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Government Shutdown Effects on Public Health: Lessons from the 2025 and 2018-2019 Closures Catherine Jones Learn about the government shutdown effects on public health, with insights from the 2025 and 2018-2019 closures. When the federal government shuts down, it exposes vulnerabilities in our public health ecosystem. It also brings to light the critical role state and territorial health departments play to protect the health of their jurisdictions. While the political dynamics behind each shutdown may vary, the consequences are unfailingly disruptive. Some federal agencies and programs continue under mandatory or advance appropriations, but the day-to-day machinery that keeps the federal public health system functioning — workforce, oversight, and technical assistance — is impacted. Federal employees from shuttered agencies are either furloughed or required to work without pay if their roles are deemed essential to public safety, as with certain functions of HHS and FDA, among others. The effects of a shutdown can be temporary or long-lasting. In the past, Congress enacted guardrails to reduce the harm of future funding lapses, but the unpredictable nature of each shutdown ensures that disruption, loss, and hardship follow. A comparison of the 2025 and 2018-2019 shutdowns displays this impact — with the 2025 impasse becoming the longest shutdown in U.S. history, surpassing the 35-day record set during the December 2018 to January 2019 closure. Key Differences Between the Shutdowns The 2018-2019 shutdown, which was sparked over a funding fight for the U.S-Mexico border wall, spared HHS because the FY2019 Labor-HHS-Education Appropriations Act had already been enacted before the funding lapse. As a result, core public-health agencies — including CMS, CDC, HRSA, and SAMHSA — continued operating. However, the programs funded through the Agriculture-FDA appropriations bill (e.g., SNAP, WIC, and FDA) were impacted, but the disruptions were somewhat contained: FDA paused some food and drug inspections, while SNAP and WIC administrators worked to stretch timing buffers to sustain benefits. The 2025 shutdown, by contrast, impacted HHS. Disputes over the Continuing Appropriations and Extensions Act, 2026, (H.R. 5371), also known as a continuing resolution (CR) — compounded by an acrimonious stalemate over extending the Affordable Care Act premium tax credits (analyses show premiums could more than double in 2026 without extensions) and reversing Medicaid cuts in the One Big Beautiful Bill — placed health care directly in the shutdown’s epicenter. After 14 failed attempts to move the CR in the Senate, the measure was revised to extend federal funding through Jan. 30, 2026, and to reverse the Reductions in Force (RIFs) enacted during the lapse in appropriations. This CR was combined with three additional minibus appropriations packages, which included the Agriculture-FDA bill that funds SNAP and WIC through FY2026. On Nov. 10, the Senate narrowly mustered the 60 votes needed for passage, with eight Democratic senators joining in support. The bill then cleared the House on Nov. 12 with a 222-209 vote, and President Trump signed it the same day. The result of the 43-day shutdown was a deeper and more systemic breakdown. Furloughs and RIFs swept across agencies. Staffing gaps impacted CDC, SAMHSA, and CMS operations, while lawsuits proliferated over withheld pay, suspended contracts, and SNAP payment distribution. As of now, ACA subsidies remain unresolved, and the full repercussions of the 2025 shutdown continue to emerge. A Closer Look at the Shutdown Impacts Furloughs In 2025, the HHS contingency plan anticipated furloughing roughly 41% of its workforce, with CDC and NIH hit hardest — about 64% and 75% of staff, respectively. During the 2018-2019 shutdown, about 48% of HHS staff were furloughed, with CDC at 61% and NIH at 76%. After the 2018-2019 shutdown, Congress enacted the Government Employee Fair Treatment Act of 2019, ensuring that all furloughed federal employees receive retroactive back pay once operations resume. The current CR provides a provision requiring the payment of federal employees who are furloughed or excepted during the lapse. Government contractors, unlike direct federal employees, are not guaranteed back pay after shutdowns. RIFs During the 2025 shutdown, CDC issued more than a thousand layoff notices, some later rescinded, while SAMHSA reported