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This organizational strategic planning guide, which details seven phases, can help health agencies create or refine strategic plans that are responsive to evolving needs.

In-depth analysis on state health policy surrounding the public health workforce. This is part of ASTHO's annual legislative prospectus series.

Insight and Inspiration: Conversations for Public Health Leaders ASTHO is honored to present Insight and Inspiration, the premier webinar series designed to motivate public health leaders as they respond to new and ongoing public health challenges. The nation’s preeminent thought leaders, authors, and strategic thinkers offer attendees strategies to further develop their leadership skills as well as ground themselves and their teams even amid crisis. This series is open to governmental public health professionals at all stages of their careers. Check out upcoming opportunities and previous session recordings below to take your leadership to the next level. website

The opioid epidemic has exacerbated the shortage of board-certified forensic pathologists, presenting a major workforce challenge for public health systems.

An ASTHO brief on the importance of understanding moral injury and burnout, with recommendations on areas of organizational focus.

Learn how boundary spanning leadership can help develop more robust and productive public health workplaces.

Explore key actions, indicators, and supports to enhance workforce recruitment and hiring in governmental public health.

Centralizing Administrative Functions, with Lessons Learned from Guam Megan Drake-Pereyra Centralizing administrative functions, such as procurement or grants management, is a strategy many organizations utilize. Having administrative functions concentrated with a specific team rather than dispersed or managed within separate teams can work well. There is potential for standardized processes and procedures, increased efficiency and quality, more control and accountability, and consistent data collection and monitoring. This brief details how health departments can utilize existing, evidence-based frameworks to centralize administrative functions and build off lessons learned from others, such as the Guam Department of Public Health and Social Services (Guam DPHSS). Getting Started Considerations When transitioning from a decentralized structure to a centralized structure, it is important to clearly outline the what, why, how, and benefits. Consider the following components to kickstart success: Leadership vision: Start with the leader’s visionary perspective. When the leader allocates sufficient time and consistently reinforces the vision, it allows for the necessary decisions, trust, and support to be established during the transition. Data-driven design: Use data and existing information, such as current standard operating procedures or process diagrams, to understand the decentralized process differences/similarities, and guide effective centralized processes and procedures. Role clarity: Clearly outline and define the new centralized infrastructure, purpose, roles, responsibilities, expectations, and procedures. This helps everyone understand and follow the new processes more consistently, with better results. Performance measures: Establish and use performance measures from the outset (e.g., team knowledge, skills, competency, process time and quality, outcomes, impact, etc.), for insight into the value, or return on investment, of the centralized model. This will help indicate the quantity, quality, and impact of programs/processes. Documentation: Capture and share decisions, vision, goals, structure, standard operating procedures, and relevant details in writing for new team members and users of the centralized functions. Communication: Transparently share plans, timelines, and additional knowledge to maximize utilization and value. Additionally, anticipate and proactively address resistance to change to help everyone embrace and adhere to the new, centralized approach. The Plan-Do-Study-Act Method Change management, quality planning, and process improvement models can also support organizational and process change. For example, the quality improvement methodology, Plan-Do-Study-Act (PDSA), offers an effective framework for centralizing administrative functions and complements many of the aforementioned considerations: Step one, plan, relies on leaders to decide the vision, scope, structure, roles/responsibilities, goals, and purpose of the centralized team. Here leaders establish and reinforce the leadership vision, using existing data to guide the design of the new centralized team. Step two, do, is dedicated to onboarding centralized team members, defining their work processes and procedures, and ensuring effective communication with all stakeholders. This requires thorough documentation and strong communications plans. Step three, study—an often overlooked but crucial building step—is for testing the processes, procedures, roles, and responsibilities, to confirm and build confidence that this centralized structure will yield the desired results. Performance measures provide clarity into what is working well and what is not. Step four, act, is for launching and rolling out the structure, ongoing monitoring of performance, and continuing to educate and coach for successful, sustainable improvements. Lessons Learned from Guam Guam DPHSS, a joint health and social services agency, is working to centralize its administrative functions to reduce inefficiencies and redundancies as well as improve quality and consistency. This has been a big change for Guam DPHSS, but leadership vision, documentation, role clarity, and communication have proven to be key throughout the process. In 2021, Guam DPHSS established a centralized Office of Grants Management (OGM). In its early stages, programmatic teams saw OGM as a regulatory body that would audit and direct their work, while OGM’s true objective was to provide support and ease administrative burden, allowing program staff to focus on accomplishing their goals and deliverables. By clarifying and documenting the vision, roles, and responsibilities as well as focusing on communication, the OGM built trust, addressed specific concerns, and established a shared vision of their role as supportive and helpful. In 2023, Guam DPHSS began the process of establishing a centralized Procurement Management Office (PMO). While Guam DPHSS reorganized and co-located staff into the new, centralized PMO, Guam was undergoing a governmentwide business process improvement (BPI) project focused on procurement—presenting an opportunity for Guam DPHSS to involve new PMO staff and other key DPHSS team members in improving its functions and centralizing the procurement process. Through the BPI project, which utilized PDSA, DPHSS clarified roles and responsibilities, defined work processes and procedures, and developed training and communications plans that supported process improvement and centralization of procurement functions. Guam DPHSS has learned many lessons throughout their journey to create a centralized OGM and PMO, including that change of this magnitude is hard—more specifically, balancing change management while ensuring maintenance of key operations. Ultimately, they found that the aforementioned considerations and methods for getting started were critical in supporting the change to centralized administrative functions. Establishing the Ideal Structure for Administrative Functions Determining if and how centralized administrative functions will work for an organization is multifaceted. An organization’s culture, size, infrastructure (including technology and systems), and workforce and skills all play crucial roles in shaping the ideal structure. The methods and considerations noted previously can help health departments determine and support the best path forward for each unique organization. ASTHO has several additional resources and tools that can support administrative change and improvement. Visit the ASTHO STAR Center to learn more. website yes

