American Public Health Association
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Health Administration
Section Newsletter
Fall 2009

Webinar Sept. 29, 2009

1:00 Eastern, 12:00 Central, 11:00 Mountain, 10:00 Pacific, 7:00 Hawaii
"Cost Model for Local Public Health," Jill Briggs, RN, MS, MPH, Chisago County Public Health, Chisago County, North Branch, Minn.

Public health leaders must be prepared to make the case for adequate funding and be prepared to show the magnitude of funding changes needed. During this Webinar, participants will learn about a Robert Wood Johnson executive nurse project that embraced a partnership approach to complete a time series analysis of local public health cost performance and outcomes and a gaps analysis of underfunded and not funded public health services. Once the gap was determined, a first-ever cost model was developed that answered the question: “How much would it cost to provide Essential Local Activities in Minnesota?”  This will also be a session at the APHA Annual Meeting on Monday, Nov. 9, 2009: 9:10 a.m.

Dial-in number:  (800) 311-9402
Passcode:  8378

Special Offer for Health Administration Members

Journal of Public Health Management and Practice

The Health Administration Section will highlight members of the Section in a special edition of the Journal of Public Health Management and Practice in spring 2010.  Because of this special edition, the  Journal of Public Health Management and Practice and the Health Administration Section are offering a Special Members Only Price.  You can receive a bi-monthly individual subscription to JPHMP for just $66.95 -- a 30 percent savings off the annual subscription price of $95.50. You’ll receive your printed copy and have full access to the journal online at

Order by clicking here|W9K706WB
or you can call (800) 638-3030. When ordering by phone, please be sure to mention promotion code D9K706PR to receive this exclusive member discount. If ordering online, use promo code W9K706WB at check out.

Learning Institutes at APHA

Saturday, Nov. 7, 2009

“Mastering Social Media and Interactive Technology to Improve Public Health Outcomes. A Practical Guide,” is a full-day Learning Institute.
Registration is now open at

Sunday Nov. 8, 2:30 – 6:00 p.m.
An interactive Learning Institute titled “Strategies for Local and State Health Departments to Reduce the Negative Impacts of a Distressed Economy” will be conducted on Sunday, Nov. 8, 2009 during the APHA Annual Meeting.  Primary objectives of the session are to give public health leaders valuable tools and strategies to implement proactive financial management strategies to reduce risk; best practices in comparative analysis and financial management; and methods to improve sustainability.

A limited number of partial registration scholarships ($150) are provided through funding from the Robert Wood Johnson Foundation. Access this site for additional information: Contact "Snow" Wang with scholarship or other questions or (601) 576-7772.

Special Session at APHA for HA Members

Sunday, Nov. 8 - 2:00 – 3:00 p.m.

Dr. Joel L. Nitzkin, a member of the American Association of Public Health Physicians, will host a special session during the Health Administration business meeting on Sunday, Nov. 8 at 2:00 p.m. (Location TBD).  He will be presenting on a policy analysis of the recently-signed-into-law FDA tobacco bill.  In contrast to the summary of the bill circulated for support, Nitzkin believes this bill promises to be a public health disaster of enormous magnitude.  It presents a classic example of how public policy should not be developed, and the traps we are likely to fall into if we adopt the habit of going along with the most fashionable trend without doing an independent "due diligence" analysis of a proposed piece of legislation.  This session will be an eye-opening presentation with lively audience participation and direct implications for state and local health department programming and community health.  To see more about the (AAPHP) analysis of this bill, go to the "Tobacco Issues" page at .

Preparing for Public Health Accreditation

By:  Kaye Bender, PhD, RN, FAAN - President and CEO, PHAB

The Public Health Accreditation Board (PHAB) was established in 2007 to institute a national voluntary public health accreditation program for state, local and tribal health departments. The idea came about as a result of a study, Exploring Accreditation, which was funded by the Centers for Disease Control and Prevention and the Robert Wood Johnson Foundation, to research two questions:  Is it desirable to establish a national voluntary public health accreditation program; and, is it feasible to do so? After several months of study and securing input from across the country, it was it was determined that it is both desirable and feasible to embark on this effort. A full report of the study and its recommendations are available on the PHAB Web site,

