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.
About Public Health Data Modernization and Informatics Understanding Public Health Data Modernization & Informatics Understand public health data modernization work and its importance, plus ASTHO’s efforts to support agencies’ data modernization initiatives. Public health data and surveillance systems are essential to the nation’s public health infrastructure — in day-to-day operations as well as crucial moments that require detecting and responding to emerging health threats. ASTHO is dedicated to supporting its members and health agency staff in advancing crucial data modernization efforts, with comprehensive tools and customized guidance. What Is Data Modernization? Data modernization is an effort to improve public health data, technology, workforce capacity, and related processes and policies, with the end goal of having more timely and actionable insights. In public health, data modernization is a cross-cutting endeavor that supports all public health programs (e.g., environmental health, infectious disease, maternal and child health, etc.) — as safe and secure data collection, management, and sharing are critical to each area’s efforts. It is fundamental infrastructure work that supports an entire health department and connects to a much larger data ecosystem, enabling critical efforts across jurisdictions and sectors. Tabatha Offutt-Powell - Page - What Is DMI Why Is Data Modernization Important in Public Health? Data modernization is important in public health because it mobilizes faster and more complete, accurate data — getting it in the hands of the right people at the right time, from infectious disease specialists responding to an outbreak to chronic disease leaders designing data-driven interventions that promote healthier communities. These people, experts and decision-makers, can then take informed actions to protect the public’s health. When public health data systems are at their best, they can support both public health and health care. Instead of relying on fragmented views of a person or a population’s health (i.e., through different programmatic lenses or health care setting experiences), those on the receiving end of this crucial data can look at individuals and populations as a whole. The reality is that people experience all aspects of health and interface with health systems in many different ways — and when public health or health care professionals are able to connect relevant data from various sources, they can gain a more complete and accurate understanding of individual and population health, ultimately enabling better interventions. Elizabeth Ruebush - Page - What is DMI What Are the Key Components of Data Modernization That Enable Modern Data Platforms? The key components that make modern public health data systems possible include technology, people, policy (legal and organizational), and sustainability. Technology An important element is, of course, ensuring and leveraging robust, up-to-date technology. Leveraging modern technology allows agencies to move from manual to automated processes and minimizes the burden on public health and data partners. People While the technology is important, the people who manage and use these systems are just as crucial. More specifically, those with the training/skills needed to support data systems and engage with the technologies for faster, more actionable data. Policy and Process The policies and processes that guide data collection, management, sharing, and use are additional components of importance in data modernization, including: Legal policies that impact public health data reporting, surveillance, and sharing. Organizational policies and governance structures that relate to the internal standards, processes, and procedures for handling public health data. Sustainability Sustainability is also critical and involves securing ongoing resources — financial and otherwise — to ensure a health department can maintain a modern data infrastructure, rather than relying on isolated, one-time upgrades. How Does ASTHO Support Public Health Data Modernization? ASTHO has a dedicated Public Health Data Modernization and Informatics team that is committed to supporting state and territorial health agency leadership in their modernization efforts, enhancing data exchange capabilities, and supporting a sustainable and resilient public health data infrastructure. The team supports public health agencies on their data modernization journeys by: Bringing health agencies and private partners together through the Public Health Data Consortium — with an objective of enhancing the quality of and access to public health data used to inform population health decisions and understand long-term outcomes. Accelerating modern data exchange through cutting-edge health IT standards and offering direct technical implementation services through the Implementation Center Program. Managing the Informatics and Data Modernization Network, which facilitates peer-to-peer learning and information sharing about informatics and data modernization activities/opportunities among members. Bringing key thought leaders together through the Joint Public Health Informatics Task Force to have meaningful conversations about and align initiatives around data modernization. Identifying sustainable funding structures that help health departments accomplish a meaningful data exchange project or infrastructure advancement. Providing technical assistance and developing resources (e.g., tactical guides, issue briefs, robust toolkits) around data modernization and informatics. Conducting legislative tracking and policy assessments to explore legal and policy considerations influencing public health data and technology. Working to modernize public health infrastructure in your health agency? ASTHO’s Public Health Data Modernization and Informatics team would love to help. To get started, browse the team’s data modernization resources, and reach out for personalized support. Contact DMI Team article
Delve into the successes, challenges, and lessons learned to inform/advance FHIR adoption among state and local public health agencies and their health care partners.
