From Vision to Action: A Blueprint for Public Health System Transformation

Posted on September 25, 2025 by Melissa Server

This entry is part 61 of 62 in the series Focus on Accreditation and Innovation

Governmental public health is at a crossroads. For decades, there have been significant efforts to revisit and revitalize the US public health system. Reports such as Public Health 3.0, Public Health Forward: Modernizing the U.S. Public Health System, Staffing Up, Reimagining Public Health: Mapping a Path Forward, and the CDC’s Public Health Data Strategy have established clear recommendations for strengthening our infrastructure.

Through the CDC’s Public Health Infrastructure Grant, historic non-categorical funding is supporting 107 state, Territorial, and large local health departments to strengthen the workforce, build Foundational Capabilities, and modernize data systems. At the same time, recent resource shifts and federal funding uncertainties have forced staffing and program cuts at the state and local level.

Yet this challenge presents an opportunity. There may be no better time than now to purposefully pause and deeply reconsider how we ensure the sustainable, efficient, and effective delivery of governmental public health services. This requires letting go of our current system structures and “getting up on the balcony” to reimagine and create a shared vision for how we protect and assure the health and wellbeing of our communities now and into the future.

We must strengthen what works, let go of what does not, and find new and innovative ways to deliver the Foundational Public Health Services and 10 Essential Public Health Services. We must collaborate in new and different ways with both traditional and non-traditional partners, revisit our governance and service delivery structures, adapt our funding approaches, update our policies, and refine our accountability structures. Our public health system must look and function differently. We must transform.

To guide this critically important work, PHAB, in partnership with the University of Minnesota Center for Public Health Systems, recently launched a Blueprint for Public Health System Transformation (Blueprint). The Blueprint provides health departments, health department systems, and their public health ecosystem partners with guidance and resources for engaging in intentional system transformation efforts. The Blueprint isgrounded in standard system transformation theory and incorporates resources and lessons learned from 21^st Century Learning Community states engaged in intentional system transformation efforts.

The structure of the Blueprint mirrors PHAB’s recently updated public health system transformation graphic and includes the following phases:

Getting Organized: Initial activities to lay the groundwork for system transformation.
Phase 1 – Assess the System: Identify strengths, gaps, and roadblocks to public health infrastructure and service delivery.
Phase 2 – Design and Innovate: Identify innovative approaches to address gaps and establish an evaluation plan.
Phase 3 – Test and Transform: Implement, test, and scale strategies.
Phase 4 – Evaluate the System: Evaluate the process and outcomes of system transformation efforts.

The Blueprint also incorporates seven cross cutting considerations that allow us to view basic system transformation theory through a public health lens including: Public Health Services Framework, Governance, Service Delivery, Human and Financial Resources, Policy and Legislation, Standards and Performance Measures, and Responsibility and Accountability. Each of these cross-cutting considerations are addressed across the system transformation phases providing key questions, resources, and recommended steps for action.

PHAB recently launched an accompanying website that provides users with a more interactive way to engage with Blueprint content. The website will be a living resource that will be updated regularly as new tools and stories from the field are developed and new learning emerges.

For more information about the Blueprint or to discuss your system transformation needs and how PHAB may be able to assist, email phabta@phaboard.org.

About the Author

Melissa Server: Melissa Sever, MPH, MCHES, is a collaborative public health leader with more than 25 years of progressive experience across local and state governmental public health, academia, and non-profit sectors. She currently serves as the Senior Advisor for Public Health Systems and Services at the Public Health Accreditation Board (PHAB), where she leads strategy development and implementation to support health departments and public health systems in their transformation efforts.

Previously, Melissa was the Director of Organizational Development and Culture at Columbus Public Health. In that role, she founded the Office of Planning and Quality Improvement, spearheaded department-wide strategic initiatives, and partnered with internal leadership and community stakeholders on efforts including multi-sector community health improvement planning and PHAB re-accreditation. She also played a critical leadership role during the COVID-19 response as Operations Section Chief.

Melissa’s career includes senior-level roles at the Ohio Department of Health, The Ohio State University College of Public Health, and the community-based organization RAPID 5. Her expertise spans workforce and organizational development, strategic planning and execution, systems improvement, performance and quality improvement, public health accreditation, and collaborative process design and facilitation. Colleagues consistently recognize her for her ability to foster strong, productive partnerships.

Melissa earned her Master of Public Health from The Ohio State University and a Bachelor of Science in Health Behavior/Health Promotion from Bowling Green State University. She is a Master Certified Health Education Specialist (MCHES), trained in the Art of Hosting, and holds a Certificate in Basic Quality Improvement and Patient Safety from the Institute for Healthcare Improvement.

A native of rural northwest Ohio, Melissa now lives in Columbus with her husband, Jeff. She is the proud mother of two adult daughters, Maddy and Claire.