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Learn how peer-to-peer collaboration has helped health agencies develop their performance management and quality improvement efforts.

Learn how public health agencies are improving their financial management strategies and systems.

Centralizing Administrative Functions, with Lessons Learned from Guam Megan Drake-Pereyra Centralizing administrative functions, such as procurement or grants management, is a strategy many organizations utilize. Having administrative functions concentrated with a specific team rather than dispersed or managed within separate teams can work well. There is potential for standardized processes and procedures, increased efficiency and quality, more control and accountability, and consistent data collection and monitoring. This brief details how health departments can utilize existing, evidence-based frameworks to centralize administrative functions and build off lessons learned from others, such as the Guam Department of Public Health and Social Services (Guam DPHSS). Getting Started Considerations When transitioning from a decentralized structure to a centralized structure, it is important to clearly outline the what, why, how, and benefits. Consider the following components to kickstart success: Leadership vision: Start with the leader’s visionary perspective. When the leader allocates sufficient time and consistently reinforces the vision, it allows for the necessary decisions, trust, and support to be established during the transition. Data-driven design: Use data and existing information, such as current standard operating procedures or process diagrams, to understand the decentralized process differences/similarities, and guide effective centralized processes and procedures. Role clarity: Clearly outline and define the new centralized infrastructure, purpose, roles, responsibilities, expectations, and procedures. This helps everyone understand and follow the new processes more consistently, with better results. Performance measures: Establish and use performance measures from the outset (e.g., team knowledge, skills, competency, process time and quality, outcomes, impact, etc.), for insight into the value, or return on investment, of the centralized model. This will help indicate the quantity, quality, and impact of programs/processes. Documentation: Capture and share decisions, vision, goals, structure, standard operating procedures, and relevant details in writing for new team members and users of the centralized functions. Communication: Transparently share plans, timelines, and additional knowledge to maximize utilization and value. Additionally, anticipate and proactively address resistance to change to help everyone embrace and adhere to the new, centralized approach. The Plan-Do-Study-Act Method Change management, quality planning, and process improvement models can also support organizational and process change. For example, the quality improvement methodology, Plan-Do-Study-Act (PDSA), offers an effective framework for centralizing administrative functions and complements many of the aforementioned considerations: Step one, plan, relies on leaders to decide the vision, scope, structure, roles/responsibilities, goals, and purpose of the centralized team. Here leaders establish and reinforce the leadership vision, using existing data to guide the design of the new centralized team. Step two, do, is dedicated to onboarding centralized team members, defining their work processes and procedures, and ensuring effective communication with all stakeholders. This requires thorough documentation and strong communications plans. Step three, study—an often overlooked but crucial building step—is for testing the processes, procedures, roles, and responsibilities, to confirm and build confidence that this centralized structure will yield the desired results. Performance measures provide clarity into what is working well and what is not. Step four, act, is for launching and rolling out the structure, ongoing monitoring of performance, and continuing to educate and coach for successful, sustainable improvements. Lessons Learned from Guam Guam DPHSS, a joint health and social services agency, is working to centralize its administrative functions to reduce inefficiencies and redundancies as well as improve quality and consistency. This has been a big change for Guam DPHSS, but leadership vision, documentation, role clarity, and communication have proven to be key throughout the process. In 2021, Guam DPHSS established a centralized Office of Grants Management (OGM). In its early stages, programmatic teams saw OGM as a regulatory body that would audit and direct their work, while OGM’s true objective was to provide support and ease administrative burden, allowing program staff to focus on accomplishing their goals and deliverables. By clarifying and documenting the vision, roles, and responsibilities as well as focusing on communication, the OGM built trust, addressed specific concerns, and established a shared vision of their role as supportive and helpful. In 2023, Guam DPHSS began the process of establishing a centralized Procurement Management Office (PMO). While Guam DPHSS reorganized and co-located staff into the new, centralized PMO, Guam was undergoing a governmentwide business process improvement (BPI) project focused on procurement—presenting an opportunity for Guam DPHSS to involve new PMO staff and other key DPHSS team members in improving its functions and centralizing the procurement process. Through the BPI project, which utilized PDSA, DPHSS clarified roles and responsibilities, defined work processes and procedures, and developed training and communications plans that supported process improvement and centralization of procurement functions. Guam DPHSS has learned many lessons throughout their journey to create a centralized OGM and PMO, including that change of this magnitude is hard—more specifically, balancing change management while ensuring maintenance of key operations. Ultimately, they found that the aforementioned considerations and methods for getting started were critical in supporting the change to centralized administrative functions. Establishing the Ideal Structure for Administrative Functions Determining if and how centralized administrative functions will work for an organization is multifaceted. An organization’s culture, size, infrastructure (including technology and systems), and workforce and skills all play crucial roles in shaping the ideal structure. The methods and considerations noted previously can help health departments determine and support the best path forward for each unique organization. ASTHO has several additional resources and tools that can support administrative change and improvement. Visit the ASTHO STAR Center to learn more. website yes

