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ASTHO letter to the White House Requesting Funding For a National Monkeypox Response

On April 4, 2022, the U.S. Senate indicated that they have reached an agreement on a $10 billion bipartisan emergency supplemental funding bill for the federal COVID-19 response.

During the COVID-19 pandemic, public health authority has been used to require the use of face masks and encourage social distancing, and other measures. In several states these legal authorities have been challenged and, in many jurisdictions, limited or eliminated by the legislature. Maintaining the legal authority to prevent and control the spread of infectious disease is crucial to preparing for and addressing disease outbreaks.

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

The State Health Policy portfolio includes an annual legislative prospectus series. This document is from 2021 and addresses the COVID-19 pandemic.

Insight and Inspiration: Conversations for Public Health Leaders ASTHO is honored to present Insight and Inspiration, the premier webinar series designed to motivate public health leaders as they respond to new and ongoing public health challenges. The nation’s preeminent thought leaders, authors, and strategic thinkers offer attendees strategies to further develop their leadership skills as well as ground themselves and their teams even amid crisis. This series is open to governmental public health professionals at all stages of their careers. Check out upcoming opportunities and previous session recordings below to take your leadership to the next level. website

Read about deference to ACIP vaccine recommendations in state and territorial vaccine policy, following recent changes to the committee.

Downstream Effects of CDC Adopting ACIP Recommendations for COVID-19 and MMRV Vaccines Downstream Effects of CDC Adopting ACIP Recommendations Susan Kansagra, Andy Baker-White, Meredith Allen, Kimberly Martin, Ericka McGowan Learn about the downstream effects of CDC adopting ACIP recommendations for COVID-19 and MMRV vaccines, as states examine how their policies and laws intersect. On Oct. 6, CDC adopted the recommendations that the Advisory Committee on Immunization Practices (ACIP) made in September — specifically, individual-based decision-making for COVID-19 vaccine and separate measles, mumps, and rubella vaccine, and the varicella vaccine in toddlers. The adoption of these recommendations now sets in motion a cascade of other processes that influence access to vaccines. In addition, several states have begun to examine how their state level policy and laws intersect with ACIP recommendations given the delay in adoption and the uncertainty of the process going forward. COVID-19 Vaccine Recommendation CDC adopted the recommendation for shared clinical decision-making for the COVID-19 vaccine for those six months and older. The adoption of this ACIP recommendation has a ripple effect on coverage and access: It enables states to begin ordering COVID-19 vaccine under the Vaccines for Children program. It allows state Medicaid programs that link coverage to ACIP recommendations to cover the cost of the vaccine. It enables pharmacists to provide the COVID-19 vaccine under the federal PREP act declaration — as opposed to or in addition to state law, which varies by state. Many state health departments issued standing orders and executive orders to enable pharmacists to administer in the meantime. It requires health insurers to cover the cost of the vaccine, as the Affordable Care Act ties insurance coverage requirements to ACIP recommendations. Though, prior to the meeting, health insurers indicated they would do so anyway this year. MMRV Recommendation The CDC also adopted the recommendation for separate varicella (V) and measles, mumps, rubella (MMR) vaccines rather than the MMRV vaccine (combined measles, mumps, rubella, varicella) for children under four years. As background, current guidance allows either MMRV or MMR + V to be administered to children 12-47 months. However, because of a small but higher risk of febrile seizures for dose one, they are recommended to be administered separately (MMR + V), unless families express a preference for MMRV. Only about 15% of children currently receive MMRV for the first dose, and the general consensus is that this decision will result in some changes but not significantly impact access to vaccines: The adoption of this recommendation means that VFC will no longer cover MMRV for children under four, but it continues to cover separate MMR and V vaccines. Since many state Medicaid plans tie vaccine coverage to ACIP recommendations, coverage of MMRV by state Medicaid will vary depending on this language, though separate MMR and V vaccines would continue to be covered. Private insurers can choose to cover MMRV and will likely continue to in the short term but are not required to. They are required to cover separate MMR and V vaccines. How States Are Preparing for the Future As it stands now, ACIP recommendations, particularly for respiratory viral season, are not that different than prior years – with influenza, RSV, and the COVID-19 vaccine recommended (the latter with shared clinical decision making). However, the delayed and unpredictable process has led many states to examine how closely they are tied to ACIP in law, regulation, or practice. Over 600 statutes across U.S. states and territories reference ACIP — whether for pharmacist vaccine authority, school entry, health care worker or other requirements. States have considered a variety of actions to ensure they maintain access to vaccinations for their jurisdictions including: Passing or introducing legislation that allows the state health department to use ACIP guidance from previous years or recommendations from other bodies (e.g., medical provider organizations) in state law, as it relates to school entry, pharmacist authority, and others. Issuing standing orders and executive orders to enable pharmacists to administer vaccines in the absence of ACIP recommendations. Examining Medicaid state plan language to determine how to interpret requirements when ACIP is referenced and considering updates to that language (e.g., North Carolina). Issuing state requirements for insurers on vaccine coverage (e.g., Oregon, California, Hawaii). Examining use of state funds to purchase vaccines. Supplemental Resources Tracking State Actions on Vaccine Policy and Access by KFF Vaccine Resources by the Common Health Coalition States Take Action to “Immunize” Vaccine Access by Mandy Cohen, Julian Polaris, and Liz Dervan Vaccine Integrity Project — Fall Immunization Information by the Center for Infectious Disease Research and Policy Special Thanks - Blog - Downstream Effects of CDC Adopting ACIP Recommendations Padding Block - Large Related Content - Blog - Downstream Effects of CDC Adopting ACIP Recommendations article yes

