Creating a new Department of Public Health: Organizational and leadership opportunities and challenges

California faced significant policy opportunities and challenges in creating a new State Department of Public Health. Pursuant to legislation, public health functions were consolidated into a new department, presenting an opportunity to reconfigure and streamline the organization of those functions, to create a new organizational culture, and to focus on leadership development. In addition, the legislation created a new public health advisory committee of gubernatorial and legislative appointees to provide expert advice and make recommendations on the development of public health polices and programs, requiring a reevaluation of how the department works with external stakeholders. The reorganization created programmatic centers, each emphasizing a distinct aspect of public health: preventing chronic disease, injury, and environmental and occupational exposures; combating infectious diseases; promoting family health; regulating the environment; and providing quality services through licensed providers. These centers provide high-level visibility on important public health issues to local health departments, health care providers, the federal government, the Legislature, advocates, the press, and the public. The challenges: accomplish the split and reorganization in less than 12 months, with no additional staff positions and no new financial resources.