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Creating an Informatics Job Classification Series for Health Departments Creating an Informatics Job Classification Series for Health Departments Ari Whiteman Learn why public health informatics jobs are critical for health departments in this brief. Why a Public Health Informatics Job Classification Matters The push to modernize public health data infrastructure has highlighted that traditional job classifications (e.g., Epidemiologist, IT Specialist, or Developer) do not fully capture the unique skill set and value of public health informaticians. Informatics professionals specialize in integrating, standardizing, and managing health data systems to ensure interoperability across platforms and agencies. Their expertise includes health data standards (e.g., HL7, FHIR, LOINC, USCDI), database management, extract-transform-load (ETL) processes, business intelligence tools, and cross-system data exchange, all of which are skills and proficiencies needed for data modernization transitions and processes. According to the 2022 ASTHO Profile of State and Territorial Public Health, 25 states and territories did not have a dedicated public health informatics job classification series, which would create several key advantages over forcing informaticians into traditional public health classifications that may not adequately reflect their job duties or the expertise needed to perform them: Recruitment: Public health informatics job descriptions are likely to attract more qualified and better-fit candidates for the responsibilities of the role, which differ from that of IT professionals or epidemiologists. Retention: Informaticians often leave for the private sector due to higher pay opportunities, as governmental roles often pay less than similar roles in the private sector. A well-defined classification series with competitive salary benchmarks helps retain talent. Role Clarity: Differentiating informaticians from epidemiologists or IT ensures staff are linked to projects that fit their skills and experience, which can improve performance and morale across disciplines. Future-Readiness: Quality health data infrastructure is a preparedness necessity. Informatics positions enable agencies to respond to emerging health crises by linking response and surveillance data with other state and national reporting systems. Common Challenges and Solutions Anticipating challenges can help maintain progress and understanding across all involved parties. Challenge: Resistance to creating new classifications. Solution: Propose consolidation or sunsetting of outdated roles and highlight national best practices. Challenge: Salary constraints compared to private sector. Solution: Emphasize total rewards (retirement, benefits, meaningful work) and seek flexibility for exceptions. Provide salary data from sources like Lightcast, Healthcare Information and Management Systems Society, American Health Information Management Association, or surveys from the American Medical Informatics Association. Challenge: Limited internal public health informatics expertise. Solution: Build capacity through “train-the-trainer” models, upskilling, and leveraging partnerships with universities. Challenge: Slow civil service processes. Solution: Start early, maintain persistence, and adapt business case arguments to different decision-makers (HR, unions, leadership). See ASTHO’s Data Modernization Primer and Tactical Guides for more information, in particular: See the Tactical Guide on Building, Equipping, and Sustaining a Data Modernization Workforce for strategies for upskilling, training, recruitment, and retention of a data modernization workforce. See the Tactical Guide on Planning Data Modernization Activities for strategies to mobilize a team, conduct current state assessments, develop plans, and gain support from leadership. Challenge: Overlap with other roles (e.g., epidemiologists). Solution: Clearly define distinctions between public health informatics and other roles, then communicate role clarity to benefit morale and efficiency. Conclusion Creating a public health informatics job classification series is both a strategic investment and a practical necessity. By distinguishing informatics as a professional path within public health, states and territories can strengthen their workforce, address long-standing recruitment and retention barriers, and prepare for the rapidly evolving demands of data modernization. While the process requires persistence, clear documentation, and negotiation across HR and leadership, the payoff is a resilient workforce equipped to manage the data infrastructure that underpins modern public health practice. Reference the How-To Guide for more details on creating public health informatics job classification series. Learn More - Brief - Creating an Informatics Job Classification Series OE22-2203 PHIG article yes

Learn about ASTHO’s work with the Public Health Infrastructure Grant (PHIG) program, which strengthens state, territorial, and local health agencies through workforce development, data modernization, and foundational public health services.

Data Modernization Primer and Tactical Guides Dive into these data modernization reports for strategies and detailed steps to move from siloed systems to a connected, resilient data ecosystem. Public health data modernization is a collective effort by federal, state, local, and tribal organizations to strengthen public health data and surveillance systems. The ultimate goal is to move from siloed public health data systems to a connected, resilient, adaptable, and sustainable “response ready” data ecosystem. The primer provides state and territorial health officials with a high-level understanding of the objective and significance of data modernization as well as the roles that they play in a successful data modernization initiative. The five tactical guides detail key strategies and tactics for implementing and maintaining data modernization initiatives within public health agencies. article yes

Learn effective strategies for addressing workforce challenges in the islands, including geographic isolation and underdeveloped academic pathways.

This playbook, originally designed for local health departments, provides resources for states and territories who would like to increase community health worker engagement.

Explore ASTHO's Medicaid Oversight Governance Map to understand the governance structures of state and territorial health agencies across the country.

