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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

Use Partner Mapping to Power Data Modernization Projects Allen Rakotoniaina, Heidi Westermann, Elyssa Stoops, Charlie Ishikawa Learn how to use partner mapping to clarify and understand your data modernization partners, and tailor engagement strategies for shared projects ownership. Partner mapping is a practical way for state, territorial, local, and tribal public health agencies to identify, organize, and engage the wide range of stakeholders involved in data modernization (DM). This resource helps agencies clarify who their DM partners are, understand their perspectives, and tailor engagement strategies to build shared ownership of DM projects. article yes

ASTHO, with support from CDC, launched the first cohort of the Linking Pregnancy Risk Assessment Monitoring System and Clinical Outcomes Data Multi-Jurisdiction Learning Community in October 2021. This brief examines themes that emerged from conversations in the learning community about the challenges encountered during data linking activities and discussed lessons they learned.

Information on disability status and type is not systematically collected during emergency department visits and, as such, it cannot be used during surveillance. ASTHO conducted six key informant interviews with disability professionals to inform development of this new diagnostic code-based definition.

Tobacco use causes 480,000 premature deaths each year, making it the leading cause of preventable death in the United States. In collaboration with CDC, ASTHO is leading an effort to explore how states can use Medicaid data to quantify tobacco use within this population, identify related best practices, and make recommendations for scaling.

ASTHO has been exploring how using GIS and data visualization tools can improve traditional public health work. This brief shares several expert use cases for visualizing and integrating environmental health and electronic health information with the assistance of GIS tools to improve public health decision making.

Public Health TechXpo and Futures Forum Come to the Public Health TechXpo and Futures Forum! TechXpo, tech expo, public health, data modernization, public health event, astho, association of state and territorial health officials, public health officials, territorial health officials, state health officials, public health workforce, public health workers, data solutions, nation health features, data management, data platforms, virtual event exploring challenges, data architecture, technology solutions, data lakes, health of all people, monitoring health threats, real time, health care, healthcare ASTHO Public Health TechXpo and Futures Forum 2023 website

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

Discover resources that can help your health agency unlock the power of internal policymaking in data modernization efforts.

