Washington Public Health

Orientation Information

Purpose and Background

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Purpose

The purpose of this orientation is to provide a structured process that will help newly hired staff function effectively in their roles, with an overall goal of fostering individual, organizational, and community effectiveness in improving public health.

By participating in this orientation, individuals can expect to:

• Gain a basic understanding of the public health system and topics related to public health practice in Washington State;

• Explore the knowledge base and skill sets critical to effectively functioning in their roles; and

• Know where to get and how to use information, support, and technical assistance needed to address job challenges.

Background

Through its various forums, the Washington State Association of Local Public Health Officials (WSALPHO) in collaboration with the Washington State Department of Health (DOH), developed orientation processes for four roles within local public health leadership: Health Officers, Administrators, Environmental Health Directors and Nursing Directors. These processes and the corresponding materials were developed over time, beginning in 1998.

Responding to a need to update the materials and to add a component for local public health assessment staff, an advisory group was formed in 2004 that included DOH staff, representatives from each WSALPHO forum, and local public health assessment staff. The group endorsed an approach to integrate the orientations, where possible and appropriate.

Framework for the Orientation

Recognizing that the need for certain skills and knowledge cuts across individual disciplines and roles; that job categories are defined differently across the state, and the lines of distinction between them are not always the same; the advisory group sought a common, but flexible framework for linking and organizing the orientation materials for the various roles.

The group decided to use a framework developed through the Public Health Improvement Partnership (PHIP). This framework identified the following nine competency domains for describing the knowledge and skills that go beyond discipline-specific education and are critically important to achieving state public health standards:

1. Systems Thinking

2. Public Health Policy, Authority and Responsibility

3. New Coalitions and Alliances

4. Communication

5. Informatics

6. Quality Improvement

7. Results-based Accountability

8. Visionary Leadership

9. Technical and Professional Competencies

This competency framework is used to arrange the various elements of the orientation. Within this structure, competencies important for each of the roles can be grouped, but the level of knowledge or skill required for an individual in a specific role may vary. (More information about the PHIP competency framework is available through the PHIP Workforce Development Committee website.

Functional Roles

Job title does not necessarily dictate the same duties within local public health agencies across the state. However, there are common functional roles. In many cases, individuals in these roles meet and work together, either as formal associations, or as peer groups. Click on the links below for additional information about these groups and their involvement in developing this orientation.

• Local Public Health Administrators

• Local Health Officers

• Local Public Health Nursing Directors

• Local Environmental Health Directors

• Local Health Assessment Staff

Local Public Health Administrators and the Orientation Process

The Public Health Executive Leadership Forum (PHELF) is an organization made up of individuals who are in leadership positions and are responsible for directing and administering the public health programs in local health jurisdictions (LHJ) across the state. Membership includes LHJ Administrators and Health Officers. PHELF is a forum of the Washington State Association of Local Public Health Officials (WSALPHO).

PHELF, in collaboration with the Washington State Department of Health (DOH), took the lead in developing an orientation for Local Public Health Administrators. This orientation process was implemented in July of 2001. The orientation process and the associated materials developed through this effort were in use through 2004, and have been updated and integrated within the current orientation process and web-based resources.

• Additional information about PHELF and WSALPHO is available on the WSALPHO website.

Local Health Officers and the Orientation Process

Chapter 70.05 RCW requires that local Health Officers (LHOs) in Washington State be physicians licensed to practice medicine and surgery or osteopathy and surgery in the state AND hold a Master’s of Public Health degree (MPH) (or its equivalent). Health Officers who do not meet the latter requirement must undertake three years of service as a provisionally qualified Health Officer that includes an orientation to public health and annual evaluations by the Secretary of Health. (Only provisionally qualified Health Officers will be required to complete this orientation. Fully qualified Health Officers may participate on a voluntary basis.)

Local Health Officers in Washington State participate in The Public Health Executive Leadership Forum (PHELF). PHELF is an organization made up of individuals who are in leadership positions and are responsible for directing and administering the public health programs in local health jurisdictions (LHJ) across the state. Membership includes LHJ Administrators and Health Officers. PHELF is a forum within the Washington State Association of Local Public Health Officials (WSALPHO).

