Displaying 1-20 of 22 results for

Initial estimates from 2020 suggest that annual drug overdose deaths in the United States reached a record high of 93,000. Fortunately EMS strategies are being put in place to combat this nation-wide issue.

Read a detailed summary of the FY26 Senate Appropriations Bill, which was released on July 31.

Get insight into the successes and challenges of integrating race/ethnicity data in public health and future directions in this field.

As in any sector, there is often talk in the public health field of “working upstream,” or addressing problems at their source. If public health is going to be a changemaker in the world, its leaders must be equal parts nimble and innovative.

A mid-session legislative update on five of ASTHO's top 10 public health state policy issues to watch in 2023: data privacy and modernization, reproductive health, health equity, strengthening public health agencies, and immunization.

Investing in Indiana’s Public Health Infrastructure Through Community-Driven Policy Change public health infrastructure, community driven policy, indiana state health commissioner, public health system, indiana department of health, outpatient facilities, technical assistance, data and information integration, emergency preparedness, child and adolescent health, legislative action, state and local elected officials, health problems, health care, health system, health departments, federal agencies, essential public health services, centers for disease control, state and local levels, health outcomes, health organization, covid-19 pandemic, health infrastructure, promoting health, public health organizations, states public health, federal funding, astho, association of state and territorial health officials Maggie Davis, Keith Coleman Indiana enacts historic public health funding through community engagement and legislative support. In April 2023, Indiana passed bill SB 4, which was a historic investment in the state's public health funding and restructuring its public health system. This case study shares how the Governor's Public Health Commission and the Indiana Department of Health approached community listening sessions, formulated recommendations, and successfully built legislative support to reform the public health system in the state. Get the Report (PDF) website yes

As the overdose epidemic continues, it is imperative for the medicolegal death investigative community to understand the importance of continuous training and the role that accurate death certification plays in protecting the nation’s health.

Creating an Informatics Job Classification Series for Health Departments Creating an Informatics Job Classification Series for Health Departments Ari Whiteman Learn why public health informatics jobs are critical for health departments in this brief. Why a Public Health Informatics Job Classification Matters The push to modernize public health data infrastructure has highlighted that traditional job classifications (e.g., Epidemiologist, IT Specialist, or Developer) do not fully capture the unique skill set and value of public health informaticians. Informatics professionals specialize in integrating, standardizing, and managing health data systems to ensure interoperability across platforms and agencies. Their expertise includes health data standards (e.g., HL7, FHIR, LOINC, USCDI), database management, extract-transform-load (ETL) processes, business intelligence tools, and cross-system data exchange, all of which are skills and proficiencies needed for data modernization transitions and processes. According to the 2022 ASTHO Profile of State and Territorial Public Health, 25 states and territories did not have a dedicated public health informatics job classification series, which would create several key advantages over forcing informaticians into traditional public health classifications that may not adequately reflect their job duties or the expertise needed to perform them: Recruitment: Public health informatics job descriptions are likely to attract more qualified and better-fit candidates for the responsibilities of the role, which differ from that of IT professionals or epidemiologists. Retention: Informaticians often leave for the private sector due to higher pay opportunities, as governmental roles often pay less than similar roles in the private sector. A well-defined classification series with competitive salary benchmarks helps retain talent. Role Clarity: Differentiating informaticians from epidemiologists or IT ensures staff are linked to projects that fit their skills and experience, which can improve performance and morale across disciplines. Future-Readiness: Quality health data infrastructure is a preparedness necessity. Informatics positions enable agencies to respond to emerging health crises by linking response and surveillance data with other state and national reporting systems. Common Challenges and Solutions Anticipating challenges can help maintain progress and understanding across all involved parties. Challenge: Resistance to creating new classifications. Solution: Propose consolidation or sunsetting of outdated roles and highlight national best practices. Challenge: Salary constraints compared to private sector. Solution: Emphasize total rewards (retirement, benefits, meaningful work) and seek flexibility for exceptions. Provide salary data from sources like Lightcast, Healthcare Information and Management Systems Society, American Health Information Management Association, or surveys from the American Medical Informatics Association. Challenge: Limited internal public health informatics expertise. Solution: Build capacity through “train-the-trainer” models, upskilling, and leveraging partnerships with universities. Challenge: Slow civil service processes. Solution: Start early, maintain persistence, and adapt business case arguments to different decision-makers (HR, unions, leadership). See ASTHO’s Data Modernization Primer and Tactical Guides for more information, in particular: See the Tactical Guide on Building, Equipping, and Sustaining a Data Modernization Workforce for strategies for upskilling, training, recruitment, and retention of a data modernization workforce. See the Tactical Guide on Planning Data Modernization Activities for strategies to mobilize a team, conduct current state assessments, develop plans, and gain support from leadership. Challenge: Overlap with other roles (e.g., epidemiologists). Solution: Clearly define distinctions between public health informatics and other roles, then communicate role clarity to benefit morale and efficiency. Conclusion Creating a public health informatics job classification series is both a strategic investment and a practical necessity. By distinguishing informatics as a professional path within public health, states and territories can strengthen their workforce, address long-standing recruitment and retention barriers, and prepare for the rapidly evolving demands of data modernization. While the process requires persistence, clear documentation, and negotiation across HR and leadership, the payoff is a resilient workforce equipped to manage the data infrastructure that underpins modern public health practice. Reference the How-To Guide for more details on creating public health informatics job classification series. Learn More - Brief - Creating an Informatics Job Classification Series OE22-2203 PHIG article yes

Explore INSPIRE: Readiness by ASTHO—an innovative hub for public health preparedness. Share strategies, tools, and solutions to boost readiness.

