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Support for programs and policies that encourage positive mental health in early childhood and provides support for parents and caregivers to have the best chance to improve mental health across the life course.

This ASTHOBrief offers a menu of strategies and considerations for organizations interested in incorporating a Health in All Policies and equity-centered approach to the development and implementation of requests for proposals and notice of funding opportunities.

Learn how state health agencies are leveraging flexible funding to advance initiatives addressing non-medical factors that influence health.

Establishing an Office of Health Equity or Minority Health Learn how to establish, structure, and fund a health equity or minority health office. A dedicated office of health equity or minority health can provide a focus on cross-cutting efforts and strategies that help to improve services, outreach, and engagement with marginalized communities. This report delves into the typical scope for setting up a health equity or minority health office, including how to establish, structure, and fund it—providing a blueprint to island areas working to build one or considering establishing one in the future. In addition, it explores lessons learned from state offices of health equity or minority health, including California, Michigan, Nebraska, Nevada, New Jersey, New York, Ohio, Vermont, and Washington. Get the Report (PDF) website yes

Opportunities for Public Health Agencies to Advance Sustainable Financing of Community Health Worker Programs Advancing Sustainable Financing of Community Health Workers Explore how health officials can play key roles as funders, administrators, and policy designers to advance sustainable financing of community health workers. Many states face upcoming funding gaps for community health worker (CHW) positions, with COVID-19 related grant funding streams expiring. Concurrently, many states are rapidly beginning to cover CHW services under Medicaid. In addition, Medicare launched a new reimbursement opportunity for CHWs in January 2024. These factors create an opportunity for state and territorial health agencies to develop or contribute to equitable reimbursement and robust implementation. This report details how health officials can play key roles as funders, administrators, and policy design champions to ultimately advance sustainable financing of CHW services. Get the Report (PDF) website yes

These states are connecting public health and transportation to improve access to healthcare—learn how in this report.

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

ASTHO convened focus groups of state environmental health directors and designated representatives from 11 states to talk about their agencies’ ventilation guidance for school districts. The discussions focused on recommendations for filtration and air cleaning technologies in schools, layered mitigation techniques, partner engagement, and challenges moving forward.

This report identifies and breaks down seven core value areas that emerge from taking a health in all policies approach to policymaking and programming.

This guide captures the experiences and best practices of state and local public health agencies and their partners who are currently in the Cardiff Model implementation phase.

