NASTAD Leadership Institute

1. NASTAD Leadership Institute March 9-10, 2009

2. Leadership Institute • Purpose: to help new and emerging leaders develop critical skills necessary to lead HIV/AIDS and viral hepatitis programs in state and local health departments  • Participants: New AIDS directors and senior program managers from select NASTAD advisory committees • Outcomes: Participants will clarify their vision for leadership, programs and staff; build media and advocacy skills, and develop a leadership plan to strengthen their programs

3. Agenda DAY ONE • Pre-work/self assessments • Vision and Leadership • Advocacy • NASTAD 101 • Understanding and working in bureaucracies • Supporting a diverse workforce • Peer Reflections on Leadership and Vision • Action Planning DAY TWO • Mentor/Needs Identification • Media Training • Leadership Presentations • Next Steps

4. Pre-Meeting Work and Connections

5. What are your hopes and expectations for this institute?

7. Public Health Leadership Competencies: Self Assessments • Visioning – ability to cooperatively create and communicate shared vision; and to express personal vision • Identify and reflect upon leadership style and skills; weaknesses and strengths • Model and incorporate ethical standards • (Understand and) Communicate the role of government • Identify and communicate staff and organizational responsibilities within the context of core public health functions • Describe data utility (and use data) for application across issues

8. Public Health Leadership Competencies: Self Assessments (2) • Strategic plan development with measured impact • Evaluate and communicate policy choices • Policy translation – to programs, organizational structures and plans • Application of federal, state and local regulations • Budget strategy • Coalition building and advocacy • Develop and implement policies for professional diversity • Create ‘safe’ space for staff and community communication • HR practices (recruit, hire, terminate) • Apply human relations skills to organizational management, motivation and conflict resolution

10. Proficiencies among Us(Limited Knowledge*) • Creating shared vision* • Leadership style identification and reflection* • Role of public health government* • Regulations and policy application* • Advocacy coalition building* • Resource Advocacy* • HR/Recruiting, hiring, training* • Strategic partners • Creating a safe space for staff/community • Describing strengths and weaknesses Institute Knowledge Exchange Mentoring Opportunities

11. What is your drag queen leader name? • First or last name of the first leader you ever learned about (whether you liked them or not) • First or last name of the leader you would most like to emulate

12. Leadership and Management Qualities Highest rated qualities among J/J survey respondents Vision Persistence Confidence Leadership Themes Leadership as distinct from management skills – you need both, but not necessarily in the same person Different models of leadership exist (and should be recognized) Leaders have a responsibility to staff to lead, inspire, empower, impart knowledge and experience, etc.

13. Public Health Leadership Competency Framework • Core Transformational Competencies • Political Competencies • Transorganizational Competencies • Teambuilding Competencies

14. Core Transformational Competencies • Visionary Leadership • Sense of Mission • Effective Change Agent

15. Vision and Leadership • The importance of vision • Clarifying your vision • For your leadership • For your program • For your staff

16. Importance of Vision Leaders have a responsibility to staff to lead, inspire, empower, impart knowledge and experience, etc. – AIDS Director, J/J study Leadership is the capacity to translate vision into reality. — Warren Bennis

17. Vision Defined • The act or power of imagination • Mode of seeing or conceiving • Unusual discernment or foresight

18. Vision is the art of seeing the invisible — Jonathan Swift

19. Case Study – Lena Marco’s Vision • How did Lena Marco establish herself as a leader when she became the new Division Director? • What are Lena’s opportunities to change the way she is perceived? • How can Lena establish and communicate her vision effectively?

20. To the person who does not know where he wants to go there is no favorable wind. -Seneca

21. YOUR Vision Defined An ideal state that you wish to achieve • For yourself as leader – What would your leadership ideally look like? Feel like? • For your staff - Staff composition, functioning together, culture of work, etc…. • For your program

22. Your Thoughts:Vision for your Own Leadership • Being fairly democratic; able to engage and motivate others; communicate theoretical and concrete ideas effectively; adapt well and easily and allow others freedom to move forward without constraints. • Innovation that provides concrete means for attaining goals and objectives • Competent, thoughtful, effective, trustworthy • Promote an efficient and productive work environment to free more time to implement activities resulting from a "bigger picture“ - more proactive perspective instead of reactionary, "fixing" activities • To develop competencies in the range of areas that the HIV/AIDS Office oversees; to work in partnership with senior staff to articulate core tenets of the HIV/AIDS prevention and care services we fund; to reaffirm the commitment to responsive services throughout our direct care efforts; and to integrate our work in a public health framework in a way that engages multiple stakeholders and collaborators.