Designing a Public Health Informatics Job Classification Series: A How-To Guide How To Design a Public Health Informatics Job Series Public health agencies can use this actionable guide to develop data informatics jobs and fill critical gaps in their workforce. As part of state and territorial data modernization programs and data system improvement, many public health agencies are realizing that their existing job classifications don’t always reflect the specialized work of public health informatics professionals. While some positions may resemble traditional roles like epidemiologists, they require a distinct set of skills. Informatics professionals focus on integrating and managing data, building stronger data systems, and improving how information flows across programs and partners. They often use advanced tools such as SQL and Tableau, and they work with national data standards — like HL7, FHIR, LOINC, and USCDI — to ensure that health information systems can “speak the same language.” Existing classifications (such as epidemiologist or information technology specialist) rarely capture these technical and cross-disciplinary responsibilities. Creating a dedicated public health informatics job classification series helps agencies attract and retain experts with the right mix of data, technology, and public health skills. It also provides a clear structure for professional growth, defining duties and qualifications for entry-, mid-, senior-, and managerial-level positions. This clarity supports both staff development and long-term workforce planning. However, establishing a new job classification is not a simple task. It requires careful planning, collaboration across departments, and formal approval processes that can take time. This guide outlines the key decisions, documentation, and steps needed to determine whether a new classification is right for your agency and how to develop one effectively. Each health department’s structure and policies are unique, so the process described here should be adapted to fit local circumstances. Steps in the Process 1. Identifying the Need for a New Job Classification The first step is to determine whether your agency truly needs a new public health informatics job classification. Many health departments find that existing job titles — like epidemiologist or clinical application coordinator — don’t align well with the skills required for informatics work. A new classification may be warranted if current titles have different job requirements, pay structures, or barriers that make it difficult to attract and retain qualified candidates. Begin by asking key questions: Does your department already employ staff performing informatics functions? If so, what are their current classifications, and are they effective in recruitment and retention? How flexible are your civil service rules for posting positions with modified requirements or titles? If there’s sufficient flexibility, you may not need a new classification. Are you relying on temporary staff or contractors for informatics work? If so, analyze whether creating permanent positions could reduce long-term costs. If a new classification isn’t immediately feasible, what options exist to train, promote, or compensate staff doing informatics work within the current framework? 2. Understanding the Approval Process and Requirements Once a need is established, identify the steps and timeline required to create a new classification. This process varies widely by jurisdiction and can take several months, or even years, to complete. Start by determining who has decision-making authority and which offices must approve the proposal. This may include local HR departments, statewide HR or civil service offices, commissioners, or budget authorities such as the Office of Management and Budget. If your HR department has a moratorium on creating new classifications, consider negotiating or repurposing existing ones. Document the rationale thoroughly, highlighting recruitment challenges, misaligned duties, and how informatics roles support data modernization goals. Include evidence such as prolonged vacancies or the impact on program performance. Prepare necessary documentation, which may include: A list of required competencies. Subject matter expert reviews. A work study or position analysis. A “career ladder” illustrating differences between entry, mid, senior, and managerial roles (see example: Nebraska’s Informatics Series (PDF)). Comparisons with other job families, such as Nebraska’s Epidemiology Series (PDF). Additionally, determine whether other state agencies also require informatics roles, as cross-agency collaboration can strengthen the case for a new classification. When it comes to salary justification, find out who sets pay scales — some states use centralized systems, while others allow departmental flexibility. In unionized settings, salary changes may also require negotiation. For example, Minnesota uses the Hay methodology through Korn Ferry to determine compensation levels. 3. Gathering Job Descriptions, Competencies, and Key Skills Developing an accurate and competitive job description is crucial. Start by analyzing the knowledge, skills, abilities, and other characteristics required for informatics work. Assess whether existing staff possess these competencies and where skill gaps may exist. Collect and review comparable job descriptions and frameworks from trusted sources, such as: Public Health Informatics Institute and Council of State and Territorial Epidemiologists Region V Public Health Training Center O*Net Online Health Informatics Profile PublicHealthCareers.org Commonly required skills include: SQL R SAS Python Tableau Snowflake ETL processes Interoperability standards (HL7, FHIR, LOINC, USCDI) Project management tools (e.g., Agile and LEAN) Certifications such as HL7 CDA Specialist, FHIR Fundamentals, or Tableau Desktop Specialist may also be valuable. For competency alignment, reference the following professional frameworks: HIMSS Global Health Informatics Competency Frameworks Applied Public Health Informatics Competency Model (PDF) Council on Education for Public Health (PDF) Council of State and Territorial Epidemiologists Competencies Toolkit Public Health Accreditation Board Council on Linkages Core Competencies CDC Competencies for Public Health Professionals You can also consult the Lightcast workforce analytics reports for skills and salary trends and review the literature review repository for additional insights. 4. Conducting Salary Benchmarking Competitive compensation is essential to attracting informatics professionals. Begin by identifying your HR department’s comparison states or agencies and reviewing their pay plans. Compare rates with large local jurisdictions when possible. Showing cost savings from converting contractors to permanent employees can strengthen your justification. If union negotiations are part of your environment, plan early to align with contract timelines. Many agencies use external benchmarking tools aligned with the location of the job, such as Salary.com, Payscale, Glassdoor, or Indeed. Large-scale workforce datasets from Lightcast — a large-scale data vendor that includes data collected from millions of job descriptions — can be useful as well. Data from Lightcast queries include examples of competitor employers, top technical and soft skills, example job titles, and salary ranges for public health informatics positions. Searching and summarizing reference data like this is vital for establishing baseline job information that is in-line with successful public health informatics positions elsewhere, which can help build a case for why your new series is different than existing jobs and requires a specific pay range. For deeper insights into salary trends and disparities, review the following: Salary and Job Requirement Differences for Jobs in Local and State Health Departments Versus the Private Sector: Analysis of Large-Scale Job Postings Data demonstrates that public-sector informatics roles can pay up to 50% less than private-sector equivalents. Salary Disparities in Public Health Occupations: Analysis of Federal Data (2021–2022) shows that informatics jobs pay between 25-45% less in local or state government compared to all other sectors, a difference of up to $71,000 per year in wages. When Money Is Not Enough: Reimagining Public Health Requires Systematic Solutions to Hiring Barriers explores structural barriers beyond pay, such as slow hiring processes or outdated job descriptions, that cause barriers to hiring in health departments. Also review relevant salary surveys from professional associations: HIMSS Nursing Informatics Survey (2022) American Health Information Management Association Salary Survey Report (2019) (PDF) American Medical Informatics Association Salary Survey iMercer Healthcare Informatics and Technology Compensation Data Other Considerations Establishing a new public health informatics job classification requires more than paperwork — it requires persistence, partnerships, and long-term planning. Building relationships with key stakeholders, such as HR leaders, civil service administrators, union representatives, and department executives, is essential. Each may have unique perspectives and concerns about creating new classifications, so tailoring your approach can make a difference. Persistence is often key. If one strategy or argument isn’t successful, try another. For example, some departments have found success by framing informatics roles as critical to data modernization, interoperability, and cost efficiency, while others emphasize workforce development or public health impact. Having distinct classifications for public health informaticians and epidemiologists also supports workforce morale and clarity. It helps staff and partners understand who to contact for specific issues (e.g., analytical versus technical data

