Skip Ribbon Commands
Skip to main content
Sign In
We improve public health and population health practice to support healthier communities
The National Public Health Improvement Initiative at State, Tribal, Local, and Territorial Levels

Date: 5/30/2013 7:39 AM

Related Categories: Performance Management, Quality Improvement

Topic: Infrastructure

Tag: Accreditation, Centers for Disease Control and Prevention (CDC), Email Newsletter Content, Essential Public Health Services, Infrastructure, Partnerships, PHF E-News

Dr. Judith A. Monroe, Director, Office for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention and Deputy Director, Centers for Disease Control and Prevention
The public health system faces sustained financial challenges—challenges compounded by an aging population, the increasing burden of chronic diseases, and variability in the operation and performance of more than 3,000 state, tribal, local, and territorial health agencies. Yet, as director of the Centers for Disease Control and Prevention’s (CDC’s) Office for State, Tribal, Local and Territorial Support (OSTLTS), I see every day how dedicated public health officials are sustaining, improving, and transforming the public health services that advance health in communities—despite these economic challenges.
The National Public Health Improvement Initiative (NPHII) is a shining example of how public health departments are transforming. NPHII is a five-year initiative operated by OSTLTS that continually helps public health departments 1) become more organized and effective, and operate with less waste; 2) generate the objective information needed to make critical decisions about the future of services in their communities; 3) improve service, value, performance, transparency, and accountability; and 4) ensure a solid foundation to perform core public health functions and deliver essential services to the public.
NPHII helps state, tribal, local, and territorial health departments increase the impact of their public health services by
  • Building and applying performance improvement systems and practices
  • Improving programs performance tracking
  • Preparing for public health accreditation; accreditation by the Public Health Accreditation Board signifies that a health department is meeting national standards for ensuring essential public health services are provided in the community
  • Strengthening delivery of public health services and programs, a process which documents the capacity of the public health department to deliver the three core functions of public health and the 10 essential public health services
  • Using evidence-based policies and practices to invest strategically in what works and reduce duplication of effort
  • Building a network of performance improvement managers across the country who share strategies for improving the public health system
  • Maximizing collaboration across public health systems to ensure seamless and coordinated services for residents
In other words, NPHII helps health departments answer the questions, “Are we doing the right things, and are we doing them right?” while providing resources for data-driven improvement and innovation. 
NPHII is already paying off. For example,
  • New Jersey implemented automated, electronic reporting of influenza test results from the state laboratory to CDC, enabling faster detection and response by drastically reducing reporting time from 2-3 weeks to 2-3 days.
  • In Tennessee, the state health department strengthened its public health data system to improve speed and accuracy of vital records tracking, enabling better health status access and monitoring.
  • In Virginia, the state health department consolidated critical metrics from 119 public health system databases into one dashboard system serving all offices, identifying at least $1.2 million in potential annual savings in IT costs to reinvest in programs and staffing.
  • As of early May 2013, 137 state and local health departments have formally applied for national public health accreditation.  While the readiness of those applicants can’t wholly be attributed to NPHII, there is strong recognition that NPHII has greatly advanced these efforts. 
These achievements show how NPHII funds leverage and improve the work and impact of other public health investments to protect health. 
I encourage you to visit OSTLTS’ Public Health Practice Stories from the Field site, where you can read stories about US public health agencies enacting innovative and impactful strategies in their states, tribes, localities, and territories.
* * * 
Please share with us your thoughts and opinions on this and other hot public health topics by posting and subscribing to comments throughout PHF’s website.
The PHF Pulse Blog welcomes conversations and commentary from contributors. Posts may not necessarily reflect the views of the Public Health Foundation.


Add A Comment

Debra Scamarcia Tews


The National Public Health Improvement Initiative (NPHII) is helping to transform the way public health does business! An increased emphasis on efficiency, effectiveness, performance management, and quality are all helping to demonstrate return on investiment and drive system-wide improvement. This has become essential in an evolving health reform environment. NPHII is spurring true public health advancement across the nation.

Caitrin McCarron National Indian Health Board


Thank you for your comments regarding this important initiative. Because of this work, Tribes across the country are improving and advancing public health in their communities. This includes the establishment of public health assessments and increased steps towards accreditation. It is critical that CDC continues to support these efforts so that Indian Country can improve the lives of future generations of American Indians and Alaska Natives.

David Dyjack Dr.PH CIH


The National Association of County and City Health Officials (NACCHO) applaud the CDC’s Office for State, Tribal, Local and Territorial Support’s vision in developing the National Public Health Improvement Initiative (NPHII). NPHII is central to our efforts aimed at promoting evidence-based practice, measuring and improving performance, and achieving nationally recognized public health practice standards among our constituents. At the same time, we credit this initiative for the increased collaboration we are observing across the public health system, particularly among and between state and local health departments.

John Poundstone MD MPH


Although I am retired, I keep up with the events dealing with the Affordable Care Act particularly regarding public health. Health Departments need to get the resources they require to make their communities healthier. We need to provide these resources through the NPHII. Now is not the time to reduce this undertaking. John Poundstone MD, MPH

Dr. Harvey Wallace PhD


Public health practice, at all levels of government, but especially at the local level, has benefitted by the work done by CDC and its public health partners which established national performance standards and measures, thus assuring every citizen that their local health agency is working to improve community health. I cannot imagine what a decrease in funding for CDC support would mean for community health outcomes. The 1988 Institute of Medicine Report - "The Future of Public Health" provided the framework for what has been accomplished to date. It would a shame to lose sight of our Future. Dr. Harvey Wallace, PhD Marquette County (MI) Board of Health Member since 1987

Jeffrey Levi PhD


NPHII is supported through the Prevention and Public Health Fund, another example of how the Affordable Care Act is investing in public health, not just health care delivery. Through the various investments and initiatives in the ACA – including NPHII, the Community Transformation Grants, and the National Prevention Strategy – there is hope that we are not just extending critically important insurance coverage, but also building the basis for wellness in the U.S., including a stronger public health system. That said, in the years ahead, I hope NPHII will be more focused in its initiatives – providing health departments with the incentive to adapt to a reforming health care system in a consistent way. Jeffrey Levi, PhD Executive Director, Trust for America's Health and Professor of Health Policy, George Washington University School of Public Health and Health Services

C. William Keck MD MPH


The Affordable Care Act is shifting the US health service paradigm emphasis from illness care to wellness and, as such, supports the idea that medicine and public health must be better melded. NPHII funding must be protected and, among other things, be used to support the development of partnerships that will make better use of existing resources in collaborative ventures to improve community health status. The academic health department, linked to academic health centers and other health professions training institutions, is one such partnership that promises to improve public health training, research and service. C. William Keck, MD, MPH

Subscribe to PHF