23. Your Thoughts:Vision for your Own Leadership (2) • Build and/or maintain a quality state HIV/AIDS Program with maximumcommunity input. • Provide the best possible atmosphere for staff development, innovation and enthusiasm for implementation of all HIV programming efforts. • Assure data-informed policy development and advocacy with all audiences, including department leaders, the Director and Governor's office. • Work to improve personal skills in strategic planning, time management and specific database programs. • Stay abreast and update analysis of the ongoing political process at the community level, department level and legislative level. • Identify the individual strengths of my staff and the needs within the program to delegate responsibilities accordingly. To be self aware enough to know my strengths and weaknesses so I can utilize my staff to best complement those strengths and weaknesses so the program does not suffer.

24. Your Thoughts:Vision for your Staff • Rewarded, competent, productive, happy, effective, flexible • To be experts in HIV Prevention and in their individual components of the prevention program. To feel comfortable providing TA to our contractors and information to the community at large. • Working with my staff to find their strengths and weaknesses and helping them rise to being the best they can be. • Development of core management and organizational skills to enhance skills and prepare them for upward mobility. • That they enjoy coming to work, and have the opportunity to develop expertise in a particular service area. That there are consistent mechanisms for staff to work across program areas to ensure service coordination and develop a broad understanding of HIV prevention and care services.

25. Your Thoughts:Vision for your Staff (2) • Highly motivated, competent people. • Multicultural composition • Training, enrichment and best practice opportunities are shared and encouraged • Provide moral and practical support for staff; fairness in consideration, and sensitivity on issues of working conditions, work/family issues, etc. • Cohesive work team and work environment • Each member will maximize his/her potential and move the program forward towards its goals with resources available. • Staff members will feel gratified by their work with a sense that they make significant contributions, along with their peers, and they mostly have a good time doing it!

26. Your Thoughts:Vision for your Program • Sustainable, high quality model for other HIV Prevention programs. • One that CBOs and other organizations trust and look to for partnership as well as funding and technical assistance. • Pushes and leads its Prevention providers to become sustainable organizations without the Prevention program. • Attracts and grooms the best minds in HIV and public health • A comprehensive prevention/service, organization equipped to managed and provide exceptional services and deliverables. • Effective, efficient, proactive, and responsive to HIV/AIDS prevention and care needs of residents • To run in accordance with CDC guidelines, making a discernable impact on the spread of HIV in our state

27. Your Thoughts:Vision for your Program (2) • Marry the concepts of passion, advocacy and science to assure best practice in HIV prevention and care programming and surveillance excellence. • Assure collaboration and cooperation with other Infectious Disease units (STD/TB/Immunizations); other parts of department, and other state/local agencies to reduce new infections, reduce disparities and increase the number of people in care, with known HIV infection. • Consistently involve, uplift and facilitate empowerment of people directly affected by HIV in advising and evaluating program activities. • Be a recognized leader in the state in reducing (and keeping low) HIV/STD and Hepatitis infection rates. • To develop a continuum of clinical and non-clinical services responsive to geographic and population level influences and needs. Leverage existing capacities and resources within the care system, while sustaining a level of readiness to integrate cutting edge prevention and care approaches as they emerge and are proven effective.

28. What are the differences…. Your vision: • for your own leadership (or for you as a leader) • for your staff • for your program

29. Honing our Vision(s) • Individual Reflection • Large Group Presentations – lunch tomorrow

30. BREAK

31. Advocacy and Advocacy Opportunities Purpose: • To build knowledge about talking with legislators, both in their state and in Washington, and build their skills and comfort level in doing Hill visits. • To build knowledge about developing advocacy coalitions and leveraging the policy environment

32. Case Study: Lena Marco’s Advocacy Activity How did Lena fulfill her advocacy role? What were the opportunities?

33. Advocacy: What is your experience? • AIDS Directors said their staff were least proficient in advocacy (J/J survey) Your experience with: • State legislative advocacy • Congressional advocacy • Federal agency advocacy • Advocacy coalitions (developing, strengthening, participating in…)

34. Your Role in Advocacy Provide information on the epidemic and programs in your state Paint the picture to justify increased resources for your programs or support for legislation Build long term relationships with community advocates, legislative contacts and your Congressional delegation Keep your Governor’s office apprised of legislative and funding priorities Be a host to legislative and gubernatorial staff

35. Your Role in State Advocacy Work with your community to add their voice Educate about the policy process and how to add their voices Raise issues to help collective planning and management during crisis Provide information they can use for state lobby days Budget forecasting Epidemiology One-page summaries that convey central messages Encourage the community to develop the “ask”

36. Your Role in State Advocacy (2) Clarify your role as a state employee and limitations on what you can and cannot do Cultivate trusted allies Be transparent when possible by keeping the community in the loop Try to get the message far and wide among the community to avoid multiple messages Create a mutually respectful relationship

37. Your Role in Federal Advocacy Your are a public health expert There are many voices with HIV/AIDS interests Only you can provide Congressional staff with the state perspective Establish a “go-to” relationship Hill visits are opportunities For information sharing To provide expert and experienced knowledge about the program’s needs Staff want to know impact on state & funding

38. Your Role in Federal Advocacy (2) Take opportunity to visit your Governor’s office when in DC Relationships can be maintained throughout the year District office visiting hours Town hall meetings Mailings to share epidemiologic data Updates on crisis situation if applicable Phone calls or emails after awards to share how the state fared or impact of legislative changes

39. Congressional Visitsknow who/what you are representing Know the type of program you are advocating for Mandatory—If you qualify for the program, you get the benefit Medicare, Medicaid (ETHA), Social Security, Pell Grants, Farm subsidies You have to pay for changes (Pay-as-you-go) Discretionary—Congress decides every year how much $$ a program will get Ryan White, CDC, HOPWA, NIH, etc.