Data Modernization Primer and Tactical Guides Dive into these data modernization reports for strategies and detailed steps to move from siloed systems to a connected, resilient data ecosystem. Public health data modernization is a collective effort by federal, state, local, and tribal organizations to strengthen public health data and surveillance systems. The ultimate goal is to move from siloed public health data systems to a connected, resilient, adaptable, and sustainable “response ready” data ecosystem. The primer provides state and territorial health officials with a high-level understanding of the objective and significance of data modernization as well as the roles that they play in a successful data modernization initiative. The five tactical guides detail key strategies and tactics for implementing and maintaining data modernization initiatives within public health agencies. article yes

Designing a Public Health Informatics Job Classification Series: A How-To Guide How To Design a Public Health Informatics Job Series Public health agencies can use this actionable guide to develop data informatics jobs and fill critical gaps in their workforce. As part of state and territorial data modernization programs and data system improvement, many public health agencies are realizing that their existing job classifications don’t always reflect the specialized work of public health informatics professionals. While some positions may resemble traditional roles like epidemiologists, they require a distinct set of skills. Informatics professionals focus on integrating and managing data, building stronger data systems, and improving how information flows across programs and partners. They often use advanced tools such as SQL and Tableau, and they work with national data standards — like HL7, FHIR, LOINC, and USCDI — to ensure that health information systems can “speak the same language.” Existing classifications (such as epidemiologist or information technology specialist) rarely capture these technical and cross-disciplinary responsibilities. Creating a dedicated public health informatics job classification series helps agencies attract and retain experts with the right mix of data, technology, and public health skills. It also provides a clear structure for professional growth, defining duties and qualifications for entry-, mid-, senior-, and managerial-level positions. This clarity supports both staff development and long-term workforce planning. However, establishing a new job classification is not a simple task. It requires careful planning, collaboration across departments, and formal approval processes that can take time. This guide outlines the key decisions, documentation, and steps needed to determine whether a new classification is right for your agency and how to develop one effectively. Each health department’s structure and policies are unique, so the process described here should be adapted to fit local circumstances. Steps in the Process 1. Identifying the Need for a New Job Classification The first step is to determine whether your agency truly needs a new public health informatics job classification. Many health departments find that existing job titles — like epidemiologist or clinical application coordinator — don’t align well with the skills required for informatics work. A new classification may be warranted if current titles have different job requirements, pay structures, or barriers that make it difficult to attract and retain qualified candidates. Begin by asking key questions: Does your department already employ staff performing informatics functions? If so, what are their current classifications, and are they effective in recruitment and retention? How flexible are your civil service rules for posting positions with modified requirements or titles? If there’s sufficient flexibility, you may not need a new classification. Are you relying on temporary staff or contractors for informatics work? If so, analyze whether creating permanent positions could reduce long-term costs. If a new classification isn’t immediately feasible, what options exist to train, promote, or compensate staff doing informatics work within the current framework? 2. Understanding the Approval Process and Requirements Once a need is established, identify the steps and timeline required to create a new classification. This process varies widely by jurisdiction and can take several months, or even years, to complete. Start by determining who has decision-making authority and which offices must approve the proposal. This may include local HR departments, statewide HR or civil service offices, commissioners, or budget authorities such as the Office of Management and Budget. If your HR department has a moratorium on creating new classifications, consider negotiating or repurposing existing ones. Document the rationale thoroughly, highlighting recruitment challenges, misaligned duties, and how informatics roles support data modernization goals. Include evidence such as prolonged vacancies or the impact on program performance. Prepare necessary documentation, which may include: A list of required competencies. Subject matter expert reviews. A work study or position analysis. A “career ladder” illustrating differences between entry, mid, senior, and managerial roles (see example: Nebraska’s Informatics Series (PDF)). Comparisons with other job families, such as Nebraska’s Epidemiology Series (PDF). Additionally, determine whether other state agencies also require informatics roles, as cross-agency collaboration can strengthen the case for a new classification. When it comes to salary justification, find out who sets pay scales — some states use centralized systems, while others allow departmental flexibility. In unionized settings, salary changes may also require negotiation. For example, Minnesota uses the Hay methodology through Korn Ferry to determine compensation levels. 3. Gathering Job Descriptions, Competencies, and Key Skills Developing an accurate and competitive job description is crucial. Start by analyzing the knowledge, skills, abilities, and other characteristics required for informatics work. Assess whether existing staff possess these competencies and where skill gaps may exist. Collect and review comparable job descriptions and frameworks from trusted sources, such as: Public Health Informatics Institute and Council of State and Territorial Epidemiologists Region V Public Health Training Center O*Net Online Health Informatics Profile PublicHealthCareers.org Commonly required skills include: SQL R SAS Python Tableau Snowflake ETL processes Interoperability standards (HL7, FHIR, LOINC, USCDI) Project management tools (e.g., Agile and LEAN) Certifications such as HL7 CDA Specialist, FHIR Fundamentals, or Tableau Desktop Specialist may also be valuable. For competency alignment, reference the following professional frameworks: HIMSS Global Health Informatics Competency Frameworks Applied Public Health Informatics Competency Model (PDF) Council on Education for Public Health (PDF) Council of State and Territorial Epidemiologists Competencies Toolkit Public Health Accreditation Board Council on Linkages Core Competencies CDC Competencies for Public Health Professionals You can also consult the Lightcast workforce analytics reports for skills and salary trends and review the literature review repository for additional insights. 4. Conducting Salary Benchmarking Competitive compensation is essential to attracting informatics professionals. Begin by identifying your HR department’s comparison states or agencies and reviewing their pay plans. Compare rates with large local jurisdictions when possible. Showing cost savings from converting contractors to permanent employees can strengthen your justification. If union negotiations are part of your environment, plan early to align with contract timelines. Many agencies use external benchmarking tools aligned with the location of the job, such as Salary.com, Payscale, Glassdoor, or Indeed. Large-scale workforce datasets from Lightcast — a large-scale data vendor that includes data collected from millions of job descriptions — can be useful as well. Data from Lightcast queries include examples of competitor employers, top technical and soft skills, example job titles, and salary ranges for public health informatics positions. Searching and summarizing reference data like this is vital for establishing baseline job information that is in-line with successful public health informatics positions elsewhere, which can help build a case for why your new series is different than existing jobs and requires a specific pay range. For deeper insights into salary trends and disparities, review the following: Salary and Job Requirement Differences for Jobs in Local and State Health Departments Versus the Private Sector: Analysis of Large-Scale Job Postings Data demonstrates that public-sector informatics roles can pay up to 50% less than private-sector equivalents. Salary Disparities in Public Health Occupations: Analysis of Federal Data (2021–2022) shows that informatics jobs pay between 25-45% less in local or state government compared to all other sectors, a difference of up to $71,000 per year in wages. When Money Is Not Enough: Reimagining Public Health Requires Systematic Solutions to Hiring Barriers explores structural barriers beyond pay, such as slow hiring processes or outdated job descriptions, that cause barriers to hiring in health departments. Also review relevant salary surveys from professional associations: HIMSS Nursing Informatics Survey (2022) American Health Information Management Association Salary Survey Report (2019) (PDF) American Medical Informatics Association Salary Survey iMercer Healthcare Informatics and Technology Compensation Data Other Considerations Establishing a new public health informatics job classification requires more than paperwork — it requires persistence, partnerships, and long-term planning. Building relationships with key stakeholders, such as HR leaders, civil service administrators, union representatives, and department executives, is essential. Each may have unique perspectives and concerns about creating new classifications, so tailoring your approach can make a difference. Persistence is often key. If one strategy or argument isn’t successful, try another. For example, some departments have found success by framing informatics roles as critical to data modernization, interoperability, and cost efficiency, while others emphasize workforce development or public health impact. Having distinct classifications for public health informaticians and epidemiologists also supports workforce morale and clarity. It helps staff and partners understand who to contact for specific issues (e.g., analytical versus technical data

