Health Services Category Career Progression Profile Report

PY 2016

LCDR Tiffany Taliaferro

LT Alex Freiman LCDR Joel Richardson

Prepared September 19, 2016

Health Services Professional Advisory Committee Career Development Subcommittee Multidisciplinary in Approach, Connected by Service, Advancing Public Health #WeAreCorpsSTRONG

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Purpose In 2014, leadership of the Health Service Professional Advisory Committee (HS PAC) charged the HS PAC Career Development Subcommittee’s (CDS) Assessment and Analytics (A&A) Team with identifying and analyzing the qualities and characteristics of successfully promoted Health Services (HS) officers. The resultant report, Analysis of Health Services Officers Promotable Officer Profile Survey: PY 2013 and 2014, was well received throughout the Corps by both senior leaders and junior officers. This year’s report, titled Health Services Category Career Progression Progress Report, PY 2016, represents the HS Category’s continued efforts to identify and document critical factors affecting officer professional development. Coupled with current HS Category Benchmarks, the information contained in this report can provide insight into key drivers of professional success. Methods The methodology for this report was consistent with the procedures from previous years. The data utilized in this study, found in Table A, was collected by way of anonymous survey results from U.S. Public Health Service Commissioned Corps officers in the Health Services Category for Promotion Year (PY) 2016. All officers selected for Temporary promotion in 2016 received an e-mail from the HS PAC Chair in June 2016, requesting that the officer complete the survey, with a hyperlink to the survey website contained within the e-mail. The 2016 survey was distributed to 179 Health Services officers (O-4 = 80, O-5=71, O-6=28), with 152 survey respondents (overall response rate = 85%). Participants were not required to complete every survey question to participate, and this report only includes information for those who responded to every question. A copy of the survey is provided in Appendix A and was designed to be consistent with the 2016 HSO Benchmarks. Descriptive statistics (counts, means, & proportions) were examined for each survey question to describe professional characteristics of HSOs promoted in 2016.

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Limitations Similar to reports from previous years, this report only includes information from officers selected for promotion in PY 2016. Officers not selected for promotion were not invited to complete the survey. Because information from those not selected for promotion is not available, no correlational conclusions can be accurately made from the data, and this report does not attempt to do so. Due to a low number of respondents promoted to either Temporary O-2 or O-3, those data groups have been excluded from this report. Any conclusions drawn from analysis of the O-2 or O-3 subsets may have led readers to inaccurate conclusions as to promotion characteristics, and thus the decision was made to omit these rank subsets of the data. Additionally, it is possible that the 15% of promoted officers who chose not participate in the survey or the 10-15% of participants that chose not to respond to all survey questions caveat our findings. These individuals may have different characteristics from those who officers responded to the survey and, had their information been captured and included, it is possible that their responses may affect our data in either an upwards or downwards direction. Lastly, any research study containing self-reported information should be caveated as there may be concerns regarding data validity. Finally, only Temporary Promotion results are included in this report as Permanent promotion results were not yet available at the time the survey was released.

Table 1. Data Points Collected through Survey Results • Promotion cycle • Current billet grade • Current Temporary and Permanent grades • Number of years in USPHS Commissioned

Corps • Professional discipline practiced • Overall COER score • Highest Individual USPHS award earned • Number of Individual USPHS honor awards • Number of Unit USPHS honor awards • Total number of USPHS service awards • Number of Deployments • Prevalence of officers who are Supervisors • Level of Commissioning Degree • Level of additional Commissioning Degree(s) • Continuing Education requirement

compliance • Prevalence of additional Public Health

training or certification(s) • Number of Transfers • Prevalence of Agency-level Committee

leadership • Prevalence of participation in HS Category

Mentoring Process • Knowledge and Use of Previous Year’s

‘Promotable Officer Profile’ Report

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Results Professional Discipline of Respondents Table 2 provides an overview of the professional disciplines of respondents represented in this survey. The HSO category represents a variety of health backgrounds. The Public Health discipline was the highest reporting discipline with 27.6 % of the survey responses, followed by Social Work (12.5%). The lowest respondents were the Optometry discipline with 2% total of the survey responses.

Table 2. Professional Discipline of Survey Respondents, PY 2016 Frequency Percent Public Health (e.g. epidemiology, global health, health promotion and education)

42 27.6

Social Work 19 12.5 Physician Assistant 18 11.8 Basic and Applied Sciences (e.g. biological sciences, mathematical sciences, physical sciences)

15 9.9

Dental Hygiene 15 9.9 Healthcare Administration 13 8.6 Health Information Technology 10 6.6 Medical Laboratory Science 10 6.6 Psychology 7 4.6 Optometry 3 2.0

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Number of Years in USPHS Commissioned Corps Figure A displays the average number of years in service with the USPHS Commissioned Corps at the time they were promoted in PY 2016. Data indicates that time-in-service increases with rank, especially for those promoted to Temp O-6. This pattern is expected and has been observed in previous promotion year profiles.