significant workforce losses. There were no RIFs during the 2018-2019 shutdown. In AFGE v. Donald J. Trump, federal-worker unions challenged the administration’s issuance of mass layoff notices during the 2025 shutdown, arguing that RIFs during a funding lapse violate the Antideficiency Act and are “arbitrary and capricious.” A federal judge issued a preliminary injunction blocking further RIFs for hundreds of employees. This case is currently ongoing. To note, as part of the revised aforementioned CR, RIFs issued during this shutdown were reversed, returning to status quo workforce levels prior to the lapse of appropriations. WIC WIC entered October 2025 with funds from Section 32, providing $300 million as a bridge. Nationally, on average, WIC (a discretionary program) needs about $150 million per week to serve approximately 7 million women, infants, and children. To support access, several states tapped emergency funds and reallocated resources to food banks. In early November, the Trump Administration transferred $450 million from unused customs revenue to fund WIC. During the 2018-2019 shutdown, WIC continued to operate without gaps using prior-year funds. SNAP Roughly 42 million Americans currently rely on SNAP benefits. SNAP is considered mandatory spending, which allows payments to continue temporarily during a shutdown, but when a lapse exceeds 30 days, disruption risk escalates. During the 2025 shutdown, EBT payment delays triggered widespread litigation. In Coalition of States v. U.S. Department of Agriculture, over 25 states sued USDA for suspending benefits despite available contingency funds, citing violations of the Food and Nutrition Act and the Administrative Procedure Act. Federal courts issued temporary restraining orders protecting millions of beneficiaries. The administration appealed to the Supreme Court to halt payments, and the Court granted the request. During the 2018-2019 shutdown, SNAP participants received benefits in December 2018 and January 2019. February benefits were also distributed in late January to avoid disruptions; these were not additional benefits. Tribal Health In 2025, the Indian Health Service remained open due to FY2026 enacted advance appropriations. This funding was in part a reaction to the dire consequences of the 2018-2019 shutdown in which the Tribal and Urban health programs reported having to limit health care services and resources, due to Indian Health Service employees having to work without pay or being furloughed. Unique Implications of the 2025 Shutdown As previously noted, because Congress fully funded HHS in 2018-2019 there was minimal impact on public health programs. However, the length and scope of the 2025 shutdown did impact HHS directly. For example: Mental health: Mental and behavioral health access contracted sharply as SAMHSA’s state-support network lost nearly two-thirds of its staff, due to shutdown RIFs as well as earlier rounds of layoffs and retirements. At-home care and telehealth: During the 2025 government shutdown, hospitals nationwide faced delayed Medicare reimbursements and the temporary suspension of hospital-at-home programs, which had become vital for managing capacity during workforce shortages. Telehealth expansion and remote monitoring efforts were also paused, causing many patients to pay out of pocket. U.S. territories: The pause on SNAP and the Nutrition Assistance Program (NAP) funding in November had disproportionate impacts on the U.S. territories, as higher percentages of their populations depend on SNAP and NAP (20%-40%). In three territories, legislatures passed bills to fund partial or full SNAP and NAP benefits for November. Implications for the Future of Public Health The 2025 shutdown underscored that lapses in government funding disrupt the public health ecosystem. A fully functioning system relies on steady collaboration from federal, state, local, and tribal health departments. The depth of the 2025 crisis has ignited bipartisan discussion about structural fixes to prevent governing by brinkmanship. Proposed congressional legislation includes bills to stabilize federal pay with automatic funding, contain congressional travel and adjournment until appropriations are complete, guarantee pay for federal workers and contractors, prevent disruption to SNAP and WIC programs, and ensure reimbursement to states. Padding Block - Large Related Contnet - Blog - Government Shutdown Effects on Public Health article yes