San Diego Academic Health Partnership Strengthens Service During COVID-19 and Beyond San Diego Academic Health Partnership Strengthens Service Mayela Arana Learn how the Academic Health and Human Services Department in San Diego strengthens service, research, workforce development, and more in the region. In San Diego County, the connection between academia and public service continues to grow stronger, shaping the future of health and human services. With over 8,200 employees serving a diverse population of 3.3 million residents, the County of San Diego Health & Human Services Agency (HHSA) plays a crucial role in advancing health, housing, and social services across the region. Recognizing the immense value of bridging education with real-world public service, HHSA and San Diego State University (SDSU) formed an Academic Health and Human Services Department (AHHSD): the Live Well Center for Innovation & Leadership (LWCIL), a first-of-its-kind initiative in San Diego County. This partnership is more than just a collaboration; it’s a transformative effort to strengthen education, research, workforce development, and service in the region, inspired by collaborative successes during COVID-19. A Vision Years in the Making Even before the COVID-19 pandemic, leaders at HHSA, SDSU, and SDSU’s College of Health and Human Services (CHHS) recognized the opportunity to deepen their relationship through an Academic Health Department (AHD) partnership. Many of those contributing to HHSA’s success began their journey at SDSU, with over half of the agency’s leadership team and a significant portion of its workforce having graduated from SDSU, particularly from CHHS. With a long history of partnering to provide real-world experiences for students, collaborating on research, and developing practice-informed curriculum, formalizing the partnership to integrate academia and health and human services practice was a natural next step. An Academic-Public Health Partnership in Action HHSA and SDSU’s longstanding relationship initially focused on student field experiences, research collaboration, and workforce development across select schools and decentralized departments but went on to have a major impact on the ground — most notably, enhancing HHSA’s COVID-19 response. Mobilizing Promotoras for Outreach and Support SDSU and HHSA worked together on recruitment, training, and community outreach. They successfully recruited 40 community health workers for a Promotoras program, which initially helped with contact tracing within the highest-risk communities. The Promotoras also identified where people needed assistance (e.g., food, services). SDSU provided support by organizing food pantries in high-risk areas, while the Promotoras took food to those in need. As vaccines became available, HHSA trained the Promotoras on messaging and communications to dispel misinformation and to encourage vaccine uptake. The Promotoras also helped those in the highest-risk communities get appointments at the county vaccination sites. Expanding Public Health Capacity with Nursing Students In addition, SDSU and HHSA worked together to train and deploy nursing faculty, students, and recent graduates in county vaccination efforts. From January through March of 2021, the SDSU School of Nursing partnered with Champions for Health, the local nonprofit arm of the San Diego Medical Society, to train 200 vaccinators. Once trained on the proper storage and administration of the COVID-19 vaccine, faculty-led groups of undergraduate nursing students administered vaccines at community sites in primarily underserved areas of the county — many organized by the San Diego Black Nurses Association. In addition to providing surge capacity staffing to support community and public health efforts, the partnership allowed students to complete clinical hours required for graduation during the pandemic when students were restricted from other clinical sites. Many of the students and graduates who served as temporary contact tracers and case investigators transitioned into full-time positions within HHSA as the COVID-19 response scaled back. Formalizing Collaboration for Lasting Impact Given the tangible value of their collaboration demonstrated during the COVID-19 pandemic, HHSA and SDSU chose to use and adapt the national AHD model — gaining access to the growing, nationwide network of AHD partnerships that inform their goal of sustaining a high-impact academic-practice partnership. They formalized the partnership with a public signing of an overarching five-year memorandum of agreement (MOA) in October 2022 that launched the bold vision of creating San Diego County’s first and only AHHSD. They assigned an additional MOA specifically addressing joint research and data sharing in December 2024, and an addendum supporting agency-wide student field experiences is underway. With formal agreements across all key areas, the foundation will be in place for increased