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

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

The Boundary Spanning Leadership Framework’s Impact on Public Health Boundary Spanning Leadership's Impact on Public Health Alice Schenall, Tyrone Bethune, Alyssa Merski Explore three examples of Boundary Spanning Leadership's public health impact, from overdose to Alzheimer's to youth behavioral health. Since 2018, ASTHO has customized the Boundary Spanning Leadership (BSL) framework for the public health workforce. BSL develops leaders’ ability to create direction, alignment, and commitment (DAC) across both vertical and horizontal relationships within health departments and with community partners. The framework aims to work across differences in geography, demographics, leadership level, department, or unit. It’s designed for settings where the goal is not only to lead people but to lead across these differences, bridging agencies, sectors, levels of authority, and communities. In short, while many leadership models help individuals become more effective leaders, BSL equips public health professionals to mobilize collective leadership across systems, which is essential for addressing complex issues such as behavioral health and emergency response. Here are three examples of BSL’s impact and utility in public health, two of which are multi-state projects. Preventing and Responding to Overdose Overdose Data to Action (OD2A) leaders are faced with boundaries that can inhibit overdose surveillance and prevention activities without proper navigation. For example, partnership with community organizations to reduce overdose may not be effective without first exploring differences between the state health agency and community organization goals and working to build trust. Throughout BSL trainings, OD2A leaders have demonstrated many ways they bridge these boundaries and apply DAC in their overdose surveillance and prevention work. OD2A leaders may need to span boundaries… Between departments within the agencies in which they work. Between hierarchical levels within the organization. With external partners like community-based organizations. With diverse cultures, demographics, and populations with which they work like people who use drugs. Across rural/urban regions, states, or localities. Collaborating across these boundaries ensures stronger team relationships, exchange of perspectives, expertise, and experience, and alignment of vision and strategy to improve program impact. For example, BSL can help OD2A leaders secure critical health agency buy-in while meaningfully engaging people with lived experience in the planning, implementation, and evaluation of prevention programs. “This program allowed me to focus on specific skills and teach me things I had never learned before. My work will be significantly better because of this. I cannot tell you how important it has been to be able to network with the others as well.” — Participant of OD2A Reducing Risk for Alzheimer’s Disease and Related Dementias In 2025 and 2026, ASTHO and the Alzheimer’s Association hosted two BSL trainings for health departments and their partners throughout the Healthy Brain Initiative. These helped equip them with a dynamic approach to addressing Alzheimer’s disease and related dementias (ADRD) by aligning partners across public health, aging, and other sectors. Through DAC, participants engaged in dialogue that bridged boundaries to integrate brain health into chronic disease, injury prevention, and other public health initiatives. Applying BSL practices to brain health created synergies that addressed shared risk factors such as hypertension, obesity, and lack of physical activity. BSL enabled state and jurisdictional teams to adapt quickly to the latest science, engage nontraditional partners, and build the skills needed to navigate potential boundaries. These practices strengthened cross-sector collaboration and built sustainable systems of shared investment and learning, positioning brain health as a priority across the public health landscape. ASTHO selected the BSL training because leaders who effectively collaborate across boundaries are better positioned to address complex public health challenges such as ADRD, which requires interagency and multisector action. Public health leaders need solutions, and there is evidence to support and measure the usefulness of BSL concepts. Participants successfully met the expectations and objectives of the workshop: Breakthrough Innovations: Drove creative solutions that integrated culturally responsive care and brain health promotion across settings. Cross-Functional Learning: Built shared understanding between public health, aging services, and community stakeholders to address complex problems (e.g., ageism, risk reduction, caregiver burnout, access to care). Partnership Development: Leveraged cross-sector collaborations to expand age-friendly environments and relationships. The BSL training left a lasting impact on those who completed the workshop, with participants reporting increased knowledge of major boundary types and mechanisms needed to boost ADRD strategies. Participants shared their excitement to immediately implement BSL elements into their public health practice. As BSL gains momentum and attention across the field, we urge organizations to leverage the framework as a conduit to build the capacity needed to accelerate brain health strategies and beyond. “My participation in this BSL training will have a lasting impact by strengthening both my individual capacity and our team's ability to approach strategic planning, stakeholder engagement, and the development of sustainable. For my team, this will translate into stronger collaboration, clearer direction, and more cohesive implementation of our ADRD strategies.” — Participant of the Healthy Brain Initiative Building Bridges for Youth Behavioral Health in New Mexico In April 2026, leaders from New Mexico’s Departments of Health and Education came together — not just to coordinate but to truly collaborate. Partnering with ASTHO, they convened an in-person BSL training designed to move beyond siloed work and toward a shared vision for adolescent behavioral health in schools across the state. A total of 18 participants joined the training, representing a cross-sector mix of state agencies and community-based organizations. While the group brought diverse perspectives, they shared a common purpose: improving outcomes for young people across the state. The BSL framework offered them a structured way to navigate differences, build trust, and define collective direction. Throughout the workshop, participants deepened their understanding of the boundaries that often limit collaboration, whether structural, relational, or based on differences in processes and priorities. More importantly, they built the skills to identify and bridge those divides. For many, the experience shifted how they think about partnership — not as coordination across systems, but as intentional, interdependent, and relationship-driven leadership. The impact was immediate. Participants reported increased confidence in their ability to break down barriers and apply BSL strategies to advance adolescent behavioral health. Just as critical, they described forming authentic connections with colleagues across sectors, which laid the groundwork for more cohesive, aligned work ahead. Perhaps most telling: Every participant committed to using BSL strategies in the next 30 days to six months. This wasn’t a one-time training, it was the start of a new way of working. The group plans to continue meeting monthly to apply these tools, strengthening direction, alignment, and commitment in their shared efforts. “Addressing boundaries is a great practical step in all of the projects we will have going forward.” — Participant of New Mexico School-Based Health Program For public health professionals, the takeaway is clear. Complex challenges like youth behavioral health don’t sit neatly within one sector and they can’t be solved there either. Boundary spanning leadership offers a practical, human-centered approach to building the partnerships needed to create lasting change. Explore more of ASTHO's work in Boundary Spanning Leadership. article yes

