ASTHO’s Year in Review: Organizational Successes and Outlook for 2019

December 20, 2018|10:28 a.m.| ASTHO Staff

With 2018 coming to a close and a new year around the corner, ASTHO asked members of its leadership team to reflect on successes from the past year and share what they hope to accomplish next. Here is what they had to say:

Amber Williams, Chief of Governance, Leadership, Engagement and Workforce
Jim Blumenstock, Chief of Health Security

Leadership: Successes

This past year brought new directions to leadership development, including the completion of the first cohort of the new ASTHO Leadership Institute (ALI), which is designed to support the development of state and territorial leaders to advance health equity and optimal health for all within their jurisdictions by enhancing the vision, skills, and abilities of health officials. This includes achieving success in their role as chief health strategist for their state or territory, developing strategic and inclusive partnerships to improve well-being, and leading a state or territorial governmental public health agency in a way that creates the conditions for better health for more people. There were 14 participants in ALI’s first cohort, which ended in August, with participants reporting an overwhelmingly positive experience. As one participant noted: "I knew a lot about leadership, business management, and health—but the components of being a SHO definitely [represents] a unique skill set that only ASTHO and a few others would be able to teach." Participating health officials highly valued the executive coaching provided, as well as the opportunity to build a trusted peer network. The second cohort, with eight health officials, also launched in August 2018.

In addition, ASTHO piloted two models for delivering Boundary Spanning Leadership workshops to support cross-sector learning and action with six state teams, including Montana, South Carolina, New Hampshire, Mississippi, West Virginia, and Maine. Further, we began to expand delivery of leadership content to other members on health agency leadership teams, including senior deputies and state legislative liaisons.

ASTHO also demonstrated ongoing leadership in the areas of public health preparedness and response.

Mother Nature was not kind again this year, with major weather-related events wreaking havoc and causing major destruction, resulting in injury and loss of life. ASTHO mobilized to support our members across the country by providing informative situational awareness, connectivity with key federal agencies and partner associations, and needed technical assistance. In addition, ASTHO helped facilitate the provision of resources being requested through the Emergency Management Assistance Compact during such major events as the wildfires in California and Nevada, a volcano eruption in Hawaii, the earthquake in Alaska, as well as Hurricanes Florence, Gordon, Lane, and Michael, and Typhoons Mangkhut and Yutu, which ravaged many states and island territories. When disasters strike your jurisdiction, ASTHO will always be there to help.

ASTHO responded to several infectious disease crises throughout the year. We have worked to increase awareness around rising STD rates and provide states with tools to stem the tide in a climate of reduced funding. ASTHO has also recognized the increasing trend of vaccine hesitancy in the nation and the potential impact it is having now on influenza and in the rising numbers of measles cases in 2018, along with such pressing topics as Legionella outbreak public reporting, the multistate hepatitis outbreak, acute flaccid myelitis, sepsis, Ebola, and monkeypox.

Leadership: 2019 Outlook
For 2019, ASTHO’s health security priorities and activities will track and keep pace with the ever-evolving and expanding threats posed by the environment. We will consider such issues as implementation of the National Biodefense Strategy, reauthorization of PAHPA, advancing the Antimicrobial Resistance (AMR) Challenge, and providing the resources and leadership support needed as states and territories prepare for and respond every day to the extraordinary challenges that face their communities.

ASTHO will also be launching a new internal initiative in 2019: ASTHO Weeks. With a growing workforce engaged all over the country in public health capacity building and technical assistance efforts, this will be time for ASTHO’s staff to come together quarterly with dedicated time for staff development, team building, cross-team staff meetings, as well as time for fun! Our first ASTHO week will be held Jan. 28-Feb. 1 and will include wellness activities, an overview of ASTHO’s Continuity of Operations (COOP) plan, trainings on change management and evidence-based public health practice, an outing to the Smithsonian National Museum of Natural History to see the exhibit “Epidemics in a Connected World,” and a special reception with ASTHO President Nicole Alexander-Scott.