Technical Assistance Offerings ASTHO STAR Center services and technical assistance to members uses a five phase process to strengthen agency culture, systems, and operations. ASTHO STAR Center services and technical assistance (TA) to members uses a five-phase process to strengthen agency culture, systems, and operations—including vision setting, engagement, assessment, planning, and evaluation in line with principles of change management and leadership engagement. Assistance is provided in the following areas and tailored to address specific needs or preferences of the requesting agency: Administrative and organizational capacity assessment and development Administrative policy assessments and development Federal grants management and spend down Financial systems and funding mechanisms Performance Management and Quality Improvement Services may also include, but are not limited to, connecting to subject matter experts and knowledgeable consultants, facilitating peer-to-peer connections to see how public health agencies are addressing administrative readiness and building organizational capacity in the above areas, and identifying existing resources, tools, and best practices. How to Request Services Public Health Infrastructure Grant (PHIG) awardees and members interested in TA services should work with their agency’s PHIG Director to determine if this opportunity aligns with and supports the agency’s PHIG workplan. If the request aligns with the agency’s workplan, PHIG recipients can submit their TA requests via the PHIVE system. If the request is outside of their agency’s PHIG workplan, recipients can submit their TA requests and any questions to performanceimprovement@astho.org. If you are unsure or have general questions about TA, contact performanceimprovement@astho.org. ASTHO will work with the requesting agency to identify needs, triage the request, define the scope, and develop a plan for the service. website no

The Peer Assessment Program provides an opportunity for health agencies to identify opportunities for modernizing their agency’s infrastructure and operations to meet the needs and challenges of public health.

Developing Internal Quality Improvement and Performance Management Training Modules Training modules can enhance staff capabilities in quality improvement and performance management methodologies, improving organizational efficiency and effectiveness. Training modules can enhance staff capabilities in quality improvement (QI) and performance management (PM) methodologies, helping to improve organizational efficiency and effectiveness. Developed in partnership with the New Mexico Department of Health (NMDOH) and the Public Health Foundation, this guidance document outlines a structured approach to developing QI and PM training modules, based on NMDOH's experiences and lessons learned. By following the adaptable processes within, agencies can effectively plan and implement training initiatives tailored to their workforce's unique requirements. Get the full Policy Guide in English (PDF) » Descarga la versión completa de la guía en español (PDF) » website yes

