Building Capacity to Detect Health Threats and Manage a Strategic Response

Education

I attended the University of Wisconsin for undergraduate school, and was awarded a degree with a double major in psychology and zoology in 2001.

I moved to the south in 2005 to enroll in an M.P.H. program at the University of South Carolina. I completed the degree in 2007.

Job Prior to CDC

After college, I was a Peace Corps volunteer in Senegal for three years. My major responsibilities were community health education (1.5 years) and volunteer site setup / coordination (1.5 years).

First CDC Job

In 2007, I came to CDC as a Public Health Prevention Service Fellow, a competitive 3-year training program sponsored by the Public Health Associate Program at CDC. This experience involved two 6-month rotations at headquarters in Atlanta and several rotations out in the field. My first headquarters placement was with the Food Safety folks in the Enteric Diseases unit. I helped build eastern European lab capacity for detecting strains of salmonella, as well as regional competence in conducting epidemiological studies of the disease and treating it. This work was beneficial to the local populations and to the American public because packaged foods shipped from eastern Europe could be contaminated.       

My second headquarters assignment was Environmental Health. I collected stakeholder input for a large report on the effects of drought on public safety. Partners pointed out, for example, that drought can mean trouble for dialysis units at hospitals.

For a further two years, I worked for the Massachusetts Health Department in the western part of the state. The Commonwealth has more towns and cities than any other state and each one has a local health board or department. Although multiple functions are required of each jurisdiction (e.g. restaurant inspections, infectious disease contact tracing, environmental health code enforcement, and flu vaccination), many are too small to support all these activities and may not need some of them. For example, in the smallest jurisdictions, there are no restaurants to inspect, and engineers are usually elected to these local health boards because they can oversee or perform inspections of septic systems. I made site visits to assess local needs and capacity, and I asked about what actually happens (e.g., who compiles infectious disease reports). Then I met with partners, stakeholders and local politicians to set priorities and make plans for filling the gaps in basic public health functions.

Later Jobs at CDC

In 2010, after the fellowship, I joined CDC under Title 42 authority. It allows qualified candidates to be hired on a non-competitive basis for a period of up to 10 years, renewed every 1–2 years, and that employment counts towards years-in-service for the purpose of Federal benefits. My mentor on the environmental side sent an email about my capacity-building work to a policy officer in a unit that developed training standards and curricula for the national public health workforce. I was brought on board there at a professional level in a brand new office for State, Tribal, Local, and Territorial support. My work involved developing trainings in collaboration with major partners like the National Association of State and Territorial Health Officials (NASTHO) and the National Association of County and City Health Officials (NACCHO). Generally, our objectives were to improve a trainee’s ability to identify a health problem or threat, to plan trial solutions systematically and strategically, and to collect data to assess and improve initial attempts to address the problem.   

I did this for 6 years with several emergency deployments along the way. They included the Haiti earthquake response in early 2010, a polio outbreak in 2013, and Ebola in 2014 and 2015. In this last deployment, I was able to make a substantial contribution because, while I was in the Peace Corps, I learned French and a local language spoken in parts of Guinea, Liberia and Sierra Leone. I also had important cultural knowledge about Guinea, a directly impacted area, having worked in the southern district of Senegal, Guinea’s northern neighbor, for three years. I conducted trainings for their Ministries of Health on topics like data visualization; that improved the outbreak response.

In 2016, I was hired for a permanent, competed position in the Program Performance Evaluation Office, a staff office in the Office of the Director of CDC. I taught people across the agency to improve their strategic planning, to write successful cooperative agreements, and to evaluate programs. The goal was always continuous quality improvement.

Final CDC Job

Beginning in 2022, I led a new office in the chronic disease unit called the Collaboration Hub. There I coordinated requests for consultation from divisional directors. This meant supporting strategic planning, continuous improvement, and better project management throughout the large unit.

Proudest Achievement  

I was probably proudest of my role in the COVID response in 2020. When things started to shut down in 2020, people didn’t have time for quality improvement. A large amount of funding, $160 million, had to be distributed to states and localities very quickly. Our division went from managing 25 grants in a year to managing 600-700 grants. We had to break the process down from start to finish to see what we could streamline, standardize, and automate. At one point, we processed 350 grants in 3 days. The tribes got what they needed in 10 days rather than the usual 180 days. We also put on a national conference on COVID issues with 14,000 attendees, and we did it in 30 days with a team of 12. It was seamless, entirely virtual, and received very positive evaluations—more than 90% of respondents said they took home valuable messages, mostly around vaccine roll-out.   

Impact of My Work

Trainings are often evaluated simply by trainee satisfaction ratings (see sentence above), and they were consistently high for my trainings. However, in the Collaboration Hub in 2024, an outcome evaluation showed that, after my training on meeting facilitation and project management, staff were 25% better at running effective meetings—something we all did every day.

Leaving CDC

Along with the other 5 people in my unit, I got a termination email on April 1, 2025, saying we would be separated on June 2, 2025. I’m still on administrative leave and getting a paycheck, but am prohibited from doing my job.

Future Plans

To start to deal with this new reality, I’ve used the time to earn a couple of certificates in process improvement and management. If I were reinstated, I would go back to CDC, but I serve the mission—I still have agency—and could quit. I did have to replace certain words in some text—to play defense—but to date, none of my ethical lines have been crossed.

Other Comments

Four Center directors were offered reassignment—and that’s 4 of 18. One went to the Indian Health Service, a couple were dismissed, and a couple retired. They are all Senior Executive Service so they are appointed and serve at the pleasure of the President, so they are all at risk. They just cut off big chunks of the agency, losing so much institutional knowledge. The lack of foresight is a big, big issue.

The biggest concern is that these RIFs were done by administrative code, not by mission, which explains why up to 30% of the people have been called back. Some won’t go back.

My office ran large grant programs and now there’s nobody in charge. Training in writing better grant proposals is gone. Many IT people also run national surveillance and they are gone. The Division of Reproductive Health is gone when national maternal mortality is going up. The Division of Oral Health which funded sealants and monitored oral health is gone. To satisfy the tobacco lobby, the Office on Smoking or Health is gone.

All we have left is a weekly newsletter staffed by RIFed employees.