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.
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.
ASTHO provides key support and resources as public health agencies undergo critical updates to their data and information systems.
Recipient Orientation Handbook for OD2A State and LOCAL Cooperative Agreements overdose prevention, substance use disorder, overdose crisis, opioid overdoses, principal investigators, project officer, grants management specialist, secure access management services, public health, mental health conditions, opioid use disorder, drug overdose deaths, opioid overdose deaths, medical condition, cooperative agreements, withdrawal symptoms, drugs or alcohol, prescription drugs, health care, overdose deaths involving prescription opioids, treatment for substance use disorders, deaths involved synthetic opioids, astho, association of state and territorial health officials ASTHO | This guide is for new recipient staff working on the CDC Division of Overdose Prevention cooperative agreements OD2A-S and OD2A-LOCAL. Overdose Data to Action (OD2A) supports jurisdictions in collecting high-quality, comprehensive, and timely data on nonfatal and fatal overdoses and in using those data to inform prevention and response efforts. OD2A focuses on understanding and tracking the complex, changing nature of the drug overdose epidemic and highlights the need for seamless integration of data into prevention strategies. The OD2A program page details funded jurisdictions, how this cooperative agreement contributes to CDC’s efforts to prevent opioid overdoses, and more. This orientation handbook serves as a resource for new recipient staff involved in the CDC DOP OD2A awards, in the hopes that it will assist them in managing their award. Get the Guide (PDF) website yes
Leveraging Healthy People 2030 to Build Non-Traditional Multisector Partnerships multisector partnerships, healthy people 2030, health equity, health outcomes, social services, health disparities, preventable disease, premature death, health literacy, economic stability, social determinants of health, department of health, improving the health, united states, long term, life expectancies, population health, chronic diseases, prevention and health promotion, health care system, disease prevention and health, health systems, healthy people 2030 objective, subject matter experts, office of disease prevention, personal health literacy, achieving health equity, health problem, population groups, astho, association of state and territorial health officials Corinne Gillenwater, Megan DeNubila-Griffin ASTHO | This toolkit helps public health build and maintain relationships with non-traditional partners across a multitude of sectors. The goal of this toolkit is to help state and territorial health agencies (S/THAs) build non-traditional, non-public health sector partnerships to improve health outcomes and advance health equity. The Healthy People 2030 objectives, aligned closely with the Social Determinants of Health (SDOH) framework and Health in All Policies (HiAP) lens, can serve as the cornerstone of these collaborations. This toolkit is implementation-focused, providing partnership-building and -sustaining skills that are rooted in Healthy People 2030 tools and success stories and can be operationalized for community needs. Overall, this toolkit encourages S/THAs to implement these described strategies in their own public health practice to: Establish and maintain partnerships within and across sectors at the state and territorial level to create a shared vision of health. Respond to public health priorities collaboratively and strategically. On This Page Using Healthy People 2030 in Non-Traditional Partnerships to Improve Public Health Types of Non-Public Health Sector and Non-Traditional Partnerships for Consideration Foundations of Strong Partnerships Sustainability of Partnerships 10 Steps for Strong Public Health Multisector Partnerships Conclusion Additional Resources website yes
Public health data collection and surveillance systems by health departments are in dire need of modernization. Though the public health community began developing a path to modernization over the last decade, attention to this issue from policy makers has sharply increased with the current response to the COVID-19 pandemic. Not only are current systems siloed, they rely on labor intensive processes to detect and facilitate a response to various public health threats.
