III i@l 1110@@lkilill iiii fill 4/25/72 STATEMENT OF MISSION, ORGANIZATION FUNCTION DIVISION OF PROFESSIONAL TECHNICAL DEVELOPTIENT REGIONAL iMFDICAL PROGRAY-S SERVICE TABLE OF CONTENTS Paqe 1. Introduction II. Otqanization Plan 2 A. Executive, Management & Leadership Function 2 B. Characteristics of the organization 3 C. Supervisory Assignment 3 D. Project teams and the Criteria for Selecting Topics 4 E. Communications 6 III. Goals of the Division 7 IV. Criteria for Determining Staff Assignment 7 A. For Project Teams 7 B. For Assignment to Supervisors 8 C. For Assistance to Regions 8 D. Special Assistance to HS.MHA and Others 9 E. Liaison with Other Agencies 9 F. Short-Term Tasks 9 G. Secretarial Assignments. 10 V. Staff ResDonsibilities 10 A. Introduction 10 B. Deputy Director 11 C. Associate Director 11 1. Policy 11 2. Accountability 12 D. Project Manager 13 1. Policy 13 2. Responsibilities and Authority 14 3. Accountability 18 E. Staff Serving as Project Team Members 18 1. Policy 18 2. Responsibility 19 introduction The purpose.of this document is to describe certain of the major aspects of the organizational structure of DPTD, including management, personnel assignments, administrative, and other activities. The section on performance evaluation, career development, and staff training will follow when completed. This statement will be reviewed'for accuracy and effectiveness in six months and periodically thereafter. I wish to thank the staff for their assistance in critiquing the various drafts of this statement. Most of their sugges- tions were incorporated in this final version. Edward i M.D., M.P.H. Director Division of Professional and Technical Development April 25, 10@72 2 organization Plan A. Executive Manaqement & Leadership Function Executive, managerial, and leadership functions are distinct but interrelated means of enabling the Division of Professional and Technical Development to carry out its mission. The executive function of DPTD requires decisionmaking at the highest levels of RMPS to define tasks and their priorities, and to establish programs, project teams, and policies to carry out these responsibilities. Emerging from this decisionmaking process are the operating policies that must be complete and understandable before the project teams begin their work. The project assignments must specify what objectives are to be accomplished, in what period and with what organizational means. The executive function includes regulating relationships among the teams to achieve desired results; and mobilizing resources to accomplish the organizational goals. The management function of DPTD requires skillful programming of team assignments, controlling performance and scheduling and allocating resources. The management function includes establishing and maintaining a singular process to ensure delegation of commensurate responsibility authority, and information to solve Problems arising in the Division. The leadership function involves three conditions that must exist simultaneously before a DPTD staff member can contribute to the goals of the Division. The individual must understand what he is expected to do, he must have the competence to do it and he must be willing to do it. The leadership function in DPTD requires effective communication to increase staff competence and motivation to do a job. Balanced emphasis of these functions 'are essential and will be sought among professionals and the supporting staff of DPTD. 3 B. Characteristics of the organization DPTD has chosen an organizational form which provides professional staff for routine tasks and for tasks which require problem solving. Some of the tasks require little interaction among specialists and are most effective when carried out alone or with one or two others who may or may not be on DPTD staff. Participation on a site visit to a region may be one example of a solo activity. on the other hand, a task such as shaping a strategy for development and imple- mentation of quality of care guidelines requires input simultaneously from several different professional back- grounds. DPTD has adopted a matrix or grid organization which combines routine and complex problem solving activities by overlaying them. Sometimes, managers wear functional hats and are involved in the day-to-day, more-routine activities. other times wearing project manager hats, they identify with project goals and are required to cope with long range issues and to achieve interdisciplinary coordination. This form of organization enabl@s DPTD to deal with multiple tasks, both routine and comdlexsimultaneouslv. Success lies in the analysis of the multi-ole tasks that must be performed, the differences between specialists, the integration that must be achieved, and the mechanism and behavior required to resolve conflict and arrive at balanced states of differentiation and integration. C. Supervisory Assignments The activities of the Division of Professional and Technical Development are supervised by a Director and Deputy Director who are responsible for the overall operation and work of the Division. The Director has four Associate Directors who have special competency in Continuing Education and Manpower, Program Development and Program Management, Health Care Practice and Standards, and Health Care Delivery Methods. 