Mejorando el Manejo de Desempeño en las Operaciones de Salud Ambiental del Condado de Licking, Ohio Colton Anderson El manejo de desempeño es crucial para garantizar la efectividad y eficiencia de las operaciones de un departamento de salud. En salud ambiental, donde las regulaciones, los estándares y las preocupaciones de salud pública son primordiales, un manejo de desempeño efectivo asegura que tareas como la supervisión de la calidad del aire y del agua, la inspección de instalaciones para el cumplimiento de normas y la respuesta a emergencias ambientales se realicen con precisión y puntualidad. Además, permite que un departamento de salud identifique áreas de mejora, asigne recursos de manera eficiente y se adapte a las condiciones ambientales cambiantes o a los requisitos regulatorios. El Departamento de Salud Ambiental del Condado de Licking, Ohio, no solo está implementando prácticas de manejo de desempeño, sino que también las está alineando con los Estándares y Medidas de Reacreditación de Salud Pública, mientras rastrea diligentemente los datos para facilitar la mejora continua, que compartieron durante un seminario web sobre el Manejo de Desempeño en Salud Ambiental para fortalecer la capacidad de los beneficiarios de la subvención para la Infraestructura de Salud Pública. Optimizando el seguimiento de desempeño Mejorar el seguimiento del desempeño puede variar desde utilizar una hoja de cálculo de Excel bien estructurada con gráficos de líneas claros hasta emplear un software sofisticado de manejo de desempeño. Al desarrollar y seguir consistentemente medidas que se adapten a las necesidades del departamento de salud ambiental, el proceso no solo se vuelve claro, sino también sostenible, fomentando la toma de decisiones informadas. El Departamento de Salud Ambiental del Condado de Licking ha implementado un enfoque exhaustivo para organizar su sistema de seguimiento, segmentándolo por área de programa y adaptando las medidas para satisfacer las necesidades y objetivos específicos de cada dominio. Se han logrado éxitos notables al integrar sin problemas las medidas de desempeño en el sistema general de manejo de desempeño del condado, un logro alcanzado tras exhaustivos esfuerzos de mejora de calidad en su programa de plomería y operaciones de servicios fiscales. Entre estas iniciativas, se lanzó un proyecto notable para abordar problemas relacionados con los permisos de plomería a punto de expirar y la falta de un mecanismo de seguimiento confiable para las fechas de vencimiento. A través de mejoras estratégicas en los procedimientos de almacenamiento y seguimiento de permisos, el condado ahora cuenta con la capacidad de evaluar con precisión la tasa de vencimiento mensual de los permisos de plomería. De manera similar, se inició otro proyecto para reducir la emisión excesiva de reembolsos dentro del departamento. Al investigar las causas raíz de las solicitudes de reembolso, esta iniciativa facilitó el establecimiento de una medida de desempeño destinada a monitorear los montos mensuales de reembolso, asegurando así la adhesión a la asignación presupuestaria anual para reembolsos. Comunicando las medidas de desempeño Comunicar de manera efectiva las medidas de desempeño es esencial para la transparencia, la responsabilidad y la alineación con los objetivos organizacionales. Comunicar claramente y de manera regular los datos de desempeño permiten a los interesados comprender el progreso del departamento, identificar áreas de mejora y celebrar los éxitos. Un aspecto crucial de la comunicación de las medidas de desempeño es el uso de formatos accesibles y comprensibles. El departamento utiliza diversos canales de comunicación (por ejemplo, reuniones de personal, boletines departamentales, portales de intranet) para difundir los datos de desempeño de manera efectiva. Los recursos visuales, incluidos gráficos, tablas y tableros, presentan información compleja en un formato comprensible, facilitando la comprensión y el compromiso del personal. Estrategias de Manejo de Desempeño Equitativas En la búsqueda de la equidad dentro del manejo de desempeño, el Departamento de Salud Ambiental del Condado de Licking ha establecido vínculos transparentes entre los objetivos de los empleados y las prioridades organizacionales, apoyando la flexibilidad para acomodar diversas necesidades. Reconociendo el papel fundamental de los gerentes, el departamento invierte en mejorar sus habilidades de coaching para garantizar una toma de decisiones justa en las operaciones diarias. Además, el departamento implementa un enfoque matizado para la evaluación del desempeño, recompensando efectivamente el desempeño sobresaliente en ciertos roles mientras aborda y mejora el desempeño en otros. Como parte de su compromiso con la salud pública y la equidad, el departamento también opera un Programa de Cumplimiento Mejorado, ofreciendo inspecciones adicionales de seguridad alimentaria a las instalaciones que no cumplen con el Código de Seguridad Alimentaria de Ohio. Las inspecciones mensuales proporcionan apoyo continuo a estas instalaciones en la implementación de procedimientos adecuados de seguridad alimentaria, complementadas con sesiones de capacitación gratuitas en el sitio para capacitar a los operadores de alimentos con el conocimiento y las habilidades esenciales. A través de estos esfuerzos concertados, el departamento se esfuerza por fomentar la equidad en las prácticas de salud ambiental dentro de la comunidad Lecciones aprendidas y direcciones futuras A partir de la experiencia del Condado de Licking, es fundamental establecer un ritmo adecuado para integrar el manejo de desempeño en las operaciones del departamento. Comenzar con pocas medidas nuevas y monitorearlas regularmente para establecer pequeñas victorias al principio es clave para una implementación sostenible a largo plazo. Por ejemplo, documentar las fuentes de datos o los informes utilizados para actualizar sus tableros hizo que mantener las medidas de desempeño actualizadas fuera mucho más sencillo, especialmente para el personal nuevo. El Condado de Licking cree que su departamento de salud local debe esforzarse por operar todos sus programas de manera óptima. Tienen un gran número de medidas de desempeño vinculadas a las operaciones para garantizar una entrega óptima de los programas. Si bien las tareas programáticas se ejecutan a un alto estándar, si no logran mejoras en los resultados de salud o equidad, esto sirve como un catalizador para discutir posibles ajustes en el modelo de entrega del programa. A medida que el Condado de Licking continúa refinando su enfoque, busca activamente mejorar su sistema de manejo de desempeño alineando más estrechamente las medidas con los resultados de salud, enfatizando el impacto y la equidad. En última instancia, como indicó el Subcomisionado de Salud del Condado de Licking, Greg Chumney, "el manejo de desempeño se ve diferente para todos". A través de la dedicación, la innovación y la colaboración, el manejo de desempeño continuará siendo un pilar fundamental para avanzar en la salud ambiental y el bienestar público. article yes