ASTHO’s 2023 Public Health TechXpo and Futures Forum is a platform to tackle the toughest public health challenges facing the nation, both today and in the future.

What We Learned at the Public Health TechXpo and Futures Forum ASTHO | Our staff's top takeaways from the TechXpo. astho, association of state and territorial health officials, public health techxpo and futures forum, public health leaders, u.s. public health system, public health policy, data sharing and modernization, population health, governmental health agencies, public health infastructure, workforce resilience, public health workforce, techxpo and futures forum, public health infrastructure, build workforce resilience, future of public health, health techxpo and futures, health leaders and experts, experts across the technology, health workforce, health outcomes, futures forum, health leaders, health departments, public health professionals, today and the future, public health services, public health techxpo Dylan Reynolds Marcus Plescia and Garfield Clunie present "The Future of Measuring Health Equity - A World of Evolving Data." Last month, ASTHO kicked off the Public Health TechXpo and Futures Forum in Chicago, an opportunity for some of the world’s top leaders in technology and to engage public health leaders on challenges and solutions for successfully modernizing the U.S. public health system. Over 600 participants were in attendance, with 200 more attending virtually from around the world. It was a packed three days. Our speakers demystified the world of public health policy, opened doors to new funding streams, and gave us a glimpse into the glittering future of data sharing and modernization. Heavy hitters from Amazon and Google weighed in as well, showing us how they’re working hand-in-hand with health agencies to change the way they approach population health and well-being. So as we look back on a busy week—and look ahead to our virtual follow-up event on June 15—here are some of the messages that stuck with us the most: "Standards are like toothbrushes. Everyone has one, and no one wants to use some else’s." The line from Gabriel Seidman, director of policy at the Ellison Institute for Transformative Medicine, was met with a belly laugh from a crowded room during one of the week’s most well-attended sessions, a panel conversation on the future of measuring health equity. However, Seidman’s comparison was an apt one. There is certainly much to be said for a public health data system that is engineered to meet the specific needs of its target community. However, for public health experts to do their best work, they must be able to speak a common language—at a local, state, territorial, and national level. When each level of public health is operating with different standards in place and with a different definition of success, data gets lost and people get left behind. One of the loudest calls to action from the week was for governmental health agencies to break down these data siloes and establish common standards between agencies. The "Next Pandemic" is a Priority—But It's Not the Only One There is—understandably—mounting national attention on preparing for what many public health experts believe will be the inevitable "next pandemic." The COVID-19 pandemic showed us what a lack of preparedness could mean for population health, and there is so much unknown about what the future of pandemics has in store. However, experts at the TechXpo reminded us that public health is about more than responding to a singular crisis. "I think many of the conversations we're having are so focused on COVID-like pandemics," said John Auerbach (alumni-MA) "But if we look at the things that are still killing people, for the most part it's not infectious disease." Instead, Auerbach cited challenges that have long been a part of the public health story, such as diabetes, the fentanyl overdose crisis, and climate change. Before COVID-19 entered the national spotlight, public health’s day-to-day work was largely centered on chronic disease and behavioral health. Auerbach reminded us that amid all of the unknowns of our future, there is plenty we do know—and plenty we can be doing to address it. "Modernizing data systems is more than buying a big computer." While there were many versions of this message over the course of the forum, Auerbach perhaps said it most concisely of all. In other words, it doesn’t matter if a public health agency has a chrome-plated exterior and a cloud-based data system, so long as the underlying infrastructure isn’t sustainably and thoughtfully built. Whether it’s a matter of restricted funding, antiquated processes, or siloed thinking, health agencies and their leaders must have a plan to address these challenges before assuming that “buying a big computer” will catch their data dashboards up to speed. This was one of the ironies of this future-forward event: Amid so many exciting innovations and inventions, many of the challenges boiled down to basic, equity-centered questions about the best way to get this new technology in the right people’s hands. If public health is going to take a technological leap at a national level, then it must also be able to make a leap at a community level—in communities of color, in territorial health agencies, and in our policies. Jumping lightyears ahead doesn’t count if entire populations are still being left lightyears behind. Workforce Resilience Cannot Be Taken for Granted We cannot separate the future of public health from the future of its workforce. The COVID-19 emergency response has left many public health workers feeling burned out and harboring traumatic levels of toxic stress, pushing many of them to seek out jobs outside the field. In fact, according to a recent analysis of data from the Public Health Workforce Interests and Needs Survey, 46% of state and local public health employees left their jobs between 2017 and 2021. For public health to reach its full potential in the future, we must begin investing in that workforce today. Over the course of the week, we heard often from mental health experts and senior health officials to learn about their priorities, challenges, and paths to improve workforce well-being in their health agencies. This included the unveiling of the PH-HERO Workforce Resource Center, which arms health agencies with the resources and knowledge they need to support their workforce. Whatever the future of public health holds, it begins with a workforce who is motivated to make that future a reality. More than anything, the TechXpo was a reminder that public health’s future is as multiple as it is uncertain. We are working toward a future that is more adaptable than ever before—with thought innovators and health experts who are constantly reflecting, pivoting, and adjusting to the moment. There are so many conversations yet to be had. For those who have not done so already, we invite you to register for our fully virtual TechXpo follow-up forum on June 15, and add your voice to the growing chorus. website yes

