Again, the CDC experience is germane. HHS agencies were asked to reduce the number of administrative management and support positions by 15 percent, moving some of these workers into frontline public health work. However, these former administrative and support staff did not necessarily have the requisite public health education and experience. (GAO, 2004)

The accountability and improved performance strategies envisioned by the committee and described in Chapter 6 would make the present shortfall in senior-level staff in the department even more acute. Improving performance would require personnel with greater expertise in managing large organizations, deep familiarity with organizational quality improvement strategies, skill in managing and motivating staff, and expertise in program assessment and evaluation. In addition, the committee’s recommendations regarding greater use of information technology, noted especially in Chapter 4, will require a range of personnel who are trained in medical informatics. Medical informatics experts are in short supply across the nation, and HHS may need to take steps to ensure that these experts become available to both the public and private sectors.

Congress and the Office of Personnel Management have taken steps to allow agencies more hiring flexibility, and these tools (including recruitment bonuses and special needs appointments above minimum salaries) should be fully utilized in recruiting the department’s next generation of managers.

Streamlining cumbersome federal hiring practices would be another substantial aid to recruitment (Partnership for Public Service, 2008). According to GAO, in recent years, the time required to hire a new employee averaged between 73 and 92 days. One motivation for hiring contract workers is that this avoids the lengthy hiring process and allows the agency to bring workers on board more quickly to meet immediate needs (GAO, 2008a).

To attract experienced professionals working in the private sector to a period—or a career—in public service will require administrative and congressional consideration of more competitive, innovative approaches to employment benefits, perhaps starting with discovery of what benefits and features this category of workers most values (McKinsey & Company, 2005). At the same time, portable benefits and job security would enable public-sector employees to work for a time outside the federal



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