Position Billet Ratings Table 3 shows the respondent’s billet grade relative to their rank. A majority of the respondents held billets at or above their Temporary grade. For example, 63.5 % of officers promoted to Temp O-5 are currently holding a Temp O-5 billet. The most common billet held among all promoted officers was O-5. As officers progress in their careers, it follows that officers would generally assume billets of higher grades. Table 3. Current Billet Ratings for HS Officer Survey Respondents by Temporary Grade, PY 2016 Current Billet Grade

Total Temporary Grade O-3 O-4 O-5 O-6 O-7

O-4 5 (7.81%)

28 (43.8%)

28 (43.8%)

3 (4.7%) 0 64

(42.1%)

O-5 0 3 (4.8%)

40 (63.5%)

20 (31.7%) 0 63

(41.5%)

O-6 0 0 4 (17.4%)

18 (78.2%)

1 (4.4%)

23 (15.1%)

Total 5 (3.3%)

31 (20.4%)

74 (48.7%)

41 (27.0%)

1 (<1%)

152 (100%)

3.0 3.9

8.4

13.2

0

2

4

6

8

10

12

14

O-3 O-4 O-5 O-6

Figure A: Number of Years in USPHS Commissioned Corps, Temporary Promotion, PY 2016

Rank

Years

5

Overall COER Scores Figure B shows the mean COER Scores for Temporary grade promotees. Most officers were rated 6 and/or 7’s, with the average for all survey respondents being greater than 6.4 out of a maximum score of 7. Overall COER scores appear to increase from Temp O-4 to Temp O-5, then remain relatively stable between Temp O-5 and Temp O-6

6.41

6.7 6.73

6.2

6.3

6.4

6.5

6.6

6.7

6.8

O-4 O-5 O-6

Figure B: Mean COER Scores, Temporary Promotion, PY 2016

Mea

n CO

ER S

core

Rank

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Individual USPHS Awards Figure C and Table 4 show the highest Individual USPHS award received by survey respondents. For PY 2016, Individual USPHS award distributions continue to be consistent with guidance found in the HS Category Promotion Benchmarks. HSO Category Promotion Benchmarks for PY 2016 states that officers should strive for increasing levels of achievement, including team or unit participation, which may result in individual or unit awards. For Award History, the level of awards should increase with increase in rank (e.g. Temp O-6 should have an Outstanding Service Medal or Outstanding Unit Citation) as stated in the HS Category Promotion Benchmarks. However for PY 2016, Temp O-5 and O-6 the majority of those individuals highest level of awards were PHS Achievement and/or Commendation Medals.

0%

10%

20%

30%

40%

50%

60%

No

Indi

vidu

alAw

ard

PHS

Cita

tion

PHS

Achi

evem

ent

Med

al

PHS

Com

men

datio

nM

edal

PHS

Outs

tand

ing

Serv

ice

Med

al

Surg

eon

Gene

ral's

Exem

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y Se

rvic

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edal

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eon

Gene

ral’s

M

edal

lion

PHS

Mer

itori

ous

Serv

ice

Med

al

O-4

O-5

O-6

Figure C: Highest USPHS Individual Award Received, Temporary Promotion, PY 2016

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Table 4: Frequency Reporting of Highest Individual USPHS Commissioned Corps Award, Temporary Promotion, PY 2016 Promoted Temporary Grade Result

O-4 O-5 O-6 No Individual Awards 20 (34) 1 (2) 3 (13) PHS Citation 7 (12) 2 (3) 0 (0) Achievement Medal 14 (24) 19 (32) 2 (9) Commendation Medal 15 (25) 25 (42) 11 (48) Outstanding Service Medal 2 (3) 9 (15) 3 (13) Surgeon General’s Exemplary Service Medal 1 (2) 1 (2) 1 (4) Surgeon General’s Medallion 0 0 1 (4) Meritorious Service Medal 0 2 (3) 2 (9)

All values given as n(%) Table 5 details the mean number of awards by type and Temporary grade promotion result. On average, officers at higher ranks reported higher numbers of awards for all categories. Respondents reported the highest average number of Unit awards, followed by Individual awards, then Service awards.

