Public Health Transformational Leader Reena Chudgar Shares Advice on How to Develop and Successfully Implement Innovative Ideas

By George T. Roberts, Jr., MHA, FACHE, NACCHO President and Chief Executive Officer of the Northeast Texas Public Health District

Reena Chudgar, MPH, is Director of Innovation at the Public Health National Center for Innovations (PHNCI). Reena joined PHNCI in April 2019 with more than 13 years of experience in public health. Prior to joining PHNCI, Reena served as Director for Performance Improvement at the National Association of County and City Health Officials (NACCHO). During her time at NACCHO, she provided support to local health departments (LHDs) and their public health system partners in community health assessments and community health improvement plans, quality improvement/performance management, strategic planning, and helped LHDs prepare for national accreditation.

Additionally, Reena provided strategic direction and management for the Performance Improvement Portfolio. Prior to joining NACCHO, Reena worked with the Millennium Water Alliance at CARE USA, interned with the DeKalb County Board of Health in Georgia, and conducted research in Ghana, all of which focused on water, sanitation, and hygiene initiatives. Earlier, Reena served as a Health and Community Development Peace Corps volunteer in the Republic of Kiribati, where she designed and implemented several grassroots health and education programs, assessed and prioritized community needs, and strengthened local economic and social capacity. Reena received a Master of Public Health degree and a bachelor’s degree in chemistry from Emory University.

Below, she discusses her leadership role at PHNCI and shares advice on how an organization can develop innovative ideas and successfully implement them.

Can you tell us about PHNCI and your role as Director of Innovations?

At PHNCI, we are exploring and spreading innovations within governmental public health and with the partners and communities they work, to tackle some of the complex, systems issues that communities face today, to ultimately support efforts towards achieving optimal health and equity. Being situated at the national level, and as a division of the Public Health Accreditation Board (PHAB) provides a nice vantage point for this—learning about examples and strategies at a variety of levels to inform the national movement and inform the accreditation program. A few ways we are doing this is through design thinking trainings, the Cross-Sector Innovation Initiative—supporting 10 communities in their innovations towards systems alignment—revisiting and refreshing the 10 Essential Public Health Services, supporting systems level changes, and our innovations stories. PHNCI also created a definition of public health innovation, with field input, to guide the field.

In my role, I am to broaden and strengthen PHNCI’s mission by supporting both the day-to-day implementation and the strategy around public health innovation. This occurs through expanding partnerships within and outside of public health organizations, implementing national level initiatives to move the field forward building the practice and evidence base through peer exchange, creating spaces for learning and growing, and more. I’m intrigued and excited by deepening my understanding around what makes interpersonal and community-level partnerships and engagement work, and not work, what it means to build trust, and to try to infuse those elements into my own work culture—both internally and externally. Building relationships is one of the most important aspects of my work, in addition to placing value on different perspectives, and different ways of being, doing and thinking.

How has your previous leadership position as Director for Performance Improvement at NACCHO informed your current work and role as Director at PHNCI?

As Director of the Performance Improvement team, I had the opportunity to strengthen a variety of different skill sets—from both the technical/content perspective and the project management, leadership, and strategy perspective. In this role, I noticed commonalities between building a culture of quality and those agencies that were building a culture of innovation. I had exposure to not just a wide variety of agencies and agency cultures, but of people—different front-line staff, leaders, and more—all with different perspectives, values and styles that help shape how the work occurs. In addition to the external facing work, I was responsible for internal management and leadership, developing and managing budgets, supervising and growing staff, and contributing to organizational leadership and strategy decisions. The wide range of activities and opportunity to grow both my technical and strategic skill set lent itself well to my new role with PHNCI.

What advice would you give to an organization that is interested in developing innovative ideas and successfully implementing them?

