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Learn about engaging partners in a virtual space, with actionable steps, examples, and resources.

Funding local subrecipients can complement public health agency efforts and expand community reach—learn to navigate each funding stage.

Learn how the Maryland Department of Health leveled up their strategic planning process to improve their critical public health work in this blog post.

Learn how Wisconsin is streamlining processes to improve the administrative experience for local health departments.

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

PHIG Recipients Accelerating Procurement Processes Melissa Touma Learn how PHIG recipients are advancing procurement processes to advocate for continued public health infrastructure investment, using thoughtful targets and tracking progress. Timely procurement is a cornerstone of effective public health infrastructure. Under CDC’s Public Health Infrastructure Grant (PHIG), recipients are encouraged to strengthen their procurement systems so that resources reach communities swiftly and efficiently. As jurisdictions continue to modernize their systems, several PHIG recipients are leading innovative practices that not only reduce procurement cycle times but also enhance transparency, accountability, and collaboration. By setting thoughtful targets and tracking progress, agencies can demonstrate improvements in procurement efficiency and make a strong case for continued investment in public health infrastructure. Best Practices for Setting Targets for the PHIG Procurement Timeliness Measure The PHIG performance measure A2.2: Procurement Timeliness tracks the median number of calendar days from when procurement documentation is received to when a contract is fully executed. It helps agencies assess and improve the efficiency of their procurement processes, particularly those funded by federal awards. Setting realistic and meaningful targets for procurement timeliness is essential for tracking progress and driving improvement. Clear, data-informed targets help agencies identify bottlenecks, allocate resources effectively, and measure the impact of process changes over time. When targets are both ambitious and achievable, they can motivate teams, guide continuous improvement efforts, and support accountability across departments. To get on track: Start with a baseline. Use historical data to establish a procurement cycle time. If data is not yet available, begin with a small sample and refine over time. Segment by procurement type. Consider setting distinct targets for various types of procurement (e.g., contracts vs. purchase orders) if they follow different timelines. Engage stakeholders. Collaborate with procurement, finance, and program staff to understand bottlenecks and set achievable goals. Align with system improvements. Adjust targets to reflect expected gains in efficiency, especially when implementing a new contract lifecycle management system or process improvements. Document assumptions and limitations. When setting targets, note any contextual factors (e.g., staffing shortages, policy changes) that may affect procurement timelines. Review and adjust regularly. As systems mature and data quality improves, revisit and refine targets to reflect new capabilities and expectations. Best Practices from PHIG Recipients Several PHIG recipients have adopted replicable strategies to improve procurement timeliness, aligning with best practices from the National Association of State Procurement Officials and principles of collaborative procurement partnerships that emphasize cross-functional coordination and interagency engagement. Here are some best practices and examples of how PHIG recipients are moving to improve their procurement systems: Establish a robust and effective data collection system that offers automated data capture, comprehensive coverage, regular audits, and validation. For example: Illinois Department of Public Health currently uses Smartsheet to streamline procurement tracking and plans to implement DocuSign’s Contract Life Management (CLM) system to track procurement in 2026. Seattle & King County Public Health utilizes Agiloft, a Contract Lifecycle Management platform, to manage procurement from planning to closeout. Connecticut Department of Public Health built a custom Grants Management System using Dynamics 365 and Power BI, enhancing visibility and reporting. Tennessee Department of Health developed a low-code Contract Tracking and Reporting Application using Caspio, improving efficiency and data accuracy. Utilize a CLM System to improve efficiency, enhance transparency and accountability and ensure compliance and risk management. For example: Iowa Department of Health and Human Services is rolling out Cobblestone, a full-spectrum CLM system that guides users through procurement pathways and supports contract execution and management.  Connecticut Department of Public Health utilizes its new Grant Management System built into Dynamics 365 and Power Bi.  