Immunization Information Systems: One Foundational Data Source, Endless Health Insights Immunization Information Systems - Endless Health Insights Kim Martin, Mary Beth Kurilo Learn how public health agencies can better share critical data across jurisdictions in this blog post. A Bold Vision Back in 2014, a state health official from the Midwest recognized a problem: immunization information systems (IIS) were jurisdictionally based — mostly at the state level — resulting in data gaps when people moved or received care across state lines. In talking with his ASTHO colleagues, he shared a bold vision: what if ASTHO led a coordinated effort to unite key stakeholders and make widespread, seamless interjurisdictional immunization data exchange a reality? Momentum built quickly, and by the end of the year, ASTHO had convened a broad coalition of stakeholders and meaningful progress followed: A draft memorandum of understanding (MOU) to enable data exchange across jurisdictions. A community of practice that fostered peer-to-peer learning and problem-solving. Stronger support for the development and implementation of the Immunization (IZ) Gateway, a federally sponsored technology solution and infrastructure that facilitates immunization data exchange. As these efforts advanced, organizations like the American Immunization Registry Association (AIRA), a national nonprofit dedicated to supporting and strengthening IIS, played a growing role in supporting IIS interstate data exchange while continuing to advance data standards, improve data quality, and promote IIS modernization across the country. Results: Connections Continue to Expand Today, 57 IIS jurisdictions have signed interjurisdictional exchange MOUs, and 44 jurisdictions are participating in IIS-to-IIS data exchange through the IZ Gateway. Those 44 jurisdictions have connections with their peer IISs for a total of 361 live connections that create pathways for data to securely flow across state lines. Have we completely solved the interjurisdictional data challenge? Not entirely, but we are well on our way to a collaborative solution that addresses a significant proportion of the data gap. As this state health official pointed out, broad collaboration is not only essential to this work — it’s a defining strength of ASTHO, AIRA, and the wider immunization community. Unprecedented Times We often hear that we are operating in unpredictable and evolving times. During recent discussions, immunization program staff highlighted potential risks to immunization infrastructure, particularly IIS, due to cuts in federal funding. With funding winding down, jurisdictions are anticipating impacts such as staffing reductions, the loss of contracted support, and the slowing or halting of ongoing data modernization work. These systems are important not just for supporting routine immunization efforts, but also for readiness in future outbreak or emergency responses. As the funding landscape continues to evolve, it's important to highlight the central role IIS play in providing timely, high-quality data to a wide range of stakeholders, including: State, tribal, local, and territorial health departments, which use IIS data to monitor coverage rates, manage vaccine ordering and inventory, and support reminder/recall efforts. Health care providers, who access IIS through bidirectional connections with Electronic Health Records or pharmacy systems to deliver informed care at the point of service. Long-term care and skilled nursing facilities, which serve vulnerable populations and depend on complete immunization histories for residents. Educational institutions — including colleges, secondary schools, and childcare centers — that verify student immunization status during enrollment. Health payers, who enhance claims data with IIS records to improve Healthcare Effectiveness Data and Information Set reporting and member outreach. Federal partners, who use IIS data to support nationwide surveillance and response efforts. Individuals and families who are increasingly empowered to access their own immunization records for health care, school, travel, and personal use. Immunization data is undeniably a vital resource that supports and strengthens both public and private health systems, helping keep communities healthy and ensuring we are better prepared for the next outbreak or pandemic. Where Do We Go Next? Broad interjurisdictional exchange of immunization data started with a vision from a single state health official. What can we tackle together next? Advocate for sustained IIS funding through public/private partnerships — We need to consider new funding models for IIS. With so many partners valuing and benefiting from IIS data, we have a rich resource to protect and support together. We could look to key partners (CMS and private payers, large health systems, EHR vendors, pharmacies) to support the systems and programs that ensure the secure exchange of immunization data. Support ubiquitous consumer access — All individuals