As agencies are deliberately thinking about innovation, it’s important to focus on both the organizational culture and people, and the outcomes or products of innovation processes. One does not occur well, and intentionally, without the other. It is not just about creating something new, but creating a culture, and fostering leadership that can support new ideas. Similar to building a culture of quality, innovation isn’t just an additional task added on to the day-to-day work. It requires a shift in the way we approach our work. It’s also important to recognize that innovation does not have to be radical, or disruptive innovation. Small scale innovation and incremental innovation are just as valuable. To build a culture of innovation, agencies should focus on empathy, which is at the heart of innovation. Agencies should take time to listen, understand, be human-centered in solutioning, ask the right questions, and spend time questioning.

For many in public health, this is at the heart of our mission, making connections with people and communities to understand and ultimately co-create meaningful and impactful solutions. Creating a culture where failing forward and risk-taking are the norm is another key ingredient. Failure is inevitable, and by making space for it, learning and improving, staff are more likely to continue taking risks moving forward. Trying out new ideas and prototyping early and often is a key aspect of innovation processes, including using agile approaches versus more traditional, waterfall approaches.

Creativity requires opportunity for staff and leaders to be imaginative in their everyday work—a way to think about what can be versus what has always been, and to shift perspective to open new ways of thinking.  Utilizing processes such as design thinking, is a structured way to innovate. These are a few essential ingredients to growing a culture that supports innovation. As communities expanded their innovation cultures, it’s important to share what works and where there are challenges. It’s important to tell the stories of innovation to grow the field, and make connections between individuals, agencies, communities, and systems to tackle some of the complex systems issues our communities are facing today.

Read more about PHNCI at or contact Reena at

To share your story of transformational leadership or to recommend a leader to be highlighted, please contact Taylarr Lopez, NACCHO Communications Specialist, at    

NACCHO Announces Over $1 Million in Medical Reserve Corps Operational Readiness Awards

NACCHO recently announced the 2019 Medical Reserve Corps (MRC) Operational Readiness Awards (ORA). The Medical Reserve Corps (MRC) is a national network of volunteers, organized locally to improve the health and safety of their communities. The MRC network comprises approximately 180,000 volunteers in roughly 860 community-based units located throughout the United States and its territories.  These awards, made possible through a cooperative agreement with the Office of the Assistant Secretary for Preparedness and Response, Medical Reserve Corps Program Office, will help support over 200 MRC units to increase their volunteer capacity (Tier 1) or strengthen the unit’s response capabilities as a whole (Tier 2).

  •  Tier 1 Awards: $2,500 – Strengthen MRC Volunteer Capabilities: MRC units that want to focus their efforts on strengthening the volunteer capabilities of their MRC unit. Project goals may include but are not limited to building MRC unit size through targeted recruitment campaigns, increasing the number of volunteers trained in the MRC core competencies, and identifying and procuring resources to meet the MRC unit’s mission.
  • Tier 2 Awards: $7,500 – Strengthen MRC Unit Response Capabilities: MRC units that are positioned to further develop their volunteer capabilities, as well as strengthen or build their unit response capabilities. Project goals may include strengthening targeted volunteer capabilities, building or sustaining specific unit response capabilities, and identifying and procuring resources to meet and/or expand the emergency and preparedness response capabilities of the MRC unit.

2020 MRC Operational Readiness Awards (ORA) by State

Tier I Award ($2500)