Table 5. Mean Number of Awards by Type and Temporary Grade Promotion Result Temporary Grade Promotion Result

Type of Award Individual Unit Service

O-4 1 2 1 O-5 3 5 2 O-6 4 8 3

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Commissioning Degrees and Additional Degrees The commissioning degrees of those HS officers included in this survey are listed in Figure D. Due to the diversity of professional backgrounds included in the HS Category (see Table 1), determining discipline-specific commissioning degrees presents many challenges. Regardless of discipline, respondents indicated that Masters degrees were their most frequent commissioning degree.

Figure E describes the types of post-commissioning degrees obtained by respondents. Across all ranks, no additional degree were obtained by at least half of respondents. Of those who did obtain additional degrees, Masters degrees were the most commonly reported additional degree.

0%

26% 15%

27%

100%

67% 76%

63%

0% 7% 8% 9%

0%

20%

40%

60%

80%

100%

120%

O-3 O-4 O-5 O-6

Bachelor

Masters

Doctoral

Figure D: Commissioning Degrees, Temporary Promotion, PY 2016

Rank

0%

20%

40%

60%

80%

100%

O-3 O-4 O-5 O-6

Bachelor

Masters

Doctoral

No AdditionalDegree

Figure E: Highest Additional Degree Obtained, Temporary Promotion, PY 2016

Rank

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Continuing Education and Public Health Training/Certifications Survey respondents provided their compliance with Continuing Education requirements for their degree/certifications (Figure F), as well as whether or not they had completed additional Public Health training or certifications (Figure G). Compliance with Continuing Education requirements was highest for the most senior officers. Approximately 20-40% of respondents at each rank reported that they had no continuing education requirement.

0%10%20%30%40%50%60%70%80%90%

O-4 O-5 O-6

Yes

No

N/A

Figure F: Percent of Survey Respondents Meeting Continuing Education Requirements, Temporary Promotion, PY 2016

Rank

0%10%20%30%40%50%60%70%80%

O-4 O-5 O-6

57%

71% 77%

43%

29% 23%

Yes

No

Figure G: Additional Public Health Training or Certifications, Temporary Promotion, PY 2016

Rank

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Supervisory Role of HS Officers The frequency of HS officers in supervisory billets increases with rank. It also reflects increased responsibility with an officer’s experience and training (Figure H).

Geographic and Agency Transfers The PY 2016 data shows that the mean of geographic and agency transfers for which Transfer Personnel Orders were issued increases for HS officers as an officer’s career progresses (Figure I). This correlates well with guidelines provided in the HS Category Promotion Benchmarks.

10%

42%

59%

0%

10%

20%

30%

40%

50%

60%

70%

O-4 O-5 O-6

Figure H: Percentage of HS Officers Who are Supervisors, PY 2016

Rank

0

1

2

3

4

5

O-4 O-5 O-6

Figure I: Billet Transfers, Temporary Promotion, PY 2016

Rank

Mea

n Tr

ansf

ers

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Deployments Survey respondents (Figure J) indicated that the average number of deployments increases as an officer’s career progresses. This may be attributable to increased time to participate in deployment activations, participation in different response teams over time, or increased value to deploying teams resulting in increased participation.

Participation in the HS Category Mentor/Mentee Process Figure K describes HS officer participation in mentorship programs. Participation as a Mentee was generally found to be inversely proportional to rank (as rank increases, an officer was less likely to be a Mentee). Participation as a Mentor was found to be proportional to rank (as rank increases, the chances of an officer being a Mentor were increased). Nearly 10-20% at each rank report no participation in HS Category mentoring programs.

0

1

2

3

O-4 O-5 O-6

Figure J: Mean Number of HS Officer Deployments, Temporary Promotion, PY 2016

Rank

Mea

n De

ploy

men

ts

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Agency Committee Participation The data suggests HS officers continue to be actively involved in agency committees (Figure L). Across all ranks, respondents averaged participation on approximately two agency committees.

Participation in USPHS Activities In addition to participation in agency workgroups, HSOs are also highly involved in numerous PHS activities including the HS PAC, PAG, Deployment Teams, Advisory Groups and the Commissioned Officers Association of the USPHS, Inc. (COA). Figures M-Q convey that the officers responding to this survey tend to be very active in these organizations and activities, with leadership roles typically increasing as rank increases.