can benefit from convenient and efficient access to their own and their family members’ immunization records to manage their health, inform their health care decisions, or supply documentation for work, travel, or school/childcare requirements. Today, only about half of the United States has direct consumer access to their immunization record in the IIS. Encourage broad IIS participation — We can all actively promote policies or incentives that encourage authorized health care providers and partners to exchange data with their IIS. However, not everything needs to be a formal law or policy. Sometimes, simply fostering a culture of routine reporting to or querying the IIS as the standard of care can make a meaningful difference. It’s also important to ensure onboarding processes are efficient and that providers and partners receive the necessary technical support. Ensure legal and policy support for your IIS — Advocate for laws and regulations that support provider reporting, data sharing, and patient access while safeguarding privacy. Address barriers such as consent requirements that may add burden to providers and limit comprehensive data collection. Together, we can ensure that IIS are robust, reliable, and an integral part of immunization programs and the broader public health infrastructure. By strengthening these systems, we help ensure individuals receive high-quality, personalized care — wherever they are. article yes

A Difficult Week for Public Health: The Cost of Incomplete Efforts The Cost of Incomplete Public Health Efforts Due to Funding Cuts Susan Kansagra Hear from ASTHO's chief medical officer who discusses the implications of funding cuts on public health. Last week state, territory, and local public health departments received abrupt notices terminating several CDC funding streams that covered a range of public health activities. While the rationale given was that these funds supported COVID-19 (no longer a declared public health emergency), the reality is that the funds supported public health response infrastructure as a whole — both for COVID-19 and for other health threats. While some jurisdictions may be able to absorb or reprioritize activities, most are reporting detrimental impacts on their ability to deliver public health services. Here are just a few of the impacts we’re hearing from states/territories, locals, and partners. A House Without a Roof First, the funding cuts will halt technology improvements and data systems modernization that would have made sharing information with health care facilities and the public timelier and more efficient. In addition to impacting future work, cutting funding early for these public health technology improvements results in waste of past work. Why? It’s like building four walls of a house and then abruptly stopping construction before the roof is in place. The usefulness of the whole house goes to waste. This is the quandary that many health departments are facing as funding terminates for updates already underway to immunization, surveillance, and case reporting systems as well as laboratories themselves. The First Line of Defense Against Health Threats When you walk into an emergency room you expect a health care provider to treat you. Likewise, when an outbreak occurs, public health expects it will step in to contain disease spread and protect the community. For some states, these funding cuts disrupt the very core duties of what health departments do to detect and respond to health threats like measles, H5N1, and mpox. And that’s to say nothing of diseases we don’t know about yet. For example, these funds were allocated by Congress to support lab capacity including specialized lab personnel and equipment. So, if there is a suspected or known measles or foodborne outbreak, many health departments will have less capacity to quickly test and use that knowledge to prevent people from getting sick. They will also have limited capacity to deliver treatments and vaccinations directly to people. For some communities, that will mean fewer clinic hours, longer waits, and delays in accessing care. Timing and Communication Matter In addition to the impact of the cuts themselves, public health departments report struggling with how abruptly they learned about them. Many public health workers found out about funding termination the same day the funding ended. The suddenness felt akin to shutting off the lights to the operating room while the surgeon is still in the middle of a procedure. In short, while the cuts themselves had a health impact, so did the lack of notice. For some funding streams, health departments were already preparing to close out the funds, but for many it created unnecessary disruption for people still depending on the services from these funds today. Overall, most jurisdictions report that the loss of these activities leaves an immediate hole in public health infrastructure that will impact their ability to respond to health threats both now and into the future. article yes