4 The Associate Director serves as the administrative.super- visor of individual staff members, providing performance evaluation and career supervision. He assists staff members to maintain professional identity and continuity of experience; serves as the informational channel to and from the office of the Director, DPTD;,and plays-the creative role of helping to formulate program policy and strategies and proposes plans for their im lamentation. p D. ams and the Criteria for Selectincr Topics The Division of Professional and Technical Development is task oriented and can be described conceptually as utilizing the management by objectives process to achieve goals (in DPTD language, accomplishing the work as specified in the Division Work Plans). Management by objectives is closely related to individual performance appraisal and review in fulfilling the goals of the organization. The process of management by objectives is associated with an effort to be fair and reasonable, to predict performance and judge it more carefully and presumably to provide individuals with an opportunity.to be self-motivating by setting their own objectives. Elements of the "ideal" process include: - measurement and judgment of individual performance - relation of individual performance to the organizational goals - clarification of what is to be done along with the expectations of the product - stimulation of increasing competence and growth of individual - enhancement of communication between the supervisor and the employee 5 - provision of a basis for making judgments about promotions and recognition - stimulation of self-motivation - provision of organizational control, integration, and coordination. Each project team has a project manager who is a professional and is responsible and accountable to the Director/Deputy Director for accomplishing the work schedules. Professional staff members make up the project teams and are either officers of the Commissioned Corps of the Public Health Service or members of the Classified Civil Service. To assure personal and professional identity, staff members may use their professional speciality titles. The support staff complement of the Division provides secretarial services, editorial assistance, correspondence coordination, staff management services, and other functions essential for the operation of the Division. The Division Work Plans are a formulation of projects that have been proposed and developed by professional staff of the Division with aQT)roDriate input and feedback from the Director, PIIPS, the Division of operations and Development, and the RMP'S. Currently, of greatest concern to DPTD are issues relating to health manpower development and utiliza- tion; improvement of the health care delivery system including entry into the system; continuity, quality, and quantity of health care; and needs of special population groups. The project team addresses itself to a particular issue, preparing background papers, specific guidelines, reference and resource lists and/or recommending options for action. The life span of a team may be determined by the state of the art or the lack of technical development in a particular area, or by political, social, economic or systems problem forces DPTD does not control. 6 Division Work Plans take cognizance of research and develop- ment that may identify future issues of significance to problem oriented solutions. Ad hoc groups of professionals from within HSYff@ or elsewhere will be convened as needed to provide information and sources of data on relevant issues to which RMPS should address itself. Topics may also be identified by the Administration, i.e., DPTD Director, RMPS Director, RMPS National Advisory Council, HSMHA, DHEW; by the professional staff of DPTD and by input from the DOD and from RMP's themselves. E. Communications There are three kinds of communication which relate back to the executive, management, and leadership functions. The first kind (executive) is information sharing by the office of the Director with all staff, professional and supportive. A general staff meeting will be held once every two weeks chaired by the Office of the Director for the purpose of providing staff with internal information from DPTD, RMPS,L HSMHA,. DHEW, etc. The second kind of communication pertains to the management function and meetings will be called by the office of the Director as needed. This kind of communication is problem- solving in nature and will deal with specific problems which require attention and recommendations of those staff members directly concerned. This may take the form of regular meetings with project managers. The third kind of communication pertains to the leadership function. It will be the responsibility of each Associate Director to communicate needed information to staff members he supervises. This will occur as needed and staff members will be involved. Seminars, staff member presentations and other kinds of learning experiences may he included in this kind of communication. 