More fiscal issues

Following up on Steve’s post, I visited the discussion forum for the web cast on Public Health Survival: Leadership in a Falling Market (which is now posted). One of the respondents wrote in to tell about his predicament – to save money, the City Council had dismantled his public health department, transferring some functions to other departments, cancelling others, and leaving this respondent as a “department of one.”

I was shocked by the drastic nature of this city council’s actions, and it struck me that a lot of drastic stuff might be going on out there that we in academia are not fully aware of. It would help us to know what is going on for you… that way we can think about things we could do or offer that would better serve you through these trying times. In any event, as a community of practice, it would be good for us all to know what’s going on and how different individuals, organizations, and communities are dealing with it. For example, the man who is the only member of his department is working on changing his role from one of “directing and controlling to one of advising and consulting,” he said on the discussion forum. Ideally, he is drawing upon connections he’s made in the past to work with others who are now doing the work he and his colleagues used to do. He asked, at the end of his post, whether there were any role models for such a drastic transformation. All I could think of was the importance of making sure you have a community of people and organizations who understand what public health is and why it is important to them that the public stay healthy and safe: that way you'll never truly be a "department of one." But I'd rather hear from you...

If you get a chance, please write in with your stories about “providing leadership in a falling market” – whether yours personally, or those you have heard from others, and what you are doing right now to cope with the challenges of these times. And we realize there are still the day-to-day challenges – what is getting cut in your health department? Are you seeing a change in your clientele as a result of the economic downturn? Also, if you’ve undertaken public health business planning in the past, are you having any positive results of work you’ve done building partnerships, using business practices, and the like?

- Anne

Fiscal issues

If you didn't see it live, take a look at the webinar on public health survival in a falling market-- should be archived at the site in the next week or so.

Here are two things that came out of the session that stuck with me and that seem to apply to our continuing discussion here:
  • Reach Out To Partners: Now may feel like the time for your organization to circle the wagons, pull back, go into your shell.It isn't. Jim Marks at Robert Wood Johnson Foundation says now is the time to reach out, and Bobby Pestrunk, the new director of NACCHO, agrees. Here's my take on why: resource deficits make it tough on many different organizations that are trying to make communities more healthy. Bobby points out "your partners are hurting too." The fiscal crisis makes it more important-- and perhaps paradoxically easier-- for you to work together now. Leah Devlin (state health director in NC) talks about going after big grants and lining up health care partners, for instance.
  • Look For New Resources: Of course. Yes, the budget is shrinking. Some things that your organization had been doing will no longer be possible. So what things do you stop doing? The opportunity here is to stop doing things that are inefficient and unimportant... and use the newly-discovered time and energy to do something new, different, more effective, more useful to your constituents, more valuable to your funders, more timely and relevant. As recently as last year, I had public health leaders tell me that their plates were too full, they had more programs and partners than they could track, and that they wished they could get out of some of their long-term commitments!
I'll stop there and listen to what you think--

--Steve Orton

Leadership Programs at NCIPH

Steve mentioned the Southeast Public Health Leadership Institute in his last post, and I thought I would take this opportunity to plug this and another leadership training program (the Emerging Leaders in Public Health program), both run through the Institute. Many of our Management Academy for Public Health Alumni are leaders in their organizations, and we see them in our leadership programs as well. This is great for us (because our alumni are wonderful) and we’ve had some really positive feed back from them, so we think it’s pretty good for them as well.

The Southeast Public Health Leadership Institute is a year-long leadership development program for mid- to senior level public health administrators working in the states of Arkansas, North Carolina, South Carolina, Tennessee, Virginia and West Virginia.

The Institute strengthens leadership competencies, such as creating a shared vision, personal awareness, systems thinking, risk communication, team building, ethical decision making and political and social change strategies. Each scholar also completes an individual learning plan, a community leadership project, a mentoring relationship and four small group assignments.

