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KidWorld3202
Read the attached articles and answer the questions below. Please…
Read the attached articles and answer the questions below. Please respond in complete sentences and justify your answer when required. Please do not copy your answers from the article – use your own words. Each answer should be at least one paragraph in length. Make sure you answer each question completely.
The article states that the annual salary difference between a senior microbiologist in the private sector and the equivalent position in public health is almost $25,000. What ideas or strategies do you have for recruiting scientists to the California Department of Health Services who might otherwise seek jobs in private biotechnology companies?
The article mentions an “antiquated state hiring system.” Briefly discuss your ideas for an efficient hiring process to identify the best health scientists. What qualities/characteristics are most important? How would you measure them?
Describe the steps you would take to invent an organizational culture that encourages scientists to stay with the California Department of Health Services?
Disease-fighting labs languish on critical care list/State’s failure to replace retiring scientists limits ability to respond to medical crises
Spread over more than 28 acres and ringed by a barbed wire fence, the California Public Health Laboratory in Richmond is the state’s most important weapon in the battle against infectious diseases. The $214 million lab, which opened in 2001, stands guard against a frightening array of emerging microbial threats — from terrorist-borne anthrax to avian influenza. But inside the gleaming walls of white concrete and blue tinted glass, veteran scientists are grappling with a different sort of biological problem: They are getting old. Short of cash, and unable to compete with private biotechnology companies, the California Department of Health Services is often unable to replace the microbiologists who retire. In June, the nonpartisan Little Hoover Commission warned that the labor shortage could have horrific consequences. “The State has not deployed a public health surveillance system that could detect serious threats in time to save thousands of lives,” wrote commission Chairman Michael Alpert, in a letter to Gov. Arnold Schwarzenegger and state lawmakers. “The State has not stopped the serious erosion of its laboratory capacity, which is essential to analyzing medical responses.” To many, the problems raised in the commission report are compounded by the recent resignation of the state’s highly regarded top health officer, Dr. Richard Jackson. San Mateo County Health Officer Dr. Scott Morrow, who also serves as president of the California Conference of Local Health Officers, called Jackson’s departure a public health disaster. “His leaving is a symptom of the problem,” Morrow said. In the view of county health officers, Jackson was just the medicine needed to reverse years of neglect. “The status of public health in California has diminished drastically in the past two decades,” said Alameda County Public Health Officer Dr. Anthony Iton. “We’ve gotten away with it only because we haven’t had a major public health crisis since AIDS.” Jackson had joined the Department of Health Services as state health officer in April 2004 with a goal of improving the state’s emergency response capability and revitalizing the state’s public health workforce. He had been recruited by the Schwarzenegger administration from the federal Centers for Disease Control and Prevention in Atlanta, where he had run the National Center for Environmental Health for nearly a decade. His appointment had been hailed by public health advocates around the state. “He’s the most qualified person we’ve had in the position of state health officer in decades,” said Bob Prentice, a health policy analyst for the Public Health Institute in Oakland. But after just 14 months on the job, Jackson resigned in frustration in June. “I felt I could do more for public health outside the position, than in it,” he said in a recent telephone interview. Jackson said the retirements and recruiting problems plaguing the department could be reversed with the equivalent of “four hours of expenditures” in the state’s Medi-Cal program, which spends about $100 million a day. His efforts at reform were stymied, he said, by an antiquated state hiring system, and by “micromanagement” from the state bureaucracy and the state Legislature. “Politics was never more than about 2 feet away,” he said. Iton said that the Department of Health Services is “preoccupied with Med-Cal,” the $34 billion health insurance system for the poor. He fears that a lack of focus on public health — which stresses the monitoring and prevention of disease — leaves the state vulnerable. His biggest nightmare: the rogue strain of bird flu decimating chicken flocks in Asia. If it mutates into a form easily transmitted among humans, it could kill millions. “Avian influenza is the clearest threat on the horizon,” Iton said. “It’s what keeps public health people up at night. If we don’t have a clear, unifying message from the governor, we’re cooked on this one.” State health Director Sandra Shewry said she was saddened as well to see Jackson leave, but maintains that the state’s emergency preparedness has improved in the past year — largely due to his efforts. “As resources become available, we will be arguing to bring up our public health lab capacity,” she said. “We’re doing a good job with the resources we have, but we are open to suggestions on how we can do even better.” Shewry said that Schwarzenegger did not cut the budget for public health despite a severe statewide deficit. In addition, the department hired staff to assure that $100 million in federal grants to combat bioterrorism would be distributed to county health departments this year. She chafes at the notion that her department is so distracted by Medi-Cal issues that it is ignoring public health. Although Medi- Cal reform is one of three top priorities for her department, she said the other two are emergency preparedness and an initiative to fight obesity — both core public health issues. Although the infusion of federal bioterrorism money will help equip both county and state labs, and will pay for the hiring of some scientists, critics