“Transforming the Public Health Service Commissioned Corps: CDC/ATSDR Perspective”
Analysis and Summary of Comments Received as of October 2005
- Recommendations: The recommendations should be prioritized, perhaps focusing on some key recommendations and separating the internal recommendations from those for the Secretary.
- Transformation: The stated purposes of transformation do not include recognition of the importance of public health and over-emphasize geographic mobility, provision of clinical services, and emergency response. Furthermore, the transformation process has been plagued by poor implementation and poor communication with officers.
- Recruitment and Retention: Recruitment and retention
of a high quality workforce of officers so that CDC/ATSDR’s important
public health mission can be accomplished should be a primary message from
Dr. Gerberding to HHS regarding
transformation.
- The transformation thus far has been implemented without a force management plan. Changes in promotion and other policies have affected officer morale and retention without providing a clear vision of the shape and role of the transformed Corps.
- The most effective way to recruit EIS officers to CDC would be to increase the emphasis on the importance of the scientific work of officers and decrease the emphasis on “militarization” and rank, etc.
- The best of officers comes when we recruit and retain the best and brightest and then reward their public health accomplishments.
- The data generated by CAPT Jeff Sacks should be added to the paper.
- We can’t retain officers if the only rewards are for deployment.
- Overwhelming support for removal of the 3 strikes policy and 6th precept.
- Public Health: The inherent value of the public health work and
scientific expertise at CDC/ATSDR should be emphasized.
- Public health and scientific work done at CDC/ATSDR has not been recognized as valuable in the transformation process thus far.
- The white paper should outline the policies and actions necessary to demonstrate to CDC/ATSDR officers that they will be valued in a transformed Corps.
- Officers want to see the Applied Public Health track implemented.
- Promotion and awards should recognize effective work in public health (not just wearing the uniform or deployment).
- Deployment and emergency response should not be over-emphasized compared with primary public health and scientific mission of the agencies.
- Readiness: Readiness requirements overemphasize
clinical response ignore public health response elements, and take considerable
time away from officers’ primary
public health work.
- The clinical emphasis for readiness is not appropriate. The importance of the CDC/ATSDR epidemiological response was clearly demonstrated in the hurricane response effort.
- We shouldn’t try to shoehorn officers into clinical roles.
- Officers would need many more than 112 hours per year (perhaps as many as 300 or 400) to maintain the clinical expertise to provide primary or emergency care in a response.
- The time needed for readiness activities (and possible deployment) is a disincentive for supervisors to hire officers.
- If readiness is required, then officers should be given time during work hours and support from supervisors for readiness activities.
- Overseas officers face special challenges meeting the readiness requirements.
- Despite the “requirement” for readiness for deployment, some officers were deployed for the hurricanes who had not met the readiness requirement.
- Readiness requirement should be made more relevant to public health.
- CDC provided extensive input on immunization requirements to align them more closely with the ACIP recommendations, but the revisions have yet to be implemented.
- Deployments: All deployments through the CDC DEOC should be counted for OFRD credit.
- Expertise: The emphasis on mobility is not compatible
with officers developing and maintaining specialized expertise, one of
CDC’s most valuable assets.
- Promotions should be based on public health achievements, not mobility. Promotion of a “jack of all trades and a master of none” will lead to the downfall of the Commissioned Corps as we lose our value to the country as we lose our expertise.
- The emphasis on mobility implies that all officers are interchangeable, which is not true at CDC where officers have very specific and valuable expertise.
- New requirements force out senior officers whose expertise cannot be easily replaced.
- If we cannot reward people for developing excellence in an area, highly qualified people will not join CDC.
- The historic strength of the Commissioned Corps and our value to the nation lines in the depth of our expertise.
- CC vs Civil Service: Comparisons with civil service must not be
self-serving or dismissive of the expertise, commitment and loyalty of
our civil service
colleagues.
- Some felt that this section does a disservice to the many civil service employees who are no less effective or important than officers in fulfilling CDC’s mission.
- Some felt that many of the points were unconvincing or irrelevant.
- Offices are not only uniquely prepared to respond but also are highly adaptable.
- Militarization:
- Some responders view an emphasis on uniforms as a sign of wanting to militarize the Corps, which they see as contradictory to the public health mission of the Corps.
- CDC provides a crucial pubic health function that is founded on and implemented by collaborative leadership, not a hierarchical “military command” structure.
- Agency allegiance: Simultaneous allegiance to CDC/ATSDR and the
Public Health Service are not incompatible and can be cultivated through
acknowledgment of
the public health expertise held by CDC/ATSDR officers
- Several officers responded that allegiance to the agency and to public health work is not a detriment to the Corps and should not be conveyed as such. Agency and PHS devotion can co-exist.
- Having officers devoted to their agency and area of expertise will enhance allegiance to the Corps, provided that expertise is acknowledged.
- Uniform: Required daily uniform wear at CDC/ATSDR continues to
have advocates and detractors.
- This is the one area where there are still polar arguments: some officers feel that daily uniform wear is long overdue, while others feel the uniform is over-emphasized relative to the more important issues of the public health work, and is detrimental to recruitment and retention.
- Examples “pro”
- Some feel that senior officers should be instructed to wear their uniforms at high level meetings in Washington, D.C. and other settings to set an example for junior officers.
- We are a uniformed service, so daily uniform wear should not be an issue.
- o Examples “con”
- Others feel that wearing the uniform is the antithesis of public service.
- The merits of our work should be judged for credibility, not a superficial measurement of uniform wear.
- The Surgeon General hasn’t required daily uniform wear and neither should CDC.
- Other comments
- Officers should be given assistance and support in obtaining the appropriate uniform components and provided training on proper wear.
- There are some circumstances where daily uniform wear is not appropriate (e.g., certain laboratory settings) or would hinder the mission (e.g., working with certain marginalized populations).
- The best way to improve the visibility of the Corps is to restore the stature of the Surgeon General’s office.
- Options for officers:
- Some officers feel that given the significant changes taking place and the direction the Corps seems to be headed, officers should be offered a one-time buy out, or other civil service options to resign their commission before 20 years of service.
- Senior officers need to show more support for the Corps and serve as role models.
Last Reviewed: September 2, 2005