ASTHO’s 2024 resource roundup highlights essential public health tools, policy guides, and best practices for state and territorial health agencies.

How Massachusetts is Advancing Public Health Data Standards How Massachusetts is Advancing Public Health Data Standards Saisha Adhikari Learn how Massachusetts is leveraging funding from the Public Health Infrastructure Grant to improve how it handles and shares public health data. The Massachusetts Department of Public Health (DPH) has long understood that strong public health systems rely on strong data. But with thousands of staff, dozens of programs, and dozens of data sources, achieving consistency across the department is no small task. Rather than treating data modernization, performance management/quality improvement (PM/QI), and data standards as separate efforts, Massachusetts is intentionally bringing them together. Through Public Health Infrastructure Grant (PHIG) funding, the department is accelerating progress toward common data standards by strengthening internal capacity, improving coordination, and laying the groundwork for meaningful impact. Massachusetts is turning standards into shared practice, using measurements to connect teams, strengthening communication and change management, and tracking early wins that signal meaningful progress. Building a Strong Foundation Data standards are not new to Massachusetts. For more than a decade, DPH has collaboratively developed standards with voluntary work groups composed of subject matter experts from across the department to improve how data are collected and used. Today, the department maintains eight approved data standards. PHIG funding enabled DPH to develop training modules for three approved data standards (disability, housing and homelessness, and employment) and to create a new module on a data standard related to adults with disabilities. With leadership support, PHIG funding has allowed the department to move forward quickly and strategically, including aligning training content with updated federal guidance such as the 2024 Office of Management and Budget revisions. “These standards have existed for a while,” shared Emily Neumann, Coordinator of Data Standards, “but PHIG allowed us to invest in training and communication so that more people across the department understand not just what the standards are, but why they matter.” Turning Standards into Shared Practice A key focus of the PHIG-supported work has been accessibility. DPH developed short, digestible training videos and housed them on the state’s internal learning platform, making them available not only to DPH staff but also to the broader Executive Office of Health and Human Services, vendors, and partners across the Commonwealth. “It’s hard to expect adoption if people don’t even know the standards exist,” said Brett Turner, Director of Data Strategy & Transformation. “The trainings are our first step toward building that awareness across a department of more than 3,000 people.” With this increased awareness through training, staff can begin to meaningfully connect systems and improve reporting. Measurement as a Bridge Between Data Modernization and PM/QI This is where PM/QI plays a critical role. By tracking participation in training modules and aligning efforts with the department’s strategic plan, PM/QI teams help translate awareness into measurable progress. Rather than setting overly broad or unrealistic goals, DPH is taking a targeted approach. For example, one performance measure focuses on data stewards (staff responsible for managing datasets) completing trainings related to race, ethnicity, and language data standards. This allows the department to set concrete, achievable goals while still moving toward broader adoption. PM/QI teams are also using data inventories and surveys to understand what datasets exist, who manages them, and where programs are already using standards. This shared visibility helps identify opportunities to connect previously siloed data and ensures that modernization efforts are grounded in real operational knowledge. Navigating Challenges Through Communication and Change Management Like many large public health agencies, DPH data systems work within a complex system that include state and federal requirements, governmental and non-governmental partners, and legacy technologies. To address this complexity, the department has leaned into advocacy and documentation. Teams are creating clear guidance for partners, engaging early in conversations with organizations that collect key datasets, and using every opportunity to promote alignment. In some cases, this has led to near-complete adoption of Massachusetts’ standards by external partners. Internally, change management remains essential. Many staff have stepped forward to contribute to data standards work beyond their primary roles, acting as champions across bureaus and offices. At the same time, the department is working to embed these processes into routine operations so that standards become part of core practice rather than a separate initiative. To support sustainability, the department is investing in knowledge management to document lessons learned, track implementation challenges, and reduce the burden on individual staff to repeatedly explain standards. “It comes back to communication,” said Kate Saunders, Director of Quality Improvement, Bureau of Health Care Safety & Quality. “When people understand the why, compliance improves. This isn’t just about technical definitions, it’s about improving health outcomes. Early Signals of Progress While the work is ongoing, Massachusetts is already seeing encouraging signs: Increased Awareness and Engagement: Training modules have expanded reach across the department and partner organizations. Stronger Measurement Practices: PM/QI teams can now track participation and link progress to strategic goals. Improved Coordination: Data inventories and shared workflows help identify where standards are being used and where support is needed. More Inclusive Data: Aligning standards makes it easier to incorporate smaller, specialized datasets, such as those related to long-term care or pediatric populations, that might otherwise be lost. Together, these efforts are helping leadership better understand the value of data modernization not as just a funded initiative, but as a driver of equity, efficiency, and prevention. A Model Grounded in Collaboration What stands out most about Massachusetts’ approach is how collaborative it has been. Staff from across bureaus and offices have helped shape the work, creating shared ownership and stronger connections across the department. “This was a ground-up effort,” Neumann reflected. “It was eye-opening to see how many people wanted to be involved once they understood the bigger goal.” That goal remains clear: improving health outcomes for everyone in Massachusetts. Common data standards provide the shared language needed to identify inequities, track progress over time, and understand the full experience of individuals and communities. As PHIG funding continues to support this work, Massachusetts is focused on next steps: refining communication strategies, engaging leadership and management, and embedding data standards into everyday practice. For other PHIG recipients navigating similar alignment challenges, the lesson is simple but powerful: start with the “why,” build collaboratively, and don’t let perfection stand in the way of progress. Reviewed by - Lindsey Myers OE22-2203 PHIG article yes

