Since Jefferson County is rarely considered to be Central New York, it is often left out of initiatives that could improve how work is conducted in the area.

Not this time, said Collene Dare Alexander, community development specialist for the Northern New York Rural Health Care Alliance. Mrs. Alexander is one of four people from the county who will participate in a national fellowship program designed to help train the next generation of health leaders.

Mrs. Alexander and the three other community leaders will participate over the next 16 months in the Robert Wood Johnson Foundation Ladder to Leadership: Developing the Next Generation of Community Health Leaders fellowship program. The foundation is devoted to improving health care while working with groups to identify health care issues.

"One of the critical needs in health and human services is that people move from one place to another," she said.

Getting quality professionals to stay in a leadership position long term is something Mrs. Alexander's group of community health leaders will discuss.

Zachary K. Chapman, primary care administrator at Carthage Area Hospital, is in Mrs. Alexander's group. In separate groups, but also from Jefferson County, are Stephen A. Jennings, Jefferson County Public Health information officer, and Aileen G. Martin, the North County Children's Clinic director of operations.

Mrs. Martin said she hopes to be able to hone her skills as a health care leader.

"Our budgets are tightening," she said. "I see us moving toward a trend of wellness. There will be people prepared to lead in the tumultuous time were headed into."

She said Jefferson County organizations have been lucky to have talented people in leadership for as long as they have, but the next generation of health care leaders needs to make sure they have the skills and knowledge of those they will follow.

"The baby boomers have been leading in health care," Mrs. Martin said. "The pool is not as large. They're making sure the skills and experience are there."

The Robert Wood Johnson Foundation will have coaches, she said, and take the feedback for her and the 28 other Central New York health leaders to develop better skills. From that, she said, a stronger base will be built for the next generation.