Data Modernization Primer and Tactical Guides Dive into these data modernization reports for strategies and detailed steps to move from siloed systems to a connected, resilient data ecosystem. Public health data modernization is a collective effort by federal, state, local, and tribal organizations to strengthen public health data and surveillance systems. The ultimate goal is to move from siloed public health data systems to a connected, resilient, adaptable, and sustainable “response ready” data ecosystem. The primer provides state and territorial health officials with a high-level understanding of the objective and significance of data modernization as well as the roles that they play in a successful data modernization initiative. The five tactical guides detail key strategies and tactics for implementing and maintaining data modernization initiatives within public health agencies. article yes
Learn about how public health is employing ethical frameworks to support and improve wastewater surveillance and other community health monitoring measures.
Supporting Incarcerated People’s Recovery: Linkage to Care Policies for People Entering and Exiting Incarceration with Substance Use Disorder Linkage to Care Policies for Incarcerated People with SUD Explore linkage to care policies for incarcerated people with SUD across states, including SUD screening upon entry, treatment referrals, linkage post-release, and naloxone access. Individuals with substance use disorder (SUD) are more likely to be involved in the criminal justice system and experience higher rates of incarceration. They also experience disproportionately high rates of death, and the risk of overdose death does not cease upon release. Jurisdictions looking to reduce the risk of recidivism, overdose, and premature death among this population can consider policies that improve linkage to care across all stages of the criminal justice system. This report delves into these policies by state, which include screening for SUD upon entry, treatment referrals, care linkage post-release, and naloxone access. Get the Report (PDF) website yes
Learn how to build a business case for data modernization efforts to translate technical needs into impact-driven narratives.
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
Fairfax County Health Department Modernizes Infrastructure to Optimize Public Health Data Sharing Susan Fluerant, Reema Mistry, Christina Severin Learn how the Fairfax County Health Department in Virginia is working to modernize its data infrastructure & optimize public health data sharing. Using lessons learned from the COVID-19 pandemic, the Fairfax County Health Department (FCHD) is coordinating with county agencies, the Virginia Department of Health (VDH), and nonprofit public health organizations to modernize its data infrastructure and optimize public health data sharing functions. FCHD’s Informatics and IT team engaged in a strategic process to develop a multiyear IT roadmap, which outlines solutions and systems required to support this modernization, including clinical services, communicable disease surveillance, laboratory information systems, communication systems, and solutions for community engagement and administrative needs. As a result, FCHD is well-positioned to leverage its robust IT and data infrastructure to align with VDH for better data sharing. Advancing IT and Informatics Infrastructure Challenges associated with manual data-sharing processes (e.g., the use of CSV files to ingest data and produce analyses) during the COVID-19 pandemic prompted FCHD to reassess its informatics capacity. It conducted department-wide needs assessments and identified the need for improved technology, increased workforce capacity, and better data governance policies. It then ascertained IT functions that could be outsourced (e.g., cloud-hosted solutions and managed services for FHIR HL7 implementation) versus core public health functions (e.g., manipulating and managing data for epidemiologic use) that needed to remain internal, allowing FCHD to preserve internal staff capacity for key public health activities. Public health staff found working with CSV files to be inefficient for large or frequently updated datasets. To address this challenge, FCHD worked closely with VDH and the Fairfax County Informatics and IT team to adopt automated processes and develop a data warehouse solution—allowing FCHD to manage and transform data from multiple sources as well as control the frequency and timing of data retrieval, enhancing their ability to respond promptly to public health needs while keeping data secure on cloud-host servers. VDH hosted an API for FCHD to retrieve death data, significantly increasing flexibility and reducing the need for manual intervention. As FCHD increases the use of new data sources and technology, it continues to develop data governance policies, roles/responsibilities for data users, and data safeguarding guidance. Noel Clarin - Brief - Fairfax VA DMI to Optimize Public Health Data Sharing Engaging State and Local Partners FCHD recognizes that data sharing agreements are vital to support data exchange and, until recently, relied on informal data sharing agreements among other jurisdictions in Virginia. It partnered with attorneys at the state and local levels to work toward a universal data sharing agreement, which can expedite the data sharing process when public health programs have new use cases for local data. As a result, FCHD executed a Memorandum of Understanding with VDH in less than six months—a notable improvement from past data sharing agreements, which historically could take over a year to execute. They worked collaboratively through complex technical and bureaucratic challenges, highlighting the iterative nature of establishing effective data sharing protocols. FCHD also supported relationship-building between programs and divisions within the Fairfax County government, allowing for greater strategic alignment around emerging technologies. Interdepartmental relationship-building between public health program staff and the Fairfax County IT team has been equally important to foster effective collaboration and identify data modernization champions within FCHD. Alida Laney - Brief - Fairfax VA DMI to Optimize Public Health Data Sharing Planning for Sustainable and Diverse Funding Sources FCHD received an initial grant from the Public Health FHIR Implementation Collaborative through NACCHO, which helped launch the IT infrastructure improvement work; however, one-time funding is not a long-term solution. Now, FCHD is developing a long-term funding strategy to support the