The nationally-developed FPHS framework reflects the consensus of public health and health care leaders across the country of the suite of skills, programs and activities that must be available in state and local health departments everywhere for the health system to work anywhere, and for which costs could be estimated. Widespread adoption of the framework has the potential to advance a more unified public health system across the country, both in terms of how governmental public health is described and how it is understood. The framework also provides a much-needed structure to estimate costs in a way that resonates with decision-makers. Furthermore, it provides states with the ability to compare the costs of public health with other states that also have adopted it.
While all of the states in the 21C learning community have models that align with every element in the FPHS framework, most of them have tailored the framework to better align with the culture and environment in their state. Specific reasons for adapting the framework include, e.g., to reflect state-mandated programs, include language proven to resonate with key audiences, and gain the buy-in of those engaged in the transformation process.
We strongly encourage states to have thoughtful and candid discussions about whether to adopt the national framework or adapt it for their specific purposes. One strategy to consider for those considering adoption is to use the communication plan for transformation efforts as the vehicle for reflecting state-specific aspects of public health practice. In other words, messages for target audiences can: convey the alignment between FPHS and mandated programs; deliberately use specific language; and otherwise speak to issues of importance to stakeholders.