In 2022, the Centers for Disease Control and Prevention (CDC) launched the Public Health Infrastructure Grant (PHIG), a historic investment in the public health workforce, foundational capabilities, and data modernization. CDC funded 107 state, local, and territory and freely associated state (TFAS) health departments to improve their core public health infrastructure. Many recipients have used their funding to strengthen their Accreditation or Reaccreditation activities. The PHIG National Evaluation, co-led by the Public Health Accreditation Board (PHAB) and the National Network of Public Health Institutes (NNPHI), uses recipient-reported performance measures and workplans/progress reports to track recipient progress and understand how they are implementing PHIG.
Accreditation Momentum Under PHIG
At the midpoint of the five-year grant (May 31, 2025), 73 percent (n=78) of PHIG recipients were Accredited or Reaccredited, and 62 percent (n=66) of recipients reported plans to use PHIG funding for Accreditation-related activities. Also, 25 percent (n=27) of PHIG recipients had been newly Reaccredited since May 31, 2023 (the midpoint of PHIG Year 1). In addition to helping Accredited health departments become Reaccredited, PHIG is helping new health departments enter the Accreditation pipeline. Since Year 1 of PHIG:
- Three recipients have achieved Initial Accreditation,
- Five recipients have registered for the PHAB Readiness and Training process, and
- One recipient has started working toward Accreditation using the Pathways Recognition Program.
PHIG is supporting this progress in practical, concrete ways. Recipients planned to use funds to develop Accreditation workplans, communicate about Accreditation within their health departments, prepare for PHAB site visits, and pay PHAB fees. Recipients also planned to track Accreditation and Reaccreditation efforts by purchasing software and updating tracking documents.
Expanding Access: How States Are Supporting Local Health Departments
Beyond internal Accreditation efforts, PHIG is also strengthening LHDs through state-led support by addressing common barriers such as staffing capacity and cost. Many state recipients planned to offer technical and financial support to LHDs pursuing Accreditation, including creating communities of practice for LHDs going through the process, hosting a summit for LHDs interested in Accreditation, and funding LHD Accreditation efforts through grant cost reimbursement.
For example, the Missouri Department of Health and Senior Services is addressing one of the most common barriers to Accreditation, staff capacity, by using PHIG funds to support Accreditation personnel. The department provides cost reimbursement funding that enables local agencies to hire staff or contractors for Accreditation work. To complement this financial assistance, Missouri offers PHAB trainings and readiness assessments to LHDs at no cost. The state has further incentivized participation by linking general revenue incentive payments to local departments’ engagement with these Accreditation offerings. As a result, over 80% of Missouri’s LHDs are now on a pathway toward Accreditation or Reaccreditation.
The Wisconsin Department of Health Services, Division of Public Health, uses PHIG funds to address the cost barrier by covering fees associated with the Accreditation Readiness Assessment, the Pathways Program, and full Accreditation for interested jurisdictions. PHAB is also working with the Wisconsin Department of Health Services to expand technical assistance for local and Tribal health departments in the state and build the state agency’s ability to deliver this support independently. This comprehensive support enables all LHDs, including small and rural health departments, to strengthen their capacity to deliver the 10 Essential Public Health Services and Foundational Capabilities. For example, the Shawano-Menominee County Health Department, a five-person staff serving 41,000 residents, achieved Reaccreditation through the Wisconsin Department of Health Services’ PHIG-funded support.
Looking Ahead
The Accreditation process enables health departments to strengthen their operational efficiency, workforce capacity, and service delivery quality through improved strategic planning, performance management, and quality improvement systems. PHIG is enabling more health departments to leverage this framework, ultimately strengthening the nation’s public health system, leading to stronger prevention, preparedness, and response to emerging public health threats. As more health departments progress through the Accreditation pipeline, continued evaluation will be essential for understanding the impacts and identifying best practices for sustaining these improvements in the long term.
Rashidat Mohammed MPH, MBA, is a Senior Research Specialist for Data Modernization Initiatives at the Public Health Accreditation Board (PHAB), where she supports evaluation and implementation efforts related to CDC’s Public Health Infrastructure Grant (PHIG). Her work focuses on public health systems improvement, program evaluation, performance measurement, and data modernization strategies across state, local, Tribal, and territorial public health agencies. With nearly 10 years of experience in public health research and evaluation, Rashidat specializes in translating complex data into actionable insights that support workforce development, infrastructure transformation, and continuous quality improvement initiatives.