How Palau is Advancing Its Data Modernization Infrastructure and Capacity Through Partnership How Palau is Advancing Its Data Modernization Infrastructure and Capacity Through Partnership Saisha Adhikari Discover how Palau is improving public health data by leveraging private-sector partnership in this blog post. The Republic of Palau is navigating a rapidly shifting public health landscape with an approach rooted in creativity, clarity, and community. Rather than slowing down in the face of limited staffing and competing priorities, the Ministry of Health and Human Services (MoHSS) has chosen to use this moment to build systems that will last. Through Public Health Infrastructure Grant (PHIG) funding, Palau hired HealthEfficient, a health care consulting organization, to support data modernization (DM) initiatives, including a new national electronic health record (EHR). Palau previously collaborated with HealthEfficient through the Pacific Islands Primary Care Association (PIPCA), which introduced HealthEfficient to the region through a multi-year initiative to support regional EHR planning, readiness, and adoption. During that time, HealthEfficient developed a strong understanding of Palau’s priorities, needs, and operating context. Palau subsequently joined HealthEfficient's Health Center Controlled Network. This multi-phased, ongoing partnership has helped Palau bring structure to complex work, expand internal capacity, and make progress on long-standing priorities. Laying the Groundwork for Meaningful Progress As part of its PHIG workplan, MoHSS is committed to adopting modern, flexible technologies and standards, reducing data silos, and strengthening its workforce. Given the need for external support to implement the EHR, Palau also considered how to leverage its partnerships to advance broader DM efforts. MoHSS collaborated with ASTHO to clarify needs and what success should look like. This preparation, combined with HealthEfficient’s familiarity with Palau’s health system and cultural context, created a strong foundation for their partnership. HealthEfficient has been instrumental as Palau transitions from a largely manual system to a modern, comprehensive EHR. The consultant’s ability to understand local realities of how staff work, how communities engage with health services, and what modernization means in Palau’s context has helped decisions remain grounded in what the country truly needs. Project Management as a Capacity-Building Strategy HealthEfficient serves as an extension of the MoHSS team, managing day-to-day coordination and creating structure around the DM work. They lead agendas, capture meeting notes, track progress, and manage overall project flow. This allows Palau MoHSS staff to stay focused on vision, strategy, and local leadership. Palau MoHSS and HealthEfficient meet on a consistent cadence: twice weekly on EHR implementation and twice monthly on broader DM activities. As demand has increased, additional meetings and hours are scheduled as needed throughout the week. This rhythm keeps the work aligned while giving each workstream to move at its own pace. Due to capacity, MoHSS moved the EHR launch from December 2025 to the first half of 2026. Rather than treating this as a setback, they used the new timeline as an opportunity to refine workflows and better support staff. Together, MoHSS and HealthEfficient updated their approach and kept the work moving. Although the workload is still considerable, the partnership has made it manageable. Clear roles, shared communication, and reliable structure have allowed the team to maintain momentum without overwhelming MoHSS staff. This progress is also driven by a strong internal MoHSS team of five staff members, several of whom are featured in this blog, who are working closely with HealthEfficient and the EHR vendor to move implementation forward. Sherilynn Madraisau, Director of the Bureau of Public Health Services at MOHSS, explained: “Even with limited staffing, leadership recognized how critical this project was for Palau and contracted HealthEfficient not only to manage much of the day-to-day work but also to help build our internal capacity, ultimately strengthening overall systems and creating long-term impact.” Navigating Challenges with Cultural Awareness Like many small jurisdictions, Palau MoHSS faces: Limited staffing and competing priorities. Navigating technical jargon. The need to coordinate across multiple external partners. These challenges show up in real ways: teams are stretched across responsibilities, vendors may not understand local context, and cross-agency communication requires ongoing attention. Edolem Ikerdeu, Executive Director of the Palau Community Health Center, noted the importance of cultural mediation in this work: “Our consultants bring valuable expertise and guidance, but it’s equally important that the work reflects our culture and our priorities.” Her role includes working with staff members to help partners understand context, smoothing miscommunication, and ensuring all stakeholders stay aligned around the mission of serving Palau’s people. That spirit of shared learning and adaptation is echoed across the team. Tmong Udui, Acting Chief of Division of Health Informatics and Intelligence at MoHSS, added, “A lot has been new for [staff], but learning together and building skills in this new area has been a good experience.” Partner engagement remains personal and intentional. The MoHSS team keeps partners engaged by having real conversations, naming the shared purpose, and showing exactly how the EHR will help the whole country, not just the health sector. Early Wins and Emerging Strengths Even just a few months into the EHR migration, MoHSS is already seeing measurable progress: Accelerated EHR Implementation: After years of anticipation, MoHSS now has a clear structure, dedicated support, and renewed momentum behind the EHR work. Informed Technology Decisions: With HealthEfficient at the table for external stakeholder discussions, MoHSS has had a trusted advisor to help evaluate system options and advocate for what best fits the country’s needs. Growing Internal Capacity: Through trainings and ongoing collaboration with subject-matter experts, staff are strengthening their skills in cybersecurity, systems upgrades, and process improvement. Stronger Organizational Coordination: Clear oversight and consistent communication have helped reduce the burden on staff and increased alignment across the ministry. These wins reflect progress beyond just technology, but in confidence, communication, and long-term planning. The work is strengthening the system as a whole and not just a single project. A Foundation for the Future With HealthEfficient managing much of the operational load for DM, Palau can focus on guiding strategy and determining long-term direction. HealthEfficient advances the work; MoHSS shapes the vision. Edolem Ikerdeu shared, “If you hire people and the funding goes away, then what is this for? We want a stronger system that includes the people who are already here.” Palau’s approach offers a compelling model for other resource-limited jurisdictions: Start with clarity. Build the right partnerships. Protect space for local leadership. Design systems that will outlast short-term funding. By centering community, embracing thoughtful project management, and working with culturally aligned partners, Palau MoHSS is building public health infrastructure that will serve its people well into the future. Reviewed by - Lindsey Myers OE22-2203 PHIG 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. 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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