Sustaining DMI: Conditions for Enhanced Funding How state Medicaid agencies can receive enhanced federal funding for certain expenditures. What are the Conditions for Enhanced Funding? Why are they important? The Conditions for Enhanced Funding (CEF) are a series of federal requirements that states must meet to receive federal financial participation. If a state Medicaid agency (SMA) meets the CEF and couples them with measurable outcomes and metrics that improve the Medicaid program, it can receive enhanced funding at the rate of 90% to design, develop, or implement a Medicaid Enterprise Systems (MES) module or at 75% to operate and maintain an MES module. Each state operates an MES to manage its Medicaid data and run its program. Increasingly, SMAs’ MES are composed of independent modules in categories such as eligibility and enrollment and financial management. An SMA that uses these funds can build a strong financial foundation for a data modernization initiative and can secure reliable funding to better sustain the initiative. How can states receive enhancing funding to design, develop, implement, or operate and maintain an MES module? To receive enhanced federal funding, SMAs must collaborate with the federal government from the original implementation of their MES module and throughout its operations and maintenance. Frequently, SMAs begin the MES development journey through a request for planning funds. Planning activities include assessing impact, conducting a Medicaid Information Technology Architecture self-assessment, convening work groups to identify potential system enhancements, and exploring outcomes and metrics. These plans often are converted into requests for design, development, and implementation funding. The 90% funding match for design, development, and implementation could cover the performance of system fixes, establishing connectivity and interfaces, developing business continuity plans, software leasing, configuring off-the-shelf software, and ongoing planning activities. To receive the 75% funding match for operation and maintenance of an MES module, the state must have its module certified by and continuously report operational metrics to the Centers for Medicare & Medicaid Services (CMS). After certification, the SMA can receive enhanced federal funding to support security updates, software leasing or licensing, portal and technology maintenance and operation, and training for personnel engaged in the operation of the MES. Although these eligible activities are diverse, states should ultimately meet seven conditions for enhanced funding (Table 1): Modularity Medicaid Information Technology Architecture (MITA) Industry standards Technology reuse and sharing Business processes Reports Interoperability Table - Resource - Sustaining DMI: Conditions for Enhanced Funding What best practices should states consider when seeking enhanced funding? If an SMA meets the CEF and couples them with measurable outcomes that improve the Medicaid program, it can receive enhanced funding. Public health data modernization initiatives and their ongoing support may be eligible for enhanced federal funding through the Medicaid program. Best practices include: Start the Streamlined Modular Certification early. Certification is a crucial piece of CEF and requires many interrelated activities. States should use the intake form to enter information about MES certification and CMS-required outcomes to develop documentation of their compliance with regulations applicable to their Medicaid-based data modernization initiative, state-specific outcomes, and metrics. The intake form can be used to show that the project is achieving outcomes on a continuous basis. Become familiar with CEF best practices. CMS highlights several best practices for successfully engaging with CEF. States should become familiar with this guidance to help them complete various required forms and documentation, understand connected activities, create realistic timelines, prevent duplication of work, identify efficiencies, and more. Identify outcomes that are feasible to achieve and measure and improve the Medicaid and public health programs. Some outcomes can take years to appear and intensive research and resources to measure. A state should identify outcomes that are feasible to achieve and measure based on its Medicaid-based data modernization initiative, available resources, staff capacity, and other factors. This includes setting measure targets that, when reached in the designated time, collectively provide proof that there is progress toward achieving Medicaid and public health outcomes. website yes

This podcast explores innovative practices for leveraging non-traditional partnerships to support and sustain health equity expansion efforts.

Get vital background on the ACA enhanced premium tax credits and read about 2025/2026 congressional developments for the subsidies.

Looking ahead to FY 25 public health appropriations.

Learn how states have increased and/or allocated funding to continue supporting core public health services.

Learn how Minnesota streamlines public health funding and has offered vital support to local and tribal subrecipients.

DELPH scholars discuss the important role of Community Health Workers (CHWs) in the public health workforce, the need for support, recognition, and investment in their development, and the importance of sustainable funding for CHW programs across the United States.

Braiding and layering funding allows state health departments to leverage diverse fundings sources and amplify their impact. Learn more about this strategy and its importance.

On Oct. 4, 2023, ASTHO responded to a Request for Information from the U.S. House of Representatives' Ways and Means Committee on the subject of improving access to healthcare and rural and underserved areas, including the island jurisdictions.

