Amid a Pandemic and Beyond: Bolstering the Critical Capacity of Public Sector Leaders

Reforming States Group State Health Policy Leadership

Today’s public sector leaders are navigating an unprecedented public health emergency, a deepening economic recession, and, at the same time, a historic opportunity to address racial disparities in the United States. As the backbone of state government, public sector leaders—including Medicaid, public health, social services, legislative staff, among others—are charged with maintaining the economic stability, health, and well-being of state residents and must be ready to face the inevitability of unforeseen challenges. They are responsible for administering billions of state and federal dollars, setting and managing strategic direction, and navigating the complex web of state government and community relationships. Yet, despite the significant role that they play and challenges they face, scant attention is typically given to the professional leadership development of the nation’s public sector workforce.

Recognizing the need to better support public sector leaders in their challenging roles, the Center for Health Care Strategies, the Milbank Memorial Fund, and the National Association of Medicaid Directors launched the Public Sector Leadership Consortium in late 2019. Through this effort, we are seeking to align our collective work focused on strengthening the capacity of public sector leaders, particularly those in state government. Drawing from our combined experience working with state leaders across the country, we created the Framework for Public Sector Leadership to provide a foundational tool to bolster state leadership capacity.

Charting a Course for Public Sector Leaders

The competency framework aims to strengthen the leadership capacity of public leaders and their teams to work effectively. Drawn from both academic research and insights from leaders across the field, the framework can serve as a guide for both established public sector leaders and their teams, as well as for rising leaders. The framework is built on a core belief that leadership does not necessarily refer to an individual’s formal position, as one can rise to the occasion as a leader regardless of stature within an organization. The framework includes five domains that are critical to the success of public sector leaders:

  • Personal leadership and self-management: Investing in one’s individual leadership capabilities and acknowledging areas for growth is essential for supporting individual leadership development. Additionally, leaders need to build resiliency and commit to receiving feedback and enhancing their technical learning.
  • Setting and managing strategic direction: There are often many competing priorities that require staff time and resources. To work toward success, leaders must set and articulate a vision with engagement of key stakeholders, develop a strategic plan to support the vision, and allocate resources accordingly.
  • Engaging and motivating people: Whether leading a small team or a large enterprise like a Medicaid agency, leaders are able to accomplish priorities by working with and through others. Leadership competencies in this area include: collaborating effectively; delegation; and developing others.
  • Practicing good public administration: Public sector leadership requires unique skills in order to effectively navigate political and bureaucratic landscapes. Particular leadership competencies include: business acumen; managing change, resources, and decision-making; and engaging diverse stakeholders.
  • Driving and delivering results: Ultimately, public sector leaders are expected to demonstrate that they can drive change and improve health outcomes by leading innovation, measuring performance, balancing organizational perspectives, and appropriately managing the work.

Taking Time to Focus on Building Capacity

When crisis hits, it can be challenging to find time to focus on professional leadership and capacity building. But this is perhaps the most important time to strengthen leadership skills. Now, more than ever, solid leadership skills are invaluable to public sector leaders as they navigate the impacts of COVID-19 and seek opportunities to address disparities and promote equity within public policies and programs. When reflecting on public sector leadership, Michelle Alletto, Texas Health and Human Services Chief Program and Services Officer, said, “An aspect of the leadership framework that really resonated with me is resiliency. This has been particularly important during the COVID-19 pandemic, not just for myself but for my team and for the community we serve.” We hope the framework will foster new and creative strategies for supporting those who commit themselves to the essential work of public service.

Conversations on Building Leadership: Look for a new series of blog posts and podcast episodes from the Consortium that will explore the application of the leadership framework through the perspectives of state leaders offering a wide range of experiences in public sector leadership. The first podcast—What Makes a Successful Public Sector Leader?—features Michelle Alletto, Texas Health and Human Services Chief Program and Services Officer and Beth Kidder, Deputy Secretary for Medicaid at Florida’s Agency for Health Care Administration discussing how they’ve used the domains, competencies, and associated skills and behavior during their leadership tenures.