7 III- Goals of the Division The Division has operational and consulting functions leading to tne formulation of policy within RMPS and to its applica- tions within Regional Medical Programs. This includes consultation with the individual Regional Medical Programs and other Federal programs, voluntary health organizations, national professional societies'and similar organizations. To improve the accessibility, increase the effectiveness and maintain the high quality of health services delivered by the provider, the Division: a. Identifies issues that affect the providers of health care and develops strategies to solve these problems; b. Serves as a creative force in the initiation of new health care issues; C. Stimulates communication between the RMP's and other organizations (Federal, non-Federal); d. Enco,-,rages the regions to consider changes in organization and delivery of health services to improve access and availability; e. Assists in the development of multi-regional approaches to health care issues; f. Provides multi-disciplinary staff services to the @S Director, other RMPS programs, Review Committee and the National Advisory Council on @2 Programs (including participation on site visits and in grant application review). IV. Criteria for Determining Staff-Assi nts A. Assignment to project teams will be given with consideration of the professional and technical expertise required for the task and the individuals cumulative experience and training, interests and career development objectives. The number of project assignments given an individual will be affected by the demand for his or her particular competencies. (For 8 detailed discussion, see section on "Staff Responsibilities"). Selection of project managers.will combine consideration of the tasks necessary-to do the job, the qualifications of staff members available for assignment, and the priority rank of,the project. In short, assignments will attempt to satisfy both organizational and personal requirements. B. For Administrative Assignment to Supervisors (Associate Directors) The purpose of assignment of each professional staff member to an Associate Director is to provide a base for professional growth and development. While the Project Team work provides for close integration, the administrative assignment provides for differentiation of professionals according to their backgrounds and experience. Criteria for supervisor's assignment of professional sta members will include: 1. Request of the staff member. 2. Attitudes of staff member and supervisor toward each other which may facilitate or interfere with process of supervision. 3. Assignments will be reviewed at two-year intervals to determine whether changes are indicated. C. For Assistance to Regions Assignments for direct assistance to regions involving consultation on specific task issues will be given.by the Project Manager for members of that particular project team. Assistance on policy and program areas outside the realm of the project team will be referred to the appropriate Associate Director, i.e., policy and program issues concerning continuing education and manpower will be referred to the Associate Director for Continuing Education and Manpower. Indirect assistance to regions will include interpretation of policy and provision of information and consultation to DOD staff in program areas in which they lack expertise, review of applications and participation on site visits. DOD requests for assistance on site and staff visits as well 9 as review of applications enter the Division over the desk of an Associate Director who has a continuing responsibility for liaison with DOD. D. Special Assistance to HSMHA and Others Requests for special or ad hoc assistance which reach staff members from sources outside P@S should be discussed and approved by the Director/Deputy Director of DPTD. When such assistance is requested, the following should be determined: (a) the source to whom final reports should be made, and (b) whether or not representation by staff member involved is in the capacity of official RMPS repre- sentation or alternatively, purely professional input. The above procedure pertains to requests to serve on inter and intra agency committees (the latter also require HSMHA notification) as well as ad hoc task force assignments. Invitations to participate in professional activities outside of RMPS should be cleared with the Asssociate Director. E. Liaison with other Agencies Appropriate staff will continue to be assigned to liaison activities with professional associations and other Federal and non-Federal agencies whose interests coincide with those of Regional Medical Programs. These assignments will be made by the Associate Directors. F. Short-Term Tasks These tasks enter the flow of work over the desks -of an Associate Director or his staff assistants who have respon- sibility for logging them. They are assigned to individual staff members who return their responses to the Associate Director who clears them for return to the sources of the requests. G. Secretarial As Each secretary will be assigned to one member of the professional staff who will serve as her primary supervisor. In addition, assignments will be made to one or two other staff members to ensure that each member of the staff has secretarial assistance. Because of the high ratio of profes- sional staff to secretaries within DPTD,.it is necessary to assign each secretary to more than one member of the staff. However, no secretary will regularly be assigned to more than three staff members. The primary supervisor of the secretary will have responsi- bility for (a) evaluating performance of the secretary and making commendations for outstanding performance, and (b) monitoring workload and resolving conflicts. All wor not directly related to the members of staff to whom a secretary is assigned (assistance to Project Teams, assistance to the office of the Director - "front of'Lice" work) will be initially discussed by the secretary with her primary super- visor in order to determine priorities of workload. In case of an administ.