The New Frontier of Digital Proximity Tracing Association of state and territorial health officials, astho, public health, covid-19, contact tracing, case investigation, public health surveillance, infectious disease, proximity tracing, exposure notification, public health agencies, data privacy, public health official, state legislature, geolocation, health data, test positive for covid-19, personal data, data collected, health departments Jeffrey Ekoma Digital proximity tracing is the cutting-edge for tracking outbreaks of COVID-19, but many have concerns about data privacy. States have proposed legislation to balance the two. As state, local, territorial, and tribal (SLTT) health departments continue to cautiously reopen parts of their economy, they also continue to take necessary measures to prevent the spread of COVID-19. A major component of this work is traditional contact tracing, a staple of public health surveillance where public health workers track down and notify anyone who might have contact with someone who tested positive for an infectious disease. However, new strategies that would supplement traditional tracing have been gaining momentum. Google and Apple collaborated to create an application programming interface (API) platform for public health agencies interested in a new type of “proximity tracing” or “exposure notification.” The platforms are expected to assist in the creation of apps between software developers and public health jurisdictions. It specifically utilizes Bluetooth technology —readily available in cellular devices—to randomly generate temporary keys on a user’s device when a user downloads an exposure notification application. This then enables the application to alert an individual if they have been or potentially exposed to someone who also uses the application and who tested positive for COVID-19. It’s worth noting the platform created by Google and Apple does not collect location information or information of users who do not voluntarily mark themselves as being positive for COVID-19. There are other notable exposure notification apps being used by SLTTs including Care19, an app developed by ProudCrowd that’s currently being used in North Dakota and South Dakota. Also, CommCare, which is currently being used in New Jersey and was developed by Dimagi. As expected, the introduction and potential influx of these types of apps have brought many different concerns, primarily centered around data privacy and how the platforms and applications would protect, store, and safely discard information that it collects. This issue became of interest to Sen. Maria Cantwell, current ranking member of the Senate Committee on Commerce, Science, and Transportation. In response she drafted S. 3861 Exposure Notification Privacy Act, which proposes assistance to public health jurisdictions exploring exposure notification applications and technologies. The act would ensure that such platforms have the necessary capacity to protect the personal data of consumers, limit the type of data collected, as well as the type of entities that would have access to such data. In addition, the legislation also: reaffirms the role of public health officials in requiring their involvement in the development and deployment of exposure notification systems; requires that participation from individuals be on a voluntary basis and with consumer consent; limits the collection and use of data; prohibits commercial use of data; and permits participants to delete their data at any time; among other things. The legislation was recently co-introduced with Sens. Bill Cassidy and Amy Klobuchar, and received support from the Washington State Department of Health, Council of State and Territorial Epidemiologists, and the National Coalition of STD Directors. This legislation is currently pending in the Senate and it is unclear if it will be considered in the upcoming months. There is also movement in state legislatures to address the use of technology. In California, legislation (AB 660) was introduced that would require any state agency contract that uses a mobile device’s geolocation data for exposure notification to a communicable disease to include provisions requiring the contractor to inform the app user of the authorized purposes of the app and collected data. Another bill (AB 1782) introduced in the state would require public health entities and businesses offering exposure notification services to allow users to revoke consent for the collection, use, maintenance, or disclosure of the user’s information. Businesses that provide exposure notification services but are not affiliated with a public health entity would be required to disclose its non-affiliation. The bill would also require the encryption of data collected by the technology, limit the use of the data as well as the amount of time the data can be maintained, and require reported exposures be verified by a healthcare provider before notifying logged contacts of their potential exposure. In New York, companion bills were introduced (A 10583A and S 8448B) that would establish requirements for the collection and use of emergency health data and the use of technology for collecting data during the COVID-19 emergency. Specifically, the bill requires the disclosure of certain information to those who install and use data collecting apps on mobile devices, including information about the right to opt-in, the right to privacy, the app’s privacy policy, time limitations for maintaining the data, and the individual’s right to access the data. Unlike the bills in California, individuals in New York would be able to sue for violations of the law. Several SLTT’s are currently either exploring, developing, or implementing proximity tracing applications within their respective jurisdictions. It remains critical that SLTT health departments evaluate the implementation of any proximity tracing option, while concurrently evaluating pertinent data and privacy related issues that may arise with the collection and sharing of information from individuals. In the coming days, ASTHO plans to release a guide to assist health officials as they think through the critical functionalities, technological options, and implementation of these emerging technologies. ASTHO will continue to track and monitor legislation that seeks to address data and privacy concerns with proximity tracing and exposure notification applications. website yes