Healthy People Coordinator Description Template This template was designed to help health agencies craft job descriptions for staff that can effectively incorporate Healthy People 2030 frameworks into public health initiatives. Healthy People is a national framework that fosters a shared vision of public health across the United States. It establishes national priorities every 10 years to guide jurisdiction planning and data collection, which is supported by the HHS Office of Disease Prevention and Health Promotion (ODPHP). The goal of this template is to create a description for the role of Healthy People Coordinator that is adaptable and flexible to meet the needs of health departments and help them identify candidates. This template was designed with the reality in mind that this is an unfunded position, and for many jurisdictions the position itself may be embedded within another position within the department/division or bureau. This description details the knowledge, skills, and abilities for a successful candidate that can be used on their own or added and adapted to fit into an existing and aligned role. The Healthy People Coordinator role has historically had connections to funding for block grants, performance improvement, or other public health infrastructure related projects. How ODPHP Defines HP Coordinators: “The Healthy People State and Territorial Coordinators make Healthy People happen every single day across the United States. Each state or territory has a Healthy People Coordinator who serves as a liaison with the Office of Disease Prevention and Health Promotion (ODPHP). ODPHP works with Coordinators to identify areas of alignment in their work and the Healthy People 2030 goals and objectives. They also collaborate with the HHS Office of the Assistant Secretary for Health (OASH) Regional Offices.” Suggested Position Description and Overview This position will ensure adequate oversight, management, and efficient and effective implementation and integration of the Healthy People framework within jurisdiction-wide, programmatic-specific, and organizational planning efforts. It will also provide support to state block grant programming and accreditation efforts. Suggested Position Duties Support both program managers and division heads in vision and strategy to align their work with the Healthy People 2030 framework. Help to assess and align planning efforts (CHA/SHA, CHIP/SHIP, Strategic Planning) and programmatic work with Healthy People 2030 objectives. Promote the adoption of data-driven and evidence-based interventions and strategies while working to adapt them to jurisdictional needs. Foster collaborative approaches through increased communication and engagement across programs, departments, and local jurisdictions. Engage leadership, community-based and non-governmental organizations, trusted leaders, and the community across multiple sectors to initiate action and educate key stakeholders around the current public health evidence base to inform policies in alignment with the Healthy People 2030 framework. Serve as the liaison to local/regional/state health departments to better align local level planning efforts with state/territory/freely associated state planning efforts. Participate in Healthy People opportunities offered by ODPHP. Suggested Qualifications for Employment Knowledge, Skills, and Abilities Knowledge of national frameworks like Healthy People 2030, as well as social determinants of health, health literacy, and health equity. Skills in performance and quality improvement and planning. Familiarity with use of evidence-based interventions and practices. Ability to manage multiple timelines and projects. Insight, general understanding, and knowledge in strategies to advance equitable health outcomes. Suggested Requirements for Education, Experience, and Competencies Master’s Degree or higher in Public Health or a closely allied field, preferred but not required. Qualifying experience (demonstrated by certificate, course work, or practical experience) in performance and quality improvement frameworks, evaluation, and data interpretation. Extensive written and oral communication skills coupled with demonstrated experience communicating complex topics or issues both verbally and in writing to diverse internal and external audiences across a broad spectrum of managerial, administrative, and professional staff, especially executive-level leaders. Demonstrated experience in the following subject areas: Organizational development. Working with diverse groups, interacting with the community or community partners. Strategic planning. Facilitation and decision-making. Coaching preferred but not required. Demonstrated competencies in the following areas: Self-awareness, self-management, and continual growth and learning. Decision making—the ability to identify issues; develop analyses of alternative positions and impacts; make data-driven, defensible recommendations; take calculated risks based on logical ratio decision-making processes; make timely/responsive decisions; assume responsibility for decisions made; and involve others appropriately in decision-making processes. Working openly and transparently with colleagues and partners, fostering trust and serving as a resource in challenging work environments. Utilizing quality improvement tools and processes in accomplishing work activities and in support of the agency’s mission and goals; this includes seeking opportunities to participate in process improvement activities and initiating efficiencies in how work is accomplished. Showing a commitment to inclusivity, encompassing cultural, racial, ethnic, and gender sensitivity and competency. Organizational and political awareness. Ability to inspire. Practicing ethics and integrity. Utilizing tools for effectively collaborating with a multigenerational workforce. Suggested Preferred/Desired Education, Experience, and Competencies Understanding, skill, and experience in data interpretation/visualization. Proficiency in co-creating organizational strategies and building shared commitments with executive-level leaders and partners. Certification(s) in facilitation, leadership development, change management, quality improvement, or other related topics. Experience working in a public health-related or governmental organization. website yes