-a@@4-ve-management conflict wnich cannot be resolved by the discussions between the secretary and her supervisor, it will be the responsibility of the primary supervisor to bring the matter to the attention of the AssociaL--e Director for Program Development-and Management. V. Staff Responsibilities A. Introduction The success of this kind of organizational structure lies in the clear understanding of mutual responsibilities and authority. Associate Directors, staff serving as Project Managers and staff serving as project team members all change roles as they move back and forth from project,team responsibilities to routine activities. Knowing in advance the channels of communication, the mechanisms for resolving conflict, and the access to assistance should create a working environment which is not only productive, but personally satisfying. B. Deputy Director The Deputy Director is responsible for the day-to-day program management of the Division. He is also the principal advisor to the Division Director and participates along with the Associate Directors in policy decisions. It is the responsibility of the Deputy Director to participate in the development of Division Work Plans and then to work with the selected Project Managers in developing project team goals, objectives, and work schedules. The Project Managers will be expected to work closely with the Deputy Director who will be the principal contact point for decisions in, implementing the Work Plans. In the absence of the Division Director, the Deputy Director serves as an Advisor to the Director, RMPS, and participates in the other assignments of the Director, DPTD. He is responsible for compliance with the DPTD Equal Employment Opportunity requirements. C. Associate Director 1. Policy The Associate Directors, DPTD, serve in a leadership role, as coordinators for project teams. They are responsible for identifying relationships and inter- faces between projects. They are responsible for long range planning and evaluation of the performance of DPTD. Since many of the projects have overlapping areas, it is their resoonsibility to prevent omissions and unnecessary duplications. It will be their respon- sibility to serve as expediters of decisions for the Project Managers and to the Project Managers. They participate, with the Deputy Director, @n advising the Director, DPTD, and in decisions affecting policy. 'l 2 DPTD receives a large number of ad hoc assignments. The majority of these will be performed by the Associate Directors. Assignment of other staff members to perform such assignment will be the responsibility of the indi- vidual Associate Director to whom the initial assignment was given.- Each staff member of DPTD will be a@si ned by the Director, 9 DPTD to an Associate Director for performance evaluation, including promotions, administrative, and career super- vision. The Associate Director will provide orientation on goals of RMPS and DPTD and be responsible for a professional standard of performance from staff members assigned. Annual performance ratings are prepared by the Associate Director based upon data he obtains from Project Managers, other units of RMPS who hav@ had experience in the given time period from working with the staff member, and other individuals who have had appropriate opportunity to assess work performance. The Associate Director receives assignment preferences from the staff, training interests and career development objectives. Performance qualifications and career prospects should be reviewed no less than twice a year and more frequently, as indicated. The Associate Director serves as the informational channel to and from the office of the Director, DPTD, on policy and technical areas affecting the professional status and work performance of the staff member, i.e., bringing new information or developments occurring within HSMHA, DHEW, or in the national picture. 2. Accountability a. Defines and documents functional needs and responsibilities for effective achievement of DPTD goals and for accurate problem and schedule per- formance reporting. 13 b. Notifies other Associate Directors of all conditions which may have an impact on their planning. C. Reports to the Director/De uty Director, DPTD, p new needs as they develop for achievement of DPTD goals, establishes objectives for personnel assigned and summarizes problems or barriers which require action. d. Selects staff to go on site visits and for national, regional, and organizational events. e. Reports to the Project Manager all events, changes, and time estimates which affect the availa- bility of staff and adequacy of functioning on a given project team. f. Reports to the Project Manager new information which can affect career development activities and works out attendance for staff to special events for career development in conjunction with the time demands as set by the Project Manager. g. Adheres to the reasonable performance stands of professional staff for that level of experience and training in completing evaluation reviews for personnel action. D. Project @anag@r 1. polisy Project Managers will be appointed by the Director, DPTD, to manage a particular project and will be responsible for making recommendations to the Director/Deputy Director, DPTD, for @IPS policy with respect to the topic of the project team and its implications for program operation. He will discuss all aspects of the problem with the Director/Deputy Director and they will decide upon the