0%10%20%30%40%50%60%70%

O-4 O-5 O-6

Mentor

Mentee

Both

Neither

Figure K: Participation in HS Category Mentor/Mentee Process, Temporary Promotion, PY 2016

Rank

0

0.5

1

1.5

2

2.5

3

O-4 O-5 O-6

Figure L: Agency Committee Participation, Temporary Promotion, PY 2016

Rank

Mea

n Ag

ency

Co

mm

ittee

s

13

0%

10%

20%

30%

40%

50%

60%

Chair ExecCmteChair

SubcmteChair

TeamLead

ActivePartic.

Non-Partic.

Other

O-4

O-5

O-6

Figure M: Participation in HS PAC Activities, Temporary Promotion, PY 2016

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Chair ExecCmteChair

SubcmteChair

VotingMbr

TeamLead

ActivePartic.

Non-Partic.

Other

O-4

O-5

O-6

Figure N: Participation in PAG Activities, Temporary Promotion, PY 2016

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0%10%20%30%40%50%60%70%80%

TeamCommander

Deputy TeamCommander

Team Lead TeamMember

Non-member Other

O-4O-5O-6

Figure O: Participation on USPHS Deployment Teams, Temporary Promotion, PY 2016

0%

10%

20%

30%

40%

50%

60%

70%

Chair ExecutiveCommittee

Member

Cmte.Chair

VotingMember

TeamLead

ActivePartic.

Non-Member

Other

O-4O-5O-6

Figure P: Participation in Advisory Group Activities (JOAG, BCOAG, etc.), Temporary Promotion, PY 2016

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Awareness and Use of Previous Promotable Officer Profile Reports Participants were asked to report their awareness and use of the previously published Promotable Officer Profile reports (Figure R). More junior officers were unaware of the report compared to senior officers. This emphasizes the importance of disseminating the report to the widest audience available in order to realize the greatest benefit.

0%5%

10%15%20%25%30%35%40%45%50%

BranchPresident

BranchExecutive

CommitteeMember

ActiveParticipant

Member Non-Member

Other

O-4O-5O-6

Figure Q: Participation in COA Activities, Temporary Promotion, PY 2016

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16% 20%

2%

15%

47%

25%

16%

9%

18%

32% 32%

27%

14%

9%

18%

0%

5%

10%

15%

20%

25%

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45%

50%

Read Reportand Made

Changes toPromotion

Packet

Read Reportbut Made

No Changesto Promotion

Packet

Read Reportbut Used inOther Ways

Aware ofReport but

Did NotAccess On

HSOWebsite

Not Awareof Report

O-4

O-5

O-6

Figure R: Awareness and Use of Previous Promotable Officer Profile Reports, Temporary Promotion, PY 2016

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Results Summary

This results summary provides an overview of information compiled from the PY 2016 Health Services Category Career Progression Profile Report.

Key findings from this year’s report are included in the points below:

Respondents to this year’s survey were most likely to report a professional discipline of Public Health, followed by Social Worker and Physician’s Assistant. The junior-level officer has approximately 3 years of Commissioned Corps service, while senior-level officers reported approximately 13 years of service. The average number of years in the USPHS for all respondents was 7 years.

The distribution of Individual PHS awards across ranks generally followed HS Category promotion benchmarks. On average, officers at higher ranks reported more awards for Individual, Unit and Service award categories than their lower ranking peers.

Officers’ reported COER scores in PY 2016 were high across all ranks, with most ranks reporting average scores at or above 6.5 out of a maximum score of 7.

For PY 2016, the report showed that the number of billet transfers (geographic and/or programmatic) for HSOs increases as the officer’s progresses. All promoted officers to Temp O-4 and above reported at least 1 billet change on average. In addition, the report showed that an officer promoted to Temp O-5 and above averaged more than two deployments.

Masters degrees were the most commonly reported. In addition, approximately 20-40% of the respondents for each rank reported that they had no continuing education requirement.

Participation in HS Category Mentoring as mentor or mentee correlate by rank. More junior officers participated as mentees, and more senior officers participated as mentors.

Lastly, some junior officer respondents indicated a lack of knowledge regarding the existence of previous HS Category Career Progression Profile reports. It underscores the report’s potential benefit to junior officers, their mentors and supervisors.

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Future Steps With this report, the HS PAC/CDS A&A Team continues to provide value-added data analytics and improved situational awareness to the HS Category regarding officers’ professional development and career progression. The A&A Team is proud to provide this resource to our fellow officers and we hope its readers will find it useful. The team reminds its readers that the limitations of this report should be carefully considered before drawing conclusions about the report’s findings. Future iterations of this report should consider ways to streamline data collection and improve the information’s accuracy, as well as ways to publicize the A&A Team’s findings.

