Local health department capacity and resources historically have varied considerably both within and between states nationwide. The resultant disparities often are cited as a driver for public health transformation among the 21C learning community states. Some states are working to determine what structural and/or operational changes could ensure equity at the local level with respect to the availability of public health services. The states below have developed new service delivery models or guidelines as part of their implementation strategy for a transformed public health system.
Missouri's foundational public health services model defines a minimum set of cross-cutting foundational capabilities and areas of expertise that should be available in every community in order to assure all Missourians the fair opportunity for health. The model provides a simplified framework by which public health professionals can define a cost for delivery of services, identify capacity gaps, and justify future funding requests.
The foundational Public Health Futures report developed by the Association of Ohio Health Commissioners includes an algorithm to help determine whether local health departments should collaborate in order to provide all FPHS.
Oregon developed a long-term Public Health Modernization Plan which describes the key priorities and strategies for implementing FPHS.
The partners in Washington have described a continuum of service provision at the state, regional and local levels. The report below includes a description and evaluation of demonstration projects to test the different models.