  • Arkansas – North Little Rock High School Medpro MRC, Marion County MRC, River City Ministry of Pulaski County MRC
  • Arizona – Mohave County MRC
  • California – Ventura County MRC, Healthcare Em Aux Response MRC, Berkeley County MRC
  • Colorado – MRC of El Paso
  • Connecticut – Middletown MRC
  • Florida – Florida Keys MRC
  • Georgia – DeKalb County MRC, Southwest Georgia MRC
  • Idaho – Southwest Idaho MRC
  • Illinois – Douglas County MRC, McLean County MRC, Macoupin MRC, Woodford County MRC, Skokie MRC, Marshall County MRC, Crawford County MRC, Hancock County MRC, Schuyler County MRC, Clay County MRC, Cumberland MRC
  • Indiana – Hendricks County MRC
  • Kentucky – Pike County MRC
  • Louisiana – New Orleans MRC
  • Maine – Downeast Maine MRC
  • Maryland – Maryland Response Howard County MRC
  • Massachusetts – Franklin County MRC, Newton MRC, Metro East MRC, Town of Monson MRC, Hampshire county MRC
  • Missouri – Bollinger County MRC, Howard County MRC
  • Nebraska – RROMRS MRC
  • New Hampshire – Greater Nashua MRC
  • New Jersey – Atlantic County Public Health MRC, Camden County MRC
  • New York – Livingston County MRC, Schenectady County MRC, Saratoga MRC
  • North Carolina – North Carolina Baptist Men MRC Central Region
  • Ohio – Montgomery County MRC, Paulding County MRC, Pike County MRC, Huron County MRC, Mahoning/Columbiana MRC, Brown County MRC, Trumbull MRC, Van Wert County MRC, Mercer County MRC, Fayette County MRC, Pickaway County MRC
  • Oklahoma – Grady County MRC, Carter County MRC, Oklahoma Stress Response Team, Leflore MRC, Oklahoma Region 3 – Kiowa & Caddo MRC, McClain County MRC, Garvin County MRC, Garfield Area MRC
  • Oregon – Linn County MRC, Eastern Oregon Regional MRC
  • South Carolina – Upstate Public Health Reserve Corps
  • Tennessee – East Tennessee Regional MRC, Upper Cumberland Tennessee Regional MRC
  • Texas – Brown County MRC
  • Utah – Bear River Cache County MRC, Central Utah MRC, Bear River Rich County MRC
  • Vermont – Southwestern Vermont, Southeastern Vermont, Rutland Addison MRC
  • Virginia – Near Southwest MRC, Richmond City MRC, Greater, Prince William County MRC, Norfolk MRC
  • Washington – Thurston County MRC, MRC of Eastern Washington
  • West Virginia – Pendleton County MRC, Mid Ohio Valley MRC

Tier 2 ORA – $7500

  • Alabama – North Alabama MRC
  • Arkansas – White County MRC
  • Arizona – Maricopa County MRC
  • California – Sacramento MRC, Marin MRC, Lake County MRC, California Veterinary MRC, Contra Costa County MRC, Alameda County (ALCO) MRC
  • Colorado – Pueblo MRC, Colorado Veterinary MRC West, Colorado Radiation Response MRC
  • Connecticut – Capitol Region CT MRC, Stratford-Trumbull-Monroe MRC, Torrington Area Health District MRC, Pomperaug Health District MRC, Naugatuck Valley MRC
  • Florida – Southwest Florida MRC, Miami-Dade County MRC
  • Georgia – MRC of West Georgia, East Metro Health District GEM MRC
  • Illinois – Kane County MRC, Adams County MRC, Bureau-Putnam MRC, Rock Island County MRC, Cook County MRC, McDonough County MRC, Effingham County MRC
  • Kansas – Kansas State Animal Response Team MRC
  • Kentucky – River Run Regional MRC
  • Louisiana – Louisiana State Animal Response Team (LSART) Veterinary MRC
  • Massachusetts – Berkshire MRC, Upper Merrimack Valley MRC, Brookline MRC, Topsfield MRC, Norfolk County – 8 Coalition MRC, Middleborough Area MRC
  • Maryland – Maryland Responds State MRC, Middleborough Area MRC
  • Michigan – Washtenaw County MRC, Livingston MRC
  • Minnesota – University of Minnesota MRC, Minnesota Veterinary MRC, Hennepin County MRC, Minnesota Behavioral Health MRC
  • Missouri – NEMO MRC, Cape Girardeau County MRC, Macon County Community MRC
  • Nebraska – Eastern Nebraska/Western Iowa MRC, Central Nebraska MRC, West Central Nebraska MRC
  • New Hampshire – Northern New Hampshire MRC, Upper Valley MRC
  • New Jersey – Somerset County, Middlesex County, Newark DOH, Mercer County
  • New Mexico – New Mexico Integrative Wellness MRC
  • New York – Dutchess County MRC, Erie County SMART, Niagara County MRC, Monroe County MRC, Rensselaer County MRC, Orange County MRC, Orleans VALOR MRC
  • North Carolina – Capital MRC
  • Ohio – Greene County MRC, Preble County MRC, Williams County Ohio MRC, Medina County MRC, Wood County MRC, Clark County MRC, Franklin County & Columbus MRC
  • Oklahoma – Tulsa OK Region 7 MRC, Kiowa County MRC, Oklahoma Nurses MRC, Norman Citizens Corps Cleveland MRC, Oklahoma County MRC, Southwest, Oklahoma MRC, HOOPS MRC
  • Oregon – Coos County MRC, Wasco County MRC
  • Pennsylvania – Philadelphia MRC
  • Rhode Island – Rhode Island MRC
  • South Carolina – South Carolina Veterinary Response MRC
  • Tennessee – Northeast Regional MRC, Shelby County MRC
  • Texas – Harris County MRC, Dallas County MRC, Tarrant County MRC, Galveston MRC, Brazoria County MRC, Fort Bend County MRC, Cameron County, Montgomery County MRC
  • Utah – Utah County MRC, Weber County MRC, Bear River Box Elder County MRC, Southwest Utah MRC, Wasatch County MRC, Salt Lake City MRC, Morgan County MRC
  • Virginia – Southwest Virginia MRC, Rappahannock-Rapidan MRC, Rappahannock Area MRC, Fairfax County MRC, Chesapeake MRC, Eastern Shore MRC, Peninsula MRC, Central Shenandoah MRC
  • Washington – Snohomish County MRC, Pierce County MRC, Island County MRC, PHRC Seattle King County MRC, Bainbridge Island MRC
  • West Virginia – Mountaineer MRC, Hampshire County MRC, Cabel Wayne MRC
  • Wisconsin – Eau Claire County MRC