costs of IT systems licensing, operations and maintenance, and research and development. FCHD recognizes as public health changes, so must the technology that supports it, and modernization will require sustainable funding from government, associations, and other sources. Centering Health Equity in Informatics Solutions FCHD is developing processes to collect and standardize data disaggregated by sexual orientation and gender identity, race and ethnicity, language, and the social determinants of health to better identify and address health disparities. By incorporating additional data into its systems, program staff can now make informed decisions to strengthen health literacy by disseminating information in preferred languages and easy-to-read formats, and ensuring materials are accessible to persons with colorblindness. Ben Klekamp - Brief - Fairfax VA DMI to Optimize Public Health Data Sharing(2) Implementation Considerations Foster relationships within and across local and state government to get buy-in for the modernization of public health informatics infrastructure and the improvement of data-sharing practices. Define clear goals for implementing new technology, and build a strategy for infrastructure improvement, partner engagement, and long-term sustainability that’s grounded in a shared understanding of the goals. Align workforce responsibilities, process improvement efforts, and technological advancements. Develop universal data sharing agreement templates between state and local health departments to expedite future data-sharing efforts. OT18-1802 website yes
Communicating About Disease Forecasting Effectively Communicating About Disease Forecasting Clearly communicating about disease forecasting helps policymakers, the media, and the public make informed decisions in public health emergencies. Communicating effectively about disease forecasting data is essential for the public to understand the associated risks, implications, and recommended actions. It’s also critical for policymakers who can use the data to determine effective, equitable strategies for outbreak response. In turn, the public can make informed decisions to keep safe. Each audience, including the media, will likely need tailored messages about the indications and limitations of a given forecast. Approaches for communicating about disease forecasts/models with policymakers and the public align with many of the key tenets of public health communications more broadly. Public health practitioners should consider integrating Crisis and Emergency Risk Communication (CERC) principles, which suggest that communications be first, right, credible, empathetic, actionable, and respectful to help the public make informed decisions during challenging circumstances. Communicating with Policymakers Policymakers—public health or elected—have important decision-making and rule-making authority; additional considerations may be needed when communicating with them about disease forecasting. Interactions frequently occur through staffers, who may have limited knowledge and/or time. In addition to CERC principles, communications should also be: Relevant. Tailor communications to policymakers’ priorities to emphasize potential impacts on resource allocation, public health outcomes, local or regional policies, and public sentiment. Collaborative. Foster relationships with policymakers and offer subject matter expertise on forecasting to inform policy decisions. Timely. Provide frequent updates, allowing for proactive collaboration, decision-making, and communication with the public. Concise. Develop briefs that summarize forecasts and their implications for constituents. Consistent. Build trust with policymakers and their staff between emergencies to highlight disease forecasting as a useful tool whose methodologies, data sources, and limitations are clear. Communicating with the Public In addition to CERC principles and in collaboration with media partners, communication about disease forecasts/models with the public should be: Accessible. Provide easily accessed information about methodology, data sources, and limitations in the forecasts. Clear. Use jargon-free, non-technical language to convey critical messages. Contextualized. Frame forecasts within the broader public health context, emphasizing how individual and community actions can mitigate risk, and reinforce the effects of collective actions as part of an outbreak response. Empowering. Give the public reasonable, actionable steps to protect themselves and their communities. Local. Use social media, news releases, listening sessions, and other relevant means to reach as broad an audience as possible. Collaborate with community leaders and health care providers to amplify messaging and reduce misinformation. Frequent. Keep the public informed with regular updates on forecast products including changes in local risk levels, new trends, guidance, and recommendations. Utah’s Best Practices for Communicating Forecasts During the COVID-19 response, the Utah Department of Health and Human Services (DHHS) modeled potential disease transmission and shared how to effectively communicate with the media and public. DO Create diverse forecasting and communications teams that include public health, universities, and ‘bonus’ team members (e.g., political representatives, laboratories, and health economists). Clarify the purpose for which a given model was developed. Discuss the limitations of the disease model. Communicate about future outcomes (i.e., what would happen without further intervention). Provide language on how to alter the current path (e.g., ‘With this intervention, we could potentially avoid…’) Remind audiences that models can affect the future, not only predict it. Share information and data that are digestible for the public. DON’T Sound definitive when outcomes aren’t clear or make predictions using absolute terms. Omit a variety of scenarios or tools when presenting a forecast. Disregard inherent uncertainties in forecasts. Show models with conflicting results. Utah DHHS also recognized that members of the media are key partners in communicating public health messages; closely coordinating and contextualizing forecasts helps communicate accurate conclusions and/or recommendations. Communicators and staff should be prepared and have information ready to share for more complex questions as needed. Storytelling with forecasts and models helps the reader internalize them and make informed decisions. CDC-RFA-OT18-1802 2018-2024 article yes
Information and resources regarding PRAMS, an ongoing, site-specific, population-based surveillance project.