PHAB has recently been busy developing and vetting the proposed standards for accreditation, in which we received almost 4,000 individual comments. Approximately 123 online surveys were completed. Many of the responses represented a group process, so a significantly larger number of public health stakeholders contributed this input. About 35 paper surveys were received. Twenty-nine feedback forms were received from groups who held vetting discussions. We also received more than a dozen narrative comments submitted in e-mails or letters. The Board has revised the standards and is now developing the beta test which will begin in the fall.  Lessons learned from the beta test will result in revisions which can then be adopted prior to the official launch of the formal accreditation program, in 2011. The beta test will involve a variety of health departments relative to size, structure, population served, governance, geographic region, and degree of preparedness for accreditation.  Beta test sites will be announced in October 2009, and training will begin shortly thereafter.
We encourage public health administrators to support their health departments if they are selected as a beta test site.  And for those who are not, it’s not too early to be working on accreditation readiness documents such as strategic plans, community health assessments and community health improvement plans. A session at the APHA Annual Meeting entitled, “Public Health Accreditation Update” on Tuesday, Nov.10, 12:30-2:00 p.m., will give you all the latest and greatest information in the world of public health accreditation. We hope you will join us!

To get more information or to get involved, please see our Web site:

Putting Public Health into Health Care Reform

By: Stewart Landers, JD, MCP, John Snow, Inc.

While Massachusetts is examined, justifiably, as a model of how health care reform can move forward, it is rare that the role of public health in health reform takes center stage in that discussion. It is well known that health insurance coverage now extends to over 97 percent of residents, ranking Massachusetts first in the country in percentage of population insured. However, less is known about the role of public health in Massachusetts’ health care reform efforts and the lessons that may be applicable to the nation as a whole as it considers health reform at the federal level.

The legislation that propelled these high rates of insurance coverage also included the creation of a Quality and Cost Council and a Disparities Council. A year later, a second piece of legislation, dubbed Health Care Reform - Part 2, supported efforts to document serious reportable events, require electronic medical records and establish a gift ban. Part 2 also established an academic detailing program with respect to prescription drugs and a health care work force center.

In the executive branch, Gov. Deval Patrick's administration has pursued additional efforts improve public health. A “Healthy Massachusetts Compact” was organized across Secretariats to address health issues. A chronic disease blueprint was pursued by the secretary of Health and Human Services. The commissioner of public health spearheaded (with the governor in the lead) an anti-obesity campaign called “Mass In Motion” to promote healthy eating and physical activity (see ). Finally, Massachusetts was selected as one of four states by the Centers for Disease Control and Prevention to test and document efforts to integrate chronic disease prevention and control.

As chronic disease accounts for a large and growing amount of health care costs, addressing chronic disease is critical for helping to address high health care costs as well as to improve the health of the public. Various measures, some collected annually through BRFSS, provide evidence of the effectiveness of health care reform including improved screening for cancers (e.g. increased colonoscopy rates) and reduced smoking rates, as more people have primary care providers to encourage and support their tobacco cessation efforts.

Still, many barriers to full access to care exist, and there are ongoing challenges that demand public health solutions such as teaching newly insured individuals how to maintain and use insurance, how to prevent co-pays and deductibles from negatively impacting public health programs and how geographic distribution of primary care providers may limit access. Cultural issues at the provider level can also be a barrier to access to services.

Please come to my presentation on Monday, Nov. 9, 2009 at 8:30 a.m. and be part of a discussion about how we move forward with innovative and integrated public health approaches that are a critical link to health care reform. It is session 3033.0, Presentation 1: Putting Public Health into Health Care Reform: Massachusetts’ Chronic Disease Integration Pilot Project.

Volunteers Needed

If you are willing to volunteer an hour or two of your time to meet and greet people at the Health Administration booth, please contact Vonna Henry at

Why is this good idea?  1) You get to meet other members of Health Administration. 2) you get to brush up on your meet and greet skills – always essential at a big conference. 3) It gives you a sense of well-being to give back to the Section. 4) You never know who you will meet to add to your professional network!

Meet the Leaders in Health Administration

Last year we celebrated the 100 year anniversary of the Health Administration Section.  This year we are focusing on the future of health administration.  Who are the future leaders, and what do they have to say about health administration and the Section?

Bud Nicola,  Chair (2008-2009), Past Chair (2009-2010)

Bud NicolaBud, or Dr. Bud Nicola, is one of those people you are glad to have met. He is authentic,and committed to the work he does. Bud first got involved in public health as a medical student when he organized a group of medical students to plan and staff a student clinic for migrant workers in rural Oregon. “That experience got me interested, excited and hooked on public health.”