CDC-funded program will accelerate data exchange between healthcare and public health to drive timely, data-informed public health action
ASTHO Requests $1 Billion in Emergency Supplemental Funding for Opioid Epidemic ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) is requesting that the Administration and Congress provide $1 billion in emergency supplemental funding for the Centers for Disease Control and Prevention (CDC) and state and territorial health departments to address the opioid epidemic. This emergency supplemental funding will allow state and territorial health agencies to allocate additional resources for their top priorities, including: Strengthening public health surveillance to improve our understanding of the epidemic. Expanding opioid misuse and addiction prevention campaigns. Linking electronic health records and prescription drug monitoring programs (PDMPs). Expanding partnerships and collaboration with law enforcement. Expanding access to naloxone and linking patients to medication assisted treatment and other services. “While the Administration has made major federal investments in treatment and recovery, health officials need funding for prevention,” says Michael Fraser, executive director of ASTHO. “We strongly encourage Congress to provide this emergency supplemental funding and address this deadly crisis like any other emergency where the Administration proposes and Congress provides the resources necessary to defeat it.” More needs to be done to provide CDC, states, and territories with investments in prevention to turn the tide on this epidemic. There is an urgent need to prevent opioid misuse through population-based and community-wide public health programs including connecting PDMPs with electronic health records, surveillance, implementation of prescribing guidelines, and prescription drug public awareness campaigns. ASTHO’s request aligns with many recommendations included in the President’s Opioid Commission report and Gov. Chris Christie’s recent call for additional resources to address the opioid crisis. To view ASTHO’s $1 billion opioid emergency supplemental request, click here. Visit my.astho.org/opioids to view ASTHO’s opioid framework, access resources, and learn about promising practices that state and territorial health agencies are undertaking to end the opioid epidemic. ASTHO Press Release Boilerplate website yes
ASTHO profile data indicates the public health workforce has more temporary and vacant positions than ever before
On May 16, 2023, ASTHO announced that the annual Public Health TechXpo and Futures Forum in-person registration is sold out. However, virtual participation is still open and encouraged.
Learn how to assess public health technology from a legal and policy lens prior to adoption.
Improving a State’s Process for Disclosing Data for Public Health Purposes to Tribal Public Health Organizations
Sustaining DMI: Medicaid Advanced Planning Document Process How state Medicaid agencies can request enhanced federal funding for Medicaid Enterprise Systems and related activities. Why is the Advanced Planning Document process important? Based on information from the Government Accountability Office (GAO), the Centers for Medicare & Medicaid Services (CMS), and the Federal Register, the Advanced Planning Document (APD) process is a procedure through which states develop a plan of action for their Medicaid information technology (Medicaid IT) projects. These plans are for designing, implementing, or operating Medicaid Enterprise Systems (MES) projects. State Medicaid agencies (SMAs) submit completed APDs to CMS—specifically a designated state officer in the Center for Medicaid and Children’s Health Insurance Program (CHIP) Services (CMCS) Data and Systems Group (DSG)—to request federal financial participation for their activities. The state officer reviews APDs to assess whether states’ requests for federal financial participation for designing, developing, implementing, or maintaining MES activities contribute to the economic and efficient operation of Medicaid and meet specific technical and operational criteria defined in statute, regulation, or sub-regulatory guidance. A state that receives federal financial participation can see increased access to stable federal funding to support MES activities. In addition, APDs are used to monitor a state’s project performance and outcomes. What are the three types of APDs? There are three types of APDs: Planning, Implementation, and Operational (Table 1). Table - Resource - Sustaining DMI: Medicaid Advanced Planning Document Process What are the major steps for states in the APD process? To request enhanced federal funding for MES, SMAs must complete the APD template that aligns with where they are in the development of their project (for example, design or maintenance) and submit it to the designated CMCS DSG state officer. The APD process contains five major steps and can take many months to complete: Meet with key state contacts and decision-makers. Based on information from the Public Health Informatics Institute’s information and tip sheets, before developing the APD, the SMA should identify and engage key state contacts and decision makers to solicit their input about the proposed project and secure their and their staff’s collaboration to complete and submit