President Trump Releases FY27 Budget Proposal: April 2026 President Trump Releases FY27 Budget Proposal: April 2026 Learn how the Administrations FY27 budget proposal impact public health funding in this Legislative Alert. On April 3, the White House released President Trump’s FY27 discretionary budget proposal, which outlines the Administration’s funding priorities for the upcoming fiscal year beginning on October 1, 2026. The documents reflect the Administration’s planned HHS reorganization, proposed funding levels, and various policy and legislative proposals. As a reminder, Congress has the authority to approve, reject, or modify the Administration’s budget recommendations. Therefore, public health leaders must continue to educate and inform members of Congress about the impact of public health funding and the need for sustainable, predictable resources for governmental public health activities across federal, state, territorial, and local agencies. For additional information, please review the following documents: HHS Budget in Brief (PDF) Centers for Disease Control and Prevention (PDF) Administration for a Healthy America (PDF) Administration for Strategic Preparedness and Response (PDF) Centers for Medicare and Medicaid Services (PDF) Food and Drug Administration (PDF) Office of the Secretary: General Departmental Management (PDF) Environmental Protection Agency (PDF) It is challenging to conduct a detailed analysis of the budget proposal because many programs are eliminated, funding is consolidated or moved to different agencies. As a result, the ASTHO Government Affairs team cannot make a comprehensive comparison between FY26 enacted funding levels and the FY27 budget proposal. The information provided below is pulled directly from tables in the budget documents released by the Administration. Key Public Health Funding Proposals Overall, the budget proposes $111.1 billion in discretionary budget authority for HHS, a $15.8 billion or 12.5% decrease from the 2026 enacted level. Eliminates the Prevention and Public Health Fund, which provided $1.4 billion in funding across various CDC programmatic activities in FY26. Proposes establishment of the Administration for a Healthy America (AHA) (similar to the FY26 budget proposal) as part of a major reorganization of the Department of Health and Human Services. Specifically, it consolidates and relocates programs from across the Office of the Assistant Secretary for Health (OASH), the Health Resources and Services Administration (HRSA), the Substance Abuse and Mental Health Services Administration (SAMHSA), and from several CDC centers such as the National Center for Chronic Disease Prevention and Health Promotion, National Center for Injury Prevention and Control, and the National Center on Birth Defects and Developmental Disabilities. Establishes a new National Center for Chemicals and Toxins within CDC, to bring together complementary programs across HHS, to include: National Institute for Toxicological Research (from FDA) Agency for Toxic Substances and Disease Registry National Institute for Occupational Safety and Health (CDC) National Center for Environmental Health (CDC) National Institute for Environmental Health Sciences (from NIH) Establishes (similar to the FY26 budget proposal) a new $300 million grant program that consolidates hepatitis, STI, and tuberculosis grant funding into one program. The budget eliminates the following programs to reset the balance between federal and state responsibilities, among other reasons: Previously in CDC: Tobacco and Prevention Control Nutrition, Physical Activity, and Obesity School Health Vision and Eye Health Inflammatory Bowel Diseases Interstitial Cystitis Excessive Alcohol Use Chronic Kidney Disease Chronic Disease Education and Awareness Prevention Research Centers Heart Disease and Stroke Diabetes National Diabetes Prevention Program Oral Health Arthritis Epilepsy National Lupus Patient Registry Racial and Ethnic Approaches to Community Health (REACH) Million Hearts National Early Child Care Collaboratives Hospitals Promoting Breastfeeding Safe Motherhood/Infant Health Adverse Childhood Experiences Firearm Injury and Mortality Prevention Research Drowning Elderly Falls Other Injury Prevention Activities Injury Control Research Centers Previously in HRSA: Rural Hospital Flexibility Grants State Offices of Rural Health Rural Hospital Stabilization Pilot Program Rural Hospital Provider Assistance Program AIDS Education and Training Centers – Part F Dental Reimbursement Program – Part F Special Projects of National Significance Minority HIV/AIDS Fund Early Hearing Detection and Intervention Emergency Medical Services for Children Healthy Start Title X Family Planning Loan Repayment/Faculty Fellowships Scholarships for Disadvantaged Students Health Careers Opportunity Program Primary Care Training and Enhancement Oral Health Training Programs Medical Student Education Area Health Education Centers (AHEC) Geriatric Programs Mental and Behavioral Health Public Health/Preventative Medicine Advanced Nursing Education Nursing Workforce Diversity Nurse Education, Practice, and Retention Nurse Faculty Loan Repayment Public Health Reports Previously in SAMHSA: Seclusion and Restraint Mental Health Awareness Training Healthy Transitions Infant and Early Childhood Mental Health Children and Family Programs Consumer and Family Network Grants Mental Health System Transformation Project LAUNCH Primary and Behavioral Health Care Integration Primary and Behavioral Health Care Integration Tribal Training and Technical Assistance Center Mental Health Crisis Response Partnership Pilot Program Homelessness Prevention Programs Criminal and Juvenile Justice Program Assertive Community Treatment for Individuals with Severe Mental Illness Homelessness Prevention Programs Mental and Behavioral Health Minority AIDS Mental Health Minority Fellowship Program Tribal Behavioral Health Grants Interagency Taskforce on Trauma-Informed Care Eating Disorder Identification, Treatment, and Recovery Community Mental Health Services Block Grant Substance Use Treatment Minority AIDS SAT Minority Fellowship Program Substance Use Prevention, Treatment, and Recovery Services Block Grant State Opioid Response Grants Strategic Prevention Framework Substance Use Prevention Minority AIDS Sober Truth on Preventing Underage Drinking Minority Fellowship Program Tribal Behavioral Health Grants Drug Abuse Warning Network Behavioral Health Workforce Data and Development Hepatitis C Previously in OASH: Teen Pregnancy Prevention Kidney X Sexual Risk Avoidance Office of Adolescent Health Administration for a Healthy America The request proposes $17.5 billion for the Administration for a Healthy America (AHA). Primary Care $3 billion, for Health Centers, including $1.8 billion in discretionary funding and $1.1 billion in mandatory resources, a decrease of $3.5 billion. $59 million, or level funding, for the Organ Transplantation program. $41.3 million, a $11 million decrease, for the Cell Transplantation program and Cord Blood Stem Cell Bank program. $14 million, or level funding, for the National Hansen’s Disease program. $11 million, or level funding, for Rural Health Policy Development. $111 million, or level funding, for Rural Health Outreach Grants. $4 million, a $2 million increase, for Radiation Exposure Screening and Education Program. $12 million, or level funding, for the Black Lung Clinics program. $145 million, or level funding, for the Rural Communities Opioid Response program. $14 million, or level funding, for Rural Residency Planning and Development. $70 million, a $24.5 million increase including $20 million for chronic care telehealth centers of excellence, for the Office for the Advancement of Telehealth. $26 million, or level funding, for the Office of Disease Prevention and Health Promotion. $45 million, a $30 million decrease, for the Office of Minority Health. $19 million for a new Prevention Innovation Program. Chronic Disease and Health Prevention $448 million, a $985 million decrease, for chronic disease and prevention activities. $35 million, a $6.5 million decrease, for Alzheimer’s disease. $413 million, or level funding, for Cancer Prevention and Control. Injury Prevention and Control $588 million, a $173 million decrease, for Injury Prevention and Control (formerly in CDC). Specifically: $12 million, a $18 million decrease, for Comprehensive Suicide Prevention. $38 million for the Preventing Intimate Partner and Sexual Violence Program. This program replaces the Rape Prevention Education and Domestic Violence Prevention Enhancements and Leadership Through Alliances programs. $25 million, or level funding, for the National Violent Death Reporting System. $506 million, or level funding, for the opioid overdose prevention and surveillance. $8 million, or level funding, or traumatic brain injuries. HIV/AIDs $2.7 billion, a $923 million decrease, for HIV/AIDS programs. Specifically: $680.7 million, or level funding, for Part A- Emergency Relief Grants. $1.4 billion for Part B Comprehensive Care, which includes $900 million for the AIDS Drug Assistance program. $209 million, or level funding, for Part C Early Intervention Services. $78 million, or level funding, for Part D Women, Infants, Children, and Youth. $165 million, or level funding, for the Ryan White HIV/AIDS Ending HIV Epidemic. $220 million, or level funding, for the Ending HIV Epidemic initiative transferred from the CDC Domestic HIV Prevention and Research. $8 million, or level funding, for the Office of Infectious Disease and HIV/AIDS Policy. Maternal & Child Health $1.9 billion, a $561 million decrease, to support maternal and child health programs. $767 million, a $51 million decrease, for the Maternal and Child Health Block Grant. $17 million, or level funding, for the Alliance for Innovation for Maternal Health program. $10 million, or level funding, for the