say it is a stopgap that does not address the chronic decline in the public health workforce. Since 1991, the number of state professionals at California’s laboratories in the Prevention Service branch has slid from 309 to 197, a decrease of 36 percent. The shift is apparent at the Richmond lab. “They designed the space here for 20 percent more people,” said Paul Duffey, an avuncular, white-haired section chief at the Microbial Disease Laboratory, one of nine state labs consolidated onto the Richmond site. “But we are operating with about 20 percent less.” At 66, Duffey has 40 years of experience as a microbiologist — 30 of them working directly for the state. More than half his staff is over 55, the age at which state employees can retire. “They are looking at retirement, right and left,” Jackson said. Some of the vacant positions are filled by freelance microbiologists working under individual contracts, or paid for by federal grants – but these fill-in posts, Duffey said, have not solved the manpower shortage. “We have a six-month training program for entry level jobs, but it can take five to seven years to bring someone up to the point where we can let them loose by themselves,” he said. An analysis by the Public Health Institute found that the state lab in Richmond pays entry level salaries 24 percent below the average for similar positions in the private sector. A senior level microbiologist would earn $63, 000 a year, while Kaiser Permanente’s regional lab pays $87,600. The state is also competing with biotech companies that can dangle stock options in front of prospective employees. As a consequence, the state lab is not only having trouble recruiting younger staff: It can’t keep them. In 1986, according to the analysis, the typical employee of a state lab had worked there for 19 years. By next year, it will have fallen to 8.5 years. The new Richmond facility has a training lab that puts recent college graduate recruits through an intensive six-month certification program. Last year, 30 recruits passed through the program. But lab managers have found they need to train 20 of the young scientists just to keep up with employee attrition. Some of the shortcomings addressed in the Little Hoover Commission report were outlined by Jackson himself, at a statewide conference of county public health physicians, just two weeks before he submitted his resignation. “You cannot do public health without infectious disease control,” he told the gathering. “You cannot do infectious disease control without good laboratories. ” As a consequence of reduced staffing, he said, many tests routinely performed by the state lab have been dropped, or are performed less frequently. For example:
A rapid blood test for whooping cough was discontinued in 2002.
Twice weekly testing for Legionnaires’ disease is now conducted only twice a
month.
Tests to detect drug-resistant forms of tuberculosis were dropped due to lack
of staff to run the equipment.
Testing to confirm human cases of brucellosis, a fever caused by a cattle
disease, was discontinued in 2001.
The state lab has no capability to test for antibodies to avian influenza.
Recent retirements sharply curtailed tests for parasitic diseases and fungal infections.
Across California, a network of county health labs that works closely with the Richmond facility is enduring a similar manpower crisis. Lab director posts are vacant in 13 of 38 local and county public health laboratories, according to Humboldt County health Officer Dr. Ann Lindsay. Six more lab directorships will become vacant in 2006. “It’s a nationwide problem,” said Lindsay, who is working with other county health officers to develop a lab director training program. “An awful lot of money is being made in medicine, but it’s not being made in public health.” Many scientists familiar with the workforce problems in state and county laboratories believe the solution lies in separating public health functions from the medical insurance role of the Department of Health Services — to invent a separate Department of Public Health under the directorship of a physician who can report directly to the governor in a crisis. “There are very good people in the state laboratory, but they are isolated from the levers of power,” said Alameda County health Officer Iton. The concept of a separate Department of Public Health has been endorsed by the Little Hoover Commission, the California Medical Association, state associations of county health officers and lab directors, as well as Schwarzenegger’s own blueprint for state government overhaul, the California Performance Review. State health Director Shewry said that the sheer size of Medi-Cal guarantees the health department “a seat at the table” in budget discussions. However, she said that the Schwarzenegger administration remains open to the possibility of a separate Department of Public Health. The issues raised by the performance review are being addressed, she said, “in a thoughtful and sequential way.” Meanwhile, San Mateo County health Officer Morrow watches the medical landscape with increasing dread. “The quality and service, and the quantity of service, that the state lab gives us has declined,” he said. “It’s difficult to get quick tests. Even the most brilliant person cannot succeed without support.” Morrow contends that the Department of Health Services, which devotes $34 billion of its $37 billion budget to Medi-Cal, is structurally unsuited to the mission of public health. “It’s like having Aetna manage the CDC,” he said. “They are in the medical insurance business.” A system in crisis The resignation last month of Dr. Richard Jackson, the heralded savior of the state Department of Public Health who was hired in 2004, has been seen as symptomatic of a state health system in crisis. Hiring and keeping lab workers has grown difficult:.
The annual salary difference between a senior microbiologist in the private sector and the equivalent, lower-paid position in public health. – – – $24,600
A state lab worker’s average years of service in 1986. – – – 19
The average years of service projected for 2006. – – – 8.5
Decline, in percent, in the number of health professionals in state labs since 1991. – – – 36%
Percent of local and county health labs where director positions are vacant. – – – 34%
Vacancy percentage projected for 2006 if none is filled. – – – 50%