the APD to the CMCS DSG state officer. The state health agency (SHA) should work closely with the SMA during this process to ensure that they provide needed support to the SMA. For example, the SHA may gather information for the SMA to include in the APD or advise on how to complete particular sections of the APD. During this process, the SMA and SHA should consult with their respective agency leadership to discuss the type of technological solutions Public Health maintains, Public Health’s relationship with the state Medicaid program, and the opportunity to align systems to reduce overall state costs and improve state efficiency through the APD process. The SMA and SHA should also engage the MES lead, who can offer critical information about current MES components and component certification needed to complete the APD. In addition, GAO recommends states involve their chief information official in overseeing Medicaid IT projects because they can play a critical role in decision making related to IT budgets, management, and oversight. Next, the SMA and SHA should engage the CMCS DSG state officer to develop a strong understanding of how the APD can support the Medicaid program and serve a public health interest. Coordinating with the state project management office can help integrate the diverse parties and processes needed to develop and submit the APD for approval. It can also help ensure that states develop a comprehensive and flexible timeline for the APD process, stay aware of approaching deadlines, and meet ad hoc requirements. Develop the appropriate APD. Next, based on 45 C.F.R. § 95.610(c), the SMA and SHA should identify which of the three types of APDs to submit to the CMCS DSG state officer. Planning APDs are recommended for large and complex projects, such as statewide projects. However, if a state can identify a clear and easy pathway to integrate a public health information technology system with a current MES procurement or development phase, it can forgo developing a Planning APD and directly develop or update an existing Implementation APD. For example, if a state is looking to integrate its counties’ public health data into its MES at once, it should develop a Planning APD as the project is large and affects all counties in the state. However, if a state already has most of its counties’ public health data in its MES but is looking to add a single county’s data to its MES using the same process it previously and successfully used to add the other counties’ data, it may not need to submit a Planning APD. If a state has already successfully integrated its counties’ public health data into its MES and is looking to make major technology upgrades and improvements, it should submit an Operational APD. Regardless of the type of APD the state submits, the SMA and SHA should work together to ensure the request meets the Conditions for Enhanced Funding (see separate document Conditions for Enhanced Funding: The Basics). Submit the APD for approval and be available for revisions. Based on information from CMS, GAO, and the Office of Child Support and Enforcement, the state should then submit the APD to the designated CMCS DSG state officer. The SMA and SHA should plan to receive questions and revision requests from the CMCS DSG state officer and ensure that the state has staff capacity to answer questions and revise and resubmit. Approval conditions can be found at 45 C.F.R. § 307.15, but approval criteria might vary by Medicaid IT project and other factors. If approved, implement the plan. Next, the state can carry out the plan described in its Planning and Implementation APDs. After the Medicaid IT project has been operating for at least six months, states can request system certification from CMS. According to CMS, certification is required to receive the enhanced 75 percent federal financial participation for operations. The certification process includes states submitting to CMS an intake form, a certification request letter, and supplemental materials with information on its system. CMS may then start its review to assess whether the state’s system meets certification requirements. If approved, monitor and report progress and submit other APDs as needed. Based on 45 C.F.R. § 95.610(c) and 45 C.F.R. § Part 95 Subpart F and information from CMS, CMCS, Office of Child Support and Enforcement, as the state continues with its Medicaid IT project, it should adhere to monitoring and reporting requirements for enhanced federal funding. It also should submit annual APDs as required. If the state wants to make any major changes to the Medicaid IT project in concept, scope, cost allocation approach, timeline, and other key areas, it must develop and submit an as-needed APD. An as-needed APD is due no later than 60 days after the occurrence of the change. State examples: Medicaid Enterprise System projects Based on information from Alvarez & Marsel, state MES projects will vary based on factors such as the maturity of a state’s technology infrastructure, its specific data needs, and its available resources. As such, projects to design, implement, or operate MES can range in size, complexity, and timeline. For example, the Alabama MES Modernization Program, the Wyoming Integrated Next Generation System Project, and the Florida Health Care Connections project all seek to transform their singular Medicaid Management Information Systems (MMIS) into modular, multi-vendor MES, but differ in approach. In addition, Arizonia and Hawaii are collaborating to modernize their shared MES. For more information on state MES projects, see the Medicaid Enterprise System Solution/Module Contract Status Report. This webpage lists states’ MMIS and Eligibility and Enrollment contract information for their MES projects. It also lists contact information for state officers to reach out to learn more about states’ MES projects. website yes