Seattle & King County Public Health utilizes Agiloft, a CLM platform. Establish a dedicated, centralized team that oversees and executes procurement activities for the entire agency. For example: Illinois centralized its procurement function by assigning a team of five people to improve collaboration and consistency across the agency. Connecticut is building a centralized team to support program staff through the procurement process. Institutionalize procurement capacity building, training, and customer support. For example: Louisville Metro Department of Health and Wellness placed a trainer on the procurement and contracting team to build the capacity of all grants/contract managers across the agency. Training materials and documents are available for staff to reference and build programmatic capacity. Connecticut established a customer support team within its Operational Support Unit to assist staff with procurement needs. Foster a working relationship with external agencies or divisions that play a role in the procurement approval process. For example: Illinois includes state purchasing officers in weekly procurement meetings to enhance communication and problem-solving. Foster cross-functional collaboration and learning through internal procurement meetings and engagement. For example: Santa Clara Public Health Department created a Grants/Fiscal Community of Practice to foster cross-functional learning. Procurement as a Strategic Lever for Public Health Improving procurement timeliness is more than a technical fix — it's a strategic investment in public health readiness and resilience. By embracing data-driven tools, centralizing expertise, fostering collaboration, and exploring emerging technologies, public health agencies are reducing delays while building the infrastructure to respond swiftly to community needs, emergencies, and long-term health goals. As these best practices continue to spread and evolve, they offer a roadmap for other jurisdictions to modernize procurement and maximize the value of every public health dollar. Next, explore how two state recipients are transforming procurement and grant management — ultimately delivering faster, more reliable services to the communities that need them most. As more PHIG recipients work to modernize their procurement systems, sharing strategies and lessons learned becomes increasingly valuable. What strategies has your agency found most effective in improving procurement timeliness? We invite you to join the conversation and contribute your insights to help strengthen public health infrastructure nationwide. Send us an email at phig@astho.org! article yes

Tennessee and Connecticut Are Transforming Procurement and Grant Management Systems States Transform Procurement and Grant Management System Melissa Touma Learn how Tennessee and Connecticut are transforming their procurement and grant management systems with new tools, smarter workflows, and transparency. Behind every public health initiative — whether it’s expanding rural care, funding local clinics, or responding to emergencies — there’s a complex system working to move contracts, track spending, and ensure accountability. For many health departments across the country, CDC’s Public Health Infrastructure Grant (PHIG) is a critical resource to modernize these foundational systems that power public health. In Tennessee and Connecticut, this investment is already paying off. With new tools, smarter workflows, and a focus on transparency, both states are transforming how they manage procurement and grants. As a result, they’re delivering faster, more reliable services to the communities that need them most. Tennessee Department of Health In Tennessee, innovation took root through a homegrown solution: the Contract Tracking and Reporting Application (CTRAC). The Tennessee Department of Health’s (TDH’s) Operations Analysis Office and Procurement Management Office built CTRAC using Caspio, a low-code platform that allowed the team to design a fully customized application without extensive programming. What began as a manual, email-based process using internal contract processing worksheets is now a fully automated, digital workflow. CTRAC streamlines how TDH initiates, reviews, and tracks contracts, making procurement more efficient and transparent. The system automates the collection of all required documentation for procurement processing, enforces validation rules to ensure data quality, and provides comprehensive reporting capabilities that meet CDC’s PHIG performance measures. It has also been expanded to support Federal Funding Accountability and Transparency Act reporting and invoice management, making it a central hub for multiple financial and administrative functions. Additionally, CTRAC integrates critical control mechanisms that strengthen financial compliance and oversight: Budget review and monitoring tools ensure that funding sources are correctly cited and aligned with contract terms. Fiscal review processes, which are embedded into the workflow, reduce the risk of errors and improve compliance with federal and state regulations. Automated data capture reduces human error and ensures timely, consistent entries. Monthly audits and validation checks maintain data integrity and support continuous improvement. PHIG funding offset TDH’s initial Caspio costs, covering the expenses that supported procurement timeliness improvements. It also enabled the development of internal dashboards that track processing times at key stages. These visual tools improved communication with stakeholders across the department and supported efficient, data-driven decision-making. In parallel, TDH enhanced several Caspio user interfaces to streamline navigation and improve the overall user experience for staff. In addition, PHIG funding supported the expansion of CTRAC to manage post-award grant functions for 22 grantees as part of the Rural Healthcare Resiliency Program project, including tools for electronic reimbursement submissions, real-time budget tracking, and status updates. Connecticut