ASTHO profile data indicates the public health workforce has more temporary and vacant positions than ever before

Data-Sharing Strategies to Support Access to Care Interventions Anna Bartels, Chikamso Chukwu Learn how primary care offices improve community access to health care in this Health Policy Update. Every state public health agency houses a Primary Care Office (PCO), which monitors the effectiveness of that jurisdiction’s health system. HRSA funds PCOs to identify communities with health professional shortages, and PCOs may also administer workforce programs to place providers in those communities. To identify which communities are experiencing shortages, PCOs collect state-level data on where health care providers work, what services they offer, and how many hours they spend on patient care. PCOs also track data on community needs, such as household income levels and community transportation options, to create a holistic picture of whether health care is truly accessible. PCOs across the country have explored different policy pathways to access reliable, accurate data, including laws that support PCO access to certain data sets, cross-sectoral relationships, and data-sharing agreements. According to ASTHO’s national PCO workforce assessment, over 85% of PCOs are part of a formal data-sharing arrangement, with licensing boards and Medicaid agencies serving as two of the most common data sources. This health policy update describes several types of actions jurisdictions have taken to support PCO data access. New Hampshire Law Allows the PCO to Survey Providers During License Renewals The New Hampshire PCO’s Health Professions Data Center administers a survey tied to health care providers’ medical license renewals that gathers self-reported provider and practice data, such as where providers work, how many hours per week are spent delivering direct patient care, and anticipated changes in capacity over the next five years. New Hampshire law outlines the scope of the survey and authorizes the PCO to collect, store, analyze, and report on health care workforce supply and capacity through surveying during license renewal. Although survey responses are the primary source of data on the health care workforce, data from the state’s all payer claims database housed within the Medicaid division provides supplemental information. Given the type of data involved, legal agreements are required between the PCO, licensing agencies, and relevant parties to maintain privacy for providers. These data are critical for the PCO to evaluate current and future capacity — especially in regions with limited providers — and proactively focus recruitment efforts on those communities. Colorado Braids Data Collection Strategies Across Multiple Sources While the Colorado PCO has relied on a similar law that authorizes collecting licensure data for more than 10 years, its data collection efforts have since expanded. The state now collects and integrates data across 16 different sources, each requiring a different procurement strategy. While some data sources are simple to access because they are public use files (e.g., Medicare provider data), other sources — namely state agencies — require the PCO to submit an application or enter into a memorandum of understanding or contract for access. Pursuing multiple data sources in this way takes significant effort and staff time, necessitating the health department to supplement HRSA’s PCO cooperative agreement funding with other sources, including state appropriations and private funding. A commitment to collaboration and investment and a willingness to build new relationships and processes from scratch support the Colorado PCO’s wide-ranging data collection strategy. Iowa Builds on Existing Relationships to Access Provider Data Iowa’s PCO has a long-standing relationship with the University of Iowa and a joint interest in health care workforce data. Currently, the PCO purchases provider phone survey information from the University of Iowa’s existing program and receives data on a biannual basis. The university’s data collection is part of its own research efforts and not collected on behalf of the PCO, so while the data are broader than what the PCO needs, it is still a valuable source of provider information. Because of this existing arrangement, the PCO could pursue a more expansive agreement (that would likely require additional funding) and expand the scope of the data, such as by adding data collection on provider residence or sliding fee scales. Other PCOs may consider approaching partners that have pieces of the data they need so there is an established relationship in place that may be expanded as new resources become available. PCOs Secure Access to Medicaid Claims Data State Medicaid agencies are another frequent data partner for PCOs, with at least 16 receiving provider data from their state Medicaid agency in various formats. In some states the Medicaid agency shares a point-in-time file with the PCO, who may manually recode the data before submission to HRSA. In other states, the PCO has direct access to the Medicaid claims processing system to independently extract the necessary data points. The nature of the partnership between the PCO and Medicaid agency may vary based on the state’s organizational structure (e.g., whether the PCO and Medicaid agency sit within the same department). However, a PCO seeking access to Medicaid claims data should be prepared to justify the need for the data, articulate how it can support the Medicaid agency, and develop the necessary relationships to support a workable solution for both parties. Conclusion Each PCO and state health agency has its own unique structure, and there is no “right” way to collect health care provider practice or access data. However, exploring how different jurisdictions approach these processes can help PCOs think strategically about new initiatives and relationships. ASTHO will continue tracking PCO success stories and remains available to facilitate connections among health agency staff. 2 UD3OA22890-13-00 article yes

