The Office for State, Tribal, Local and Territorial Support

1. The Office for State, Tribal, Local and Territorial Support Judy Monroe, M. D., Director June 8, 2010 Centers for Disease Control and Prevention Office for State, Tribal, Local and Territorial Support

2. Agenda • Introduction • Our Values • Our Mission • Our Working Model • 14 in 12 • Proposed Organizational Structure • Value to our Partners • CDC’s Winnable Battles • How You Can Help DRAFT – For Discussion Purposes Only

3. Our Values Success for this office means demonstrating the values of Service and Stewardship internally and externally DRAFT – For Discussion Purposes Only

4. Our Mission Improve the capacity and performance of the public health system DRAFT – For Discussion Purposes Only

5. Our Working Model The Concept of Operations provides the overarching framework and functional foundation for OSTLTS. Identify: • Bring standards, policies, and best practices to light • Confirm relevance, quality, and integrity • Deploy across public health system • Support implementation and effective outcomes Validate: Disseminate: Adopt DRAFT – For Discussion Purposes Only

6. 14 in 12 • Best Practices: 5 identified and disseminated via STLTS networks • Grants Standardization and Optimization: At least 5 improvements identified and made to CDC grants process, guidance, approach, or standards • SHO welcome packet: System in place to recognize incoming SHOs and trigger a welcome packet from STLTS • PHAP: Program expanded to add 75 more apprentices in 2010 (total 100) • STLTS Partner Portal: Established and manage a one-stop information center and service for STLTS partners

7. 14 in 12 (cont.) 6. Score cards: 2-3 prototypes developed with health department partners by the third quarter of 2010 7. Field Training: Develop and deliver a training opportunity for CDC field staff and the staffs of state and local health agencies. 8. Health Officer Orientation: A re-designed, 2-day orientation to CDC will be provided for new health officials (appointed within 2 years) 9. PHL Training: Develop and deliver the first of a series of public health law trainings for CPPW grantees 10. CDC Organizational Resource Directory: Develop and implement this external portal for STLT public health professionals to be able to reach into CDC (Seligman and SharePoint - not duplicative of anything)

8. 14 in 12 (cont.) 11. ACD subcommittee: Establish the subcommittee on public health practice 12. Completion of a “beta-test” of the national accreditation standards, measures, and site visit process 13. Develop version 3 of the National Public Health Performance Standards Program assessment tools for use by State, Tribal, and local health departments 14. Deliver an annual training program to 120 NPHPSP & MAPP users from State, Tribal and local health departments

9. Proposed Division Structure The Division structure of OSTLTS reflects the mission of the Office, with a focus on public health performance and capacity. • The Office will explore and support system-wide collaboration for the efficient, effective, and equitable delivery of core public health functions and essential services. • The Division of PH Performance Improvement will lead standards and best practices identification and evaluation activities. • The Division of PH Capacity Development will serve as the implementation, training, and grants management arm of the Office. DRAFT – For Discussion Purposes Only

10. Proposed Branch Structure The OSTLTS Branch structure below is informed by the Concept of Operations. DRAFT – For Discussion Purposes Only

11. Proposed Leadership Staff Office of the Director Agency and Systems Improvement Branch Dennis LenawayBranch Chief (Currently on Detail) Liza Corso (POC) Judith Monroe, M.D.Director Associate Deputy Director (Vacant) Steven L. ReynoldsPrincipal Advisor/Director of Operations Georgia Ann MooreAssociate Director for Policy David DaigleAssociate Director for Communications Associate Director for Science (Vacant) Associate Director for Strategic Alliances (Vacant) Division of Public Health Capacity Development Dan BadenDivision Director Mark WhiteDeputy Director Division of Public Health Performance ImprovementDennis LenawayDivision Director (Acting) Stacey MattisonDeputy Director Research and Outcomes BranchBranch Chief (Vacant) Tim Van Wave (POC) Technical Assistance Branch Kristin BrusuelasBranch Chief Partnership Support Branch Samuel TaverasBranch Chief Knowledge Management Branch Lynn Gibbs-ScharfBranch Chief DRAFT – For Discussion Purposes Only