and accelerated collaboration by summer 2025. Building on the regional collective impact vision called Live Well San Diego, the AHD partnership adopted joint branding as LWCIL. An active Steering Committee, co-chaired by HHSA’s Deputy Chief Administrative Officer and CHHS’s Dean, meets quarterly and represents the highest-level leadership for each organization. Members include key leaders in HHSA operations, human resources, and strategy, and the directors from each of its eight service departments. On the academic side at SDSU, the Steering Committee includes representatives from the six schools and multiple institutes within CHHS. Setting Partnership Priorities LWCIL co-created and recently adopted a joint, multi-year Strategic Roadmap to guide the next three years of the partnership’s development and its contribution to a healthy, equitable, safe, and thriving San Diego region. It is organized around four high-impact priority areas: People Success: Build a diverse, competent, and engaged health and human services workforce​, including students and both partners’ workforces.​​ Research & Data Excellence: Inform and improve academia, policy, and practice with rigorous and relevant research. Service to Community: Integrate academia, practice, and community to advance equity and eliminate health disparities. Leadership & Sustainability: Create a nationally recognized academic-practice model with innovative leadership committed to improving academia, policy, and practice. Subcommittees for each priority area, co-chaired by leaders from both organizations, have launched and created action plans tied to advancing the Strategic Roadmap. In addition, emerging workgroups are aligning ​work plans​. Next steps include: Assessing what is already in place and integrating it into the partnership. Developing a standardized and streamlined process for students to complete internships at HHSA. Leveraging opportunities to bridge research and practice and, where appropriate, in collaboration with the community. Investing in capacity has been essential in moving the partnership forward and providing coordination. The director of LWCIL is a “boundary spanning” position, co-funded by SDSU and HHSA. Additional staff support has assisted the partnership, including two HHSA Management Fellows engaged in a year-long program. Advice for Others Seeking to Establish AHD Partnerships HHSA and SDSU offer the following tips to agencies looking to develop or expand AHD partnerships, based on their experiences: Secure leadership commitment: Ensure the highest-level leaders are committed to the partnership’s success and sustainability. LWCIL started with the support of the dean, deputy chief administrative officer, and directors within both organizations who continue to be actively involved as members of the Steering Committee and subcommittees. By doing so, they have helped set priorities, identified staff to participate, and continuously champion the partnership within their respective organizations. Start small: Build from what already exists between the partners, leverage willing internal resources, and celebrate early successes. LWCIL started with conversations focused on workforce development because of existing relationships and shared interests. Those conversations eventually evolved to include collaborating on rigorous equity-focused research and partnering to address needs identified by the community, such as housing stability for our older adult population and food insecurity. The subcommittee structure was created to support those shared priorities; however, it began with smaller, more narrowly focused conversations. Be strategic: Create a common agenda/plan that aligns with the goals of both organizations, making it easier for already-stretched organizations to commit to and benefit from the partnership. LWCIL's co-creation of a multi-year Strategic Roadmap allowed the partners to discuss the many opportunities for collaboration and integration, and to prioritize. It now guides where the partnership is going and helps keep everyone focused on what they collectively decided is important. Then, grow: By getting systems in place and understanding the benefits and challenges between two organizations (HHSA and SDSU), LWCIL is setting the stage for expansion to include other local universities. Take time to plan and set up structures: Creating the LWCIL ​Strategic ​Roadmap was a six-month process that engaged leadership from both organizations. This was critical for identifying priorities and direction, including what structures and systems needed to be organized so the work could move forward. Learn more about San Diego’s Live Well Center for Innovation & Leadership and AHD partnerships, or explore other workforce development resources from the Public Health Foundation. If your health agency wants more information about planning support, please submit a PHIG technical assistance request through PHIVE or contact