While trying to determine what to do and where to go after medical school, he remembered a student who had gone onto the School of Public Health in Michigan. He had described the program and it sounded just like what Dr. Nicola was looking for, so he went to Michigan to get his degree in Health Services Administration from the School of Public Health. During his time at the SPH, he served as an ER physician for a private corporation and would find himself travelling into small towns in Michigan on Friday night, and would cover for ER doctors in those locations. During that time, he was also working with a program that connected him with the state legislature. Working in small towns he became aware of the major holes in emergency medical services network in Michigan. One night as he was working in the ER, he watched a hearse drive up with a person in the back – that person still had a faint heartbeat. It was then he realized that with a little effort he could work with the legislature to put together a coordinated and more comprehensive system of emergency medicine in Michigan.

From there, Dr. Nicola went to work with Denver Health and Hospitals in a neighborhood health program. After managing programs at the Tri-county District Health Department in Denver, he moved to Washington and served as Director of the Tacoma Pierce Health department for four years and then Director of Seattle King County for six years. Another move took him to the University of Washington to serve as the director of the Preventive Medicine Program. At this point he was invited to join the CDC as the associate director in the Public Health Practice Program Office. He eventually became division director in the Public Health Systems Division. In all, Dr. Nicola spent nine years in Atlanta. From that position, he moved to the National Turning Point program and was a CDC assignee at the University of Washington, where he is today working with the NW Center for Public Health Practice supporting a variety of activities in the Northwestern United states.

Dr. Nicola has been involved in APHA for his entire career. "Once I went to one of the annual meetings and got excited about what was happening, I became a regular attendee. I Think I’ve made it to every meeting since 1975.” Dr. Nicola started out in the Medical Care Section. But realized that Health Administration was a better fit as he was required to run local health departments. Dr. Nicola has served the Section and APHA by serving on a variety of ad hoc committees. When asked what was most rewarding part of being chair he responded, “Working with really dedicated people from across the country – helping us all to support others who haven’t been as involved and getting excited about health administration.” As we move into this next year, Dr. Nicola will be immediate past chair and will be responsible for Section nominations. “I think we have a great leadership group in the Section. I’m very excited about Gretchen Sampson taking over as chair, and for Mark Bittle as chair-elect. All of our committee chairs are very dedicated - a number who have been involved with the Section for years, and a lot of new people who are getting involved. As a Section we are promoting active involvement that will help your profession as a health administrator and improve health of the public. We have some good interaction with students and how to expand into the future.”

When reflecting on the greatest challenge we face in health administration, Dr. Nicola emphatically says “our economy.” “We as health administrators are dealing with the challenges of the country – the economic problems. We exist in a climate where funding for all our activities is being threatened. We are seeing an increased threat to health that is related to the economic downturn. We need to be very creative and keep our eye on what is important. We are living in challenging times, but we have a lot of tools that have been developed over the years to help us think about and respond to the issues. We need to rely on the support of each other and be creative together. It’s only when we see these types of challenges that we rise to our best performance – tests us to our fullest. We seem to be on the edge of great opportunity – hoping health reform will result in improved ties between population health and health care delivery systems. If public health has been in disarray, health care has as well. I’m hoping that our ability to influence population health will be improved with the reform.”

Gretchen Sampson, Chair elect (2008-2009) Chair (2009-2010)
Gretchen SampsonGretchen Sampson is a public health nurse who transitioned into public health administration over the years.  Her education includes a BSN with an MPH from the University of Minnesota.  Her focus area for graduate study was health services administration.  She has been active in governmental public health for 32 years, and has gone through the ranks from a staff public health nurse to a supervisor, then assistant director and for the last 11 years as a health officer.

Gretchen has been very involved in her local affiliate for over 20 years.  She served as the president of the Wisconsin Public Health Association in 2005. She has been active in WPHA committee work serving on the public relations, nominating and awards committees. She has also helped WPHA write grants for special projects.

She has been a member of APHA for at least 11 years and served as the program chair in 2008 during the Health Administration 100 Year Anniversary celebration year.  She still serves as a co-chair on that committee.

Gretchen is very involved in Wisconsin’s new Public Health Institute and serves as the president of the Board of Directors.  Her other organization work includes Chair of the Western Wisconsin Public Health Education Consortium. She is a past advisory committee member for the Healthy Wisconsin Leadership Institute and a Year 12 scholar from the National Public Health Leadership Institute.

Gretchen will take over as chair of the Health Administration Section at this year’s APHA Annual Meeting on Wednesday, Nov. 11.  Her goal is to get to know more members of the Section at a deeper level as well as carrying forward some of the initiatives started by the past two chairs.

