The purpose of this study was to assess the competencies and training needs for public health professionals managing chronic disease prevention programs. Focus groups were conducted among representatives from 12 state health departments across the United States, and data from the interviews were analyzed. The findings support additional training to enhance specific competencies for management/leadership, epidemiology/biostatistics, chronic disease prevention/policy development, and evaluation. Commonly reported competencies were knowledge of public health and chronic diseases, communication, and diversity. The findings can be used to design future competency-based training programs to build the capacity for chronic disease programs in state and territorial health departments.