States Reassessing Vaccine Policy and Public Health Powers Shalini Nair, Andy Baker-White Review of state policies to weaken vaccine requirements and reduce public health powers. Immunization is a key pillar of public health, crucial for protecting communities and preventing infectious diseases from spreading. State and territorial health officials and their departments play critical roles in setting and implementing immunization requirements, managing disease surveillance and outbreak response, and ensuring access to vaccines. In recent years, however, the immunization landscape has evolved as legislative changes alter public health authority and access to vaccines. As these challenges persist, public health officials must be informed and prepared to navigate the dynamic policy environment to ensure immunization programs’ continued effectiveness at protecting public health. The True Cost of Vaccine Skepticism and Misinformation In the years since the pandemic, rates of routine vaccinations among U.S. children have steadily declined; there has simultaneously been an increase in non-medical exemptions. While reasoning behind personal decisions about vaccination are not always clear, increasing prominence of vaccine-related myths is a significant contributor to this phenomenon. Perhaps the most glaring consequence of this decrease is best illustrated by the 2025 measles outbreak and the first measles-associated deaths in more than a decade. Previously considered to have been eliminated, measles is now under threat of resurgence as vaccine rates fall below the thresholds to uphold herd immunity. Health officials are also seeing declines in coverage for several other vaccine preventable diseases like pertussis, mumps, hepatitis, and even polio. Legislation Restricts Innovation and Sows Doubt About Vaccine Components The use of mRNA technology expanded in 2020 following its breakthrough success in COVID-19 vaccines. These mRNA vaccines prevented more than 120 million additional COVID-19 infections and 3.2 million additional deaths. Researchers are currently assessing mRNA technology to address pandemic influenza, HIV, Zika, and even cancer. During 2025 sessions, at least seven states introduced legislation to ban or limit using mRNA vaccines. Iowa’s SF 360 sought to prohibit any “gene-based vaccines” (i.e., those developed using mRNA or DNA technology); the bill was based on a widely debunked myth that mRNA vaccines can interact with and alter human DNA (they can’t). New York’s A 4798 would prevent administering COVID-19 mRNA vaccines until the department of health conducts a risk-benefit analysis. Several states have introduced legislation to prohibit selling — or require labeling foods that contain — vaccine or vaccine material. This bill is based on another common internet rumor that mRNA vaccines are being introduced into the food supply via livestock and produce (they aren’t). Nonetheless, Utah enacted a bill (HB 84) requiring that food intended for human consumption that contains a vaccine or vaccine material be designated as a drug. Similar bills were introduced in Florida (HB 525), Alabama (HB 316), and Tennessee (SB 616, HB 1100). Vaccine Authority’s Shifting Landscape While the federal government plays an important role in putting forth policy recommendations, the ultimate power to impose or revoke vaccine requirements and determine exemptions outside of health emergencies rests with states. In many jurisdictions, state health agency expertise determines the vaccines required for school enrollment. These decisions, while ultimately at the feet of state health officials, rely heavily on input from experienced, knowledgeable, and skilled agency staff. Recent legislative actions in several states seek to shift authority for determining school-based immunization requirements solely to the legislature. Idaho’s new law (H 290) removes the state board of health’s authority to determine which immunizations are required for daycare and school enrollment, as well as the manner and frequency of their administration. The bill also repeals a former law establishing the Idaho Childhood Immunization Policy Commission, created in 2010 to issue recommendations to the legislature and board of health. A similar effort in Maine (LD 727) would remove health department authority to determine school vaccine requirements as part of a larger repeal effort responding to the 2019 law disallowing vaccine exemptions based on religious or philosophical grounds. In New Hampshire, existing statutes define required immunizations for school attendance and allow the state health official to add to this list via the rulemaking process. Recently, lawmakers introduced a bill (HB 357) that would remove this add-on ability. If passed, existing commissioner-led requirements for vaccines such as varicella, hepatitis B, and Hib would expire in June 2026 and no future amendments could occur under this authority. Several other bills introduced in Texas (HB 468, HB 3304, SB 94, SB 117, HB 3852), West Virginia (SB 108, HB 2203), and North Carolina (HB 89) target shifting authority and/or modifying vaccine requirements for certain school types. Evidence-Based Policy as the Path Forward State and territorial health agencies are foundational to preventing the spread of infectious diseases through vaccine education and administration. ASTHO has identified public health expertise in developing vaccination policy as one of three recommended strategies that prioritize evidence-based public health authority and support agencies to protect and improve health. As this landscape further evolves, ASTHO will continue tracking legislative and executive action on this important public health issue. article yes