Her message to the Health Administration members: “Get involved! I think we have so much talent and expertise in our section that can be tapped for Section activities. I believe that we have improved our communication to members drastically in the past few years and have started some exciting initiatives like the special issue of the Journal of Public Health Management and Practice and the member-driven Webinars  -  if you’re interested, there are many ways for our members to be involved.” 

Another goal shared by many of the Health Administration leaders is to be more involved at policy at all levels.  “I think we could do a better job of impacting policy. As health administrators, it is critical that we inform our legislators about what challenges we face in terms of funding, quality improvement and work force issues. We also have much to offer in terms of health care reform ideas. Since we are such a large section, a united voice on many of these topics would be very influential.”

Mark Bittle – Chair Elect (2009-2010)

Mark BittleMark Bittle has been involved in health care for nearly 25 years. His interest in the field of public health peaked when he became involved in emergency medical services in the early '80s as an EMT/rescue diver with a volunteer ambulance and rescue company. From there he went on to attain a B.S. degree in Emergency Health Services and began working in a hospital emergency department. He went on to get an MBA and continued to work on the outpatient side of health care delivery in both the academic setting and community physician group practices. One of his professional goals was to earn a doctorate and the choice of a Doctorate in Public Health (DrPH) was an easy one. 

“I felt that health care in general needed to move from a largely episodic focus to more of a population-focus and expand the focus on prevention. In my current role as Vice President of Ambulatory Services within Johns Hopkins Medicine, a large, vertically integrated delivery system, I am part of a small team of colleagues focused on positioning the organization to care for patients along the continuum. Our efforts are to create more effective linkages, alignment of incentives, and incorporate prevention along every step of the care delivery process. In other words, embed more of the Public Health perspective into the traditional Health Care delivery system.”  Mark also serves as adjunct faculty in the Johns Hopkins University’s Carey Business School and Bloomberg School of Public Health and serves on the DrPH Executive Committee within the Johns Hopkins Bloomberg School of Public Health.

Mark has been an APHA member since 2003 and was originally elected to the Governing Council in 2005 for a three-year term. He has served the Section in a variety of ways including as an abstract reviewer, session moderator, and on the Policy Review Committee every year since 2005. In addition, he served a term as a Section Councilor.

As chair-elect, Mark is looking forward to assisting the Chair to achieve the goals of the Section and to represent the section as needed within APHA. “I have had the opportunity to observe the previous and current chairs of the Section and want to put what I have observed into action to further grow the Section and help guide relevant policy development.”

When reflecting on the Section, Mark explains that Health Administration can be defined in many ways. “Whether it is about leadership, innovation, patient/population care, or strategy and vision, if there is no action, there is no progress. Now more than ever, as trite as that may sound, the Health Administration Section and those in other sections who have influence over change need to contribute our voices to defining the care delivery models of the future and assure the basic principles of public health are not only preserved, but woven into the very fabric of these new models.”

As a leader of the Section he plans to work with the past chair and chair to build upon the successes of the past. He also believes that the next several years will be a prime opportunity for the APHA, with the support of the HA Section, to enhance its standing within the health care community as a professional organization that best meets the needs of its members. He sees the HA Section as a viable professional organization for anyone involved in the community health setting, acute care, home care, or any other segment of the care delivery system.

APHA 2009 Annual Meeting Logo

APHA Annual Meeting & Exposition - Register for the meeting and make your hotel reservation soon (advance registration closes Oct. 2, housing closes Oct. 9). Note: Presenters must be individual members of APHA to present their paper(s) and must register in advance for the meeting. Session organizers and moderators are also required to be members and pay the registration fee.


APHA Career Guidance Center
Don't miss this opportunity! Sign up now for a one-on-one or a group session with a professional career coach at APHA Annual Meeting & Exposition. These coaches can guide you in strategizing the next phase of your career and help you define your goals. Select a 45-minute individual session or a 90-minute group session. The group sessions are designed according to your career needs. To see which session is the best fit for you, please read about each coach's experience and education before setting an appointment. If you have never experienced coaching before, this is a wonderful introduction to what may become a useful service for your career!  This is the link to the the Career Guidance Center:

New Books
APHA Press has three books in production of interest to epidemiologists and other health professionals that will be available at the Annual Meeting.  They are: Chronic Disease Epidemiology and Control, 3rd edition by Patrick Remington, Ross Brownson and Mark Wegner and two books by Steven S. Coughlin, Ethics in Epidemiology and Public Health Practice, 2nd Edition and Case Studies in Public Health Ethics, 2nd edition