Three Public Health Training Needs Rise to the Top

Chera Kowalski, 33, who works with teens and adults at McPherson Square library, holds naloxone. While other libraries practice fire drills, McPherson Branch has overdose drills. (Photo by David Maialetti, Philadelphia Inquirer Staff Reporter. Via

You might be surprised at the diversity of professionals who are on the front lines of public health practice without formal education and experience in the field.

In fact, local librarians increasingly find themselves stretched beyond traditional responsibilities like providing information access, programming, and instruction on information literacy.

Librarians are now entering unchartered waters in the nation’s raging opioid epidemic. In city libraries in Denver, San Francisco, Chicago and Philadelphia, heroin users camped out in parks are injecting in library bathrooms, as community centers become daytime havens for homeless people. Like other social services professionals confronted by intense and sometimes surprising public health challenges, many librarians are seeking high-quality training and support.

Responding to the crisis, library employees are being trained in the use of the drug Narcan to help reverse overdoses in people coming off the street. One librarian at Philadelphia’s McPherson Square Library reversed six overdoses in a two-month period.

Across the country, 91 Americans die every day from an opioid overdose. Overdoses nationwide more than tripled from 1999 to 2015. Drug OD deaths are the leading cause of injury and death in the U.S. today, according to the Centers for Disease Control and Prevention.

It’s getting worse, too, and tackling this crisis and other emerging public health problems like climate change, emergency preparedness, Zika, and Ebola require specialized workforce training.

It’s no wonder the numbers of course participants at regional public health training centers doubled or more in the last two years in areas such as social and behavioral sciences, environmental health, epidemiology, and first responder-EMT training. “We’re seeing more lay people, first responders, and injury control prevention professionals taking courses in different areas,” reports Dorothy Evans, MPH, Med, Program Manager/Team Lead at the National Network of Public Health Institutes (NNPHI). Data show lay and family caregiver training participants increased from 1,399 in 2014-2015 to 7,612 the following year.

The National Coordinating Center for Public Health Training recently released the Summary of Regional Public Health Training Center Needs Assessment Activities (2014-2016), an analysis of all training needs assessment findings produced by Public Health Learning Network members. The summary identified three core competencies as those most needed by public health professionals:

1. Leadership and Systems Thinking
2. Financial Planning and Management
3. Policy Development and Program Planning

Under each of these domains are between 10 and 16 specific competencies, points out Ron Bialek, president of the Public Health Foundation. “In fact, we’ve seen these needs for well over a decade,” he said.

Systems thinking evolves constantly, so the need to build skills and competence in this area will always exist. “Most workforce training doesn’t offer much in the way of financial planning and management, so it’s not surprising that many workers lack skills and competence in this area,” said Bialek. “Policy development and planning is another area where those coming into public health have not had formal training.”

All three skill areas are on display in the opioid epidemic, antibiotic resistance problems, responses to disease outbreaks, and more. These challenges call for leadership, efficient systems, funding mechanisms, policy advocacy, and related competencies. All require different professionals to work together, too. For instance, the City of Philadelphia has begun working with the American Library Association to train librarians as first responders and put together a guide for library staff members for their role in the opioid epidemic.

“Our workforce lacks competency in these areas,” said Brenda Joly, PhD, MPH of the Muskie School of Public Service Graduate Program in Public Health. “My students always do a self-assessment grading the importance of various competencies. Historically, across the board, these are most important.”

Adopted by the Council on Linkages Between Academia and Public Health Practice in 2014, “Core Competencies for Public Health Professionals” can be found at

Who Needs These Competencies?

Front Line Staff/Entry Level – These people carry out the day-to-day tasks of public health organizations and are not in management positions. Responsibilities may include data collection and analysis, fieldwork, program planning, outreach, communications, customer service, and program support.

Program Management/Supervisory Level – These are professionals in program management or supervisory roles. Responsibilities can include developing, implementing, and evaluating programs; supervising staff; establishing and maintaining community partnerships; managing timelines and work plans; making policy recommendations; and providing technical expertise.

Senior Management/Executive Level – At the senior management and leadership levels of public health organizations, these professionals typically have staff who report to them and may be responsible for overseeing major programs or operations, setting a strategy and vision, and creating a culture of quality within the organization, and working with the community to improve health.