40. Congressional VisitsKnow your message and how you will convey it Know what you want to say before you walk in Review talking points on issues Role play with tips to follow Express appreciation for the support that Congress has given HIV/AIDS programs Federal funding Ryan White Be succinct in your ask Demonstrate that programs are effective and need to be continued and enhanced If you don’t have an answer to a question, say so Opportunity for follow-up

41. Tips for All Visits Thank them for meeting with you Introduce yourself Give staff your card Quick overview of governmental public health Quick overview of local epidemic Make a few key asks

42. Tips for Visits: Delivering Your Message Hook – Your ID: Your name, where you live, the organization you are with (volunteer or staff), or the why and who you represent Line– Your Message: A personal story, facts about the program or persons living with HIV/AIDS, etc. Sinker – The Ask: “Currently the ADAP Program receives no state funding. We are one of only 14 states that do not provide state appropriations for the program. If given the opportunity, Will you vote to provide state funding for the ADAP Program in Iowa?” credit: Pat Young, Iowa Department of Public Health

43. Lunch

44. About NASTAD NASTAD Leadership Institute April 8-9, 2010

45. Introduction to NASTAD • NASTAD is a non-profit national association of state health department HIV/AIDS program directors who administer HIV/AIDS and viral hepatitis prevention, care and treatment programs funded by U.S. state and federal governments. • NASTAD was established in 1992 as the voice of the states. • NASTAD is governed by a 20 member, elected Executive Committee charged with making policy and program decisions on behalf of the full membership. • NASTAD’s Washington, DC headquarters has a professional staff of 30. We have small field offices in Haiti, Zambia, Botswana, Ethiopia and South Africa.

46. Mission:NASTAD strengthens state and territory-based leadership, expertise and advocacy and brings them to bear on reducing the incidence of HIV infection and on providing care and support to all who live with HIV/AIDS. Vision: NASTAD’s vision is a world free of HIV/AIDS. Strategic Map Central Challenge: Strengthen the role and promote the success of state and territorial public health programs to reduce HIV/AIDS and viral hepatitis incidence, ensure quality care and treatment, and improve health outcomes. Introduction to NASTAD

47. The National Alliance of State and Territorial AIDS Directors (NASTAD) Strategic Map—2010-2013 (Approved 03.02.10) Strengthen the Role and Promote the Success of State and Territorial Public Health Programs With sound POLICY AND ADVOCACY With quality Capacity Building And Technical Assistance With strong PARTNERSHIPS WITH EFFECTIVE COMMUNICATIONS To Reduce Health Disparities in Racial and Ethnic Minority Communities and Among Gay and Bisexual Men and Other Disproportionately Impacted Populations With ORGANIZATIONAL EFFECTIVENESS To Develop and Inspire Strategies that Incorporate Social Determinants of Health To Improve Systems of Surveillance, Prevention and Care and Treatment To Encourage and Mainstream Beneficial Integration and Coordination of Policies and Practices To Successfully Integrate New Technologies in Public Health Practice To Bolster the Public Health Workforce by Strengthening Leadership and Effectiveness To Minimize the Challenges and Maximize the Benefits of Emerging Issues To Reduce HIV/AIDS and Viral Hepatitis Incidence, Ensure Quality Care and Treatment and Improve Health Outcomes

48. NASTAD Members(HIV/AIDS Program Integration with STD, VH and TB Programs) 2007 National HIV Prevention Program Inventory

49. How does NASTAD impact national HIV/AIDS and viral hepatitis policy and programs? • NASTAD staff develop policy/program recommendations based on input from the Executive Committee and members. • Work groups and advisory committees of AIDS directors and/or their program staff guide programs and ensure products reflect needs/concerns of members. • Use “peer” technical assistance (TA) model to link AIDS directors and to share expertise across jurisdictions.

50. How does NASTAD impact national HIV/AIDS and viral hepatitis policy and programs? • We work with: • Executive Branch agencies to influence policies that impact state programs • Congress to influence Executive Branch agencies, provide funding, develop sound legislation • Coalitions to influence both Congress and the Executive Branch • We communicate positions through: • Meetings, letters, position statements, issue briefs, reports, assessments of state policies and programs, etc. • NASTAD members visit Members of Congress and meet with the leadership at federal government agencies on a periodic basis.