Explore INSPIRE: Readiness by ASTHO—an innovative hub for public health preparedness. Share strategies, tools, and solutions to boost readiness.

These resources are intended to support island jurisdictions in program planning, retaining community health workers (CHW), preventing CHW burnout, integrating them into health systems, and communicating their role.

Learn how a Strategies to Repair Equity and Transform Community Health (STRETCH) 2.0 series of national convenings supported public health agencies in their work to improve community health.

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

Learn how California is empowering new public health professionals and building its public health workforce.

Rethinking “Soft” Leadership Skills in Public Health Rethinking “Soft” Leadership Skills in Public Health Angela Cochran, Jamilia J. Sherls Learn how public health leaders can leverage interpersonal skills to better navigate cross-sector partnerships in this blog post. Budget reductions, staff lay-offs, conflicting federal guidance, limited funding opportunities, being asked to do more with less — these are just some of the challenges public health professionals navigate. Public health’s goal to promote health, safety, and wellness across the nation is difficult to achieve while negotiating these challenges, often leading to stress and burnout. According to the 2024 Public Health Workforce Interests and Needs Survey, approximately 71% of state and local government public health workers are experiencing at least one symptom of burnout and about 20% are experiencing near-constant symptoms. When stress creeps into collaborative spaces, it can lead to frustration, misalignment, poor decisions, strained relationships, and weakened outcomes. As leaders work with internal teams and external partners to achieve public health goals, they must remain vigilant for signs of stress impacting the work. Stress often presents as irritability, conflict, errors, and stagnation. When stress gets in the way, it is critical for leaders to tap into their “soft” skills to alleviate pressures and create a clear path forward. Across sectors, communication, empathy, adaptability, and critical thinking are often grouped under the label “soft” leadership skills. Soft skills are considered foundational, interpersonal qualities or skills that help individuals interact with peers and navigate complex work environments. They may also increase resiliency, which is important in today’s ever-changing world. The term “soft skills” may sound neutral, but it carries an implicit assumption that these skills are easier, less rigorous, or secondary to technical expertise. These are, in fact, the skills that most define the quality of a leader. In practice, they are the very competencies that determine whether collaborative efforts succeed or stall. While there are many “soft” skills or leadership practices that can be helpful in stressful partnership situations and reducing conflict, there are three leadership habits especially critical to sustaining collaboration: Practice Intellectual Humility. Intentionally Build Psychological Safety. Anchor Communication in Values, Not Reaction. Each of these habits is learnable and, when applied with intention, can shift the entire energy of a room. Practice Intellectual Humility Collaborative leadership requires the ability to rethink assumptions without abandoning core values. In cross-sector work, leaders frequently navigate different perspectives, competing priorities, and incomplete information. Approaching these situations with a fixed mindset or rigid assumptions can limit progress, while intellectual humility creates space for better solutions. Practicing intellectual humility does not mean being easily persuaded or lacking confidence. It means remaining open to new information, asking thoughtful questions, and recognizing that no single perspective fully captures the complexity of the issue. Leaders who model this behavior create environments where others feel more comfortable contributing ideas, raising concerns, and engaging in meaningful dialogue. This becomes especially important when partnerships, both internal and external, are under strain. As expectations shift or challenges emerge, the ability to pause, reflect, and reconsider can prevent unnecessary conflict and support more productive problem-solving. For example, in cross-program initiatives where teams bring different priorities or funding requirements, taking time to understand competing perspectives before moving forward can prevent misalignment and strengthen long-term collaboration. Intentionally Build Psychological Safety Effective collaboration depends on trust, but trust does not develop passively. It must be built intentionally through leadership behaviors that create psychological safety. In practice, this includes clearly defining roles, maintaining open communication, and creating space for respectful disagreement. Proactive relationship management, such as regular check-ins and early disclosure of challenges, is essential to maintaining alignment and preventing breakdowns in collaboration. Without these efforts, stress can quickly erode trust and lead to disengagement. At the local level, building psychological safety often requires visible leadership behaviors that demonstrate support rather than control. This can include showing up alongside teams during outreach efforts when additional support is needed, not to direct the work but to reinforce shared ownership and trust. It also involves intentionally creating space for team members to share perspectives and acknowledging when or how those perspectives shift your own thinking. For example, when team members raise concerns or offer alternative approaches, responding with openness, such as acknowledging a perspective that had not been previously considered, can reinforce that you value their input. Over time, these behaviors help establish an environment where staff feel more comfortable speaking up early, allowing leaders and teams to address challenges before they escalate. Leaders play a critical role in shaping this environment by normalizing open dialogue and demonstrating that they value differing perspectives. Anchor Communication in Values, Not Reaction In fast-paced and often high-pressure environments, it can be easy for communication to become reactive. However, reactive leadership can create confusion, erode trust, and shift focus away from shared goals. Anchoring communication in shared values provides consistency and clarity, particularly when navigating uncertainty or competing demands. This means responding thoughtfully, aligning messaging with the broader mission, and maintaining transparency even when challenges arise. For example, during executive leadership discussions involving shared funding opportunities or cross-agency initiatives, leaders may face competing priorities and uncertainty around ownership of the work, responsibilities, or decision-making authority. In one discussion regarding a collaborative grant opportunity, a leadership team navigated tensions by grounding the conversation in organizational values that had been intentionally developed through prior team building, reflection, and difficult conversations around how the group wanted to lead and work together. Because there was already a shared understanding around values such as honesty, respect, integrity, trust, and clarity, team members felt comfortable asking difficult questions openly and respectfully. Rather than reacting defensively or avoiding tension, the leadership team was able to clarify expectations, define roles, and move forward with greater alignment and confidence. Listening to partners and stakeholders remains essential, but listening does not require immediate agreement or action. Leaders must balance openness with discernment, ensuring that decisions remain aligned with both evidence and organizational values. This approach reinforces stability within partnerships and helps to sustain collaboration over time, even when external pressures are high. Applying these three leadership habits the next time you feel the room get tense will significantly improve group dynamics, allowing the team to focus on the tasks at hand. It is important that leaders understand these practices require intention, consistency, and reflection. After an event, leaders should take time to think and reflect on how they used these practices, what the immediate outcomes were, and if there is anything different they would do the next time. These leadership habits do take practice, so leaders should be patient with themselves as they get more comfortable applying them in the heat of the moment. As the great philosopher Epictetus said, “It’s not what happens to you, but how you react to it that matters.” Public health is truly in unprecedented times, bringing with them unpredictable, challenging, and nuanced situations. Leadership calls for not only “technical” expertise, but for “soft” expertise as well to manage stress and complexity, provide clarity, and achieve the best possible outcomes in collaborative spaces. Resources PH WINS 2024 Findings by de Beamount Soft Skills Matter Now More Than Ever, According to New Research by Harvard Business Review Intellectual Humility by Character Lab Values-Based Communication (PDF) by TCC Group What Is Psychological Safety at Work? Here’s How to Start Creating It by APA Reviewed by - Mason, Prather article yes