Colorado Department of Public Health and Environment Improvements in Public Health Hiring Practices ASTHO Staff Colorado Department of Public Health and Environment’s (CDPHE) Prevention Services Division (PSD) is working to streamline its hiring approach, process, and procedures to remove biases that commonly plague hiring practices. Colorado Department of Public Health and Environment’s (CDPHE) Prevention Services Division (PSD) is working to streamline its hiring approach, process, and procedures to remove biases that commonly plague hiring practices. The division’s innovative efforts take a practical approach, starting with diversifying application questions to allow candidates to highlight their multiple skills and lived experiences, moving away from the idea that having a more formal education automatically makes someone the best candidate. The approach also extends to harvesting data on salary to remove bias in salary offers, allowing for greater consistency in compensation across the agency. PSD’s efforts do not stop there! In this video, meet the team promoting the diversification of human capital within their public health agency. CDPHE discusses the vision behind its methods, the tools it developed, and lessons learned. If you are interested in learning more about Colorado’s advances in hiring practices, you can reach out to the team at athina.lujan-roche@state.co.us and meladie.lowe@state.co.us. article yes

Strengthening Public Health Communication: Oklahoma’s Strategy and Lessons Learned ASTHO Staff Communications is a foundational capability for all health departments, essential for supporting public health protections, programs, and activities that ensure community well-being and promote equitable outcomes. To educate their communities and encourage healthy behaviors, health departments must communicate clearly and effectively. After COVID-19, the Oklahoma State Department of Health revisited and modernized its communication strategies. This video shares their journey, including the process they followed, best practices they adopted, outcomes achieved, and lessons learned—offering valuable insights for other Public Health Infrastructure Grant (PHIG) recipients aiming to enhance their communications capabilities. OE22-2203 PHIG article yes

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

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.

How State Health Agencies Can Address Gaps in the Policy Review Process article yes

Missouri Takes Strategic Steps to Improve Policy Processes Colton Anderson Learn in this blog post how Missouri’s department of health is improving its internal policies and building a more robust agency by partnering with ASTHO. Why Strong Administrative Policies Matter For public health agencies, effective administrative policies are essential. They set clear expectations, support fair decision-making, and help agencies deliver consistent, high-quality services to the communities they serve. Recognizing this, the Missouri Department of Health and Senior Services (MO DHSS) partnered with ASTHO to improve its policy development and review process. ASTHO’s Role in Supporting Policy Improvements ASTHO provides tools and practical support to help public health agencies improve their internal policy processes. In 2023 – 2024, ASTHO launched a technical assistance program to help public health agencies enhance their administrative policy frameworks. This program, funded by the Public Health Infrastructure Grant, offered tailored support—including coaching sessions, resources, and on-site visits—aimed at giving agencies practical tools and guidance for a more efficient policy structure. ASTHO’s Guide on Conducting a Policy Assessment and Gap Analysis played a central role in this initiative, helping agencies learn about best practices, identify policy gaps, and prioritize areas needing attention. For MO DHSS, ASTHO’s support led to the creation of a policy review committee representing all divisions within the department. This structure promotes a more collaborative approach to policy development, ensuring that different perspectives within the agency are considered. MO DHSS’ Health Planning Coordinator Ashlyn Sherman said, “This work goes beyond preparing for reaccreditation cycles; it’s about embedding a continuous improvement mindset across MO DHSS.” Missouri’s On-Site Visit An on-site visit was a key component of Missouri’s technical assistance collaboration with ASTHO. Thanks to the thoughtful preparation by the MO DHSS team and funding support from the Public Health Infrastructure Grant, ASTHO facilitated a two-day visit to help Missouri improve their policy development process. During this visit, Missouri relaunched a policy review committee, established new by-laws, and used ASTHO’s policy and gap analysis tool to create an overview of existing and required administrative policies that guide the agency’s operations. Key Goals of ASTHO’s Technical Assistance Opportunity ASTHO designed this technical assistance opportunity with a few key goals in mind: Build capacity within public health agencies to systematically develop, review, and update critical policies. Encourage the use of quality improvement principles in policymaking. Provide tools for assessing policies and identifying gaps. Foster a community of agencies sharing best practices and lessons learned. How Other Health Agencies Are Advancing Policy Efforts MO DHSS isn’t the only one benefiting from ASTHO’s resources. Other public health agencies have also leveraged ASTHO’s support to rethink their policy development and review processes. For example, one health agency noted that ASTHO’s external perspective helped them re-launch and organize their approach with a fresh, structured strategy. Another agency received technical assistance in updating a process map and policy review team charter. All health agencies agree that the impartial facilitation and project management support from ASTHO helped them implement a more cohesive, comprehensive policy process that aligns with their organizational goals. To support these efforts, public health agencies are exploring additional areas for improving their policy processes, including establishing compliance units and incorporating AI into policy development. Recognizing the need for shared resources, ASTHO is building a library of administrative policy examples from public health agencies willing to share their work. This growing resource allows agencies to learn from each other, adapt successful policies, and reduce the time spent on creating new frameworks. Learn More and Take the Next Step If your public health agency is interested in improving its administrative policy process, explore ASTHO’s STAR Center or consider submitting a Public Health Infrastructure Virtual Engagement request to see how ASTHO’s programs might support your efforts. With ASTHO’s guidance and tools, public health agencies can take practical steps toward building a streamlined, effective policy process that supports their mission and the communities they serve. For more information, visit the ASTHO STAR Center. article yes

