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Over the years evidence has expanded on community health workers (CHWs) improving outcomes and even reducing disparities in heart disease and many other public health priority areas. However, their presence in state and local public health workforce is still modest. A number of efforts have sought to expand the role of CHWs in medical care settings by developing reimbursement through third party payers, along with including them in managed care contracts and incorporating them in state Medicaid plans. The experience and lessons of the COVID-19 pandemic could substantially change the way we practice public health in the future, and provides opportunities to expand the role and presence of CHWs in the state and local public health workforce.

Economic security and well-being, job stability, access to safe and affordable housing, access to healthy and nutritious foods, and access to resources to manage mental and physical health—all of these things impact individual, family, and community health. The COVID-19 pandemic has fundamentally impacted each of these social determinants of health for many Americans. Furthermore, some communities and industries have faced harder economic impacts than others, including households with low incomes, non-white households, and households with children. Human services and public health leaders can collaborate to make sure we are rebuilding systems and programs in a way that creates healthier, more resilient families and communities.

As the country prepares for the inauguration of President-Elect Joseph R. Biden, Jr. on Wednesday, the incoming administration has highlighted several priorities over the next four years. This post is a summary of priorities that are closely aligned with the work and interests of state and territorial public health, including continued COVID-19 recovery and response, and climate change.

In-depth analysis on state health policy surrounding the public health workforce. This is part of ASTHO's annual legislative prospectus series.

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.

Sandra Powell, deputy director of Rhode Island Department of Health, how her department was able to increase the number of permanent positions to meet critical public health needs.

After decades of underinvestment, health departments received increased funding for disease intervention services, strengthening the existing workforce, and providing opportunities to expand workforce capacity.

Public health agencies have an opportunity to recruit for and retain a diverse and skilled workforce. As new funding opportunities emerge ASTHO recommends a focus on proof, people, and processes.

In addition to the countless hours worked during the COVID-19 pandemic, many public health workers are also grappling with how to repay outstanding federal loans. In response, the U.S. Department of Education (DOE) recently announced temporary relief to current and future Public Service Loan Forgiveness (PSLF) program participants as a result of the COVID-19 pandemic.

Though now an illegal practice, government contracts, policies, and practices have generally excluded women, and Black, Indigenous, and people of color. Still, practices and existing structures continue the inequitable distribution of all contracts. Governmental and non-governmental grants and funding should benefit the communities they serve while being proportionate to the communities' demographics. This is where inclusive contracting comes in.

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.

In recent years, states and territories have started looking at braiding and layering funding streams as a way to leverage existing resources to achieve population-level impact. Adverse childhood experiences is one area that lends itself well to braiding and layering funds, since the risk and protective factors span across multiple program areas, including maternal and child health, violence prevention, substance misuse, behavioral health, housing, chronic disease, and early childhood education.

Congress released FY24 Labor, Health and Human Services, Education, and Related Agencies appropriations bill.