Likely Public Health Legislative Trends for 2025 Prospective Public Health Legislative Trends for 2025 Maggie Davis Get an inside look at prospective public health legislative trends for 2025, based on ASTHO's legislative tracking efforts and member feedback. Drawing from member feedback and ASTHO’s legislative tracking efforts, ASTHO identified five key issues state and island legislatures are likely to work on for the upcoming legislative sessions for the annual 2025 Legislative Prospectus Series. Each brief provides public health leaders and policymakers with a synopsis of the topics, recent legislative trends, and anticipated legislation in upcoming sessions. Public Health and Health Care Workforce States are continuing to address workforce shortages within public health and the health care systems. ASTHO’s prospectus outlines strategies that legislatures are considering, from bolstering state public health funding to legislative efforts addressing nationwide workforce shortages through recruitment incentives, workforce commissions, and pipeline programs. Containing Spread of Infectious Disease State and territorial public health agencies are responsible for protecting the health and safety of their residents and have legal authorities to fulfill those responsibilities. In recent years, many legislatures have revisited the scope of these legal authorities, with states like Washington (SB 6095) expanding the health official’s authority to issue standing orders for a range of disease interventions. Similarly, legislatures may continue considering vaccine-related legislation. While many bills in recent years aim to weaken vaccine policy, state leaders have listened to medical leaders within their state who advocate for strong vaccine policies. In 2024, West Virginia’s governor vetoed HB 5105 that would have weakened school enrollment requirements, informed by strong opposition from the state’s medical community and evidence that the existing vaccine policy had prevented disease outbreaks. Data Modernization and Privacy Modernizing public health and health care data systems have taken big steps forward, including federal initiatives like the Trusted Exchange Framework and Common Agreement (TEFCA), which establishes guiding interoperability principles and standards for health data exchange. Nevada enacted AB 7 in 2023 requiring new regulations governing health information exchanges (HIEs) and granting certain liability protections to providers using them. In the proposed rules published in August 2024, the Nevada Department of Health and Human Services intends to require that participating HIEs are TEFCA members. ASTHO anticipates more jurisdictions will allow public health agencies access to a wider range of privacy-protected health data through secure platforms like HIEs. Maternal and Child Health Public health supports mothers and children throughout their development. There are three emerging issues that legislatures are likely to work on in the next year: maternal morbidity and mortality, fetal and infant mortality, and youth mental health. One strategy to address youth mental health is using laws to regulate social media companies, requiring them to implement safeguards for minors who use their services. For example, California enacted SB 976 in 2024, which requires “addictive internet-based” services to gain parental consent before minors could use the service and limit the hours in which minors could use an application. Technology industry groups are challenging these efforts in court, with one suit asserting that California’s measure is unlawful governmental interference with First Amendment rights of minors. Substance Misuse and Overdose Prevention Although there was a significant decrease in overdose deaths in 2023, there are still legislative actions to help reduce substance misuse and prevent overdose likely to be considered in 2025. During the 2024 sessions at least 24 state legislatures considered bills to regulate products like kratom and hemp derived products (e.g., Delta-8). Additionally, at least 18 legislatures considered bills to decriminalize drug checking equipment like fentanyl and xylazine testing streps. ASTHO anticipates states legislators will continue implementing harm reduction efforts, policies to connect people with substance use disorders to care, and efforts to regulate products with potential for abuse or misuse in the next session. What We Know So Far The majority of states will convene their legislative sessions in January 2025, with at least 15 states scheduled to conclude their session by the end of April; there will likely be a flurry of legislative activity in the first quarter of the year. Already the Texas legislature has prefiled more than 1,200 bills for their 2025 session, covering topics including a health commissioner’s authority to establish routine childhood immunization requirements (HB 468) and making changes to the state’s maternal mortality and morbidity review committee reporting requirements (HB 713). Additionally, Virginia’s General Assembly convened its two year session in January 2024 and has a number of bills carrying forward into 2025 including bills related to suicide prevention (HB 80) and improving maternal health data quality (HB 286). ASTHO will monitor legislation related to these topics and more during the 2025 sessions and will provide relevant updates. 