North Dakota Lead Exposure Outreach Program North Dakota Develops Tribal Communication Plan to Support Lead Poisoning Prevention Learn how North Dakota's lead prevention team built strong partnerships with tribal communities in this blog post. Madison Novosel, Paula Comeau Tribal Communication Plan Partnerships with local jurisdictions are crucial to the effectiveness of the North Dakota Lead Prevention Program. This collaboration enhances the depth and sustainability of the community outreach. One priority after transitioning the program from the Department of Environmental Quality to North Dakota Health and Human Services was to connect with local public health units and ensure they were informed about the change. When reaching out to local partners, the lead prevention team realized that there was not a document that clearly outlined who the correct contacts were between tribal communities and state agencies for lead-related events. Recognizing this gap led the team to develop a communication plan to strengthen coordination between the tribal and state lead prevention programs with the Standing Rock Sioux Tribe’s environmental health official. This communication plan established points of contact between the state program and tribal government officials if a lead-related event were to occur involving tribal members or on tribal land. It clearly charted out the corresponding contacts for specific scenarios, which included: A tribal community member who lives on or off the reservation receives an elevated blood lead result. A tribal community member in the Head Start Program receives an elevated blood lead result. An environmental assessment or remediation is requested/needed on tribal lands. Tribal government officials are interested in hosting a screening event or identifying a screening clinic. Community Engagement The outreach to Standing Rock resulted in more opportunities for collaboration. NDHHS staff were invited to attend a community health event at the local high school. This opportunity revealed a gap in the state lead program; no formal outreach guidelines had been developed yet, as the program was (and still is) in its infancy. The team began to create a lead prevention curriculum guide to be used for low-cost outreach activities at the state and local level. The activities range from interactive lead-safe nutrition games to identifying potential lead hazards in a model home. The team was able to pilot one of the activities in the curriculum guide at the Standing Rock Community High School’s “Walk for Wellness.” Students and community members were asked to play a game that teaches dietary tips for preventing lead poisoning for a prize. Over 30 students and 10 community members came to the table to learn about lead prevention and have open discussions around environmental health. This engagement not only strengthened connections between NDHHS and the Standing Rock community, but also expanded education on lead poisoning prevention to a new population. Future Impact Attending the Walk for Wellness event enhanced collaboration with local public health staff also participating in the event. These in-person conversations offered firsthand insight into the challenges rural communities are facing in accessing care and lead testing. The team walked away with a better understanding of what needs to be addressed to support an increase in statewide lead screening, as well as deeper connections with new and existing partners. The lead outreach team at NDHHS will continue to seek more opportunities to conduct outreach efforts throughout the state, including other tribal communities. While spreading lead prevention education through outreach is important, having the opportunity to connect with those in communities face-to-face around the state is invaluable. These connections are essential to decreasing the burden of lead exposure across North Dakota. article yes

