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ASTHO’s federal legislative agenda guides the organization's advocacy work and sets priorities for the government affairs team. The team's success is measured by the impact of that work.

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.

This video highlights specific administrative strategies, partnerships, and metrics used by the North Carolina Division of Public Health to support efficient and effective spending of federal funding.

What’s Next? An Update From the Hill Devon Page The new year began with a storm. A rare snowy blaze was unleashed on D.C., causing confusion, bewilderment, and inactivity. Though the snowfall subsided, its remnants melted, and Sen. Tim Kaine (D-VA) is no longer stuck in Armageddon-level traffic, a disorienting flurry of political activity (and inactivity) continues to swarm the Hill and for that reason, with respect to crossing off some priorities on Democrats’ agenda, members of congress might as well still be stuck in traffic. Last week, the House passed a third continuing resolution to fund the government through March 11. In order to avoid a government shutdown, Senators must approve the resolution by Friday, Feb. 18. Despite the small window and ongoing disputes over vaccine mandates and harm reduction efforts, party leaders appear confident that they'll be able to avoid a shutdown. Furthermore, the past two weeks have marked significant progress in a months-long party standoff over funding the government for Fiscal Year 22. There is bipartisan agreement for top line numbers, and congressional staff are now actively engaged negotiating and writing legislation. Despite Senator Manchin’s (D-WV) insistence that the Build Back Better Act is dead, the social spending package lives in the minds of Democratic legislators. However, attention has shifted from passing the entire $2 trillion package to passing several popular provisions originally included in the legislation. With nothing set in stone, advocates are diving into the mud, pushing for their top priorities. Of all the great BBB provisions—and in the eyes of this correspondent, there are a lot—ASTHO is doubling down on two: the establishment of a mandatory public health infrastructure fund to provide sustained, flexible, and long-term funding for public health departments and a permanent fix for Medicaid funding for the U.S. Territories. Among a plethora of strategic advocacy efforts, ASTHO in a recent letter exhorted Senate Majority Leader Chuck Schumer (D-NY) to include the two policies in any revised social spending package. But, as of earlier this month Sen. Schumer’s title as Majority Leader might, well, be just that—a title. While Sen. Ben Ray Luján (D-NM) recovers from a stroke, Democrats are facing an effectively balanced Senate for the foreseeable future. So now passing party-line legislation has become not only a practical impossibility (because of filibuster rules); it’s also, without a majority, a theoretical impossibility. If the fragility of the Democratic majority has not yet been made indubitably clear, Sen. Luján’s absence certainly does. Hopefully—for reasons beyond just the political, however important the political are— Sen. Luján makes a speedy and full recovery. For the time being, it seems that BBB sits on the back burner—and not just because of Sen. Luján’s malady. There is, plainly, a lot to get done, and much of it has a deadline. Confirming a Supreme Court Justice, especially in the contemporary Senate, is neither easy nor quick. The cumbersome selection and confirmation process—filled with private meetings, stakeholder input, and high scrutiny—requires months. Justice Breyer’s retirement announcement adds another serving to an already full congressional plate. Although the future of federal policy and the Biden Administration’s agenda remains as unclear as ever before, optimism can—and I argue, should—be found. First, reports are surfacing that, without any complications, Sen. Ben Ray Luján could be back to the Senate in as little as a month. Additionally, it appears that bipartisan support is growing for several ASTHO priorities, notably for ensuring equitable Medicaid funding for the U.S. Territories. And after about a year, Senate Health, Education, Labor, and Pensions (HELP) Committee Chair Patty Murray (D-WA) and Ranking Member Richard Burr (R-NC) released a discussion draft of the long-awaited PREVENT Pandemics Act, marking a step forward for the advancement of bipartisan public health initiatives. (ASTHO has submitted comments on the discussion draft to the Chairwoman and Ranking Member.) Last but certainly not least, ASTHO’s annual hill day is around the corner. In the middle of an exciting and eventful Washington Week on Wednesday, Feb. 23, ASTHO members will hold meetings with their respective congressional delegations in support of ASTHO FY22 and FY23 appropriations requests among other legislative priorities. …and yes, you read that right: “FY23”… Traffic, as frustrating as it may feel, does not stop the world from moving. website yes

In the late fall of 2021, ASTHO leadership visited select jurisdictions in the Pacific and the Atlantic for the first time since COVID-19 curtailed travel to these regions. It was a fantastic to reconnect with our leadership and dedicated staff. Unsurprisingly, we heard about the jurisdictions’ challenges, including chronic ones related to funding and infrastructure, as well as new challenges resulting from the global pandemic.

Housing and overall neighborhood conditions significantly influence a community’s health. Housing quality, stability, and affordability also directly impact an individual’s opportunity and ability to be healthy. There are several policies and initiatives at the federal and state levels focused on improving four pathways connecting housing and health as discussed in this post.

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.

As the Delta variant spreads across the country and increases the number of COVID-19 cases, the strain it is placing on the nation’s health system continues to grow. The surge of COVID-19 patients is contributing to a shortage of the medications and equipment used to treat the disease. As these limitations grow, decisions will need to be made as to which patients receive resources and care and which patients don’t. To guide these decisions, policies called crisis standards of care are often established to maximize resource benefit and ensure they are distributed equitably.

Each September, the United States observes National Preparedness Month, a month dedicated to raising awareness of public health preparedness. Preparedness—a field that readies our nation to respond to a range of emergencies—is a newer public health discipline, advanced by lessons learned from each response to a public health threat. While significant progress has been made over the past 20 years, the COVID-19 pandemic has shed light on the need to strengthen state and local capabilities to address future emergencies. The history of public health preparedness is worth understanding, as each current and future response is impacted by lessons from the past.

The COVID-19 pandemic has highlighted the intersections of social determinants of health, such as transportation, education, and housing, and their impact on the health of individuals and communities. As the moratorium on evictions ends in many parts of the United States, housing in particular looms as a potential public health crisis. Braiding and layering funding is when government agencies and non-traditional partners collaborate and coordinate to combine different streams of funding to address social determinants of health. This post lists three examples where funding has been successfully braided or layered to support housing needs.

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 policy update emphasizes the importance of policymakers choosing to increase funding for public health infrastructure and important initiatives, such as health equity, in the wake of the COVID-19 pandemic.

The COVID-19 pandemic has underscored the consequences of decades of underfunding. To ensure we are better prepared for future pandemics and biological threats, we must consider the long-term investments required to bolster our public health infrastructure and workforce.

An analysis of the state of the federal budget in the wake of the May 2023 agreement between lawmakers and President Biden, who struck a last-minute deal to raise the nation’s debt limit until 2025.

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.

The opioid crisis continues to claim the lives of thousands across the United States and has cost the economy billions in health care, mortality, and criminal justice costs. In 2018, it’s estimated that 67,367 people died of overdose, with opioids (prescription opioids, heroin, and other synthetic opioids other than methadone) made up almost 70% of overdose deaths. Provisional data for the twelve-month period ending December 2019 shows that there were 71,130 overdose deaths, with 50,178 overdose deaths attributed to opioids. The COVID-19 pandemic has also exacerbated the drug overdose crisis. Data shows that in the time of continued lockdowns and social distancing that overdose rates have increased, indicating a sustained need to support people with substance use disorder.

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.

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

Alabama shares six ways a cross-cutting approach successfully impacted its PHIG workplan implementation.