Learn how Austin's health department used PHIG funding and assistance from ASTHO to improve their processes in this blog.

Licking County, Ohio uses performance management to advance environmental health, emphasizing impact and equity.

Advanced Grant Payments: Creating a More Equitable Public Health System Advanced Grant Payments Promote Equity in Public Health Jignasa Jani, Ryan Rivera Learn how advanced grant payments can ensure smaller community-based organizations have necessary resources, creating greater equity in public health. Community-based organizations are critical partners to state health agencies in implementing public health programming, often reaching underserved populations and those at greater risk of experiencing health disparities. However, smaller or less-established organizations frequently face significant barriers when receiving grant funding (e.g., not having the necessary upfront capital to cover initial project costs). The Colorado Department of Public Health and Environment (CDPHE) recognizes these challenges and is taking bold steps to improve administrative processes for grant funded programs. These steps will go a long way towards ensuring that smaller community-based organizations have the resources they need to succeed, creating greater equity in the public health system. Redesigning Payment Structures for Greater Access To improve its administrative process, CDPHE is redesigning its payment structure for grant-funded programs. Historically, many grants have operated on a cost-reimbursement basis, where organizations must first cover the costs of services or goods before being reimbursed by the state department. This approach can exclude or unfairly burden smaller or less-established organizations that lack the upfront capital to participate fully in grant-funded initiatives, many of which serve disadvantaged and under-resourced populations. As such, CDPHE identified advanced payments as a priority, reflecting the department’s commitment to inclusion, diversity, equity, and accessibility. Following the enactment of Colorado House Bill 21-1247, CDPHE worked with policymakers to allow the department to provide advance payments to certain grantees and were granted the authority to provide certain grant recipients up to 25% of the total award value immediately on execution or renewal of the contract. By doing this, CDPHE may provide funding opportunities for eligible organizations to have the financial support they need from the start to support their communities. Jignasa Jani 1 - Advanced Grant Payments Promote Equity in Public Health The Prevention Services Division (PSD) within CDPHE led implementation of House Bill 21-1247 and administers a wide range of programs, including those focused on chronic disease prevention, tobacco cessation, injury prevention, suicide prevention, sexual health, and women’s health. By offering advanced payments, PSD empowers smaller organizations to carry out these important public health programs, which are essential to improving the health and well-being of Colorado’s most vulnerable populations. Ryan Rivera - Advanced Grant Payments Promote Equity in Public Health Overcoming Challenges in Implementation While the benefits of advanced payments are clear, implementing this new process has come with its fair share of challenges. The complexity of state and federal rules often places smaller organizations at a disadvantage, making it difficult for them to navigate the administrative requirements of grant funding. PSD staff dedicated significant time and effort to developing the necessary guidelines, policies, and procedures to support the advance payment process. These safeguards were crucial in gaining the support of department fiscal staff, ensuring that taxpayer funds are used appropriately and effectively. PSD staff had to go above and beyond their regular duties to create a robust process that would mitigate risks while providing necessary support to grantees. Their dedication to this initiative reflects a deep commitment to equity and inclusion, and to ensuring that all organizations, regardless of size, have equitable access to grant funds for public health work. Jignasa Jani 2 - Advanced Grant Payments Promote Equity in Public Health Supporting Grantees Through Ongoing Assistance To ensure the success of the advance payment process, PSD staff work closely with grantees to help them understand and comply with the new requirements. This includes providing technical assistance on financial management, invoicing, and compliance with state and federal regulations. By offering this support, CDPHE helps organizations build the capacity they need to manage grant funds effectively and reduce the likelihood of being classified as high-risk in the future. PSD’s efforts extend beyond the initial implementation of the advance payment process. The division is committed to continuous improvement, regularly gathering feedback from grantees and internal staff to refine and enhance the process. This approach ensures that the system remains responsive to the needs of community-based organizations and continues to support their success. Looking Ahead This initiative has the potential to increase the number of applications and funding awards to community-based organizations serving under-resourced populations, further enhancing the diversity and reach of public health programs in Colorado. As more organizations successfully navigate the grant funding process, the overall capacity of Colorado’s public health system will grow stronger, leading to better outcomes for all communities. article yes