Advanced Grant Payments: Creating a More Equitable Public Health System Advanced Grant Payments Promote Equity in Public Health Jignasa Jani, Ryan Rivera Learn how advanced grant payments can ensure smaller community-based organizations have necessary resources, creating greater equity in public health. Community-based organizations are critical partners to state health agencies in implementing public health programming, often reaching underserved populations and those at greater risk of experiencing health disparities. However, smaller or less-established organizations frequently face significant barriers when receiving grant funding (e.g., not having the necessary upfront capital to cover initial project costs). The Colorado Department of Public Health and Environment (CDPHE) recognizes these challenges and is taking bold steps to improve administrative processes for grant funded programs. These steps will go a long way towards ensuring that smaller community-based organizations have the resources they need to succeed, creating greater equity in the public health system. Redesigning Payment Structures for Greater Access To improve its administrative process, CDPHE is redesigning its payment structure for grant-funded programs. Historically, many grants have operated on a cost-reimbursement basis, where organizations must first cover the costs of services or goods before being reimbursed by the state department. This approach can exclude or unfairly burden smaller or less-established organizations that lack the upfront capital to participate fully in grant-funded initiatives, many of which serve disadvantaged and under-resourced populations. As such, CDPHE identified advanced payments as a priority, reflecting the department’s commitment to inclusion, diversity, equity, and accessibility. Following the enactment of Colorado House Bill 21-1247, CDPHE worked with policymakers to allow the department to provide advance payments to certain grantees and were granted the authority to provide certain grant recipients up to 25% of the total award value immediately on execution or renewal of the contract. By doing this, CDPHE may provide funding opportunities for eligible organizations to have the financial support they need from the start to support their communities. Jignasa Jani 1 - Advanced Grant Payments Promote Equity in Public Health The Prevention Services Division (PSD) within CDPHE led implementation of House Bill 21-1247 and administers a wide range of programs, including those focused on chronic disease prevention, tobacco cessation, injury prevention, suicide prevention, sexual health, and women’s health. By offering advanced payments, PSD empowers smaller organizations to carry out these important public health programs, which are essential to improving the health and well-being of Colorado’s most vulnerable populations. Ryan Rivera - Advanced Grant Payments Promote Equity in Public Health Overcoming Challenges in Implementation While the benefits of advanced payments are clear, implementing this new process has come with its fair share of challenges. The complexity of state and federal rules often places smaller organizations at a disadvantage, making it difficult for them to navigate the administrative requirements of grant funding. PSD staff dedicated significant time and effort to developing the necessary guidelines, policies, and procedures to support the advance payment process. These safeguards were crucial in gaining the support of department fiscal staff, ensuring that taxpayer funds are used appropriately and effectively. PSD staff had to go above and beyond their regular duties to create a robust process that would mitigate risks while providing necessary support to grantees. Their dedication to this initiative reflects a deep commitment to equity and inclusion, and to ensuring that all organizations, regardless of size, have equitable access to grant funds for public health work. Jignasa Jani 2 - Advanced Grant Payments Promote Equity in Public Health Supporting Grantees Through Ongoing Assistance To ensure the success of the advance payment process, PSD staff work closely with grantees to help them understand and comply with the new requirements. This includes providing technical assistance on financial management, invoicing, and compliance with state and federal regulations. By offering this support, CDPHE helps organizations build the capacity they need to manage grant funds effectively and reduce the likelihood of being classified as high-risk in the future. PSD’s efforts extend beyond the initial implementation of the advance payment process. The division is committed to continuous improvement, regularly gathering feedback from grantees and internal staff to refine and enhance the process. This approach ensures that the system remains responsive to the needs of community-based organizations and continues to support their success. Looking Ahead This initiative has the potential to increase the number of applications and funding awards to community-based organizations serving under-resourced populations, further enhancing the diversity and reach of public health programs in Colorado. As more organizations successfully navigate the grant funding process, the overall capacity of Colorado’s public health system will grow stronger, leading to better outcomes for all communities. 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

