Public Health System Assessment

Public Health System Assessment

Conducting an analysis of the gap between current investments and capacity and what is needed for implementation of the FPHS framework provides a critical foundation for developing cost estimates and planning implementation strategies. Ideally, all local health departments in the state commit to participating in an assessment, ensuring the best possible information for successful transformation efforts. When that is not possible, other methods can be used to generate helpful estimates.

The Kansas Health Institute conducted an assessment of local health department capacity to provide the foundational public health services, in addition to areas of strength, areas of improvement, and barriers to providing the services. The assessment also collected information on departments’ operating budgets and number of full-time equivalent employees.


Alongside the capacity assessment, BERK Consulting, Inc., conducted a separate assessment to estimate the projected costs of financing the full implementation of the Kansas FPHS model.

Kentucky’s proposal to strengthen public health includes information on existing and needed capacity with respect to the number of full-time equivalent employees in each local health department and the funding to support the positions.

The Ohio Public Health Partnership conducted an analysis of how much Ohio LHDs spent on the FPHS in 2018 and what percentage of the FPHS was achieved with that investment. Based on this information, they then estimated the investment that would be needed to close the resource gap and assure adequate provision of the FPHS in communities across the state.

In 2016 Oregon Health Authority contracted with BERK Consulting, Inc. to conduct a public health system-wide assessment. The assessment measured each state and local public health authority’s current implementation of the public health modernization framework and the cost to fully implement it. In addition to this information, the final report addresses implementation strategies and policy implications.

BERK Consulting worked with the state’s FPHS Steering Committee and Technical Workgroup, department of health, state board of health, and the Washington State Association of Local Public Health Officials (WSALPHO), worked with BERK Consulting to conduct a public health system assessment. This report includes a picture of current statewide implementation and spending on FPHS as well as the estimated cost to fully provide FPHS statewide.