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Appendix A: Promotion Information Survey for PY 2015 Promoted Officers Promotion Information Survey for Health Services Officers Officer Information:

1. Number of years in the Corps (#)

2. Current Permanent Grade (dropdown menu of all grades O-1 through O-8)

3. Current Temporary Grade (dropdown menu of all grades O-1 through O-8)

4. Current Billet Grade (dropdown menu of all grades O-1 through O-8)

5. Discipline within HSO Category (Basic and Applied Sciences, Dental Hygiene, Healthcare Administration, Health Information Technology, Medical Laboratory Science, Optometry, Physician Assistant, Public Health, Psychology, Social Work)

6. Were you considered for TEMPORARY (Yes, No) promotion during the 2015 cycle

7. Were you promoted? (Yes, No)

8. If yes, to which grade? (dropdown menu of all grades O-1 through O-8)

9. Were you considered for PERMANENT (Yes, No) promotion during the 2015 cycle?

10. Were you promoted? (Yes, No)

11. If yes, to which grade? (dropdown menu of all grades O-1 through O-8)

1. Performance Rating and Reviewing Official’s Statement (Performance)

12. What was your overall COER Score during your promotion year? (#1-7)

13. What is your highest level individual PHS honor award received? (Dropdown menu including DSM, MSM, Surgeon General’s Medallion, Surgeon General’s Exemplary Service Medal, OSM, CM, AM, Citation, N/A)

14. What is the total number of PHS Individual Honor Awards you have received? (#)

15. What is the total number of PHS Unit Honor Awards you have received? (#)

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16. What is the total number of PHS Service Awards you have received? (#)

17. I am a supervisor of at least one employee in my current position. (Yes, No)

2. Education, Training, and Professional Development Related to the Needs of the PHS

18. What is the level of your Commissioning Degree? (Dropdown menu: Bachelor, Masters, Doctorate)

19. What is the highest level of additional degrees earned since commissioning? (Dropdown menu: Not applicable, Associate, Bachelor, Masters, Doctorate)

20. I meet/exceed the minimum Continuing Education standards or requirements for my discipline. (Yes, No, N/A)

21. I have accumulated additional Public Health training or certifications beyond my commissioning degree (Yes, No)

3. Career Progression and Potential

22. How many transfers have you had during your PHS career? Only include geographic and agency transfers for which Transfer Personnel Orders were issued – these do not include billet changes. (#)

23. How many agency-level committees did you participate with or lead during the previous year? (#)

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4. Professional Contributions & Services to the PHS Commissioned Corps (Officership)

Questions #24 and #25:

PHS Activity Highest position held (select the single highest position for each)

1. Health Services Professional Advisory Committee (HS PAC)

(Dropdown menu: HS PAC Chair, HS PAC Executive Committee Member, HS PAC Subcommittee chair or co-chair, Team Lead within subcommittee, Active Participant, Non-participant, other)

2. Professional Advisory Groups (PAPAG, BASPAG, etc.)

(Dropdown menu: PAG Chair, PAG Executive Committee Member, PAG Subcommittee chair, PAG Voting Member, Team Lead, Active Participant, Non-participant, Other)

3. Deployment Team (APHT, RDF, etc.)

(Dropdown menu: Team Commander, Deputy Commander, Team Lead, Team Member, Non-member/Non-Deployable Billet), Other

4. Advisory Group (JOAG, BCOAG, etc.)

(Dropdown menu: Chair, executive committee member, committee chair, voting member, team lead, active participant, non-participant, other)

5. Commissioned Officers Association (COA)

(Dropdown menu: National board member, branch president, branch executive committee member, active participant, member (pay dues to organization but not otherwise active), non-member, other)

26. How many times have you been deployed as a USPHS Officer? Do not include non-Corps/agency deployments. (#; (if never deployed, enter “0”)

27. Describe your level of involvement in the official HS Category officer mentoring program. (Dropdown menu: Mentor, mentee, both mentor and mentee, neither)

28. Data from a survey similar to this one was used to produce the HS PAC’s Promoted Officers Profile report in 2014 and 2015. Were you aware of the reports and if so, did you utilize them to help prepare yourself for the 2016 promotion cycle?

(dropdown menu: I was not aware of the reports from previous years, I was aware of the reports but did not access them on the HSO website, I read the reports on the HSO website but didn’t need to make any changes in my promotion package as a result of the reports, I read the reports and made changes to my promotion package as a result of the data in the reports, I read the reports and used the information in

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ways other than promotion preparation (mentoring advice to junior officers, further career planning, etc.)

29. Please provide any additional feedback or comments that you’d like to include with your responses. (free text area)

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