Advancing Performance Management Webinar Series website no

Strengthening Grant Management Functions in Puerto Rico ASTHO | Toolkit helps to optimize grant activities and funds in Puerto Rico The Grants Management Office Structure Optimization Toolkit helps to assess a health department's federal grant workload, staffing requirements in its grant management office, and potential to optimize grant management activities. The Puerto Rico Department of Health (PRDOH) is using it as a guide for improving internal grants management capacity and oversight to maximize federal funding outcomes. PRDOH anticipates increased information flow, a more inclusive culture, and additional benefits. Get the Infographic in English (PDF) Obtén la infografía en español (PDF) website yes

U.S. Virgin Island’s Federal Grant Planning and Set Up Process Improvement ASTHO, Association of State and Territorial Health Officials, u.s. virgin islands, grant management, federal grant planning, grant planning, workflow visibility, cross agency leadership, federal grant management, community of practice, cross agency, oversight responsibilities, standard process, facilitate workflow, community of practice cop Kristin Sullivan, Colton Anderson ASTHO | Recommendations to improve speed and quality of the U.S. Virgin Island’s Federal Grant Management processes. This infographic details strategies for improving the speed and quality of the U.S. Virgin Islands’s Federal Grant Management “Plan and Set Up” process. Get the Infographic (PDF) website yes

Grants Management Office Structure Optimization Toolkit As part of its STAR Center services, ASTHO offers valuable technical assistance to state and territorial health agencies for enhancing grants management functions. This opportunity is designed to empower health agencies by providing them with expert guidance to streamline their grant management processes and gain valuable insight into transitioning certain grant functions from decentralized to centralized. The Grants Management Office (GMO) Structure Optimization Toolkit was collaboratively developed to assist health departments in establishing and maintaining a more centralized GMO to optimize the utilization of federal funding. The purpose of this toolkit is to comprehensively assess the department's current federal grant workload, grant management office staffing requirements, and potential opportunities. Doing so enables efficient allocation of efforts and support among funded programs. The primary objective is to centralize critical functions through a comprehensive grants management system led by specialized and well-trained personnel who maintain close communication with program staff. The toolkit also aims to define the transition costs associated with adopting this structure and appropriately distribute the expenses across multiple programs. Once fully implemented, the centralized grants management system is expected to: Strengthen the infrastructure of public health agencies and enhance overall performance. Improve the capacity to manage federal grants and their funds effectively and efficiently. Foster greater collaboration and stronger working relationships among different program areas. Technical considerations: IT support for application download Microsoft Power Platform for Power BI usage Exploring the Toolkit in Depth The GMO Structure Optimization Toolkit includes a set of electronic tools designed to conduct a self-assessment, recommend the best structure to manage grants, and allocate costs. Through the self-assessment, health departments will gain valuable insights into their current and projected workload demands and they can better comprehend their existing program management practices. By doing so, they can identify the necessary staffing requirements and uncover opportunities within the GMO, enabling them to efficiently allocate their efforts across funded programs. Accordion - Grants Management Toolkit website no False