12. Creating Value Any public sector organization must bring its strategies into alignment by meeting three broad tests: • Does this produce value for the public we serve? • Is it able to attract support and money from the political system to which we’re ultimately accountable? • Can it feasibly be accomplished given our resource equation? The proposed organizational structure is designed around the concept of value creation for the public health system. The “Strategic Triangle Test” for Creating Public Value Mark Moore, Creating Public Value DRAFT – For Discussion Purposes Only

13. Winnable BattlesWe can make a big difference

14. Winnable Battles • Each area is a leading cause of illness, injury, disability, or death • Evidence-based, scalable interventions already exist and can be broadly implemented • Our effort can make a difference • We can get results within 1 and 4 years – but it won’t be easy

15. Key Winnable Battles • Tobacco • Nutrition, physical activity, obesity, and food safety • Healthcare-associated infections • Motor vehicle injury prevention • Teen pregnancy prevention • HIV prevention

16. Tobacco • Why important? • Leading preventable cause of death (kills 440,000 people annually in U.S.) and largest potential public health impact • 60% of Americans not protected from second-hand smoke – • 22 million are children under age 11 • Tens of billions of dollars in medical expenses and lost productivity • What can we do? • Increase excise taxes • Promote smoke-free environments • Media • Assist with FDA regulations

17. Nutrition, Physical Activity, Obesity, and Food Safety • Why important? • Obesity rates have doubled for adults and tripled for children in past 20 years • Sodium reduction = 100,000 fewer deaths annually; artificial trans fat elimination = tens of thousands fewer deaths annually • Complex, globalized food supply with tens of millions of food-borne illnesses annually in U.S. • What can we do? • Change environment to promote healthy food (e.g., trans fat, sodium reduction, junk food) and active living • Food procurement • Improve food-borne illness detection, response, and prevention

18. Healthcare-associated Infections • Why important? • Affects 1 in 20 patients in U.S. hospitals annually • Increases costs, length of hospitalizations, and deaths • Infections in blood stream, urinary tract, and surgical sites preventable • What can we do? • Strengthen national surveillance through National Healthcare Safety Network • Increase implementation of evidence-based prevention guidelines in hospitals • Public reporting – data for action • Prevention reimbursement policies

19. Motor Vehicle Injury Prevention • Why important? • 45,000 deaths and 4 million ED visits each year • Leading preventable cause of death in young people • What can we do? • 100% seat belt use = 4,000 fewer fatalities annually • Reductions in impaired driving = 9,000 fewer fatalities annually • Strong Graduated Drivers License policies = 350,000 fewer non-fatal injuries, 175 fewer deaths annually • Collaborate with transportation sector and other agencies to promote safety policies

20. Teen Pregnancy Prevention • Why important? • Teen birth rate rising after declining 1990-2005 • Nearly 2/3 pregnancies under age 18 years unintended • Perpetuates cycle of poverty • Increases infant death, low birth weight, preterm birth, health care costs • What can we do? • Increase access to long-acting reversible contraceptives • Improve reimbursement policies to cover teen family planning needs • Work to change social norms

21. HIV Prevention • Why important? • 1.1 million Americans have HIV – estimated 1 out of 5 unaware they are infected • Increasing unsafe sex and spread of syphilis and HIV in young men who have sex with men • Men who have sex with men approximately 50 times more likely to be infected than other men • What can we do? • Increase HIV status awareness • Improve linkage to care • Prevention with Positives • Expand prevention programs to reduce risky behaviors

22. Winnable Battles in Global Health • Substantially reduce mother-to-child HIV transmission globally • Reduce malaria morbidity and mortality by half in high-burden countries • Reduce under-five mortality in developing countries through integrated package of preventive services

23. Winnable Battles in Global Health (II) • Eliminate • Lymphatic filariasis globally • Onchocerciasis in the Americas • Prevent and control high blood pressure by reducing salt intake in China • Build health ministry infrastructure to prevent and control non-communicable diseases in developing countries • Particularly to reduce smoking, injuries, and cardiovascular disease

24. How can the Institutes help?

25. Questions Centers for Disease Control and Prevention Office for State, Tribal, Local and Territorial Support