Leveraging Medicaid to Support Community Health Workers astho, association of state and territorial health officials, community health workers, health equity, medicaid coverage, chw workforce, social service, public health, health care system, improve health, individual and community, mental health, achieving health equity, social determinants of health, underserved communities, united states, health disparities, medicaid program, state Medicaid, advance health equity, highest level of health, people of color, community they serve, improve access, people living, increased health Vanessa Finisse, Madison Hluchan How to leverage Medicaid to support community health workers. Community health workers (CHWs) are pivotal in advancing health equity and improving population health, especially for marginalized communities. Today, there is increasing federal investment to better integrate CHWs into the health care system, spurred by post-COVID-19 federal legislation. While the benefits of CHW integration are well-documented, sustainable funding remains a challenge. This brief, developed in partnership with the Center for Health Care Strategies (CHCS), explores Medicaid coverage for CHW-led services and highlights opportunities for state and territorial health agencies (S/THAs) to collaborate with Medicaid to support CHWs. Key Considerations Medicaid-Funded CHW-Led Services Medicaid authorities can finance CHW-led services, such as state plan amendments (SPAs), section 1115 demonstrations (1115 waivers), and managed care flexibilities. States can pick a pathway depending on their goals, timeline, and administrative capacity. As compared to SPAs, 1115 waivers provide states with more flexibility to waive federal Medicaid rules to test innovative approaches (see Table 1). website yes

This brief discusses the difficulty of maintaining compassion and empathy during public health crises, which ultimately leads to a phenomenon called compassion fatigue. 

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

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.

Government Shutdown Puts Nation’s Health at Risk Government Shutdown in 2018 Puts Nation’s Health at Risk ARLINGTON, VA—Michael Fraser, executive director of ASTHO, issued the following statement on the federal government shutdown: “We are deeply disappointed that Congress and the Administration have failed to fund the federal government. This inaction means that 50 percent of HHS staff will be furloughed, which in turn will compromise public health professionals’ ability to rapidly respond to outbreaks, detect diseases, and provide the necessary support to state and territorial health departments. Health promotion and disease prevention activities require support from a robust federal, state, and local workforce and sustained funding. The longer the federal government is shut down, the more harmful the consequences. We strongly urge Congress and the Administration to develop a long-term budget solution so we can continue our mission with certainty and in partnership with our federal partners to improve the health and wellbeing for all.” ASTHO Press Release Boilerplate website yes

Lunch and Learn: Building Strategic Skills for Public Health Professionals website yes

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.

Laura Parajón, MD, MPH, deputy cabinet secretary for the New Mexico Department of Health details the process of building a pilot internship program with the University of New Mexico.

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.

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.

Dr. Laura Parajon, New Mexico’s Deputy Secretary of Health, reacts to the findings of the new PH WINS survey and tells us how we can begin to support and rebuild frontline teams; Dr. Jose Montero, Director of the Center for State, Tribal, Local, and Territorial Support at the CDC, says the new Pathways to Population Health Equity Framework is an adaptation of one used in health care and business; ASTHO reports on its work to develop strategies states and territories can follow to reduce maternal mortality and morbidity in a new article published in the Journal of Public Health Management and Practice; and leaders in the Pacific Islands describe how they have held the COVID-19 virus at bay the last two years.

Joanne Pearsol, ASTHO’s Director of Workforce Development, says the PH WINS survey shows many public health workers remain committed to their work despite the way they’ve been treated during the pandemic; Dr. Brian Castrucci, President and CEO of the de Beaumont Foundation, wants elected leaders to put the PH WINS findings into action; the results of a survey asking public health agencies to report their ability to respond to climate change and extreme weather events are available now; and there's still time to offer comments about a new road map for the Healthy Brain Initiative scheduled to come out later this year.