Introduction: Workforce Development Plan (WFDP) Training and development of the workforce is one part of a comprehensive strategy toward agency quality improvement. Fundamental to this work is identifying gaps in knowledge, skills, and abilities through the assessment of both organizational and individual needs, and addressing those gaps through targeted training and development opportunities. Workforce Development in public health encompasses those efforts to improve health outcomes by strengthening the public health workforce through training and skills building. The following organizational competencies are grounded in the Council on Linkages between Academia and Public Health Practice: June 26, 2014 (Council on Linkages or COL) competency set and were revised by DPHSS Quality Improvement Council to meet the needs of the agency. This plan serves as the foundation of the Department of Public Health and Social Services (DPHSS) ongoing commitment to the training and development of its entire workforce. Agency Profile: Department of Public Health and Social Services (DPHSS) Guam Department of Public Health and Social Services | Workforce Development Plan: 2019-2021 1 | P a g e Mission, Vision, and Strategic Priorities Mission The mission of the Department of Public Health and Social Services is “To assist the people of Guam in achieving and maintaining their highest levels of independence and self-sufficiency in health and social welfare”. Vision Empowered people of healthy minds and bodies living in a safe environment throughout their lifetime. Strategic Priorities DPHSS developed an Organizational Strategic Plan (OSP), 2015-2017 which includes six (6) priorities. The goal of the DPHSS OSP is to enhance the agency’s capacity to contribute to improving the health of our island community and markedly reducing its physical and socio-economic burden from disease and ill health through action along six priorities: Tier 1: Tier 1 Priorities 1. Workforce development to best meet Guam’s health needs; Workforce development 2. Information Technology (IT) systems that are modernized IT modernization and support and supported to ensure efficient communications; Organizational structure and processes 3. Organizational structure and process that maximize the agency’s capacity for meeting its mission; Tier 2: Tier 2 Priorities 4. Enhancements in the regulatory framework to create a Regulatory framework health promoting policy environment; Client-centered initiatives 5. Client-focused initiatives that deliver people-centered public health and social services; and, Sustainability 6. Sustainability in designing the health system to meet the population’s health needs. Action across these six priorities is expected to lead to a strong, equitable, accountable, efficient, sustainable, and resilient health system that delivers quality health services to the entire Guam community, leading to optimal health outcomes and high-quality health care. The first three priorities are considered the most urgent, and action is needed from the outset. Thus, these priorities are the starting point for the process of change within DPHSS, and are considered Tier 1 priorities. The last 3 priorities require the strengthening of the Tier 1 priorities first; therefore, action for these priorities will have to occur after the Tier 1 priorities have been addressed. Guam Department of Public Health and Social Services | Workforce Development Plan: 2019-2021 2 | P a g e Governance and Organization The Guam DPHSS was created by 5 Guam Code Annotated (GCA), Government Operations, Chapter 3, Departments of the Government, Article 1, §3111. The Director of DPHSS is appointed by the Governor with the advice and consent of the Guam Legislature. DPHSS is organized into five service divisions including General Administration, Public Health, Environmental Heath, Senior Citizens, and Public Welfare. These divisions are further organized into bureaus, programs, and sections as applicable. An organizational chart can be found in Appendix A. This plan was developed with a focus on the Divisions of Public Health (DPH) and Environmental Health (DEH). The WFDP was further updated to incorporate the following three divisions: Divisions of General Administration (DGA), Division of Senior Citizens (DSC), and Division of Public Welfare (DPW). DPHSS administers programs and services by promoting primary care, environmental health, welfare and social services, and senior services. DPHSS has oversight over the Guam Community Health Centers (Northern and Southern Regional Community Health Centers), that are multi-specialty primary care clinics. Other chief programs include administering to the island’s residents and households by providing healthcare, welfare benefits, and program