This brief dives into the impact of the COVID-19 pandemic on the ability of people with disabilities to access vital health care services during the public health emergency.

Defining Disease Forecasting and Modeling Disease forecasting, generated by disease models, helps the public health workforce understand potential future outbreaks. Learn more about disease forecasts and models. Disease forecasting is important in describing potential future outbreaks that will affect the population and demand for health services in a given geographic area. Forecasts pull input from various sources (e.g., disease models, demographic, mobility, and intervention impact data). Individual forecasts can also be part of an ensemble forecast to improve accuracy. Forecasts can cover any length of time, but most target a window of several weeks to a few months. A subset of forecasts, known as nowcasts, seek to estimate present conditions, or those expected to occur imminently. Disease models are mathematical tools that are foundational components of disease forecasts. They estimate quantifiable factors that are impossible or impractical to directly measure, (e.g., future hospitalizations from a given disease, or its infection count in a population). Although models can be useful for specific questions, they do not give as complete a picture as a forecast. There are four major disease model types: Mechanistic. Attempts to simulate biological and/or social processes of transmission based on assumptions from prior or experimental data. Statistical. Relies on past data (such as infections or death) to predict future trends and can incorporate some assumptions about intervention application and uptake. Quality and quantity of past data can be a major limitation, and some models may suggest biological improbabilities. Agent. Simulates individual risks and behaviors in a population. These are highly complex, computationally very expensive to develop and run and require vast amounts of data and strong assumptions. Ensemble. Like their forecasting counterparts, they compile models and outputs, mitigating the risk of relying on one data point. While raising the overall confidence in output, they require coordination of many models to be built and simulated, which can be complex and costly unless the models already exist (such as for COVID-19 case counts). Forecasts and Models Work Together While disease forecasts and models are often conflated, they are discrete concepts. Forecasts offer a general prediction, whereas models are the mathematical pieces forecasters use to create them. Weather forecasts are commonplace, and their weekly predictions are often reasonably accurate. In contrast, predicting a big storm’s individual factors (e.g., rainfall, wind speed, lightning strikes) fall to the job of models. Together, those models help meteorologists better understand the weather and generate a forecast. In a public health context, disease forecasting informs public health officials, health care providers, and policymakers about potential risks and guide decision-making regarding preventive measures, resource allocation, and response strategies. Meanwhile, disease models aim to simulate the behavior of infectious diseases under different scenarios, allowing researchers to explore and evaluate various factors that influence disease transmission. Considerations for Decision-Making Decision-makers should consider scope and limitations of forecasts and models. They may consider adding inputs—such as projections for economic and long-term impacts. Examples include economic impacts of school closures, costs of more staffing ahead of an outbreak, and supply chain shortage forecasts for personal protective equipment (PPE). Decision-makers at all levels should consider using modeling to answer more specific, practical questions rather than predicting overall trends. Forecasts can cover different geographic scales. Public health leaders will need granular, local data to most effectively inform decision-making and communications. Novel conditions and pathogens may not have readily available data to inform models or forecasts, which will affect their predictive ability. Health officials must effectively communicate these limitations to decision-makers and the public. Examples of Forecasts and Models CDC’s COVID-19 Forecast for Hospitalizations (ensemble forecast) shows the number of daily COVID-19 hospitalizations reported in the United States from the prior two months and projected daily COVID-19 hospitalizations over the coming four weeks. Information sources are independent teams meeting submission and data quality requirements. CDC’s FluSight (ensemble forecast) has many contributing teams and models that predicts the upcoming weekly laboratory confirmed influenza hospital admissions both nationally and by state. Johns Hopkins University’s Center for Systems Science and Engineering county-level risk model for COVID-19 in the United States. This model leverages epidemiological data, mobile phone data, demographic and socioeconomic information, and behavioral metrics. The Global Epidemic and Mobility Framework simulates the global spread of infectious diseases by mathematically representing infection dynamics, population geographies, and population mobility patterns. Additional Resources Disease modeling for public health: added value, challenges, and institutional constraints Predictive Models for Forecasting Public Health Scenarios: Practical Experiences Applied during the First Wave of the COVID-19 Pandemic Applying infectious disease forecasting to public health: a path forward using influenza forecasting examples Technology to advance infectious disease forecasting for outbreak management CDC-RFA-OT18-1802 2018-2024 article yes