Department of Public Health For the Connecticut Department of Public Health (CTDPH), PHIG funding has been vital to advancing a more transparent, efficient, and data-informed grants and procurement ecosystem. At the core of this transformative effort is a new, agency-wide grants management system, developed using Microsoft Dynamics 365 and Power BI. PHIG’s support enabled CTDPH to hire a dedicated data engineer to design and implement the system’s foundational database, an essential technical capability that underpins the success and sustainability of the initiative. This integrated platform streamlines workflows and enhances accountability and tracking across the grant and procurement lifecycle. By centralizing data and automating reporting, CTDPH can now: Track procurement and contract status in real time, reducing delays and improving responsiveness. Ensure compliance with federal and state requirements through built-in validation and audit trails. Generate dynamic dashboards that provide leadership with actionable insights into spending, timelines, and bottlenecks. Standardize documentation and approvals, reducing variability and increasing transparency across departments. To further strengthen and sustain these improvements, CTDPH is establishing a centralized procurement support team that guides program staff through the often-complex procurement process — ensuring consistency, reducing redundancy, and ultimately improving the speed and quality of contract execution. For health program staff in the agency, this system transformation means less time navigating administrative hurdles and delays, and more time focusing on public health outcomes. Another key focus area for CTDPH is procurement timeliness, an important component of achieving public health goals. CTDPH reported a median procurement cycle time of 137 days in PHIG Reporting Period 4 and set a target to reduce this to 80 days. This commitment aligns with PHIG’s broader goal of improving foundational capabilities and reflects CTDPH’s proactive approach to building a more agile and accountable public health infrastructure. Conclusion Both Tennessee and Connecticut exemplify how PHIG funding can catalyze meaningful change in procurement and grants management. Whether through custom-built platforms like CTRAC or enterprise-grade systems like Dynamics 365 and Power BI, these states are laying the groundwork for more efficient, transparent, and accountable public health operations. As PHIG continues to support foundational improvements, Tennessee and Connecticut’s successes offer a roadmap for other states seeking to modernize their systems and accelerate public health impact. Next, learn about best practices and strategies for procurement PHIG peers are implementing. article yes

This brief provides actionable steps for state health departments to reduce administrative hurdles in grant management for local health departments.

Assessment of Foundational Capabilities Assessment of Foundational Capabilities in Public Health Grace Gorenflo, Brian Lentes, Melissa Touma, Anna Bradley Learn how state health departments are implementing the Foundational Public Health Services model to bolster their public health work in this report. The Foundational Public Health Services model serves as the core framework for defining cross-cutting capabilities essential for public health departments to deliver a minimum standard of service. This report compiles examples and assessments from 25 states to illustrate the implementation and progress of these foundational capabilities. Highlighting the importance of public health infrastructure, the report also includes a summary of state activities, showcases models and strategies for modernization and transformation, and reference tools such as cost assessments, legislation, and funding mechanisms used to strengthen public health systems nationwide. Dive into the full report to access these resources. Download the Report (PDF) article yes

PHIG-Funded Local Health Agencies Model Strong Performance Management Systems Health Agencies with Strong Performance Management Programs Anna Bradley, Melissa Touma Performance management is essential in modern public health—learn about three local health agencies with strong performance management programs. Performance management (PM) systems are essential in modern public health, driving efficient service delivery, resource optimization, and transparency. By measuring and improving performance, public health agencies can enable data-driven decision making and communication, and support public health accreditation. With support from Big Cities Health Coalition, ASTHO conducted key informant interviews with performance management leaders from three accredited local health jurisdictions with Public Health Infrastructure Grant (PHIG) funding. These interviews highlight work by Columbus Public Health, Philadelphia Department of Public Health, and San Antonio Metropolitan Health District to build PM programs, create a culture of performance and quality improvement (QI), and ultimately enhance performance. In addition, they provide important insights to other health agencies. Visible Leadership Successful PM systems begin with strong leadership support. Visible leadership includes promoting a customer focus, transparency, strategic alignment, and a culture of quality within the organization. In each of the three health departments, PM programs sat directly under the health commissioner or an assistant director, ensuring the visibility and involvement necessary to