Likely Public Health Legislative Trends for 2025 Prospective Public Health Legislative Trends for 2025 Maggie Davis Get an inside look at prospective public health legislative trends for 2025, based on ASTHO's legislative tracking efforts and member feedback. Drawing from member feedback and ASTHO’s legislative tracking efforts, ASTHO identified five key issues state and island legislatures are likely to work on for the upcoming legislative sessions for the annual 2025 Legislative Prospectus Series. Each brief provides public health leaders and policymakers with a synopsis of the topics, recent legislative trends, and anticipated legislation in upcoming sessions. Public Health and Health Care Workforce States are continuing to address workforce shortages within public health and the health care systems. ASTHO’s prospectus outlines strategies that legislatures are considering, from bolstering state public health funding to legislative efforts addressing nationwide workforce shortages through recruitment incentives, workforce commissions, and pipeline programs. Containing Spread of Infectious Disease State and territorial public health agencies are responsible for protecting the health and safety of their residents and have legal authorities to fulfill those responsibilities. In recent years, many legislatures have revisited the scope of these legal authorities, with states like Washington (SB 6095) expanding the health official’s authority to issue standing orders for a range of disease interventions. Similarly, legislatures may continue considering vaccine-related legislation. While many bills in recent years aim to weaken vaccine policy, state leaders have listened to medical leaders within their state who advocate for strong vaccine policies. In 2024, West Virginia’s governor vetoed HB 5105 that would have weakened school enrollment requirements, informed by strong opposition from the state’s medical community and evidence that the existing vaccine policy had prevented disease outbreaks. Data Modernization and Privacy Modernizing public health and health care data systems have taken big steps forward, including federal initiatives like the Trusted Exchange Framework and Common Agreement (TEFCA), which establishes guiding interoperability principles and standards for health data exchange. Nevada enacted AB 7 in 2023 requiring new regulations governing health information exchanges (HIEs) and granting certain liability protections to providers using them. In the proposed rules published in August 2024, the Nevada Department of Health and Human Services intends to require that participating HIEs are TEFCA members. ASTHO anticipates more jurisdictions will allow public health agencies access to a wider range of privacy-protected health data through secure platforms like HIEs. Maternal and Child Health Public health supports mothers and children throughout their development. There are three emerging issues that legislatures are likely to work on in the next year: maternal morbidity and mortality, fetal and infant mortality, and youth mental health. One strategy to address youth mental health is using laws to regulate social media companies, requiring them to implement safeguards for minors who use their services. For example, California enacted SB 976 in 2024, which requires “addictive internet-based” services to gain parental consent before minors could use the service and limit the hours in which minors could use an application. Technology industry groups are challenging these efforts in court, with one suit asserting that California’s measure is unlawful governmental interference with First Amendment rights of minors. Substance Misuse and Overdose Prevention Although there was a significant decrease in overdose deaths in 2023, there are still legislative actions to help reduce substance misuse and prevent overdose likely to be considered in 2025. During the 2024 sessions at least 24 state legislatures considered bills to regulate products like kratom and hemp derived products (e.g., Delta-8). Additionally, at least 18 legislatures considered bills to decriminalize drug checking equipment like fentanyl and xylazine testing streps. ASTHO anticipates states legislators will continue implementing harm reduction efforts, policies to connect people with substance use disorders to care, and efforts to regulate products with potential for abuse or misuse in the next session. What We Know So Far The majority of states will convene their legislative sessions in January 2025, with at least 15 states scheduled to conclude their session by the end of April; there will likely be a flurry of legislative activity in the first quarter of the year. Already the Texas legislature has prefiled more than 1,200 bills for their 2025 session, covering topics including a health commissioner’s authority to establish routine childhood immunization requirements (HB 468) and making changes to the state’s maternal mortality and morbidity review committee reporting requirements (HB 713). Additionally, Virginia’s General Assembly convened its two year session in January 2024 and has a number of bills carrying forward into 2025 including bills related to suicide prevention (HB 80) and improving maternal health data quality (HB 286). ASTHO will monitor legislation related to these topics and more during the 2025 sessions and will provide relevant updates. OE22-2203 PHIG article yes

