Washington State Department of Health
The first recommendation in the report Public Health Forward: Modernizing the U.S. Public Health System calls for decision-makers to provide flexible funding, avoid issue-specific grants, and maximize existing assets to support public health services and capabilities, including those needed to address health inequities. The report charges departments with building accountability mechanisms to track how current funding is spent and the impact of that spending. Showing accountability helps public health practitioners to build the trust and political will needed to protect public health services.
Washington state has a decentralized governmental public health system comprising 35 autonomous local health jurisdictions under the authority of county government and local boards of health, a state department of health, a state board of health, and 29 federally recognized sovereign tribal nations and Indian health programs. The Foundational Public Health Services Steering Committee is the decision-making body for efforts to support the provision of foundational services across the state. Legislation passed with bipartisan support in 2019 (RCW 43.70.512 and 43.70.515) reflects recommendations from elected officials to mandate the provision of Foundational Public Health Services (FPHS). The accountability process described in this case study is part of Washington’s system-wide effort to secure and maintain adequate and stable funding for FPHS by demonstrating the value and impact of these services across the public health system.
Eleven neighboring local health departments in California have a resource-sharing arrangement that increases their capacity to provide foundational public health services to communities.