NACCHO Announces 2020 Food Service Guidelines Action Institute

NACCHO and the Society for Public Health Education (SOPHE) in collaboration with the Centers for Disease Control and Prevention’s (CDC) Division of Nutrition, Physical Activity and Obesity, announces six communities recently selected to attend the 2nd annual convening of the Food Service Guidelines (FSG) Action Institute in Atlanta, Georgia, February 26-27, 2020.

The FSG Action Institute will prepare multi-disciplinary teams to adopt FSG policies and healthy food procurement practices in a variety of community-based institutions, such as, hospitals, universities, and state or local government agencies. The Action Institute will provide hands on technical assistance to empower local and state health officials to work with decision-makers from community institutions that run large food service operations. The end goal is to increase healthy food options for employees, visitors, and clients, while maintaining or increasing financial success.

The selected communities had to demonstrate the required team make-up (i.e. public health officials, food directors, and leadership from the community-based institution) as well as the ability to influence healthy food procurement practices and food service operations. Selected teams are also current awardees of CDC’s Division of Nutrition, Physical Activity, and Obesity, and work to implement evidence-based strategies that improve nutrition and physical activity, while addressing long-standing health disparities.

The following six regional teams will be attending and receiving travel assistance for the 2020 FSG Action Institute:

  • Indianapolis, Indiana (Marion County Health Department)
  • St. Paul, Minnesota (Minnesota Department of Health)
  • Columbus, Ohio (Ohio Department of Health)
  • Salt Lake City, Utah (Utah Department of Health)
  • San Joaquin Valley, CA (California Department of Public Health)
  • Sacramento, Madera, & Merced, CA (California Department of Public Health, and
    Madera and Merced County Departments of Public Health)

Each team will participate in related pre- and post-course activities, including the development of an action plan that will serve to augment and accelerate their Food Service Guidelines efforts.

Summer Environmental Health Hazards Are Coming: Are You Ready?

This story originally ran on NACCHO’s Essential Elements.

Whether or not Punxsutawney Phil sees his shadow when he emerges on Groundhog Day, spring is on its way and summer won’t be far behind. Along with beach trips and backyard barbecues, summer also brings environmental health risks from mosquitoes and ticks, recreational water activities, extreme heat, storms, and more.