Disease Forecasting and Modeling Data for Public Health Action Disease Forecasting Benefits Public Health Planning Disease forecasting and modeling help prepare public health departments for future infectious disease outbreaks and epidemics. Disease forecasting and modeling data can be powerful tools for state and local health agencies (S/THAs) that respond to outbreaks, develop appropriate policies, and ensure interventions have maximum impact. Actions for which decision-makers can leverage such data include: Surveillance. Forecasts and modeling help public health agencies anticipate the spread of disease or outbreaks. This advance warning allows public health officials to inform public health recommendations, preparation, and response. Communication. Disease forecasts help relate the risk of disease outbreaks to various audiences accurately and quickly, which, in turn, can inform messages on important preventive measures and encourages compliance with recommended interventions. Resource allocation. Modeling data can help decision-makers better allocate resources by predicting where and when disease outbreaks are likely to intensify and create the greatest need. Evaluation. Forecasts and modeling can help make evaluating the effectiveness of public health policies and interventions more efficient by comparing predicted outcomes with observed data and adjusting as needed. Considerations Informed by S/THA Forecasting Jurisdictions with forecasting experience identified key indicators to monitor as part of outbreak forecasting, which fall into three main categories: Epidemic spread indicators (e.g., symptom monitoring, morbidity and mortality data, percent positivity, regional pictures of transmission). Health care system capacity (e.g., essential and/or surge personnel, available beds, ventilator usage, and supply of personal protective equipment. Public health capacity for testing capacity and contact tracing. Further considerations for S/THAs: Know your strengths. Identify the unique skillsets among partners in public health, academia, and the private sector and consider how they foster reciprocal relationships. Recognize capacity/expertise gaps. Consider leveraging partnerships for specific types of analytics expertise while exploring internal capacity building opportunities (e.g., job shadowing and resource-sharing programs on workflows and methodologies). Engage legal and compliance teams. Ensure policy and practice are aligned among partners. Explore data access/sharing pipelines. Connect public, private, academic partners, and their audiences. Start small. Identify discrete forecasting and modeling projects to demonstrate success. Identify decision-makers’ needs. Provide quick access to analyses, metrics, dashboards. Michigan Used Models and Forecasting for Hep C Cases In response to Hepatitis C virus (HCV) in young adults from 2010-2018, the Michigan Department of Health and Human Services (MDHHS) simulated how HCV treatment could significantly reduce HCV prevalence among young people who inject drugs, especially for those both previously or currently injecting drugs. MDHHS used several novel predictors to paint a local picture of probable HCV diagnoses among residents up to age 40. These predictors included measures related to a variety of population characteristics (e.g., access to transportation, college education, presence of non-family households) and public health indicators (e.g., heroin treatment admissions, newborns with neonatal abstinence syndrome, and sexually-transmitted infections). MDHHS also leveraged county-level assessments of HCV vulnerability to identify locations for new syringe services programs in the state. MDHHS has recognized several modeling and analytics use cases that benefitted their work during responses to HCV and COVID-19: Short-term forecasts (i.e., weeks) helped predict likely transmission patterns and potential ranges of projections. Longer-term forecasts (i.e., months) explored scenarios based on new recommendations and policy changes. Retrospective counterfactuals evaluated the impact of policies or other changes by examining “what-if” situations. MDHHS is considering using forecasts and models for COVID-19, influenza epidemics, tuberculosis vulnerability, and C. auris spread. Resource constraints require decision-makers and public health practitioners to consider how they are using available resources for the highest return on investment. Models generated momentum to respond to threats and evaluate whether interventions were successful. CDC-RFA-OT18-1802 2018-2024 article yes