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Illinois Strengthens Public Health Infrastructure with New Data Modernization Director Alicia Camuy Learn how Illinois is using Public Health Infrastructure Grant funding to promote data modernization. As COVID-19 demonstrated, robust data infrastructure is critical to an effective public health emergency response. The pandemic highlighted the urgent need for health departments and other public health entities to improve how health data is collected, stored, and shared. The CDC-led Data Modernization Initiative (DMI) is working across all levels of public health to meet this urgent need. Part of this initiative is the Public Health Infrastructure Grant (PHIG), a groundbreaking investment supporting 107 recipients working to bolster the public health workforce, enhance foundational capabilities, and advance data modernization and informatics. PHIG national partners and specialized Implementation Centers support these efforts through technical assistance and capacity building. Some PHIG recipients have utilized this funding to staff dedicated DMI positions and convene advisory committees. The Illinois Department of Public Health (IDPH) recently hired Gayatri Raol as its Data Modernization Director to oversee the state’s efforts in this area. What are your highlights from your data modernization work around PHIG so far? Gathering Data Modernization Stakeholders To build some structure around DMI implementation, IDPH recently kicked off a data governance board, data modernization advisory committee, and DMI strategic planning workgroup, which all bring in key stakeholders to have focused conversations on data initiatives. The board defined data governance for IDPH and is working on approving and adopting a department-wide data suppression policy, which will be a major success for the department. Adopting a Data Sharing Agreement IDPH has finalized a Master Data User Agreement to streamline data sharing practices, which will allow local health departments to access data for birth and death records, hospital discharge, cancer registries, syndromic surveillance, prescription monitoring programs, and more. Bolstering the Data Modernization Workforce We are working with the CDC Foundation Workforce Acceleration Initiative, a program that places data and technology experts in public health agencies to accelerate data systems improvement. Through that collaboration, we have been awarded two technical and two project management support positions. Training a Data Literate Health Department IDPH has also started exploring a data literacy program to support IDPH staff and local health departments in understanding the data we have, what it means, and how to manage it. This program will be the initial step towards change management to build a data-driven organization and a data literate workforce. Building a Streamlined Data Request Management System IDPH is streamlining and centralizing data request processes across the department. The department is collaborating with IT to develop a data request tracking and management system. If we can reduce the time of the process by even 25%, then it will be a success. This project will increase the transparency around data requests processing and keep our data governance board, internal review board, and data owners informed about data sharing practices. What challenges do you expect to encounter and how do you plan to meet them? Our challenges are not unique compared to those faced by other public health departments, but they are significant in the context of other data modernization initiatives. Some of our main challenges are: Slow, cumbersome, and complicated hiring and procurement processes. Stringent policies. Understanding diverse workforce and population needs. Acquiring sustainable funding and buy-in. For those challenges beyond our control, our team focuses on communication and collaboration to move toward improvement. However, for those challenges we can directly impact, we follow several key strategies: Reviewing and updating existing policies to make them more flexible and adaptable, allowing us to respond more quickly and effectively to new opportunities and challenges. Investing in data literacy programs to enhance our workforce’s skills, enabling them to better interpret and use data in decision-making processes. Incorporating a health equity and justice lens into data-related projects and processes to better meet the needs of the communities we serve. Investing in foundational data management practices and processes. How is IDPH’s data modernization work impacting IDPH itself and, ultimately, Illinois residents? It is difficult to measure the direct impact of state-level data modernization efforts on the lives of Illinois citizens. However, enhanced data management practices will equip our public health leaders to make more informed decisions. Better quality and more integrated data will help keep decision-makers informed on how to allocate resources, identify public health trends and outbreaks, and respond efficiently to public health crisis. OE22-2203 PHIG article yes

