PHLF Releases White Paper on Public Health Infrastructure, Outlines Potential New Federal Funding Stream

This week, the Public Health Leadership Forum (PHLF), with support from the Robert Wood Johnson Foundation (RWJF), published a white paper titled, “Developing a Financing System to Support Public Health Infrastructure.” The white paper examines the current state of public health infrastructure, public health foundational capabilities, and current public health financing structures in the U.S. The paper assesses total costs of foundational capabilities and determines that a $4.5 billion gap exists between current spending and needed spending to fully implement foundational public health capabilities throughout the country.

To address this gap, the white paper proposes the creation of the Public Health Infrastructure Fund to enhance and maintain foundational public health capabilities of state, local, territorial, and tribal governments. Key principles are identified to guide the proposed new federal funding stream, which include:

  • All people in America should be served by a public health agency that ensures equitable access to and protection by foundational public health capabilities.
  • Financing of foundational capabilities is a governmental responsibility and should be assured through sustainable, dedicated revenue streams. Local, state, and federal governments should share in financing those capabilities as all levels of government ultimately benefit from them.
  • Foundational public health capabilities should be assessed and provided in every community based on national standards – and maintaining those standards should be a condition of continued funding.

The proposal suggests that funding could be phased in over a period of time, distributed on a per capita basis, and require state matching. Funds could also be set aside for federal support of technical assistance, research, and demonstration projects. The white paper was primarily authored by Karen DeSalvo, former U.S. Department of Health and Human Services (HHS) Assistant Secretary for Health, and Jeffrey Levi, former Trust for America’s Health (TFAH) President and CEO. The full white paper is available here.