SEPHLI begins in December and ends the following December. Face-to-face interactions between the scholars and guest faculty occur three times during the program year: at the beginning, at mid-year (May) and at the end. Between these scheduled meetings, Institute activities take place via distance learning using a mixture of both real time and asynchronous delivery modalities. Scholar distance learning requirements include attending a minimum of four telephone conference calls and two online computer forums.

The Emerging Leaders in Public Health (ELPH) program is designed to prepare the next generation of public health leaders to serve in significant leadership capacities in the next decade. The program focuses on minority public health professionals because African Americans, Native Americans/Alaska Natives, Native Hawaiian/Pacific Islanders, Asian Americans, and Hispanics are under-represented in terms of public health leadership.

ELPH scholars learn through a combination of on-site intensive workshops, personalized coaching, action learning teams, and individualized leadership coaching.

Every year an extremely impressive cadre of scholars apply for and attend the programs. In both cases, scholars attend as individuals and complete individual projects. Unlike the Management Academy, their projects do not have to be for revenue generating programs, or use business planning at all – and they can be internal to their organizations. Check out the SEPHLI and ELPH websites to read some amazing stories about graduate success stories.

Applications for ELPH are being accepted now until May 31, 2009. SEPHLI applications are generally in late summer – we’ll keep you posted.


Spent several hours with the new and graduating scholars of the Southeast Public Health Leadership Institute on Monday-- a group that included many graduates of the Management Academy on both sides of the room!

While I was there I talked to one health director who is preparing his management team to write a business plan on access to care in their county. He's very concerned about the rise in emergency room use.

The issue is complicated by the fact that his county has two mid-size towns in it, separated by 9 miles, and each with their own hospital. The two hospitals are both part of bigger networks of hospitals, and those two networks (Baptist and Novant) are battling with each other for market share in many different counties around the Winston-Salem market.

I got goosebumps hearing what this leader was going to ask his staff to do. They are going to try to build a strategic alliance for their community that would result in a win-win-win-win situation: a plan to create better, more sensible primary and urgent care in two adjacent communities, and reduce emergency visits simultaneously for two competitors!

Would love to hear your comments and suggestions for this team.

My reason for sharing the story was to inspire you. David Altman of the Center for Creative Leadership said at the conference that everybody should have a BHAG: that's certainly the point of a leadership development program. What is your Big Hairy Audacious Goal?

--Steve Orton

Attracting a Younger Workforce

I recently received the following email from a colleague, whom I had asked to write something for me:

i did a ppt for a buncha reporters a week or so ago. gives you some idea of the ground i would cover in the piece. I think the dec deadline is prolly doable but when is the deadline for the NEXT edition, btw?

My first thought on receiving this email was, Will I have to ask him to write “probably” instead of “prolly” in his article? My second thought was, Boy, I’m getting old!

Wouldn’t it be nice if we had the problem of too many young people entering the public health workforce? As you may know – by looking around and by reading the literature – our workforce is aging. Many of us are merely a bit too old to take easily to writing that looks like a phone-text message. Others are actually aging out – retiring – and leaving the workforce depleted. It behooves us all to think about ways to bring more young people into the profession. Positive benefits of this might be a workforce that is

- open to (and full of) new ideas
- more technologically savvy
- energetic and idealistic
- more in touch with the population we serve

So, how do we get people interested? One way might be to reach out to high schools, colleges, and universities to inform students about what public health is and how they might make a difference with a career in this field. A great way to do this might be through a public health business plan!

Some Dare County, NC grads started a great plan that involved middle school students teaching elementary school students about healthy living. Students took their involvement much further than the original plan required, and ended up getting involved in other local programs around addressing teen smoking and drinking. A team from Wilmington partnered with veterinary students and introduced them to population-level pet concerns while training them and tapping into their enthusiasm and budding expertise; a South Carolina team worked with a university partner to plan a women’s health clinic on campus. A team this year is planning a summer program for children that will provide intern possibilities to local college students.

Other teams over the years have planned programs at schools, or for young people, but not necessarily getting young people involved. A small tweak to their plan might add a component that ensures at least some kids say, “Hey, that might be something I want to do” (or, more likely, “i wanna do”) long-term!