dimension of the Project operation. once a project team 14 is established, all communications, consultation requests, speaking engagements, interagency policy development, and similar responsibilities coming to the attention of -the Office of the Director, DPTD, and/or Associate Directors will be discussed fully and promptly with the Project Manager for mutual agreement upon an appropriate course of action. The Project Man ager will report directly and solely to the Director/Deputy Director, DPTD, with regard to discharging his obligations on the Task Force. He will be apprised by the Director/Deputy Director, DPTD, of information from other Project Managers as appropriate. The Project Manager will receive technical and adminis- trative support from the Associate Directors to whom he will provide reports as necessary for program coordination, personnel administration, and guidance'. Personnel from DPTD assigned to the project team will report administratively to the Associate Director to whom they are assigned. 2. Responsibilities and Auth t Except as modified in writing by the Director/Deputy Director, DPTD, each Project Manager will have the following responsibilities and authority: a. He will act for the Director, DPTD, in providing direction to all elements of @ S on any and all aspects of the topic of the project. He is authori- zed to make decisions, consistent with RMPS policy, guidelines, and instructions for any aspect of the topic, including the resolution of conflicts with and between the interdisciplinary staff assigned to the task. Where such decisions would appear to be in conflict with the nature or function of a particular discipline, the Project Manager will -pursue resolution of the matter, up to and including the Associate Directors involved. If concurrence cannot be achieved at this level, the matter will be brought to the attention of the Director/Deputy Director, DPTD. Pending resolution, however, the Project Manager's decision will be followed. The Project Manager will, 15 of course, delay implementation of the decision until resolution is achieved in all cases where in his opinion time permits. .b. He will be responsible to give guidance to other Divisions and offices of RMPS regarding strategy and technical advice for the topic of the project. c. He is responsible for determine the nature of technical advice to RMP'S, HEW Regions, to other groups within HSMHA and other Federal and non- Federal agencies regarding the topic of the project. d. He is responsible for recommending technical experts in the field to be used as site visitors and for consultant purposes in the topic of the project. e. He is responsible for defining all requirements of the project team operation including such factors as new dimensions of the topic which may require additional teams to be appointed, cost factors, time-and work allocation for reports and communications for each aspect of the project objective. During the life of the project team, he will be responsible for auditing the relationships of these factors. If any of them deviate in sucn a way as to jeopardize the overall DPTD program commitments, he will take corrective action. If such action is beyond his control, he will make this fact known to the Director/ Deputy Director, DPTD immediately. f. He will familiarize himself with significant aspects of all major projects and other DP.TD major activities as well as major RMPS program emphases and HSMHA emphasis in order to insure that his project's work is carried out in the balanced best interest of the Division and RMPS. If, in carrying out his responsibilities as delineated above, he cannot resolve a conflict with other project teams as to priority or use of staff and resources, and after seeking resolution with the appropriate Project Managers, he will bring to the Director/ Deputy Director, DPTD, any matters which cannot be resolved at that level. 16 g. He will establish project team organizational structure and staffing plans for approval by the Director, Deputy Director, DPTD. He will then establish staffing of the project team using staff preferences of work interests as a guide but he is not limited to staff preferences. He states staffing needs to the Associate Directors responsible for personnel assignments and together they work out assignment of staff to a project team. Whena shortage of competency exists or no staff competency is available, he discusses the alternative plans to obtain such assistance with the appropriate Associate Director. When concurrence is obtained, he seeks approval of plans from the Director/Deputy Director, DPTD. He is responsible for adequate staffing and will report any deficiencies in staffing to the Director, DPTD. Staff-will ordinarily be assigned to two Task Forces, but exceptions will be made in the best interests of the Division. He will also be responsible for "de-staffing" project teams as appropriate. The Associate Director will make every effort to assure that the-project work is accomplished and will continue to be responsible for the management of staff assigned to them. He will seek the comments of the Project Manager when apprising the staff assigned to the Division. All changes in key personnel by Associate Directors will be approved by the Project Manager before instituting the change. h. He will estimate costs of project operation as indicated and if contract possibilities emerge from the work of the team, he will so notify the Director/ Deputy Director, DPTD. i. He will determine types and details of handling information about project operation, and informs MIS, through the Director/Deputy Director, DPTD, of special print-outs required as well as additions of descriptors to keep MIS current and responsive to RMPS demands. 