Sustaining DMI: A State Health Official’s Guide to Enhanced Funding Sustainable financing strategies for state health officials to support data modernization and Medicaid. What is the relationship between a state’s Medicaid program and its public health data system? Although state implementation of the Medicaid program (Title XIX of the Social Security Act) varies, each state’s program has enrollment and claims data on Medicaid participants, including demographic data on race and ethnicity, age, and service utilization, such as vaccines received. At the same time, a state’s public health system needs to collect, analyze, and report diverse data from public health initiatives and related programs to support its goals to protect and improve the health of individuals and communities by promoting healthy lifestyles, researching and encouraging disease and injury prevention, and detecting, preventing, and responding to infectious diseases. A state’s Medicaid program and public health agency can collaborate to implement a sustained data modernization initiative (DMI) that combines Medicaid and public health data and integrates these data into the state’s health-related data ecosystem. A sustained DMI can yield various improvements to a state’s health-related data ecosystem, such as improved data quality, public health reporting, data storage and resiliency, and analytics to respond to pandemics. It can also set the stage for data sharing with additional data system partners, which can further improve the state’s health-related data ecosystem. Why is sustainable funding necessary to continue DMIs? Sustainable funding to support personnel, processes, and technology is imperative to the continued success of a DMI. Stable funding can increase state Medicaid and public health agencies’ likelihood of recruiting and retaining personnel with advanced degrees, such as biostatisticians and epidemiologists, by enabling the agencies to offer compensation packages that are competitive with job market rates. Stable funding also enables the agencies to maintain and refine new and existing data-sharing processes, and it ensures that technology is maintained and upgraded appropriately to meet evolving needs. Medicaid funding is a potentially large and stable funding stream that can support the personnel, processes, and technology in a DMI that focuses on integrating Medicaid and public health. However, public health funding has historically been an unstable patchwork of federal, state, local, and private funding streams and mechanisms, largely because of changing economic and political priorities and the perceived risk level and severity of major public health threats. What sustainable financing strategies can support the personnel, processes, and technology needed to continue DMIs? State health officials can use the following three strategies when pursuing Medicaid funding to sustain a DMI: Blend and braid funding sources. Optimize existing and potential funding streams by blending or braiding administrative approaches to grow and maintain programs. To blend funding sources, program officials combine funding into a single stream, which results in a loss of award-specific requirements and thus requires statutory authority. In contrast, braiding funds allows program officers to direct funds toward a single strategy or initiative while preserving funding requirements (Box 1). Callout 1 - Resource - Sustaining DMI: A S/THOs Guide to Enhanced Funding Support personnel by using cost allocation through the Advance Planning Document (APD) process or the Administrative Cost Allocation Plan. A DMI team often has people with specialized skills, such as clinical and technical experts, compliance or legal officers, and financial experts. The salary for these people may be cost-allocated via the APD process or the Administrative Cost Allocation Plan described in Social Security Act Section 1903(a)(7) (Box 2). To illustrate, the Administrative Cost Allocation Plan provides 50 percent match for costs that meet a series of requirements to cover personnel costs. In addition to this strategy, state health officials can cover salary costs through blending and braiding approaches. Callout 2 - Resource - Sustaining DMI: A S/THOs Guide to Enhanced Funding Align public health functions with Medicaid business and technical functions. To explore whether a state Medicaid agency could access enhanced federal funding to support public health, a state public health agency must approach the state’s Medicaid program collaboratively and design and implement a DMI that does the following: Meets the Conditions for Enhanced Funding and couples any technical system improvements with measurable outcomes that improve public health and the Medicaid program. Investigates the extent to which the public health technical functions (for example, health care provider enrollment) align with similar Medicaid business functions. Confirms the extent to which the public health functions and Medicaid Enterprise Systems share or could share (that is, reuse) core technical components to support common business functions. Callout 3 - Resource - Sustaining DMI: A S/THOs Guide to Enhanced Funding After this investigation is complete, the state Medicaid agency should explore cost allocation models that apportion costs with the benefits received (Box 3). Box 4 provides examples of public health use cases that successfully acquired enhanced Medicaid funding. Callout 4 - Resource - Sustaining DMI: A S/THOs Guide to Enhanced Funding website yes
In May 2021, President Biden released full details of the fiscal year 2022 budget. Overall, the budget request combines President Biden's American Jobs Plan, his American Families Plan, and funding priorities for the Pentagon and domestic agencies, for a projected total of $6 trillion. Read more about what the president is proposing in this post.