Illinois Strengthens Public Health Infrastructure with New Data Modernization Director Alicia Camuy Learn how Illinois is using Public Health Infrastructure Grant funding to promote data modernization. As COVID-19 demonstrated, robust data infrastructure is critical to an effective public health emergency response. The pandemic highlighted the urgent need for health departments and other public health entities to improve how health data is collected, stored, and shared. The CDC-led Data Modernization Initiative (DMI) is working across all levels of public health to meet this urgent need. Part of this initiative is the Public Health Infrastructure Grant (PHIG), a groundbreaking investment supporting 107 recipients working to bolster the public health workforce, enhance foundational capabilities, and advance data modernization and informatics. PHIG national partners and specialized Implementation Centers support these efforts through technical assistance and capacity building. Some PHIG recipients have utilized this funding to staff dedicated DMI positions and convene advisory committees. The Illinois Department of Public Health (IDPH) recently hired Gayatri Raol as its Data Modernization Director to oversee the state’s efforts in this area. What are your highlights from your data modernization work around PHIG so far? Gathering Data Modernization Stakeholders To build some structure around DMI implementation, IDPH recently kicked off a data governance board, data modernization advisory committee, and DMI strategic planning workgroup, which all bring in key stakeholders to have focused conversations on data initiatives. The board defined data governance for IDPH and is working on approving and adopting a department-wide data suppression policy, which will be a major success for the department. Adopting a Data Sharing Agreement IDPH has finalized a Master Data User Agreement to streamline data sharing practices, which will allow local health departments to access data for birth and death records, hospital discharge, cancer registries, syndromic surveillance, prescription monitoring programs, and more. Bolstering the Data Modernization Workforce We are working with the CDC Foundation Workforce Acceleration Initiative, a program that places data and technology experts in public health agencies to accelerate data systems improvement. Through that collaboration, we have been awarded two technical and two project management support positions. Training a Data Literate Health Department IDPH has also started exploring a data literacy program to support IDPH staff and local health departments in understanding the data we have, what it means, and how to manage it. This program will be the initial step towards change management to build a data-driven organization and a data literate workforce. Building a Streamlined Data Request Management System IDPH is streamlining and centralizing data request processes across the department. The department is collaborating with IT to develop a data request tracking and management system. If we can reduce the time of the process by even 25%, then it will be a success. This project will increase the transparency around data requests processing and keep our data governance board, internal review board, and data owners informed about data sharing practices. What challenges do you expect to encounter and how do you plan to meet them? Our challenges are not unique compared to those faced by other public health departments, but they are significant in the context of other data modernization initiatives. Some of our main challenges are: Slow, cumbersome, and complicated hiring and procurement processes. Stringent policies. Understanding diverse workforce and population needs. Acquiring sustainable funding and buy-in. For those challenges beyond our control, our team focuses on communication and collaboration to move toward improvement. However, for those challenges we can directly impact, we follow several key strategies: Reviewing and updating existing policies to make them more flexible and adaptable, allowing us to respond more quickly and effectively to new opportunities and challenges. Investing in data literacy programs to enhance our workforce’s skills, enabling them to better interpret and use data in decision-making processes. Incorporating a health equity and justice lens into data-related projects and processes to better meet the needs of the communities we serve. Investing in foundational data management practices and processes. How is IDPH’s data modernization work impacting IDPH itself and, ultimately, Illinois residents? It is difficult to measure the direct impact of state-level data modernization efforts on the lives of Illinois citizens. However, enhanced data management practices will equip our public health leaders to make more informed decisions. Better quality and more integrated data will help keep decision-makers informed on how to allocate resources, identify public health trends and outbreaks, and respond efficiently to public health crisis. OE22-2203 PHIG article yes

