Leading the Transformation of
the Public Health System:
Are “We” Prepared?
Dennis Lenaway, PhD, MPH
Office of the Chief of Public Health Practice
Centers for Disease Control and Prevention
November 4, 2007
2007 PHLS Annual Program
Public Health Challenges
Public Health Challenges
Emerging Diseases (SARS, Pandemic Flu)
Re-emerging Diseases (XDR-TB)
Food Safety
Bioterrorism
Natural Disasters
Obesity
Aging Population
Health Disparities
Global Warming
Health Care Crisis
Health Care Crisis
Aging Population
Re-emerging Diseases
Emerging Diseases
Obesity
Health Disparities
Access to Quality Health Care
Health Insurance Costs
Uninsured and Underinsured
Federal, State and Local Silos
Public
Health
Health
Care
Emergency Education
Law
Management
Enforcement
Rebalancing Health Priorities
General
protection
Safer
Healthier
People
Targeted
protection
Vulnerable
people
Primary
prevention
Secondary
protection
Affected people
without
complications
(undiagnosed
asymptomatic)
Tertiary
protection
Affected people
with
complications
Death from
Complications
Traditional Healthcare
Safer
Healthier
People
Vulnerable
People
Affected People
without
complications
(undiagnosed
asymptomatic)
Affected People
with
complications
Traditional Healthcare
Disease Care
Traditional Public Health
Safer
Healthier
People
Public Health System
Vulnerable
People
Affected People
without
complications
(undiagnosed
asymptomatic)
Affected People
with
complications
Need to Rebalance Health Priorities
Safer
Healthier
People
Vulnerable
People
Public Health Network
Health Protection: Health Promotion,
Prevention, and Preparedness
Affected People
without
complications
(undiagnosed
asymptomatic)
Affected People
with
complications
Healthcare Delivery System
Disease Care
Questions
“Given the significant public health and health care
challenges we face, are Public Health Leaders
adequately prepared to address these issues?”
“What are the requisite leadership competencies
needed to address these challenges?”
“Do we have a system of leadership development
that can meet this challenge?”
Transforming the Public Health System
Transforming the Public Health System
Structure and Functions
Setting Agency Standards
 Public Health Accreditation Board
Setting System Standards
 National Public Health Performance Standards
Establishing Public Health Laws and Policies
Community Engagement
 MAPP
Local – State – Federal interaction (SMOs)
Transforming the Public Health System
Workforce
Competencies for Public Health professionals
 Epidemiologists
 Environmental Health
 Nursing
Credentialing and certification
 National Board of Public Health Examiners (2005)
 Existing programs in nursing, environmental health,
laboratorians
Transforming the Public Health System
The “Strategic Influence” of Public Health Leaders
Politics
Policy
Programs
PH
Leaders
Resources
Experience
Community
Transforming the Public Health System
Goals and Priorities
National-level Goals and Priorities
CDC’s Health Protection Goals
Healthy People 2010
State and Community-level Goals
MAPP
State and Local Health Departments
Leadership is Essential to Success
Leadership
Agency Standards
System Standards
+
Laws and Policies
Community Engagement
Workforce
Portfolio Management
Improved
Performance
Improved
Health
Outcomes
Leadership Development at CDC
National Public Health Leadership Institute
Regional Public Health Leadership Institutes
National Public Health Leadership Development Network
Association of Public Health Laboratories
National Center for Environmental Health
Emerging efforts
CDC Leadership Development Framework Architecture
Initiative for Leadership Enhancement and Development (I LEAD)
Leadership Development efforts are most effective when they are strategic,
coordinated and measurable.
Evolving High Performing Leaders
Outcome
Evaluation
Leadership Assessment and Consultation Center (LACC)
Components:
Development
Offerings
Tier 1
Tier 2
Tier 3
Tier 4
Leader
Development
Map
Leader
Development
Map
Leader
Development
Map
Leader
Development
Map
Four-Tier Leadership Competency Model
Foundation
Learning Management System (LMS)
Strategic Human Capital Management Plan
CDC Health Protection Goals and Organizational Excellence Assessment
DRAFT – For Discussion Purposes Only
23
Leadership Development at CDC
Office of Workforce and Career Development
Crisis Leadership Competencies
Communication
Conflict management
Credibility
Decisiveness
Flexibility
Initiative
Influence
Partnering
Thoughts about Leadership Competencies
Foresight
Insight
Action
(Johansen, 2007)

Anticipate needs and sense emerging trends
 Forecast what “might” happen
 Provoke new thoughts and ideas
 Move from problem-solving to tackling dilemmas
 Early action
Better results
Issues Surrounding Leadership Development
Continuum Dilemma
–
–
–
Leadership vs. Management competencies
Basic vs. Advanced
Regional vs. National
Crisis Leadership
Integrated or single program?
Discipline specific Leadership
How to build effective networks
Fragmentation
Develop a “system” for Leadership
Shared vision, shared funding, common purpose
Final Thoughts
“Leaders are visionaries with a poorly developed sense
of fear and no concept of the odds against them”
(Robert Jarvik)
“Success is the child of audacity”
(Disraeli)
Leading the Way to Better Health