The “Infrastructure grant” is anticipated to result in substantial and long-lasting structural changes to public health systems, hopefully positioning those systems to better meet the critical challenges.

It is no secret that the governmental public health system is a little worse for wear as of late. Following the recognition of shortcomings via the COVID-19 pandemic, federal authorities crafted a new aid-to-local grant opportunity, the most substantial in decades, to meet some of the most pressing concerns. The “Infrastructure grant”—Strengthening U.S. Public Health Infrastructure, Workforce, and Data Systems (CDC-RFA-OE22-2203)—is intended to “strategically support strengthening public health infrastructure and systems related to the workforce, foundational capabilities, and data infrastructure.”^1, This $3.945 billion investment will occur alongside, and is complimentary with, many Centers for Disease Control and Prevention (CDC) and Health Resources and Services Administration (HRSA) initiatives, as well as other state and local initiatives. The aims and impacts of this grant have the opportunity to, at the very least, start to transform the national public health landscape for the better.

Overview of the Infrastructure Grant

The Infrastructure grant is dedicated toward governmental public health systems and collective services for the population, including marginalized and underserved communities, ethnic minority groups, and those disproportionately affected by COVID-19.¹ The grant is divided into two parts, Component A and Component B. Eligible applicants for Component A were governmental public health entities or their bona fide agents (those operating on behalf of government); the focus of the investment was on governmental public health. Component A ($3.9B total) included three categories of strategic direction for the Infrastructure grant:

• Strategy A1 – Workforce: Key activities within this strategy are the recruitment and retention of diverse and effective public health staff, including through improvements to training and professional development opportunities and enhancements to planning, policies, and processes.
• Strategy A2 – Foundational Capabilities: Key activities within this strategy are those which strengthen or enhance each of the Foundational Capabilities (FCs) from the Foundational Public Health Services (FPHS) framework stewarded by the Public Health National Center for Innovations (PHNCI): 1) Assessment/Surveillance, 2) Emergency Preparedness and Response, 3) Policy Development and Support, 4) Communications, 5) Community Partnership Development, 6) Organizational Competencies, 7) Accountability/Performance Management, and 8) Equity.
• Strategy A3 – Data Modernization: Key activities within this strategy are development of agile, enterprise-wide approaches to assess, plan for, and implement data modernization activities such that the public health data environment utilizes a forward-looking, flexible, scalable, and sustainable infrastructure.

Component B, $45M total, was dedicated toward provision of technical assistance to Component A recipients. Those efforts will serve to support overall grant performance.

Figure 1. Distribution of Infrastructure Grant Funds

How the Infrastructure Grant May Impact Public Health Systems and Services

Intended Impacts of the Grant

Federal agencies and stakeholders crafted the grant components with a number of strategic aims in mind. The grant has short-term aims of improving diversity hiring practices, enhancing organizational systems and processes, and modernizing data systems and services.¹ The grant has intermediate-term aims of increasing the size and skills of the workforce, focusing on Foundational Capabilities, and then make improvements to how public health data are collected and used.¹ In all, the Infrastructure grant is anticipated to result in substantial and long-lasting structural changes to public health systems, hopefully positioning those systems to better meet the critical challenges.

What Does This Mean for Public Health Practice?

Each of us who participate in public health systems and their services has the fantastic opportunity to support our local, state, and national public health systems as they navigate the transformative aims of this grant. There are a wide number of support roles that each of us may play, from providing training and educational opportunities, to assisting with recruitment pipelines to practice, to supporting data modernization efforts. Public health, after all, is a team effort.

References

1. Centers for Disease Control and Prevention. Strengthening U.S. Public Health Infrastructure, Workforce, and Data Systems. Atlanta, GA: Center for Surveillance, Epidemiology, and Laboratory Services;2022. Agency Notice of Funding Opportunity Number: CDC-RFA-OE22-2203.

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Jason Orr, MPH, BS, is a Researcher with the Center for Public Health Systems. He is experienced in policy analysis and mixed-methods research as well as systems design, systems analysis, and engineering project and risk management. He holds a BS in Chemical Engineering and an MPH from Kansas State University and is a doctoral candidate in Systems Engineering at Colorado State University. He has academic interests in topics related to public health services frameworks (eg, Foundational Public Health Services); collaborative service delivery (ie, cross-jurisdictional or cross-sectoral collaboration); and other public health systems transformation and innovation initiatives.