Health providers have widely used telehealth to mitigate the spread of COVID-19 infection and to improve access to healthcare services thanks in large part to policy changes and regulations. This brief explores how state and territorial health agencies (S/THAs) are responding to COVID-19 through telehealth policy and operational changes, as well as how telehealth has quickly emerged as a tool to improve health equity.

Case investigators and contact tracers must understand and adapt to the culture of people with COVID-19 to conduct effective interviews and follow up. It is important that case investigators acknowledge existing fears and concerns, and work with residents to build trust. This brief explores four elements of cross-cultural communication.

An issue brief by ASTHO and the Duke University Margolis Center for Health Policy that highlights considerations for state health officials as they look to maximize the benefits of COVID-19 therapeutics.

This infographic highlights 10 high-level strategies to advance work in school behavioral health.

"Bounce forward" into a better world by using these resources to create healthier, more resilient communities.

Making Contact: A Training for COVID-19 Case Investigators and Contact Tracers The nation's ability to quickly contain infectious disease outbreaks is more important than ever, and an expanded contact tracing workforce is critical for this effort. ASTHO and the National Coalition of STD Directors are pleased to offer this free online course to support the rapid training and scale-up this new contact tracing workforce. Interested in taking the course? Check out our FAQs for Learners (PDF). Interested in directing your learners to the course? Check out our FAQs for Public Health Authorities and Training Providers (PDF). Additional questions? Contact the training team. Looking for additional contact tracing resources? Visit ASTHO's COVID-19 page. website no

#MaskUp Campaign ASTHO and the Big Cities Health Coalition produced a public service announcement to encourage people across the country to express their compassion for others and #MaskUp. Please download, share, and encourage others to do their part to protect the community from the pandemic. website no