How the U.S. Virgin Islands is Improving Federal Grants Management astho, association of state and territorial health officials, public health, grant programs, grant management, overall health, health system, improving health, social determinants of health sdoh, grant funding, health outcomes, united states virgin islands, territory of the united states, health community, long term, quality of life, health care, grants management system, u.s. virgin islands. social determinants of health, population health, federal grants, federal grants management, federal grant planning, electronic grants management system Kristin Sullivan Learn about new grants management practices in the United States Virgin Islands. The United States Virgin Islands (USVI) continues to lead the way, making headway on improving key business processes. Last year, ASTHO reported on the beginning of a new "all-of-government" approach in the USVI to more efficiently manage and expend federal grant funding to identify territory-wide social determinants of health and in turn yield population health improvement. Under the leadership of Governor Albert Bryan, Jr., cabinet members from four administrative agencies (Offices of Management and Budget; Property and Procurement; Personnel; and Finance), four programmatic agencies (Health; Education; Human Services; and Justice), and the Governor’s Office comprised a Cross Agency Leadership Team (CALT). After evaluation of the federal grants' life cycle value stream, the team prioritized improving the Federal Grant Planning and Set Up process to prevent bottlenecks and other issues that occur throughout the rest of federal grant lifecycle. During this planning phase, the CALT—along with a project team comprised of key staff in each agency— were oriented to performance improvement basics and participated in Boundary Spanning Leadership workshops where they discussed a unified vision of collaboration to modernize business processes for the benefit of their community. In addition to the benefits to the community they serve, participants envisioned becoming better stewards of funds, increasing respect and trust with funders, increased cross-agency collaboration and communication, and improved job satisfaction due to less rework and urgent requests. "As we promote health equity in our diverse communities, we must recognize operational efficiency as a key driver including our ability to move resources to those most in need. This initiative creates an intentional focus through cross-agency dialogue on saving time, reducing duplication, and building workforce capacity to continuously improve." - Justa Encarnacion, Commissioner, USVI Department of Health Through a series of virtual and in-person workshops, each agency identified the steps in their current process revealing significant commonalities and supporting the feasibility of process standardization across agencies. The full project team worked to uncover the root causes behind process inefficiencies and identified and prioritized solutions. The workshops culminated in a set of recommendations for improvement, which was presented to and vetted by the CALT:   Create one standard process for all agencies documented in a standard operating procedure (SOP). Electronically enable the process (i.e., no paper or emails) using the existing grants management system to track information, facilitate workflow visibility and approvals, and store all information in one common location. Enhance quality and reduce errors through mistake-proof templates and checklists. Work toward removing redundant data entry across financial and grant systems. Streamline information sharing of notice of awards via the creation of general email inboxes. Establish Federal Grants oversight responsibilities in programmatic agencies. Establish Federal Grants Community of Practice (COP) among participating agencies to ensure continual effectiveness and efficiency.   Since then, the project team—with leadership support—has made significant progress developing the recommended improvements, working through challenges, and monitoring progress. To date, one standard process and SOP for all agencies was developed, and four workflows were created to automate the new process within their electronic grants management system, eCivis. Collaboration among programmatic, administrative agencies, and the eCivis vendor resulted in resolution of access issues, better-defined field entries for the automated workflows, and enhanced buy-in on broader system use. 100% of project team evaluation respondents reported improved communication and customer service among participating agencies. Additionally, the COP was established and alternates leading biweekly meetings allowing for the necessary time and space to develop emerging leaders, build capacity of the team, and prepare to sustain collaboration and improvement.  Options to establish federal grant oversight responsibilities in programmatic agencies is under discussion by a subgroup of leadership and COP members. Similar challenges that can be found in other jurisdictions, such as limited staffing capacity and turnover, changes in leadership, and managing daily priorities, affects the speed of which improvements are developed and implemented. These disruptions as well as individual agency process changes that occur over time, will need to be managed with attention given to momentum or resistance experienced, as well as to empowering the project team to adjust. Collaboration and decision making across multiple agencies is not easy. Success lies in engaging all agencies that play key roles in the grants process and strong executive leadership.  These keys to success can be replicated by other jurisdictions similarly interested in improving their ability to procure needed goods and services in a timely manner, efficiently recruit and on-board staff, and effectively manage grants and contracts.  Next Phase and Future Actions There are several critical actions USVI is working to execute prior to moving to full implementation of the new, improved process. Each agency will need to test the new workflows and prepare to roll out training to programmatic and administrative staff beyond the project team. Once completed, the new process will be in place and the COP will monitor process performance including speed and quality, and support ongoing process and system improvements. With reaffirmed commitment and prioritization from Governor Albert Bryan, Jr. and the U.S. Department of the Interior, ASTHO was recently awarded additional funding to continue supporting USVI on its journey to improve its federal grants management. Continual Impact thank you website yes

One of President Biden’s first actions just before being sworn into office was to draft up the American Rescue Plan, a sweeping proposal that ASTHO has committed to working with the Biden Administration on. The proposal offers a national vaccination plan, a promise to address COVID-19 health disparities, and efforts to prioritize the expansion the public health workforce. This post details some of the high-level takeaways, as they relate to public health.

One of tools presidents have to implement and drive their strategy are executive actions. Executive orders and presidential memoranda carry the force of law and allow presidents to move quickly, deliver a clear message, organize the functioning of the executive branch, and spotlight critical issues with declarations of commemorative observances.

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.