drive PM efforts across the organization. Leadership involvement proved particularly important during periods of rapid growth and change, such as during the COVID-19 pandemic. All three jurisdictions experienced an increase in staff, programs, and funding, and leadership played a crucial role in championing the integral operational and administrative functions PM teams provided. For example: San Antonio prioritized growing the PM team as the agency grew to support agency operations as the “engine of the department.” Interviewees recalled that direct access to an assistant director was essential for team growth. As a result, the team expanded from three to seven people serving a department of 700 staff, for a ratio of 1:10. Columbus and Philadelphia also invested in expanding their PM programs. Funding for PM programs in these departments came largely from general funds, Medicaid waivers, and previous grants. However, PHIG funding went towards partial and full staff salaries as well as operational and programmatic dollars. One key informant reflected on the importance of this support, noting that prior to PHIG, the team felt shorthanded. Examples of the influence leadership had on a strong PM system included obtaining participation in QI councils, setting expectations for regular PM reviews, prioritizing PM among other projects, and advocating for increased resources. Performance Standards, Measures, and Reviews The importance of investing in a simple, manageable PM system and corresponding software tools cannot be overstated. When it comes to reporting on performance, the three jurisdictions favor methods that can provide progress snapshots, such as Balanced Score Cards. In Philadelphia, there is not a maximum or minimum required number of indicators per division, but there tends to only be six to 15 each. Keeping the number of metrics manageable and the format simple makes regular reviews between the PM staff and other agency teams easier to maintain. Columbus described a system with a similar focus on simplicity: Only one to two users per division have accounts within the performance management software for updating data. Conversations about performance management can focus less on learning how to use the software and more about how to decide on, analyze, and act on the resulting data. The three jurisdictions described ongoing discussions and training with programs around how many and what types of measures to collect. Relevant standards, indicators, goals, and targets naturally vary by jurisdiction: Philadelphia division directors review the Strategic Plan and the Community Health Improvement Plan and consider current needs of Philadelphians. Data are collected quarterly via Excel spreadsheets, which the Performance Management Unit maintains and distributes for use in quarterly reviews with the health commissioner. Columbus and San Antonio gather data quarterly using Insight Vision (Columbus) and VMSG (San Antonio) and condense it into Quarterly Data Reports for leadership review. Quality Improvement The three jurisdictions prioritize fostering a culture of QI over compliance by emphasizing one-on-one connections and coaching. The adoption of hybrid work environments and virtual communication platforms has opened more informal communication channels between PM/QI staff and other agency members. This allows staff to ask questions more frequently and identify “little QI” projects instead of only looking for larger, agency-wide, “big QI” projects. Hybrid environments also make it easier for staff from multiple locations to join in virtual trainings, meetings, and celebrations, ensuring broader engagement. These agencies also model QI by allowing their PM systems to adapt. They shared examples of how their QI Councils have periodically taken breaks to reassess scope and update group charter documents, membership, and participation requirements, ensuring the systems remain flexible and effective: Columbus recently changed their schedule from quarterly to monthly, with two months of one-on-one meetings between the QI team and members, and a group gathering in the third month. Membership includes the PM team, the Safety Officer, an epidemiologist, the Workforce Development Manager, a union representative, QA staff, and at least one representative from each division. Philadelphia is considering a matrix-style approach to their structure, in which the PM team would communicate with both QI Council members and individual division leadership to improve awareness of internal improvement opportunities and progress. Membership includes the PM team and representation from each division. San Antonio is planning to restructure the QI Council to be project-focused, potentially meeting every other month with less than 15 members representing each division, which is a reduction from 38 total staff. Membership includes upper leadership, frontline staff, and mid-level management from throughout the agency. PM teams can be champions and subject matter experts in change management. Getting ahead of change by communicating clearly, consistently, and with transparency is an important part of every strong workplace culture. Frameworks, such as NACCHO’s Roadmap to a Culture of Quality Improvement, can make change easier. Staff recognition and development are vital for embedding a QI culture. The three jurisdictions shared stories about celebrating and promoting QI by providing QI awards, staff symposiums, and partnering with academic institutions to display QI storyboards, in addition to leadership development