 2022 ASTHO Legislative Prospectus: Public Health Workforce astho, association of state and territorial health officials, association of state and territorial health officials astho, public health officials, state health officials, territorial health officials, island jurisdictions, state health, public health, leading cause of death, mental illness, 10th leading, center for disease control, united states, national suicide prevention lifeline, save lives, suicide prevention resource center, disease outbreak, disease control and prevention, national institute of mental health, preparedness plans, centers for disease control and prevention, mental health conditions, preparedness and response, attempting suicide, mental health problems, health care, evidence base, covid-19, mental health, suicide prevention, pandemics preparedness, behavioral health Years of underinvestment in public health left a fragile public health system to respond to COVID-19 in early 2020. The public health workforce overcame extraordinary conditions responding to the pandemic—working long hours, risking exposure to the disease, and withstanding threats and abuse from the public—which negatively effected the mental health of many public health workers. A Spring 2021 survey of over 26,000 public health workers found that 52.8% experienced symptoms of anxiety, post-traumatic stress disorder, or suicidal ideation. States and territories are considering several policies to support the public health workforce, including efforts to increase the number of public health workers, strengthening protections for workers privacy and safety, and ways to sustain public health funding. Download the Prospectus website

A guide to setting up and facilitating Health Equity Circles in the workplace.

One of President Biden’s first actions just before being sworn into office was to draft up the American Rescue Plan, a sweeping proposal that ASTHO has committed to working with the Biden Administration on. The proposal offers a national vaccination plan, a promise to address COVID-19 health disparities, and efforts to prioritize the expansion the public health workforce. This post details some of the high-level takeaways, as they relate to public health.

If EMS can change the perception of patients with Substance Use Disorder, they will see that building rapport and encouraging the patient to seek help from resources they provide can be mutually beneficial. For EMS, it reduces the call volume, and often the financial cost, of repeated responses for the same patient—and the patient gets the help they need to break the cycle of substance dependence.

Gain access to information, resources, and tools to develop an effective workforce planning process to create a three- to five-year workforce plan.

One of tools presidents have to implement and drive their strategy are executive actions. Executive orders and presidential memoranda carry the force of law and allow presidents to move quickly, deliver a clear message, organize the functioning of the executive branch, and spotlight critical issues with declarations of commemorative observances.

Colorado's New Online Mentorship Initiative Supports Local Public Health Agencies Elise Moore Learn how CDPHE developed an online mentorship program to enhance local public health leadership, with tips for other health departments. The Colorado Department of Public Health and Environment (CDPHE) launched their Athena Success Partnering program, an online staff mentorship initiative for local public health agencies. CDPHE's Office of Public Health Practice, Planning, and Local Partnerships (OPHP) developed the program as part of its Executive Director Learning Pathways project, which supports those leading local health agencies in Colorado—especially after many of those leaders faced intense scrutiny during the pandemic. CDPHE used Public Health Infrastructure Grant (PHIG) funds to procure the software to support its online mentorship programs. Several different entities in CDPHE are now using the software for mentoring initiatives, including programs for new hires, human-centered leadership, and peer support. In addition to the Athena Program, OPHP uses the software for a peer connection program for Colorado Chief Medical Officers. Development and Launch of the Mentorship Program An Executive Director Advisory Group helped guide OPHP’s thinking around the options and elements to include in its online mentorship program for local health agencies. The Athena Program provides new and experienced executive directors and emerging leaders the opportunity to form supportive peer relationships for skill development, confidence building, networking, effective agency leadership, and supporting retention efforts. OPHP started by focusing on local public health agency executive directors and has recently opened the program to all Colorado local public health agency staff. The program offers a series of steps or prompts to guide mentors and mentees, with content to last for a year of regular meetings. Some of the automated prompts include ice breakers and questions about communication, goal setting, and leadership. Additionally, the platform has a learning section where users can find articles and resources related to professional development. Participants use the platform for traditional mentoring, and to connect with colleagues with expertise in specific areas. Users can ask questions or request mentorship for specific time-sensitive problems or learning needs. They can also join role-specific groups, such as planners and emergency preparedness and response and resiliency staff. OPHP notes that it took time for staff to develop new habits for using the platform for questions and resource sharing and that some executive directors did not feel qualified enough to become mentors to other executive directors. To address some of these challenges, OPHP created resources and opportunities for users to understand the program's benefits, including a monthly newsletter. In one edition, OPHP outlined reasons to become a mentor—addressing the benefits, time investment, preparation guidance, and qualifications to be a mentor. Program Receives Positive Response Both mentors and mentees in the Athena Program have expressed positive outcomes and benefited from their relationships. Broomfield County Executive Director Jason Vahling shared that he benefitted from the mentor experience. “Initially, I was signing up to be a mentor, but I feel like, at times, we switch back and forth between being the mentor and mentee and learn from each other. It has been great to have a partner outside the metro area to get insights and learn from." Mentorship Platform Evaluation Plans As the program continues, OPHP is using quantitative and qualitative data (e.g., participation counts, user surveys, and key informant interviews) to assess participant engagement. Program administrators are also assessing supports and barriers to participation and whether participation in the mentorship program is helping build essential knowledge and skills in implementing best practices for core public health services and foundational capabilities, management and leadership, and staff support and retention. OPHP’s Advice on Planning an Online Mentorship Program For health departments seeking to build their mentorship platform, OPHP shared a few tips: An advisory group was valuable for program planning. Talk to potential participants about their needs, as these may vary. Be patient and take the long view. Demonstrate how the program benefits both mentors and mentees. Provide various options for engaging with mentoring, peer support, and group interaction opportunities. Future Plans for Strengthening Staff Expertise CDPHE plans to continue leveraging PHIG funding, as well as their academic health department partnership with the Colorado School of Public Health, to offer a program to prepare participants to successfully take the Certified in Public Health (CPH) exam and earn certification with a pilot beginning in January 2025. PHIG recipients interested in learning more about Colorado’s experience can reach out to the team at ophp@state.co.us. Special Thanks-Blog - Colorado's New Online Mentorship Initiative Supports Local Public Health Agencies OE22-2203 PHIG website yes

Learn how public health leaders can lead through crisis and support their teams in this blog post.