assistance, such as Medically Indigent Program (MIP) and Medicaid; licensing of child care facilities and foster care homes; child protective services; administration of health and sanitary certificates; immunization shots; dental services; issuance of birth and death certificates; marriage licenses; reporting of communicable diseases; services for Woman, Infant, & Children (WIC); and administration of the Title X of the Older Americans Act, to include adult protective services, Medicare and community support services. Location & Population Served Located in the Western Pacific Ocean, Guam is the largest and southern-most island in the Mariana Islands archipelago. According to the 2010 U.S. Census, Guam had a population of 159,358 with an estimated projection of 168,322 by 2020. Guam houses several U.S. military bases, which make up nearly thirty percent of the island’s total land area. According to the data from the Guam State Data Center, Bureau of Statistics and Plans, the population for 2016 for Military Active Duty and Family Members was 5,572 active duty members and 7,235 family members. In addition, the relocation of U.S. Marines from Okinawa, Japan to Guam will increase the military’s presence on-island. The anticipated “military buildup” is expected to increase the number of active duty members by 5,000 Marines by 2020 to 2025. Per military officials, Guam will see an increase in more jobs as construction projects begin for the military buildup. Guam also serves as a critical transportation hub for neighboring islands and parts of Asia, which has led to population growth over the last decade. Families from neighboring islands have relocated to Guam seeking greater socio-economic opportunities and health services. Guam’s military presence and location in the Pacific Ocean have contributed significantly to the island’s changing demographics, as well as its public health issues. In 1986, the Compact of Free Association (CoFA) was enacted. The CoFA is an agreement between the U.S. and the Federated States of Micronesia (FSM), the Republic of Marshall Islands (RMI) and the Republic of Palau. The compact agreement allows for citizens of these freely associated states to enter and reside indefinitely in the U.S. It also allows compact migrants to enter the U.S. (including all U.S. States, Territories, and possessions) to work and establish residence indefinitely. According to the Compact Impact Report, the Government of Guam expended $142.3 million in FY 2016 for providing educational and social services to migrants from the Freely Associated States to Guam. The cost for providing healthcare and welfare services made up $17.1 million. In 2023, the CoFA is up for renegotiation. Guam Department of Public Health and Social Services | Workforce Development Plan: 2019-2021 3 | P a g e Table 1: Population by Election District, Guam 2010 Table 2: Population by Ethnic Origin or Race, Guam 2010 Guam Department of Public Health and Social Services | Workforce Development Plan: 2019-2021 4 | P a g e Learning Culture Learning at DPHSS is a continual process with the intent to positively impact the overall operations, performance and morale among the Department’s workforce. The foundation of DPHSS’s learning culture is three-fold: 1) To provide and/or support necessary trainings and educational opportunities to ensure a competent and effective workforce; 2) Translate knowledge to action through the sharing of new ideas and approaches within the Department to promote organizational transformation; 3) Continually assess training and development needs and availability to ensure the Department’s workforce remains dynamic and capable of accommodating the changing public health environment. Through the development of this plan, DPHSS will focus on meeting additional training and educational needs of the Department in an effort to improve in our programs and services that we provide to our island community. Funding and Locations To achieve its mission, As of December 2018, DPHSS has 438 Full-Time Employees (FTE) positions based out of 8 locations: Northern Regional Community Health Center (NRCHC) in Dededo, Central Public Health in Mangilao, Southern Regional Community Health Center (SRCHC) in Inarajan, Woman, Infant, and Children (WIC) Office in Tiyan & Santa Rita, Terlaje Building in Hagatna, Castle Mall in Mangilao, and Environmental Public Health Laboratory in Dededo. The fiscal year 2017 operating budget was $62,659,461 (general funds) and $6,194,646 (special funds). Employee Manual The DPHSS Employee Manual (June, 2015) informs departmental staff of the policies, rules and procedures applicable to the DPHSS. This plan complements the Training and Development Guidelines and Policy of the Government of Guam, Department of Administration