While COVID-19 has shown some of the best attributes of the U.S. public health system, it has exposed the weaknesses of our data systems—wrought by chronic underfunding and further exacerbated by siloed, categorical funding and planning. Yet, even with our pandemic weariness and persistent, systemic inequities, this historic event has revealed resiliency across the country. It has also yielded new innovations, along with promising practices and partnerships in how we leverage technology and data to better respond and mitigate public health threats. To build further momentum and support the ongoing modernization efforts of our partners, ASTHO is hosting its first-ever TechXpo.
Neonatal Abstinence Syndrome (NAS) has become more prevalent in the United States, with the hospitalization rate increasing from 2.9 to 7.3 hospitalizations per 1,000 newborn births between 2009 and 2017. NAS occurs in newborns who experience withdrawal from substances they were exposed to during pregnancy. While NAS is most often associated with exposure to opioids (e.g., Neonatal Opioid Withdrawal Syndrome), it can also be caused by exposure to other drugs such as cocaine, amphetamines, or barbiturates. Infants with NAS experience withdrawal symptoms including tremors, irritability, poor feeding, vomiting, dehydration, and increased sweating. These symptoms usually appear within 72 hours of birth.
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
Public Health Data Disclosure or Request Readiness Assessment Chris Alibrandi O’Connor Explore key steps and lessons for effective public health data sharing. Organizations that want to share or request data to support public health work should take several preparatory steps. An organization’s data sharing efforts will develop more quickly and smoothly if certain considerations have been analyzed, or actions taken before negotiations begin on a data sharing agreement. The same is true for organizations trying to obtain data to support their public health efforts. Consider the following prompts and questions before initiating data sharing or a request for data to prepare for a more efficient and effective negotiation for the data’s disclosure. That consideration will identify barriers to data sharing as well as result in greater clarity around organizational data sharing needs and data governance. For those seeking data, what data do you need? What type of public health work is on the table and what data is needed to achieve the related public health goals? Identify which entity has the needed data Identify the required data elements Specify the type of data needed (e.g., line level, identifiable, Limited Data Sets, de-identified, aggregated) Having identified the data elements and type of data needed will help later in the legal analysis of which laws apply to the disclosure of data Pre-Negotiation Considerations Review organization’s existing written data sharing or data governance policy. Determine whether the project is covered by it and whether any related data disclosures or uses would comply with it. If there is no such policy, consider developing one for adoption. That process will clarify and/or resolve many issues, including data governance guidelines, which could become barriers during data sharing agreement negotiation. Having an organizational “champion” in a position of authority to support a data project may help overcome internal obstacles. Identify a champion — or develop one. Identify and get to know the people who play key roles in data sharing agreements (data stewards, leadership, legal counsel) to facilitate project communication. Pre-Negotiations Review of Legal Issues Evaluate the answers to these questions about disclosing the data at issue: Can I? (i.e., does the law permit the data’s disclosure?) Must I? (i.e., does the law require disclosure?) Should I? (i.e., is disclosing the data the right call when considering legal, policy, and equitable factors) When considering the risks of disclosing data, also consider the risks of not disclosing it for public health purposes; consider what public health efforts will not succeed without the data. Author Funding Disclaimer - Resource - Data Sharing Request Disclosure Alaska article yes