Beyond the 80,000 Estimate: Calculate How Many FTEs your Health Department Needs

Posted on November 4, 2022 by Naomi Rich

This entry is part 35 of 46 in the series Focus on Accreditation and Innovation

The Public Health Workforce Calculator is a tool to help local health departments with workforce planning efforts by utilizing information provided about the local health department to estimate the number of full-time equivalents (FTEs) needed to ensure the provision of the Foundational Public Health Services.

Long before the COVID-19 pandemic reached the United States, the public health workforce felt the limitations of operating with minimally sufficient staff. Employees at governmental health departments were accustomed to doing more with less, innovating out of necessity, and working as hard as they could within an under resourced system – the pandemic shed light on the dire need to support public health and presented an opportunity to transform the public health system.

In October 2021, the Public Health National Center for Innovations (PHNCI) at the Public Health Accreditation Board (PHAB) and the de Beaumont Foundation released a national estimate of staffing needed to perform the Foundational Public Health Services (FPHS) – the analysis found that more than 80,000 additional full-time equivalents (FTEs) are needed in state and local health departments to implement the FPHS. An 80% increase in the public health workforce is needed just to provide basic community services.

Following the release of the estimate, the de Beaumont Foundation, PHNCI at PHAB, the University of Minnesota School of Public Health Center for Public Health Systems, and the Centers for Disease Control and Prevention, Center for State, Tribal, Local and Territorial Support partnered to develop a Public Health Workforce Calculator. The Calculator is a tool to help local health departments with workforce planning efforts by utilizing information provided about the local health department to estimate the number of full-time equivalents (FTEs) needed to ensure the provision of the Foundational Public Health Services. The Calculator is intended for use in decentralized public health systems that serve less than 500,000 residents.

On October 27^th, 2022, the Calculator was shared with the field during a webinar launch. The Calculator provides users with an estimate of the minimum number FTEs needed by a jurisdiction to provide the Foundational Public Health Services by Foundational Capability (FC) and Foundational Area (FA). Health departments can use the estimate to support their workforce planning, identify gaps, and advocate for additional resources. Calculator estimates should be used for planning purposes only and should not be viewed as exact.

To use the Calculator, first view the Public Health Workforce Calculator User Guide.

Highlights of the Calculator:

The Calculator should be used by local health departments in decentralized public health systems that serve less than 500,000 residents – results for health departments not fitting these criteria will not be reliable.
The Advanced User option is available for local health departments that have data on the number of FTEs that contribute to each Foundational Capability and Foundational Area from FPHS and Capacity and Cost Assessment work.
The Calculator was developed based on data from 170 local health departments in 4 states and several model assumptions.
- All data used in the development of the Calculator was from 2018 and therefore does not reflect any staffing changes that health departments may have made because of the pandemic – the Calculator is not meant to attend to planning for surge capacity.

Learn more about the Calculator at phnci.org/transformation/workforce-calculator.

The Public Health Workforce Calculator was developed through a partnership between the de Beaumont Foundation, Public Health National Center for Innovations at the Public Health Accreditation Board, UMN SPH Center for Public Health Systems, and Centers for Disease Control and Prevention, Center for State, Tribal, Local and Territorial Support. Development would not have been possible without contributions from a range of public health practitioners and experts, including the Staffing Up Steering Committee; Staffing Up Research Advisory Committee; Crow Insight, LLC; JP Leider Research and Consulting; Mac McCullough; Sieger Consulting SPC; Northwest Center for Public Health Practice, University of Washington; Singh Research and Consulting LLC; Valerie A. Yeager, LLC; ; and WE Public Health.

Author Profile

Naomi Rich: Naomi Rich is a Program Specialist at PHAB, where she provides administrative and strategic communications support to the Public Health National Center for Innovations and Program, Research, and Evaluation teams. Prior to joining PHAB in 2020, Naomi applied a community organizing lens to her work in political campaigns, nonprofits, and a communications agency. She holds a Bachelor of Science in Community and Regional Development from the University of California, Davis.