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.
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
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
Likely Public Health Legislative Trends for 2025 Prospective Public Health Legislative Trends for 2025 Maggie Davis Get an inside look at prospective public health legislative trends for 2025, based on ASTHO's legislative tracking efforts and member feedback. Drawing from member feedback and ASTHO’s legislative tracking efforts, ASTHO identified five key issues state and island legislatures are likely to work on for the upcoming legislative sessions for the annual 2025 Legislative Prospectus Series. Each brief provides public health leaders and policymakers with a synopsis of the topics, recent legislative trends, and anticipated legislation in upcoming sessions. Public Health and Health Care Workforce States are continuing to address workforce shortages within public health and the health care systems. ASTHO’s prospectus outlines strategies that legislatures are considering, from bolstering state public health funding to legislative efforts addressing nationwide workforce shortages through recruitment incentives, workforce commissions, and pipeline programs. Containing Spread of Infectious Disease State and territorial public health agencies are responsible for protecting the health and safety of their residents and have legal authorities to fulfill those responsibilities. In recent years, many legislatures have revisited the scope of these legal authorities, with states like Washington (SB 6095) expanding the health official’s authority to issue standing orders for a range of disease interventions. Similarly, legislatures may continue considering vaccine-related legislation. While many bills in recent years aim to weaken vaccine policy, state leaders have listened to medical leaders within their state who advocate for strong vaccine policies. In 2024, West Virginia’s governor vetoed HB 5105 that would have weakened school enrollment requirements, informed by strong opposition from the state’s medical community and evidence that the existing vaccine policy had prevented disease outbreaks. Data Modernization and Privacy Modernizing public health and health care data systems have taken big steps forward, including federal initiatives like the Trusted Exchange Framework and Common Agreement (TEFCA), which establishes guiding interoperability principles and standards for health data exchange. Nevada enacted AB 7 in 2023 requiring new regulations governing health information exchanges (HIEs) and granting certain liability protections to providers using them. In the proposed rules published in August 2024, the Nevada Department of Health and Human Services intends to require that participating HIEs are TEFCA members. ASTHO anticipates more jurisdictions will allow public health agencies access to a wider range of privacy-protected health data through secure platforms like HIEs. Maternal and Child Health Public health supports mothers and children throughout their development. There are three emerging issues that legislatures are likely to work on in the next year: maternal morbidity and mortality, fetal and infant mortality, and youth mental health. One strategy to address youth mental health is using laws to regulate social media companies, requiring them to implement safeguards for minors who use their services. For example, California enacted SB 976 in 2024, which requires “addictive internet-based” services to gain parental consent before minors could use the service and limit the hours in which minors could use an application. Technology industry groups are challenging these efforts in court, with one suit asserting that California’s measure is unlawful governmental interference with First Amendment rights of minors. Substance Misuse and Overdose Prevention Although there was a significant decrease in overdose deaths in 2023, there are still legislative actions to help reduce substance misuse and prevent overdose likely to be considered in 2025. During the 2024 sessions at least 24 state legislatures considered bills to regulate products like kratom and hemp derived products (e.g., Delta-8). Additionally, at least 18 legislatures considered bills to decriminalize drug checking equipment like fentanyl and xylazine testing streps. ASTHO anticipates states legislators will continue implementing harm reduction efforts, policies to connect people with substance use disorders to care, and efforts to regulate products with potential for abuse or misuse in the next session. What We Know So Far The majority of states will convene their legislative sessions in January 2025, with at least 15 states scheduled to conclude their session by the end of April; there will likely be a flurry of legislative activity in the first quarter of the year. Already the Texas legislature has prefiled more than 1,200 bills for their 2025 session, covering topics including a health commissioner’s authority to establish routine childhood immunization requirements (HB 468) and making changes to the state’s maternal mortality and morbidity review committee reporting requirements (HB 713). Additionally, Virginia’s General Assembly convened its two year session in January 2024 and has a number of bills carrying forward into 2025 including bills related to suicide prevention (HB 80) and improving maternal health data quality (HB 286). ASTHO will monitor legislation related to these topics and more during the 2025 sessions and will provide relevant updates. OE22-2203 PHIG article yes