Here are a few ways local environmental health professionals can start planning now to be fully prepared when the temperatures start rising:

Vector Control

Mosquitoes and ticks are more than just a nuisance for outdoor enthusiasts; they can spread deadly diseases and pose a serious public health threat. Tickborne diseases hit a record high in the United States in 2017 with nearly 60,000 reported cases, including 42,743 cases of Lyme disease. Cases decreased in 2018 but are still significantly higher than they were in the early 2000s.

Vector control is a growing challenge across the country because of climate change, which is transforming more and more regions into hospitable breeding grounds for ticks and mosquitoes. Rising temperatures also mean these tiny creatures are active throughout more of the year.

Even if vector control is not a focus in your community during the winter, there is plenty you can do now to be ready for warmer weather.

“This is the time of year that you look back at last year’s results and look for gaps in supplies, maintenance, or planning,” says Phil Maytubby, Director of Public Health Protection at the Oklahoma City-County Health Department. “Check your traps and sprayers, plan your budgets, collaborate with your local partners, and look for current research on your area.”

Peter Tripi, Senior Public Health Sanitarian at the Erie County, NY Department of Health, highlights the importance of education. “Start working on educational press releases that you can put out immediately when the season starts or if an event happens,” says Tripi. He also advises reviewing your website and other educational tools (e.g., Erie County’s “Fight One Yard at a Time” series on mosquitoesticks, and rats) to ensure all materials are organized and updated.

Additionally, both Maytubby and Tripi recommend making sure staff are fully trained and ready to go. As Maytubby says, “there is always room for improvement!”

Pool Safety

From 2000–2014, 493 outbreaks associated with treated recreational water caused at least 27,219 cases and eight deaths in the United States. Many people look for relief from the summer heat at their local pool, so keeping pools clean and safe is key to a healthy summer.

While indoor pools, spas, and hot tubs may be open year-round, many jurisdictions have seasonal outdoor pools and water parks that make summer a particularly busy time.

Take advantage of any winter lull by making the following preparations recommended by Marty Thompson, Environmental Health Supervisor in the Division of Environmental Health at the Fairfax County Health Department:

  • Review and assess issues and trends from the previous year.
  • Review and update forms and resource documents, including application forms, inspection forms, and associated marking instructions.
  • Prepare topics and dates for pre-season industry and pool operator meetings.
  • Review staff caseloads and assignments.
  • Review, update, and coordinate staff training.
  • Complete staff equipment and test kit inventory.
  • Meet with your public information officer to discuss and prepare a public messaging plan.

Want a deeper dive into pool safety? See NACCHO’s recent report on pool code updates and use of the Model Aquatic Health Code (MAHC) in local jurisdictions here, and sign up for the next MAHC Network webinar here.

Extreme Heat

2019 was the second-hottest year on record, and the summer months are likely to continue heating up across the country. Extreme heat can affect health in many different ways, including triggering heat stroke and respiratory problems.

While the winter chill makes it hard to imagine the hot summer sun beating down, now is an ideal time to review your extreme heat plans, says Erin Polich, Senior Program Manager in the Office of Public Health Preparedness at the Boston Public Health Commission (BPHC). When reviewing your plans, Polich recommends identifying and updating health heat thresholds, risk groups (based on location, demographics, etc.), communication materials, and your outreach/engagement strategy.

If you conducted any after action reviews following extreme heat events in the last couple years, review any key takeaways or recommendations. Now is also the time to set a cross-agency initial coordination meeting for early spring.

In 2019, BPHC used a NACCHO climate and health adaptation grant to translate extreme temperature fact sheets in an effort to reach all residents. Learn more about how BPHC prepares for extreme temperature here, and see the extreme heat fact sheets here.


Over the last 40 years, the United States has sustained $1.75 trillion of damage from nearly 260 major weather and climate disasters. In 2019 alone, communities across the country endured 14 disasters costing at least $1 billion each, including major inland floods, severe storms, and tropical cyclones.

Summer storms can significantly affect environmental health, with water quality issues arising from flooding, food safety concerns from power outages, and more. Making sure the entire health department is prepared for severe storms is crucial before the warm weather hits.