Understand the impact of PHIG in California, as Del Norte County introduces health education kiosks into the community to meet diverse needs.

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

This ASTHOBrief addresses the importance of developing robust, culturally competent risk-appropriate care systems for American Indian and Alaska Native communities.

States Partner Across Sectors to Address Lead Poisoning Kayley Humm, Kerry Wyss, Ali Aslam Learn in this brief how three states are using partnerships to improve lead testing and reduce cases of lead poisoning. ASTHO partnered with the National Center for Healthy Housing (NCHH) to provide technical assistance and capacity-building support for lead poisoning prevention efforts in three state health agencies: Maryland Department of Health, North Dakota Department of Health and Human Services, and Arkansas Department of Health. This brief highlights each agency’s strategies for collaborating across sectors along with accomplishments for strengthening lead poisoning prevention capacity in each jurisdiction. Many of these strategies align with those used in a health in all polices (HiAP) approach to lead poisoning prevention. State Examples Maryland Department of Health Maryland adopted a collaborative approach to prevent lead poisoning. The Maryland Department of Health (MDH) has an established lead poisoning prevention program that partners with the Maryland Department of the Environment. The Department of the Environment oversees the childhood lead registry and case management, while MDH focuses on lead testing regulations and Medicaid services. This partnership has been implemented across the 24 local health departments in the state. Maryland enhanced lead case management by providing staff support and tackling complex cases that require additional assistance. In addition to supporting an increase in lead case management activities and lead awareness, ASTHO funding also helped strengthen collaboration and coordination among local health departments, state agencies, and local health care providers. The MDH Environmental Health Bureau also improved efficiency by moving data from the lead registry to MDH for lead surveillance and case management. They also developed and launched sub-county lead testing data as part of their Environmental Public Health Tracking public portal. These activities align with HiAP strategies of developing and structuring cross-sector relationships, coordinating funding and investments, and synchronizing communications. North Dakota Department of Health and Human Services The North Dakota Department of Health and Human Services (NDHHS) made significant strides in building up the state lead program, which recently transitioned from the department of environmental quality to NDHHS. With support from ASTHO and NCHH, NDHHS developed a lead prevention website with a data dashboard, developed a lead screening questionnaire, and built collaborative partnerships. The activities in North Dakota align with the HiAP strategies of developing and structuring cross-sector relationships, synchronizing communications, and integrating research, evaluation, and data systems. Building collaborative partnerships is a key initiative for the NDHHS lead program. Already developed partnerships include stakeholders such as Health Tracks and WIC. Health Tracks developed a newsletter article for their provider network so physicians can stay up to date and aware of the lead program transition and lead testing changes, and WIC will host informational lunch and learns to raise awareness about lead testing within their network. North Dakota is also prioritizing building partnerships with tribal communities. A tribal communications plan was developed with the goal of establishing an effective communication plan between the state of North Dakota and each tribal government for lead-related events. Anticipated outcomes from the communication plan include testing for blood lead levels, conducting environmental assessments on tribal lands, and seeing if a tribal member or government is interested in hosting a lead screening event. Progress has been made with the Standing Rock Sioux Tribe, Turtle Mountain band of Chippewa, and NDHHS is hopeful to establish intertribal meetings with all four governmental tribal representatives. Arkansas Department of Health The Arkansas Department of Health established its lead program in 2011 to support abatement of lead-based paint in residential and commercial properties. With support from ASTHO and NCHH, Arkansas has been using a data-driven approach to gain a more comprehensive understanding of lead exposure burden in the state. These activities align with the HiAP strategy of incorporating health data into decision-making and integrating research, evaluation, and data systems. The Arkansas Department of Health conducts periodic audits on its data system to support access to timely and accurate data. To improve data quality and frequency of blood lead testing reports, the health department is establishing incentive programs to encourage facilities to report cases of elevated blood lead. In addition to conducting outreach to its partners, the Arkansas Department of Health has been working to improve lead case data access and data quality through data mining efforts, case report matching, and migration to a new lead surveillance system. Arkansas has been working to modernize the current reporting system to facilitate automation and promote overall efficiency of data analysis and case identification. Conclusion The collaborative efforts of Maryland, North Dakota, and Arkansas highlight the importance of multi-sector partnerships and data sharing in addressing lead poisoning prevention and align with many of the strategies used in a HiAP approach. Each state implemented tailored strategies that sought to grow collaboration in its unique context. These initiatives highlight the importance of cross-sector collaboration in public health initiatives and may serve as valuable models for other jurisdictions. article yes