programs that include QI projects and participation in the PM system or QI Council that empower staff and future leaders to confidently propose and discuss improvements with leadership. Key Recommendations for a Strong System Keep in mind that PM and QI are related and interdependent but not the same. Review the best practices available through PHAB standards and measures to fully develop and monitor the PM system, with QI as a critical component that uses PM data to prioritize agency-wide QI projects. Formalize processes, consider developing process flow maps to create consistency and clarity, and commit to transparent process improvement. Enhance training programs by making clear plans for training of different levels of staff. For example, differentiate the requirements for members of the QI Council, leadership, program managers, and agency wide opportunities. Also, include foundational elements of QI, the agency-specific PM system, the interaction of PM and QI, and how QI culture manifests. Engage staff of all levels through participation in the QI Council, training opportunities, and development and implementation of the PM system. Check out ASTHO’s online courses on QI and process improvement to refresh your memory on the basics and share them with peers. Schedule regular PM reviews with the highest levels of leadership, and use easy-to-adopt and at-a-glance tools to understand and report on performance. Get ahead of change management by using an established framework and developing a transparent internal communication plan. Operationalize health equity, including in PM systems. Connect with peers through online communities to share ideas, solicit feedback, and find inspiration. Managing public health organizations to improve quality and performance can be overwhelming—submit a PHIG TA request through the PHIVE system for support. Looking Ahead As health departments continue to evolve their PM systems, a focus on leadership participation, staff engagement, and change management is critical for driving improvements. By fostering a culture of continuous quality improvement and investing in infrastructure, public health agencies can ensure their PM systems not only meet accreditation standards but also contribute to better health outcomes for the communities they serve. OE22-2203 PHIG article yes

Sustaining Accreditation: How Montana and Southern Nevada Are Building Resilient Public Health Infrastructure for the Long Term How Montana and Southern Nevada Are Building Resilient Public Health Infrastructure for the Long Term Melissa Touma Learn how public health accreditation helped Montana and Nevada improve their health agencies' work in this blog post. Public health accreditation is a dynamic process that requires ongoing commitment, strategic planning, and organizational alignment for agencies to uphold consistent quality, accountability, and performance over time. Across the country, health departments are reimagining how they approach accreditation, shifting towards sustainable systems that weave accreditation practice into everyday operations and bolster the agency’s ability to face the common challenges of changing resources, limited funding, and leadership or staff turnover. During ASTHO’s webinar Tools and Strategies for Building a Sustainable Accreditation Infrastructure, two health departments — Montana Department of Public Health and Human Services and Southern Nevada Health District — described how they leveraged ASTHO’s Guide for Sustainable Accreditation and strategies gained from participating in ASTHO’s Accreditation Sustainability Learning Community to develop plans that strengthen their accreditation infrastructure, improve internal communication, and help maintain momentum beyond each accreditation cycle. Montana’s Sustainability Plan: From Rodeo to Roadmap Montana’s sustainability journey began with the launch of its Performance Excellence Program, a strategic initiative to embed the Public Health Accreditation Board’s (PHAB) standards, best practices, and data-driven methodologies into everyday agency operations. After Montana earned reaccreditation, the team launched an effort to transform the agency’s approach to sustaining accreditation. Their objective was to build an organizational resilience that would support continuous improvement throughout each cycle by fostering shared ownership across the agency and strategically spreading accreditation activities over the five-year timeline. Their plan of action: developing and implementing an accreditation sustainability plan that turned accreditation from a sporadic, rodeo-like scramble into a structured, data-driven ecosystem. Montana’s Public Health Accreditation Sustainability Plan defines the agency’s accreditation approach and framework by: Structuring team roles and defining responsibilities for accreditation coordinators, subject matter experts, and support staff. Creating a detailed roadmap with quarterly milestones and annual reporting requirements. Integrating with the agency’s performance management system, AchieveIt, for real-time tracking and accountability. Structuring an internal communication plan and campaign to raise awareness and keep staff engaged throughout the five-year cycle. Incorporating onboarding and ongoing training to build institutional knowledge. Establishing a single-source repository for required documents, templates, and examples. Knecht - How Montana and Southern Nevada Are Building Resilient Public Health Infrastructure for the Long Term By having a plan in place, Montana’s