Leadership and Systems Thinking

Jennifer J. Edwards, Ph.D. is Manager of Knowledge & Information Design at NNPHI. She said that leadership and systems thinking are essential for problem-solving in day-to-day activities as well as during health crises or emergencies. “Where implementation of services is broken or lacking, you’ll often find this competency lacking, too. Public health solutions have to unite people with various backgrounds and skill sets. You need to be able to pull together problem solvers from hospitals, government, community organizations, workplaces, funders and more, and engage your staff at all levels.” She added, “These skills are most critical in foreseeing, responding to, and managing health emergencies and epidemics.”

In the bigger picture, Bialek pointed out these are also vital in developing a vision for a healthy community and advocating for the role of public health in providing services.

Financial Planning and Management

How do you get public health funding? How do you manage budgets for the near and long-term and make sure staff are paid? How do you plan for unforeseen needs? Bialek mentions myriad skills needed, such as leveraging categorical grants, fees, third-party reimbursement, tobacco taxes, and value-based purchasing to address needs. He also said performance management systems should be established for performance objectives and targets, increasing efficiency, refining processes, meeting Healthy People objectives, and sustaining accreditation.

Staffers with no finance experience are often responsible for program and project budgets. At the same time, finance staff are typically skilled budget auditors and managers without programmatic skills or interests. “You may be a clinical expert in immunizations, but not in budget management for operations,” said Edwards. “Diverse responsibilities require that public health staff know how to budget for salaries, equipment and supply stockpiles, depending on the program need.”

Policy Development and Program Planning Skills

This essential competency might be the most critical, particularly in today’s political climate. “Being able to advocate for public health with all the challenges we face today is so important,” said Edwards. So many health departments are accountable to city councils and county commissioners, for instance, and being able to interact in that capacity, as well as engaging and informing stakeholders, can make an enormous difference in resources and funding.

“A community health improvement plan describes measurable outcomes, determines needed policy changes, identifies parties responsible for implementation, and more,” Bialek said. “You need to be able to influence policies, programs and services external to the organization that affect community health, such as zoning, transportation routes and bike lanes.”

Strong governance, smart financial planning and effective policy skills so often address issues and provide solutions. Fortunately, there are many options for training and skills development, at every level of need, from the nation’s public health training centers.

Learning Opportunities

The PHLN delivers a wide variety of courses and trainings through regional centers. These include webinars and self-paced online modules on Leading Change, Planning for Financial Success, Grants Management and Policy Development and Program Planning.

Leadership and Systems Thinking

Leading Change, from Region V – Great Lakes Public Health Training Collaborative (GLPHTC)

This seven-part immersive webinar series will coach participants through knowledge on the process of creating long-lasting, effective organizational change. Participants of the recorded webinar sections will develop strategies for addressing individual change initiatives, successful implementation, tactics for responding to resistance, and steps to enhance resilience. Learn More »

Learning Objectives:

  • Develop strategies for addressing individual change initiatives
  • Prepare for successful implementation
  • Understand tactics for responding to resistance

Contact Region V – GLPHTC »

Financial Planning and Management

Grants Management 101 Toolkit from Region VIII – Rocky Mountain Public Health Training Center (RMPHTC)

Participants of this self-paced series will be equipped with the tools and resources to help write, win and manage grants in their organization. The three available 101-level modules include Grant Writing, Grant Budgeting and Grant Management. Learn More »

Learning Objective:

  • Explain key components of successful grant writing, grant budgeting and grants management process

Contact Region VIII – RMPHTC »

Policy Development and Program Planning

Diversity and Succession Planning from Region V – Local Performance Site (LPS), University of Minnesota (UMN)

This workshop is designed to prepare participants as leaders in their respective public health organizations to both prepare for and take part in structured leadership presentations and conversations about their succession plans. Workshop components include an overview of succession planning with mini-exercises to try out the concepts, explanation of a seven-step succession and diversity presentation method, a review of how staff development activities tie to succession planning work, introduction of templates for succession planning, and a deep dive into the methods for integrating diversity and cultural competence work into succession analysis. Learn More »

Learning Objectives:

  • Purpose, terminology and basic methods of succession planning
  • Methods, approaches and templates for a succession planning and talent review process that integrates diversity into the conversation
  • Practices that improve diversity sourcing, recruitment and retention
  • Dialogue with one another about how to best integrate workforce diversity status and health equity assessment into upcoming succession planning work
  • Benefits of linking planning and diversity and concrete ideas how to do so for respective organizations

Contact Region V LPS – UMN »

See the September 2017 edition of Elevate, your resource for lifelong learning »

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