Karen Street, Assistant Community Health Nursing Director and Public Health Preparedness Coordinator at the Florida Department of Health in Brevard County, advises coordination of staff trainings and updating emergency duty staffing rosters. Public information officers should meet with partners to strategize emergency messaging, and other partner meetings should be scheduled with hospitals, durable medical equipment suppliers, etc.

Street also recommends encouraging staff to update their own emergency plans for themselves, family, and pets.

Are you prepared?

How is your local health department getting ready for summer? Let us know in the comments, and visit our website to learn more about NACCHO’s environmental health resources.

Pandora’s Lab: Seven Stories of Science Gone Wrong

By Emily Yox, MPH, Program Analyst, Global Health

Each month, NACCHO will bring you a new public health book, read and reviewed by NACCHO staff. We hope to provide a well-rounded reading list that you will find enjoyable as well as informative.

Paul Offit is one of my favorite health authors because he covers highly complex scientific topics in a way that is easily digestible. In Pandora’s Lab, he discusses seven different ideas that originally started with strong scientific claims, but were ultimately horrible ideas with lasting negative impacts. Offit covers opioids, trans fats, extracting nitrogen from air, eugenics, lobotomies, DEET, BPA and our all or nothing attitude toward chemicals, and nutritional supplements. While the individual stories are all fascinating in their own right, the main takeaway that is especially important for those of us in public health is to approach scientific claims by demanding data and evidence, not allowing a notable name to forego questioning, and recognizing the importance of the dose-response relationship. This is a great book that provides interesting facts and provides people like myself, with a more limited scientific background, with digestible scientific lessons that I can bring to my work.

Given my love of Paul Offit’s writing style, I’m sure this is not the last recommendation I will give for an Offit book, but especially given our placement in the era of “fake news,” I think this is an important read for all of us who rely on science and discovery.

Want to discuss this book and others? Head over to NACCHO’s Virtual Communities page and connect with peers.


Leader and Health Director, Melissa Lyon Discusses Important Partner Characteristics and Shares Her Hopes for Public Health Leadership

By George T. Roberts, Jr., MHA, FACHE, NACCHO President and Chief Executive Officer of the Northeast Texas Public Health District

Melissa C. Lyon, MPH, leads Pennsylvania’s Erie County Department of Health as Public Health Director. While earning her Master’s in Public Health, Ms. Lyon worked as a site manager for Great Lakes Medical Research, a clinical research site located in Westfield, NY. She spent nine years at Chautauqua County Health Department in New York working in various public health positions including, environmental health and inspections, health promotion and education, public health emergency preparedness, and community collaboration and coalition building.

Below, she discusses the current goals for her health department, highlights important factors to consider when partnering with other organizations, and shares her hope for public health leadership in Erie County. Continue reading

NACCHO Year in Review

What a year 2019 was! At times it seemed like a non-stop roller coaster with plenty of hills and valleys for public health along the way. NACCHO’s government affairs team was there at every turn, advocating for public health and local health departments.

Here is a recap to take a look at where we have been and where we are headed in 2020.

Public Health Funding

As always, one of NACCHO’s top priorities is to advocate for funding for local health departments to do their work.

The year started in the midst of a 35-day partial government shutdown, which ended when Congress and the White House came to agreement on funding for FY2019. Quickly, they had to shift to FY2020 funding obstacles, including a projected equivalent of ~12% across the board funding slash, if a budgeting agreement was not agreed to. This happened in August, through the Bipartisan Budget Act, but disagreement over top-line funding levels for each appropriation bill and controversial policy disagreements led to two continuing resolutions before a bipartisan, bicameral deal was finally reached just before the winter holiday break.  The final FY2020 LHHS appropriations agreement included slight increases to many public health programs at CDC and HRSA, including new money for data modernization at CDC, as well as local and state health departments. Some existing priority areas also received significant increases, including HIV prevention, tobacco, and hospital preparedness. Read NACCHO’s press statement. Continue reading