17 He will use the experience of other project teams and will consult with the Associate Directors on administrative needs and performance requirements. k. He will initiate formal written status reports covering progress toward objectives, schedule and technical performance for the Direc tor/Deputy Director, DPTD, at time intervals mutually agreed upon. In addition, he is responsible for making periodic oral reports to the Director/Deputy Director, DPTD. Any unusual items will be brought to the attention of the Director/Deputy Director, DPTD, as they occur. 1. He is authorized to make all changes in project operation within the charge of the project team including planning and major personnel changes. He will establish procedures for administration through the Associate Director concerned and monitor performance for compliance with policies. m. As indicated above, he will use the staff in an interdisciplinary manner and consult regularly with the Associate Directors for sustained quality performance. Technical performance problems arising from staff on project teams, will be brought to the attention of the Associate Director responsible and the agreement for action will be arrived at in a manner satisfactory to both the Project Manager and the Associate Director. Problems of attendance to project team duties and responsibilities as far as time, work completion, etc., will be handled directly by the Project Manager with the staff person concerned. In the case of technical as well as administrative operational problems which cannot be resolved at the Project Manager level or the Associate Director level, the Project Manager will bring the case to the Director/Deputy Director, DPTD, for resolution. n. He will meet information demands concerning his project team from DPTD or RMPS as required. 0. He is responsible for disseminating project team information to the appropriate Associate Directors and will state in writing recommendations for superior or outstanding performance for individual staff members as indicated. 3. Accountability a. Defines and documents organizational responsi- bilities and procedures designed to meet the objectives of the project. b. Selects and designates "milestones" or progress guideposts for project management. c. Provides to each Associate Director copies of organizational plan with projected "milestones" indicated. This will be done initially and after each periodic update. d. Establishes after review with Associate Director, the degree and type of additional assistance needed, the timing for such assistance and recommendations for manner of receiving assistance. e. Establishes periodic cut-off points and timing of problem and update reporting, in conjunction with the functions. E. Staff Serving as Project Team Members 1. Policy Staff members seeking assignment to a project team should notify the Project Manager first. If the Project Manager concurs, he so notifies the Director/Deputy Director, DPTD, and the Associate Director responsible for the staff member. The Director and Associate Director will support the decision of the Project Manager in all instances unless such an assignment jeopardizes the balance of workload for the total DPTD program. 19 if the Project Manager does not concur with the staff member, he so notifies the Director/Deputy Director, DPTD and the Associate Director explaining his reasons. Again, the Director/Deputy Dir-ector and Associate Director will support the decision of the Project Manager unless such a decision clearly represents a narrow or biased view on the part of the Project Manager, or is not in the productive interests of DPTD. Staff members seeking transfer from a project team will discuss their reasons first with the Project Manager. Whether he agrees or disagrees, he notifies the Director/ Deputy Director, DPTD, and the Associate Director. They will talk with the staff member after first talking with the Project Manager and in conjunction with the Project Manager, make a decision relative to the transfer request. Staff members will have access to the Director/Deputy Director, DPTD, for conflict resolution after making reasonable efforts to work first through the Project Manager. Staff members always have access to Associate Directors, but matters pertaining to the administration and effective relationships within project team operation should be handled in the manner described in the above paragraphs. The Associate Director has an advocacy relationship to staff which should protect staff career interests, but should not be used to circumvent managerial channels. 2. Responsibility It will be the responsibility of DPTD staff assigned to Project Teams to advise the Project Manager on any items that the individual staff member feels might be of 20 importance to the proper execution of the project. It will be the responsibility of the individual staff members to identify gaps in the work plan for the individual project and so advise the Project Manager. If a staff member foresees a conflict in time commitments, it is his responsibility to bring it to the attention of the project managers that he is assisting and if it cannot be resolved to take it to the Associate Director to whom he is assigned.