Tribal Health association of state and territorial health officials, astho, tribal health, American Indian, Alaska native, ai/an, ai/an communities, high quality public health services, state health departments, tribal health liaisons, tribal communities, state tribal liaison, public health agencies, public health needs, tribal environmental health, American Indian health American Indian (AI) and Alaska Native (AN) populations are a rich tapestry of diverse and resilient cultures. Their population is growing, and they number in the millions. However, they are among the most marginalized communities with some of the poorest health outcomes in the country. ASTHO works with tribal, federal, state, and local partners to change this. Tribal health and public health systems interact but are distinct from state and federal systems. The resources below aim to foster connections across systems and community members to improve health outcomes, with a focus on health equity and the unique challenges tribal populations face. article

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

This toolkit is designed to support public health leaders in leveraging the policy development process to achieve health equity in their jurisdiction.

ASTHO partnered with the International Association for Indigenous Aging to produce this series of communication materials to address the connection between brain health and heart health.

Arizona Department of Health Services Pursues Policies to Advance Data Sharing with Tribal Nations Erik Skinner, Christina Severin, Reema Mistry The Arizona Department of Health Services is pursuing policies to advance data sharing with tribal nations, centered around partnerships, education, and more. With leadership support and funding to modernize its public health infrastructure, the Arizona Department of Health Services (ADHS) is pursuing policies to advance data sharing with tribal nations. This includes investing in partnerships with tribal leaders, educating the public health workforce about tribal governments and tribal health care, and working to improve data identification processes to support effective data sharing between the state and tribal nations. Data sovereignty is an important consideration for ADHS, as there are 22 federally recognized tribal nations in Arizona. ADHS recognizes the inherent right of tribal nations to access their citizens’ public health data and is developing a tribal data sovereignty policy that both acknowledges their unique data needs and aligns with state requirements around tribal engagement. Leadership Support and Effective Tribal Engagement ADHS leadership understands the importance of making strong connections with tribal nations and recognizing each nation’s public health priorities while meeting its statutory requirement to develop tribal consultation policies. To that end, ADHS developed the tribal liaison position to serve as a resource, advocate, and communication link between ADHS and Arizona’s Native American health care community partners, including tribal community leaders, health and epidemiology directors, Indian Health Service (IHS), and Tribal Epidemiology Centers (TECs). Understanding cultural norms is essential to building trust with tribal partners; the tribal liaison role has been vital to ADHS engagement with tribal nations on data sovereignty topics. People and processes are important to establishing data sharing policies, and a well-informed workforce is essential for effective collaboration with sovereign tribal nations. ADHS is working with the Native Nation Institute to provide training on tribal sovereignty and cultural humility for staff. It has also developed a tribal handbook for public health staff on sovereignty, cultural trauma, and the roles of IHS and TECs. Identifying Tribal Affiliation within Datasets and Tribal Public Health Priorities ADHS conducted a data assessment to identify instances in which data sharing was active and ongoing between ADHS and tribal nations, and instances in which it had expired. A notable technical challenge was identifying tribal members within existing datasets, as many public health datasets are incomplete (e.g., do not include tribal affiliation) or rely on IT systems that are unable to aggregate data appropriately—making it difficult to ensure tribal authorities receive relevant, comprehensive public health data for their communities. In addition, because each tribal nation’s public health priority areas and data needs could differ from the data that state health information systems collect, sharing relevant data with tribal nations can be challenging. ADHS is working with each nation to identify tribal public health priority areas, find solutions to identify tribal data within state collected datasets, and share it with the respective nations. Ken Komatsu - Brief - AZ DHS Pursues Policies to Advance Data Sharing with Tribal Nations Honoring Sovereignty in Data Sharing Relationships Data sharing agreements with public health agencies often establish that the state agency controls the disposition and use of the data, and that each party benefits. Acknowledging that tribal partners are entitled to their citizens’ data without conditions differs from how ADHS has historically approached data-sharing relationships with others. ADHS plans to formally establish a non-transactional data sharing policy with tribal public health partners, and establish data sharing agreements that align with this approach going forward. Implementation Considerations Considerations for state health agencies in fostering strong relationships and effective engagement with tribal partners around data-sharing efforts include: Center tribal sovereignty when framing data sharing agreements with tribal nations. Engage tribal liaisons in data-sharing efforts with tribal nations. They maintain close relationships with tribes and can help develop mutual cultural understanding, which is essential to engaging tribal partners. Assess datasets to determine data completeness with regards to tribal affiliation and identify opportunities to improve comprehensive data sharing with tribal authorities. Invest in state health agency staff training on tribal sovereignty and cultural humility, so staff can be well-prepared when engaging in data sharing conversations with tribal partners. Gerilene Haskon - Brief - AZ DHS Pursues Policies to Advance Data Sharing with Tribal Nations OT18-1802 website yes

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.

Co-authors from CDC and the Alzheimer’s Association provide details about the new 2018-2023 Healthy Brain Initiative Road Map, which offers strategies for public health agencies to promote cognitive health and support people living with dementia and their caregiver, and a forthcoming companion guide for Indian Country.