How Washington State Leverages Data to Improve Emergency Preparedness Erin Laird Learn how Washington State has created a robust system for distributing public health and medical supplies during emergencies. When an emergency strikes, supplies like personal protective equipment (PPE) need to be deployed rapidly and strategically. Local, state, and federal partners must work together to identify and meet community needs—a process that requires timely access to actionable data about medical countermeasures and other vital public health supplies. State health agencies need to know how many public health supplies are on hand so they can make informed decisions and react to developing situations. In March 2024, ASTHO, with support from the Administration for Strategic Preparedness and Response (ASPR) and HHS Coordination Operations and Response Element, selected three state health agencies—Ohio, Massachusetts, and Washington—to identify and pilot scalable solutions to improve data and information sharing for public health response. ASTHO conducted a site visit to the Washington State Department of Health (WA DOH) in June 2024 to learn about their medical logistics center and observe the first in a series of regional tabletop exercises—Highly Efficient Local Logistics Operations Tabletop Exercise (HELLO TTX)—they conducted to better understand logistical considerations of requesting, receiving, and distributing PPE and medical countermeasures and tracking last mile distribution. Medical Logistics in Washington State: Moving Faster to Save Lives Key Term - Blog - How WA Leverages Data to Improve Preparedness The Washington State Medical Logistics Center plays a pivotal role in emergency response, supporting WA DOH’s ability to quickly distribute vital supplies and medical countermeasures before and during major incidents. Through the COVID-19 response, the WA DOH medical logistics effort expanded to include vehicles, systems, and a 198,000 sq. ft., temperature-controlled warehouse. This effort ultimately supported WA DOH’s ability to distribute over 150 million gloves, 66 million surgical masks, 30 million N95 respirators, and other vital supplies throughout the COVID-19 emergency response. This increased logistical capacity has allowed WA DOH to respond to many other events. In 2023, in response to wildfire smoke, WA DOH distributed 850 air cleaners across the state in just two days to support points of dispensing (PODs) in tribal communities. The Yakima Fire Department experienced an opioid overdose outbreak in September 2023 and WA DOH coordinated statewide to identify supply of naloxone and support mutual aid. Finally, in May 2024, WA DOH distributed 96 portable air cleaners and pallets of N95 respirators to the Benton Franklin Health District to support POD operations for communities with air quality impacted by the Lineage Cold-Storage Fire. Receiving, storing, and distributing medical countermeasures and other supplies requires strong data management systems and practices. WA DOH strives for a collaborative approach to enhance data management for logistics. By facilitating bidirectional data sharing among health care, emergency management, public health, and tribal partners, WA DOH aims to enhance its ability to track assets and “last mile” logistics. To this end, WA DOH conducted a series of in-person tabletop exercises (TTXs) with each region of the state. These TTX discussions focused on the logistical considerations of requesting, receiving, and distributing PPE and medical countermeasures using a scenario of a novel influenza outbreak. Leveraging TTX Discussions to Understand Local Logistics Washington Department of Health staff gathered for a tabletop exercise with ASTHO staff. The tabletop discussions were organized into two modules: Medical Logistics Requesting, and Medical Countermeasures Planning and Last-Mile Distribution. The tabletop discussions focused on understanding how local jurisdictions source, receive, and distribute supplies. Cory Portner, director of WA DOH’s Office of Emergency Medical Logistics, praised the discussions: “The HELLO-TTX series highlighted the power of collaboration and gave us actionable insights into refining our response strategies and logistics operations. Effective communication across agencies is key. As always, at the end of the day it comes down to relationships and knowing who to call.” Many jurisdictions indicated they do not have the space or staff to manage more than a small stockpile of supplies. Once requested from the state, local jurisdictions coordinate with local partners—such as libraries, foodbanks, fire departments, and immigrant assistance centers—to get materials distributed to the community, often using either PODs or using trusted partners to distribute to the population they serve. Space came up as an issue repeatedly, with some jurisdictions utilizing creative solutions such as leveraging storage available at fairgrounds, a county-owned airport, and even an old jail (a solution that raised some unique challenges for receiving). Last mile tracking depended on the type of asset. For example, tracking for PPE typically ended at the community partner level (the agency or site that received the supplies), while tracking for vaccines could show more data on number of vaccines administered by a provider. The focus of last mile tracking for local jurisdictions centered around using last mile information to ensure that the requestors received what was needed. Looking ahead, additional last mile tracking could shed light on equity and a better sense of whether community needs were met, rather than just whether orders were filled. Portner reflected, “HELLO TTX showcased that local partnerships vary widely: larger urban areas typically focus on health care and emergency management organizations, while smaller rural areas engage a broader range of local sectors like fire departments and veterinary services. Medical logistics operations also differ, with urban areas having greater storage capacity and more advanced data tracking, while rural areas face limitations in both. Additionally, local prioritization of PPE and medical countermeasures affects how each area tracks logistics and manages storage.” Looking Ahead This 198,000 sq. ft., temperature-controlled warehouse serves as the Medical Logistics Center for WADOH, housing PPE, medical countermeasures, and other supplies. Effective public health response requires an understanding of what supplies are needed, where they are needed, and to track whether those needs were met. To achieve this, coordination and communication across multiple levels of public health is critical. "Next up, we’re focusing on asset tagging and improving supply chain visibility through enhanced data readiness. Our goal is to create a more transparent and responsive logistics system, to make sure that we’re fully prepared for any future emergencies in support of communities in Washington state and beyond,” explained Portner. The strategies explored by these data readiness pilot sites can improve critical processes and demonstrate sustainable methods to meet the demand of bidirectional information sharing for public health agencies and their partners. article yes