How Washington State Leverages Data to Improve Emergency Preparedness Erin Laird Learn how Washington State has created a robust system for distributing public health and medical supplies during emergencies. When an emergency strikes, supplies like personal protective equipment (PPE) need to be deployed rapidly and strategically. Local, state, and federal partners must work together to identify and meet community needs—a process that requires timely access to actionable data about medical countermeasures and other vital public health supplies. State health agencies need to know how many public health supplies are on hand so they can make informed decisions and react to developing situations. In March 2024, ASTHO, with support from the Administration for Strategic Preparedness and Response (ASPR) and HHS Coordination Operations and Response Element, selected three state health agencies—Ohio, Massachusetts, and Washington—to identify and pilot scalable solutions to improve data and information sharing for public health response. ASTHO conducted a site visit to the Washington State Department of Health (WA DOH) in June 2024 to learn about their medical logistics center and observe the first in a series of regional tabletop exercises—Highly Efficient Local Logistics Operations Tabletop Exercise (HELLO TTX)—they conducted to better understand logistical considerations of requesting, receiving, and distributing PPE and medical countermeasures and tracking last mile distribution. Medical Logistics in Washington State: Moving Faster to Save Lives Key Term - Blog - How WA Leverages Data to Improve Preparedness The Washington State Medical Logistics Center plays a pivotal role in emergency response, supporting WA DOH’s ability to quickly distribute vital supplies and medical countermeasures before and during major incidents. Through the COVID-19 response, the WA DOH medical logistics effort expanded to include vehicles, systems, and a 198,000 sq. ft., temperature-controlled warehouse. This effort ultimately supported WA DOH’s ability to distribute over 150 million gloves, 66 million surgical masks, 30 million N95 respirators, and other vital supplies throughout the COVID-19 emergency response. This increased logistical capacity has allowed WA DOH to respond to many other events. In 2023, in response to wildfire smoke, WA DOH distributed 850 air cleaners across the state in just two days to support points of dispensing (PODs) in tribal communities. The Yakima Fire Department experienced an opioid overdose outbreak in September 2023 and WA DOH coordinated statewide to identify supply of naloxone and support mutual aid. Finally, in May 2024, WA DOH distributed 96 portable air cleaners and pallets of N95 respirators to the Benton Franklin Health District to support POD operations for communities with air quality impacted by the Lineage Cold-Storage Fire. Receiving, storing, and distributing medical countermeasures and other supplies requires strong data management systems and practices. WA DOH strives for a collaborative approach to enhance data management for logistics. By facilitating bidirectional data sharing among health care, emergency management, public health, and tribal partners, WA DOH aims to enhance its ability to track assets and “last mile” logistics. To this end, WA DOH conducted a series of in-person tabletop exercises (TTXs) with each region of the state. These TTX discussions focused on the logistical considerations of requesting, receiving, and distributing PPE and medical countermeasures using a scenario of a novel influenza outbreak. Leveraging TTX Discussions to Understand Local Logistics Washington Department of Health staff gathered for a tabletop exercise with ASTHO staff. The tabletop discussions were organized into two modules: Medical Logistics Requesting, and Medical Countermeasures Planning and Last-Mile Distribution. The tabletop discussions focused on understanding how local jurisdictions source, receive, and distribute supplies. Cory Portner, director of WA DOH’s Office of Emergency Medical Logistics, praised the discussions: “The HELLO-TTX series highlighted the power of collaboration and gave us actionable insights into refining our response strategies and logistics operations. Effective communication across agencies is key. As always, at the end of the day it comes down to relationships and knowing who to call.” Many jurisdictions indicated they do not have the space or staff to manage more than a small stockpile of supplies. Once requested from the state, local jurisdictions coordinate with local partners—such as libraries, foodbanks, fire departments, and immigrant assistance centers—to get materials distributed to the community, often using either PODs or using trusted partners to distribute to the population they serve. Space came up as an issue repeatedly, with some jurisdictions utilizing creative solutions such as leveraging storage available at fairgrounds, a county-owned airport, and even an old jail (a solution that raised some unique challenges for receiving). Last mile tracking depended on the type of asset. For example, tracking for PPE typically ended at the community partner level (the agency or site that received the supplies), while tracking for vaccines could show more data on number of vaccines administered by a provider. The focus of last mile tracking for local jurisdictions centered around using last mile information to ensure that the requestors received what was needed. Looking ahead, additional last mile tracking could shed light on equity and a better sense of whether community needs were met, rather than just whether orders were filled. Portner reflected, “HELLO TTX showcased that local partnerships vary widely: larger urban areas typically focus on health care and emergency management organizations, while smaller rural areas engage a broader range of local sectors like fire departments and veterinary services. Medical logistics operations also differ, with urban areas having greater storage capacity and more advanced data tracking, while rural areas face limitations in both. Additionally, local prioritization of PPE and medical countermeasures affects how each area tracks logistics and manages storage.” Looking Ahead This 198,000 sq. ft., temperature-controlled warehouse serves as the Medical Logistics Center for WADOH, housing PPE, medical countermeasures, and other supplies. Effective public health response requires an understanding of what supplies are needed, where they are needed, and to track whether those needs were met. To achieve this, coordination and communication across multiple levels of public health is critical. "Next up, we’re focusing on asset tagging and improving supply chain visibility through enhanced data readiness. Our goal is to create a more transparent and responsive logistics system, to make sure that we’re fully prepared for any future emergencies in support of communities in Washington state and beyond,” explained Portner. The strategies explored by these data readiness pilot sites can improve critical processes and demonstrate sustainable methods to meet the demand of bidirectional information sharing for public health agencies and their partners. article yes