ASTHO Awards Public Health Leaders and Agencies for Service BETHESDA, MD—The Association of State and Territorial Health Officials (ASTHO) presented several awards during its 2019 Annual Meeting and Policy Summit this week to commend public health leaders and agencies for their service and dedication to improving our nation’s health. “We’re pleased to recognize this distinguished group of health professionals and agencies,” says Elke Shaw-Tulloch, state health officer at the Idaho Department of Health and Welfare, past ASTHO president, and chair of ASTHO's Nominations, Awards, and Membership Committee. “The excellence we highlight today touches millions of lives and represents just a small sample of our nation’s dedicated public health professionals, who continuously strive to promote the public’s health and well-being.” The 2019 ASTHO awardees include: John Wiesman, DrPH, MPH, Secretary of Health, Washington State Department of Health Arthur T. McCormack Award Dr. Wiesman has served as Washington state’s health official since 2013 and currently co-chairs the Presidential Advisory Council on HIV/AIDS. Under his leadership, the Washington State Department of Health is spearheading the End AIDS Washington program, developing the Healthiest Next Generation initiative, identifying and funding foundational public health services, implementing the governor’s executive order to reduce suicide and prevent firearm injuries and deaths, and addressing the public health impacts of climate change. Stephanie C. Williams, RNP, MPH, Senior Deputy, Arkansas Department of Health Noble J. Swearingen Award As deputy director for public health programs at the Arkansas Department of Health, Ms. Williams oversees and guides the work of the agency’s four operational centers: Health Advancement, Health Protection, Local Public Health and Public Health Practice. She also oversees the state public health laboratory and the state offices of Health Communication and Minority Health. Ms. Williams also advises and assists the state health official in setting policy and programmatic direction for the department and serves as state health official in his absence. Janae Price, MPH, Senior Epidemiologist, Illinois Department of Public Health State/Territorial Excellence in Public Health Award Ms. Price served the Illinois Department of Public Health from April 2016 to March 2019 as a member of the U.S. Public Health Service Commissioned Corps. She led or co-led more than five nationally-funded statewide projects, ten committees or workgroups, and numerous complex multi-year projects. Price’s contributions led the health agency to strengthen its chronic disease epidemiology capacity by integrating evaluation and performance monitoring for chronic disease programs, developing critical partnerships, improving data collection and reporting quality, and using innovative methods to assess public health needs. Paul K. Halverson, DrPH ASTHO Alumni Award Dr. Halverson served as the state health official for the Arkansas Department of Health from 2005-2013. He oversaw the development of Arkansas’ statewide trauma system, which has become a model for other states, and he greatly enhanced the effectiveness of the Arkansas Public Health Preparedness Program and the Arkansas Public Health Laboratory. As a state health official, Dr. Halverson was a mentor to many new state health officials and a trusted colleague to his peers. After transitioning to his position as founding dean of the Indiana University Richard M. Fairbanks School of Public Health, he has remained active as an ASTHO alumnus, serving as president of the ASTHO Alumni Society. Increasing Immunization Capacity in Texas Emergency Responder Facilities—Texas Department of State Health Services ASTHO Vision Award, First Place, Category A (Programs ≥ $250,000) ASTHO recognizes Texas Department of State Health Services for its work raising immunization rates for Texas emergency responders. Implementation of the New York State Prevention Agenda 2013-2018—New York State Department of Health ASTHO Vision Award, Second Place, Category A (Programs ≥ $250,000) ASTHO recognizes New York State Department of Health’s for its work developing a six-year state health improvement plan, which aims to make New York the healthiest state. Developed in collaboration with the Ad Hoc Committee to Lead the Prevention Agenda and more than 140 statewide organizations, the plan identifies New York’s most urgent health concerns and recommends ways statewide organizations and local health departments, hospitals, and partners from the health, business, education, and nonprofit sectors can work together to address them. Office of Grants Management—Northern Mariana Islands Commonwealth Healthcare Corporation ASTHO Vision Award, First Place, Category B (Programs less than $250,000) ASTHO recognizes the Northern Mariana Islands Commonwealth Healthcare Corporation for establishing the Office of Grants Management to improve coordination of the administration of all of the health agency’s federal programs and external funds. The office was created to oversee the financial and record keeping aspects of the annual grant-making process for the corporation and its divisions for all grants received or awarded. It also collaborates closely with all program managers to streamline and improve grant applications, implementation, administration, compliance, performance, and reporting requirements on all grants. Local and Tribal Public Health System Improvement Program—Montana Department of Public Health and Human Services ASTHO Vision Award, Second Place, Category B (Programs less than $250,000) ASTHO recognizes Montana Department of Public Health and Human Services for its efforts to improve Montana’s local and tribal public health infrastructure. As part of this work, the health agency has strengthened partnerships between the healthcare sector and public health agencies; accelerated the use of the Public Health Accreditation Board’s national standards for public health practice by state, local, and tribal public health agencies; and strengthened local boards of health. ASTHO Press Release Boilerplate website yes

The 2020 holiday season is coinciding with a nationwide surge of COVID-19 cases. With great concern that holiday travel to see loved ones may exacerbate community spread of the virus, many states are increasing public health measures before the winter holiday season. As of November 16, 2020, 13 states and D.C. had a quarantine requirement for out-of-state travelers. The U.S. territories also have instituted travel restrictions to limit the spread of COVID-19.

In this episode, three experts discuss the Federal Advisory Committee on Infant and Maternal Mortality’s most recent report on American Indian and Alaska Native health outcomes and the data-focused recommendations for states and territories.

In this episode, two maternal healthcare veterans share approaches for bringing providers into the process, as well as how state health officials can promote risk appropriate care strategies and address challenges in achieving equitable risk appropriate care.

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ASTHO engaged Oklahoma public health officials, members of the Oklahoma Harm Reduction Alliance, Health Minds Policy Initiative, and representatives of the Southern Plains Tribal Health Board, and others in a Boundary Spanning Leadership workshop.

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.