Public Health Systems Change

​Towards a public health system that works for all.

​Data Modernization Initiative

​Effective public health depends on access to community health data and the skills to use it. Currently, essential public health data is often siloed, delayed by years, and less representing of rural communities and some marginalized groups. Supported by the CDC-led Data Modernization Initiative, CALPHO and its partners are catalyzing data systems improvements through developing communities of practice,  mapping agency paths to modernization with thorough assessments, advocating for improved data access, and researching potential shared data structures.

• ​Assessing and Advancing Public Health Data Modernization in Colorado Report
• Data Modernization Toolkit
• LPHA Data Readiness Framework 

Workforce

​Retaining today’s public health professionals is our highest workforce priority. The pandemic thinned the ranks of local public health workers, but it also demonstrated their resilience, determination, and professionalism. Other priorities include increasing community representativeness in the workforce, improving the education-to-profession pipeline, and expanding mental health supports. Along with our partners at Trailhead Institute, the Colorado Health Institute (CHI), and CDPHE's Office of Public Health Practice, Planning, and Local Partnerships (OPHP), CALPHO conducted a workforce gap and needs assessment in early 2023.  Download the final report. 

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Colorado's Core Public Health Services

Building on lessons learned from several states that initiated similar efforts, we aligned Colorado's existing Core Public Health Services with the nationally-recognized Foundational Public Health Services framework. The framework defines a public health system that is more equitable, effective, accountable, collaborative, and adaptable through a “minimum package of services” that every local public health agency should provide. This package is suite of skills, programs, and activities that – because our health systems, economies, and communities are all interconnected - must be available everywhere for the system to work anywhere.

The 2008 Public Health Act mandated that each county or district agency must adopt the core services, but provided a loophole for lack of funds. As a result, A 2019 assessment found that the core public health services were only 61% implemented in Colorado. A key goal of Transformation is to reduce this implementation gap. ​​ Explore the Core Public Health Services.

​Core Public Health Services (CPHS) 2019 Needs Assessment

​After updating our Core Public Health Services in 2019, CALPHO and the Colorado Department of Public Health and Environment (CDPHE) contracted with Habile Consulting LLC to develop and conduct a comprehensive needs assessment to 1) Understand current statewide implementation and spending on core public health services, and 2) Estimate the cost to fully deliver core public health services statewide based on the current service delivery paradigm. ​

Download the overall report.
Download the executive summary. 

Some Key Findings

• The state of Colorado was approximately 61% implemented across the 12 CPHS.
• The service Access to and Linkage with Health Care and the capability Health Equity & Social Determinants of Health were the least implemented statewide.
• The capability Assessment & Planning (which includes data capacities) and the service Communicable Disease Prevention, Education & Control were the most implemented statewide.
• Colorado spent about $278 million on CPHS in 2018 (mostly through federal funding sources), and the assessment estimates that we would need to spend or allocate $188 million more to support full CPHS implementation.
• Underfunding is only part of the story.  The way public health is funded - through disease-specific federal programs with short-term cycles - undermines agencies' ability to be responsive to community-determined needs or urgent threats.