Leading Health Security Efforts Through Strategic Collaboration and Innovation Margaret Nilz This blog post illustrates how health agencies' strategic plans can improve health security and emergency preparedness. Strategic planning is a cornerstone of effective public health systems, guiding organizations in preparing for and responding to health threats. Three pivotal documents—the CDC Office of Readiness and Response (ORR) Strategic Plan, the ASTHO Strategic Plan, and the ASTHO Environmental Scan—are part of the foundation of ASTHO’s work. Each plays a critical role in shaping public health policies and practices. Understanding their synergies and differences is beneficial and crucial for enhancing our collective efforts in safeguarding public health. ASTHO’s Environmental Scan tracks U.S. public health concerns and trends. Through qualitative analyses of select health agency materials and health official feedback, this blog identifies state, territorial, and freely associated state health agencies’ (S/THAs) top current and emerging priorities across public health programs, infrastructure, and health equity and agency strategies to address them. Across 2023 and 2024, S/THAs consistently identified emergency preparedness and response as a critical priority. Callout 1-Blog - Leading Health Security Efforts through Strategic Collaboration and Innovation It is essential to align strategic plans and address emerging public health priorities in order to effectively respond to new health challenges. The ORR and ASTHO Strategic Plans share several common goals, such as implementing equitable, evidence-based practices, partnering for sustainable infrastructure improvements, and focusing on operational excellence while providing technical assistance. However, each plan also has unique missions. Callout 2-Blog - Leading Health Security Efforts through Strategic Collaboration and Innovation ASTHO’s Health Security team has a unit mission and vision that align with ORR goals and focus on supporting the needs of ASTHO members, as identified in the Environmental Scan. Callout 3-Blog - Leading Health Security Efforts through Strategic Collaboration and Innovation Aligning these strategic goals with current public health priorities is crucial in addressing existing and emerging health threats. Values The ORR and ASTHO plans express shared values like collaboration and innovation. These values guide strategic decisions and foster a cohesive public health community. Table-Blog - Leading Health Security Efforts through Strategic Collaboration and Innovation Competencies and Priorities Both organizations focus on developing competencies like leadership and technical expertise. ORR concentrates heavily on competencies specific to preparedness, including planning, response, and research for public health emergencies. ASTHO emphasizes competencies to support S/THAs, such as technical assistance, communication, capacity building, and advocacy. Building and aligning these competencies is essential for improving public health outcomes and ensuring workforce preparedness. With that in mind, ASTHO’s competencies are specifically aimed at aiding and supporting its members, and consequently the nation, in achieving the ORR competencies. Environmental Scan Observations The ASTHO Environmental Scan thoroughly evaluates current public health trends, challenges, and opportunities. Key highlights from the 2023 and 2024 Environmental Scans include: Focus on emerging threats such as infectious diseases and the impact of climate change. Changes in public health funding and resource availability. Technological advancements and their implications for public health practice. Common trends identified include a heightened focus on health equity, the importance of data-driven decision-making, and the need for increased interagency collaboration. Organizational competencies, including performance management and quality improvement, were listed as current priority areas for public health infrastructure and capacity-building. Focus issues include financial infrastructure, business processes, including procurement, recruitment, and grants management, policy development, and public health governance structures. Workforce development was listed as a priority for public health infrastructure and capacity building. Focus issues include recruitment and retention, local academic pipelines and training opportunities, staff compensation, and staff salary gaps. Data modernization and informatics are priority areas in states with state health improvement and strategic plans and were listed as current public health infrastructure and capacity-building priorities. Accountability, performance management, and quality improvement are priority areas in states with state health improvement and strategic plans and were listed as current public health infrastructure and capacity-building priorities. Implementation While ORR and ASTHO aim to achieve similar overarching goals of supporting health agencies, their implementation strategies vary. The ORR Strategic Plan focuses on four primary strategies that directly address the emerging threats and challenges highlighted by S/THAs, including: Modernizing and integrating data and systems across multidisciplinary public health entities to support data readiness and interoperability. Advancing readiness and response science to improve public health practice, including maturing and implementing evidence-based research in preparedness. Building and enhancing the response capability of CDC and state, tribal, local, and territorial health departments and driving collaboration among partners to enable rapid and effective response to public health emergencies through improved capabilities, partnerships, and funding mechanisms. Conducting rapid and ongoing readiness and response evaluation to inform continuous improvements across the detection of public health threats, readiness science, and emergency operations. While ASTHO’s Strategic Plan is less explicitly focused on preparedness, its guiding mission in supporting, equipping, and advocating for S/THOs and their agencies with a focus on leadership development highlights several strategic priorities critical to improving public health preparedness and addressing emerging priorities. Health and Racial Equity: A state and territorial public health system that prioritizes implementing policies and programs advancing health and racial equity to achieve optimal health for all. Workforce Development: A diverse state and territorial public health workforce that is engaged, well-resourced, well-trained, and connected to the communities it serves. Data Modernization and Interoperability: A state and territorial public health system supported by an enterprise-level data infrastructure in which public health data systems are interoperable, secure, and supported by a well-trained workforce. Collaborative Opportunities Maximizing the impact of these strategic plans involves leveraging the strengths of each organization through collaboration and innovation. There are numerous areas where ORR and ASTHO can collaborate to enhance public health outcomes: Joint programs leveraging CDC’s national scope and ASTHO’s state-level connections. Shared research initiatives pooling resources and expertise from both organizations. Coordinated emergency response efforts that create a unified front addressing public health emergencies. By continuing to communicate, these organizations can effectively address complex public health challenges and enhance overall public health resilience. Future Outlook Looking ahead, the strategic efforts of ORR and ASTHO will play a crucial role in shaping the future of public health infrastructure and preparedness. Engaging with and supporting these initiatives is essential for all stakeholders. To adapt to the changing health security threats, future iterations of all documents must be routinely updated to meet the needs of the nation and ASTHO’s members. A collective effort is required to improve public health resilience and response capabilities, ensuring we are well-prepared for future challenges. Ultimately, the synergy between ORR and ASTHO’s strategic plans presents a powerful opportunity to enhance public health outcomes. We can create a more resilient and effective public health system by fostering collaboration, building competencies, and addressing emerging trends and challenges. website yes

This blog post discusses mitigating risks of AI use in government agencies, emphasizing privacy, transparency, and ethical concerns.