Ohio Department of Health Using Partnerships to Improve Public Health Data and Emergency Preparedness Margaux Haviland Learn how Ohio leverages partnerships to promote data modernization and improve public health emergency preparedness. In a public health emergency, it’s crucial to quickly and strategically deploy supplies such as personal protective equipment and medical countermeasures (MCM). This requires coordinated efforts among local, state, and federal partners to assess and address community needs. Timely access to actionable data about MCMs and other essential public health supplies is vital for this process. State health agencies need up-to-date information on available public health supplies to make informed decisions and respond effectively to evolving situations. In order to explore opportunities to improve data sharing for public health response, 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 for enabling bidirectional information sharing regarding ASPR-deployed assets across all levels of public health. The Ohio Department of Health (ODH) proposed a highly collaborative approach to their data readiness proposal that encompassed ongoing strategic planning, which included MCM plan revisions, broadening coalitions, data modernization through standardizing systems, and last-mile delivery using equity-based allocations. Incorporating Local Perspectives As a home rule state, where public health authority is decentralized, the ODH team worked to ensure that local health department perspectives were included in the ODH data readiness project work. The ODH project team collaborated with the Association of Ohio Health Commissioners (AOHC) as well as Ohio’s seven regional health care coordinators to solicit feedback on barriers to sharing MCM inventory data, challenges with data reporting, and operational changes that could improve bidirectional MCM data sharing. ODH engaged directly with long-standing partner AOHC, a nonprofit organization representing Ohio’s local health districts, to capture the local health department perspectives by establishing a diverse focus group, facilitating surveys, and gathering feedback. With AOHC support, ODH was able to successfully field its first survey with responses from 111 public health leaders and emergency response coordinators. Survey results indicated consistent responses when considering challenges experienced or expected with reporting MCM data, with three clear themes emerging: A lack of continuity between systems and compatibility (i.e., the duplication of efforts due to having both local and centralized data solutions). Staffing constraints, including time, money, and personnel. Issues with data accuracy and efficiency, having no standard nomenclature for reporting resources and allocation. The survey also captured proposed solutions for enhancing bidirectional MCM data sharing, with a centralized system being the top-ranked theme as the most relevant to respondents. A state-wide system would allow for state and local health agencies' visibility and real-time documentation that could be easily reported for state and federal requests. Another recurring theme was the importance of collaboration and diversifying partnerships, which will only aid in furthering MCM efforts within Ohio. MCM Summit To further collaborate with local public health and health care stakeholders, ODH held a one-day summit—Medical Countermeasures for a More Prepared Ohio—focused on enhancing MCM preparedness and response through improved integration with public health partners. The summit offered an opportunity for participants to develop local and regional relationships, initiate discussions, and increase awareness and collaboration through operational data sharing. The presentations and workshop included speakers from Ohio State University, Columbus Public Health, Cardinal Health, MMCAP Infuse, the Department of Health and Human Services, and the Ohio Department of Health. The sessions centered around developing a unified operational view, the equitable and timely distribution of MCMs, better integration of the health care supply chain into public health preparedness, and medical surge response during public health emergencies. The workshop then allowed attendees to work through a developing medical surge scenario, including steady-state situational awareness and the transition into initial response decisions and subsequent MCM distribution and logistics. Feedback from the event has been extremely positive, with participants sharing takeaways that could be leveraged in their jurisdictional planning: “How we may be able to better plan for shortages by leveraging private sector opportunities.” “We have a strong working relationship with our partners that needs to be protected and promoted.” “Showing the importance of MCM and keeping better inventory along with learning more about MCM supply chain process, how my organization uses it, and who they order from.” “Overall, I enjoyed the event. I felt the morning speakers were strong and informative. I really took away a lot regarding supply chain dynamics.” Opportunities to Improve Data Readiness and Response During the data readiness project, ODH identified critical opportunities for local, state, and federal partners to bolster data modernization efforts and improve efficiencies, mainly through standardization and interoperability. Currently, MCM distribution and reporting are largely directed by two federal agencies, CDC and ASPR, which use different processes as well as reporting and tracking systems. Improving the alignment of requesting and reporting processes for local agencies would reduce administrative burden during an emergency response. The standardization of data elements across agencies, as well as the reporting requirements, would reduce duplication of effort and improve jurisdictional capacity to respond to public health emergencies where MCMs are deployed. The next phase for Ohio includes leveraging the relationships developed during the project to continue to improve state responsiveness and effective through planning, exercising, and determining a feasible data solution that supports the goals of the state’s evolving MCM strategy. 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