Carolyn Mullen, Chief of Government Affairs and Public Relations
Advocacy and Policy: Successes

The year got off to a rocky start. Congress approved five continuing resolutions, shut down the government twice, and the future of the Prevention and Public Health Fund was uncertain. Then, somewhat miraculously, Congress and the Administration struck a bipartisan budget deal extending funding for the Children’s Health Insurance Program for 10 years and the Maternal, Infant and Early Childhood Home Visiting Program for five years, while at the same time restoring funding for the Prevention and Public Health Fund. Public health received the largest increase in funding in over a decade, including a $350 million increase to address the opioid epidemic in the FY18 Consolidated Appropriations Act. For the first time in 20 years, Congress approved the FY19 LHHS bill, which provided public health with guaranteed funding through Sept. 30, 2019. ASTHO also reviewed, analyzed, and provided substantive comments on at least five versions of the Pandemic and All-Hazards Preparedness Act (PAHPA) reauthorization bills. The team monitored over 100 bills to address the opioid crisis, which were introduced and approved at a breakneck pace. In September, a final compromise bill, the SUPPORT for Patients and Communities, was signed into law. Three state health officials testified before Congress on different occasions about preparedness, the opioid epidemic, and lead-based paint in homes. Finally, ASTHO submitted comments on the proposed Title X and the public charge rules. It was a year for the record books and the outcome was much better than expected.

Advocacy and Policy: 2019 Outlook
A divided government in the coming year means ASTHO’s voice is especially important because to truly invoke change, advocacy approaches must be non-partisan and consensus-driven. To that end, ASTHO’s board of directors approved the 2019 federal legislative agenda to guide our work for the upcoming year. A central component of that is the 22 by 22 campaign, which is an initiative to grow CDC’s budget 22 percent by FY22. Over 70 national organizations have endorsed this campaign. A next step for ASTHO is identifying and cultivating Congressional champions for this initiative. If Congress does not approve the PAHPA reauthorization bill before the end of the year, ASTHO will be working diligently to encourage Congress to approve this legislation as soon as possible. We anticipate an extremely busy start to the year with the looming budget fight over sequestration to be top of mind for policymakers. Although, if history is a guide, we should expect to wait until the last minute for Congress to fund the government and a scenario similar to 2018 may rear its ugly head again. Nevertheless, ASTHO is here to help and provide the tools and information necessary to our members to navigate the coming year.

Zarnaaz Bashir, Chief of Programs and Strategy
Capacity Building: Successes

ASTHO submitted and was approved for another five-year cooperative agreement with CDC to support state and territorial public health capacity building. It was all-hands-on-deck at ASTHO, with staff working hard to submit over 50 project proposals in 30 days. This year, ASTHO was successful in receiving $53 million in awards across a range of public health issues, including infectious disease, preparedness, chronic disease prevention, substance misuse and addiction, and family and child health.

This includes the “Technical Assistance for Response to Public Health or Healthcare Crises” Notice of Funding Opportunity. With this precursor approval in place, we received cooperative agreement awards to support impacted members for hurricane response and recovery and to address the opioid epidemic. ASTHO received $15.7 million to provide staff and procurement services in Puerto Rico and the U.S. Virgin Islands in the aftermath of Hurricanes Irma and Maria to aid in restoring their public health infrastructure. Given the extent of activities that will be provided this year and next, ASTHO opened up an office focused on Caribbean operations, with staff located in San Juan. For work related to opioids, ASTHO received approximately $7.3 million to support up to 30 states to build comprehensive state approaches to address the complexity of substance use disorders among pregnant and postpartum women. In the years to come, ASTHO is well-positioned to continue receiving funding from CDC for other crisis-related services needed by our members through this novel cooperative agreement process.

Finally, following the launch of ASTHO’s new strategic plan, ASTHO developed an operations plan with goals and targets to help carry out ASTHO’s three strategic priorities focused on leadership, capacity building, and advocacy. The plan was launched over the summer and outlines specific tasks and related metrics to accomplish these priorities. Having a clear plan and communicating that vision to staff—and making that vision part of ASTHO’s daily activities—helps staff see and understand the impact of their work and promote a “One ASTHO” culture.

Capacity Building: 2019 Outlook
In 2019, ASTHO will complete an annual environmental scan that forms the basis of the organization’s capacity building and leadership development work. The scan will pull from a variety of sources to understand issues on the radar for state and territorial health agencies and analyze national public health priorities that impact state and territorial public health. Look for issue briefs and other resources available in the spring that share programmatic and policy priorities.

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