Performance Excellence Program improves the agency’s capacity to sustain accreditation by: Securing buy-in and support from agency leadership to prioritize accreditation as part of core operations. Preventing last-minute scrambles and distributing accreditation work evenly across the cycle instead of backloading tasks. Ensuring continuity and preserving institutional memory by providing a clear handoff if staff turnover occurs. Improving accountability through dashboards and automated reminders that keep teams on track. Building a culture of quality by linking quality improvement projects and performance measures directly to accreditation standards. Enhancing transparency by creating a clear, documented process that can be shared internally and externally. Southern Nevada’s Communications-Driven Strategy Southern Nevada Health District (SNHD) serves a densely populated region with over 2.5 million residents and 800 full-time staff. During their initial accreditation phase, SNHD’s accreditation team arrived at the process with limited context and institutional knowledge, and a large Accreditation Committee Action Report response with a tight 90-day turnaround time. The experience underscored the need for earlier preparation, better alignment, and a more predictable, agencywide approach to documentation and communication. Recognizing these lessons, SNHD made a strategic commitment to shift toward building a more organized, proactive, and sustainable accreditation infrastructure. Central to this shift was the development of a robust internal communications strategy designed to increase transparency, strengthen engagement, and create consistent accountability mechanisms that keep accreditation visible, relevant, and understood across the entire organization. This communications-driven model now serves as the backbone of SNHD’s reaccreditation sustainability strategy, ensuring that staff at every level — executive leaders, managers, frontline contributors, and new hires — remain aligned and supported as they collectively move through the reaccreditation timeline. Key elements of SNHD’s internal communications strategy include: Engagement of the Internal Communications Team: SNHD’s communications departments plays a key role in shaping messaging, designing materials, and identifying new channels. Quarterly Executive Updates: SNHD’s accreditation manager meets with the executive leadership team every quarter, using this time to share structured progress updates, highlight outstanding contributors, surface challenges, and reinforce why accreditation matters. All-Hands Meetings: SNHD hosts virtual all-hands meetings that bring together staff and senior leadership across the organization to share big-picture updates, celebrate accomplishments, and reinforce the value of accreditation. Tailored Messaging: Communications are customized for different audiences to ensure relevance and impact. A tailored approach ensures every audience understand the “why” and their role in the “how.” Creative, High-Visibility Channels: SNHD utilizes multiple channels to make accreditation part of daily life and reinforce visibility of accreditation as a shared organizational priority. Reader Boards: Digital displays throughout offices feature rotating content that keep accreditation visible and engaging. Login Bubble Messages: When staff log into their computers, brief, high-impact messages about deadlines, successes, or calls to action reinforce awareness. Onboarding Videos: A three-minute accreditation explainer video introduces new hires to PHAB, expectations, and the department’s quality culture from day one. Hazeltine - How Montana and Southern Nevada Are Building Resilient Public Health Infrastructure for the Long Term By treating accreditation as a shared responsibility and leveraging every opportunity to communicate its importance, SNHD has built a communication-driven infrastructure that aims to strengthen organizational cohesion, maintain momentum across all five years, and prepare the department to weather staffing changes, leadership transitions, and shifting priorities. Their approach demonstrates how intentional, consistent communication can help turn accreditation from an isolated project into a unifying force within the agency. A Shared Vision for Sustainability As health departments continue to navigate evolving public health demands, sustainability planning has become essential for maintaining accreditation momentum, strengthening organizational resilience, and embedding quality improvement into everyday practice. The experiences of Montana and Southern Nevada demonstrate that with intentional planning, robust internal systems, and clear communication, accreditation can begin to shift from a fragmented documentation collection process to a continuous, agency-wide commitment. This blog post highlighted the work of Public Health Infrastructure Grant recipients as they strive to develop a resilient accreditation infrastructure for their communities and ensure accreditation becomes a continuous journey. Check out ASTHO’s two-part webinar series to hear how their systems are evolving: Tools and Strategies for Building a Sustainable Accreditation Infrastructure (October 30, 2025) Sustaining Accreditation Through Smart Documentation Systems (November 6, 2025) To learn more about ASTHO’s Guide for Sustainable Public Health Accreditation and access tools to support your department’s journey, visit A Guide for Sustainable Public Health Accreditation. Reviewed by - Lindsey Myers OE22-2203 PHIG article yes