Development of the orientation process began in 1998 with a survey of current Local Health Officers in Washington State to determine the roles and responsibilities common to most. Over the next 16 months, existing health officers and Washington State Department of Health (DOH) staff established an orientation process that supported those roles and responsibilities within the financial constraints of public health practice. Developmental steps included small group brainstorming sessions, consultation with public health practitioners and educators, and collection and development of the orientation materials. The Local Health Officer Group played a critical role in identifying the necessary elements of the orientation and in reviewing and commenting on draft procedures and materials. A variety of other public health practitioners contributed formally and informally to the process by sharing ideas, experiences, and training materials.

The orientation process and the associated materials developed as a result of this effort were in use through 2004, and have been updated and integrated within the current orientation process and web-based resources.

• Additional information about PHELF and WSALPHO is available on the WSALPHO website.

Local Public Health Nursing Directors) and Development of the Orientation Process

The Public Health Nursing Directors of Washington (PHND) is an organization made up of individuals who are in leadership positions and are responsible for managing the "personal health" programs in local health jurisdictions (LHJs) across the state. PHND is a forum within the Washington State Association of Local Public Health Officials (WSALPHO). Not all individuals in “PHND” roles are nurses, and not all of these positions are structured the same in LHJs across the state. Generally, individuals in these positions are responsible for carrying out or managing the “personal health” or “community health” programs in LHJs across the state.

Development of the orientation process for PHND began in the spring of 2000, with a review of PHND and other nursing leadership roles and responsibilities. Over the next 12 months, the PHND Forum and the Washington State Department of Health (DOH) established an orientation process that focused on high priority PHND roles and responsibilities (i.e., those felt to be most crucial to new nursing leadership at the beginning of their tenure).

Developmental steps included brainstorming sessions with a small workgroup (i.e., the PHND Orientation Workgroup), consultation with other public health practitioners and educators, and collection and development of orientation materials. The PHND Forum played a critical role in confirming the necessary elements of the orientation and commenting on draft procedures and materials. A variety of other public health practitioners contributed formally and informally to the process by sharing ideas, experiences, and training materials.

The orientation process and the associated materials developed as a result of this effort were in use through 2004, and have been updated and integrated within the current orientation process and web-based resources.

• Additional information about PHND and WSALPHO is available on the WSALPHO website.

Local Environmental Health Directors and Development of the Orientation Process

The Washington State Environmental Health Directors (WSEHD) organization is made up of individuals who are in leadership positions and are responsible for managing environmental health programs in local health jurisdictions (LHJs) across the state. WSEHD is a forum within the Washington State Association of Local Public Health Officials (WSALPHO).

An Ad Hoc Environmental Health Directors Orientation Manual Committee was established at the Statewide Environmental Health Directors’ meeting in Leavenworth in 1998. That committee developed a tool kit of resources and information, parts of which are being updated and incorporated into this orientation effort.

• Additional information about WSEHD is available on the WSEHD website, and the
  WSALPHO website.

Local Health Assessment Staff and Development of the Orientation Process

Individuals come to local community health assessment positions with diverse backgrounds in education, training and experience. Not all of these positions are structured the same in LHJs across the state. For some individuals in these positions, coordinating and/or conducting assessment activities is the singular focus of their job; for others, it may be only one of multiple roles assigned to them.

The Washington State Department of Health (DOH) and local health jurisdictions (LHJs) have worked in close partnership to design and implement a system for community health assessment. Developed in the context of the Washington State Public Health Improvement Partnership (PHIP), this system involves the coordinated effort of public health agencies across the state to make data available and accessible for assessment; provide consultation, technical assistance, and training on the analysis of this data; and support the use of assessment findings for program planning, priority setting, and policy development.

Support for community health assessment is provided by DOH through training, consultation and technical assistance, peer learning and exchange and other methods. Grant funding made it possible to build on these efforts, and several workforce development efforts were undertaken to improve the ability of local health staff to perform community health assessment. These include peer mentoring, AssessNow, a web-based resource library for people working in community health assessment, and this orientation for new local community health assessment staff.

The Local Community Health Assessment Liaison coordinates quarterly Regional Assessment Meetings for local community health assessment staff across Washington State. These meetings provide an opportunity for networking, sharing successful practices, and updates. During 2004, these meetings provided a forum for involving local community health assessment in the development of the orientation process. Through brainstorming sessions and group discussion, individuals at these meetings participated in developing, reviewing and refining elements of the orientation process. In addition, a small workgroup of DOH and LHJ assessment staff played a major role in developing the tools and resources used in the orientation process.