How Staffing and Workload Can Impact Public Health Agencies Kelsey Tillema Public health is combating burnout and high turnover by focusing on key practices to improve workforce infrastructure—learn more in this blog post. Public health agencies often face significant challenges managing workforce priorities related to staffing and workload. While these issues are not new, the COVID-19 pandemic underscored the importance of retaining the public health workforce as a critical component of emergency response. A lack of capacity to manage an agency's workload can create a toxic cycle, often negating any impact of positive organizational culture improvements. In turn, productivity diminishes, turnover increases, and the remaining workforce suffers. To combat this pattern of inadequate staffing and attrition, a robust combination of effective recruitment, timely hiring practices, equitable workload policies, pay considerations, and skilled leadership to champion changes are essential. With one in three public health employees considering leaving their organizations within the next year—citing pay, work overload and burnout, lack of opportunities for advancement, stress, and organization culture as top reasons for leaving—retaining employees in public health has never been more important. As demonstrated during the COVID-19 pandemic, a lack of solid workforce infrastructure and workload imbalance among health care professionals and public health employees can have disastrous consequences for the workforce and overall public health. According to an analysis by the de Beaumont Foundation, “state and local health departments need to hire a minimum of 80,000 more full-time equivalent positions (FTEs)—an increase of nearly 80% —to provide adequate infrastructure and a minimum package of public health services.” As challenges and uncertainties continue to arise in an ever-changing public health landscape, quickly filling open positions and retaining current public health professionals is a key strategy to ensuring a healthy workload balance among teams and programs. Timely recruitment and hiring practices, creative recruitment strategies, broader job requirements and qualifications, as well as conducting capacity and project prioritization assessments can help alleviate stress and burnout that existing employees may experience due to open roles or understaffing. Chronic understaffing and delays in filling positions can contribute to stress, burnout, and higher turnover due to employee dissatisfaction. While an agency can have meaningful organizational culture and well-being initiatives in place, understaffing and workload imbalances can quickly counteract these efforts if not addressed quickly. Policies such as providing additional pay to employees who are taking on extra duties due to unfilled positions, cross-training or cross-skilling across duties and/or programs, assessing team and individual workloads, as well as providing avenues for staff to work toward promotions when taking on work that isn’t normally part of their role can motivate employees who are asked to take on more than their job description outlines. One such framework in discussion at North Dakota Department of Health and Human Services is a creative take on a career ladder—called a “career honeycomb.” In contrast to the ladder framework that typically reflects straight upward career growth, the honeycomb is a bi-directional opportunity to look at career development from various angles. The desire is to increase employee retention and satisfaction by providing avenues for staff to receive bonuses or other incentives for taking on extra work, earn “points” toward specific career milestones or promotions, be recognized on various platforms by their colleagues and leadership team, and embed their workforce development plan and mentorship program opportunities into the various “cells” of the honeycomb. This kind of creative thinking is an innovative way to holistically address both the agency’s and individual’s needs and strengthen overall workforce development. When understanding and implementing effective hiring policies and ensuring equitable workloads across a public health agency, human resource and workforce development/well-being teams are a crucial component. An internal team that is dedicated to assessing employee capacity, hiring and promotion policies, well-being, and overall organizational culture can help mitigate burnout among staff, lower turnover rates, and ensure wise use of resources. By continuously evaluating both the staffing needs and the overall health of the organization, HR and workforce development professionals can foster an environment that attracts and retains top talent, leading to improved job satisfaction and agency performance. The relationship between staffing, capacity, and workforce culture in public health agencies is undeniable. Ensuring that there are timely and efficient recruitment and hiring practices in place, equitable workload policies, and advancement opportunities can foster a healthy and effective workforce. These efforts must be supported by a dedicated team of workforce development and human resource professionals who regularly focus on assessing and addressing workforce staffing, capacity, well-being, and organizational culture. By prioritizing these internal needs, agencies can break cycles of burnout and turnover to create a resilient and capable workforce that effectively responds to public health challenges. OE22-2203 PHIG article yes

On Aug. 3, 2022, ASTHO and the de Beaumont Foundation announced the 2021 PH WINS findings. They provide a unique snapshot of the state and local government public health workforce.

On Nov. 2, 2022, ASTHO announced the launch of PublicHealthCareers.com, a new website for job seekers in the field.

On May 2, 2023, ASTHO released a statement of support for the President’s Council of Advisors on Science and Technology’s new report and recommendations for supporting the U.S. public health workforce.

Anne Zink (Chief Medical Officer, Alaska Department of Health and Social Services) and Larry Lewis (licensed psychologist and executive coach) speak on the importance of celebrating “small wins”—tangible stories of progress that can sustain the public health workforce in an otherwise trying time.

The experts on today’s episode make the case for how a robust public health workforce could have changed the trajectory of the pandemic response, but also explain why we can reimagine what a strong public health workforce requires as we enter into pandemic recovery.