Title
Authorize Acceptance of Additional Public Health Infrastructure and Workforce Grant Funding (Districts: All)
Body
Overview
The Strengthening U.S. Public Health Infrastructure, Workforce, and Data Systems grant (PHIG) is a groundbreaking investment that supports critical public health infrastructure needs of jurisdictions across the United States. This funding is intended to modernize public health jurisdictions to expand, improve, and strengthen public health services to better prepare and respond to future emergencies. The County of San Diego (County) Public Health Services Department (PHS) aligns with this action through its commitment to promote health and improve quality of life by preventing disease, injury and disability and by protecting against and responding to health threats and disasters.
On January 24, 2023 (07), the San Diego County Board of Supervisors (Board) authorized the acceptance of $33,336,020 in Strengthening U.S. Public Health Infrastructure, Workforce, and Data Systems from the Centers for Disease Control and Prevention (CDC) for the term of December 1, 2022, through November 30, 2027. The $33,336,020 included $27,007,405 for PHIG Strategy A1: Workforce and $6,328,615 for PHIG Strategy A2: Foundational Capabilities.
For PHIG Strategy A2: Foundational Capabilities, the actual award is more than the originally anticipated amount. With this additional funding, the County has exceeded the amount authorized in the prior Board action. This funding will enable us to sustain our current Public Health Infrastructure Initiatives by maintaining existing staff levels and supporting efforts necessary to continue delivering critical services. It will also ensure uninterrupted implementation of program activities while preserving the capacity needed to meet project objectives and community needs.
Today’s action requests the Board authorize the acceptance of an additional estimated $3,799,610 in funding for PHIG Strategy A2: Foundational Capabilities, for a revised award amount of $10,128,225 for the period of December 1, 2022 through November 30, 2027 and to apply for additional funding opportunities to further develop and strengthen the public health workforce.
Today's action supports the County vision of a just, sustainable, and resilient future for all, specifically, those communities and populations in San Diego County that have been historically left behind as well as our ongoing commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities. This will be accomplished by ensuring the local health department can continue to proficiently improve the health and well-being of San Diego County residents
Recommendation by Chief Administrative Officer:
1) Authorize acceptance of an additional estimated $3,799,610 in Strengthening U.S. Public Health Infrastructure, Workforce, and Data Systems Grant-Strategy A2: Foundational Capabilities from the Centers for Disease Control and Prevention, for a revised total award of $10,128,225 for the period of December 1, 2022, through November 30, 2027, to modernize public health jurisdictions to expand, improve, and strengthen public health services to better prepare and respond to future emergencies, and authorize the Chief Administrative Officer, or designee, to execute all required funding documents, upon receipt, including any extensions, amendments, and/or revisions thereto that do not materially impact or alter the services or funding level.
2) Authorize the Chief Administrative Officer, or designee, to apply for any additional funding opportunities, if available, to further develop and strengthen the public health workforce and infrastructure.
Equity Impact Statement
The COVID-19 pandemic highlighted the importance of a robust public health workforce to address historical and current health inequities and disparities. In 2020, the Centers for Disease Control and Prevention (CDC) updated the 10 Essential Public Health Services framework, with ‘equity’ as the center. In 2021 the Council on Linkages updated the Core Competencies for Public Health Professionals to include a health equity skills domain. Additionally, in 2022 the Foundational Capabilities of Public Health were updated by the Public Health National Center for Innovations, and equity was underscored as a key component and foundational element of the capabilities. As such, the County of San Diego (County) Health and Human Services Agency, Public Health Services (PHS) intends to strengthen foundational capabilities through training, technical assistance, working group meetings, sharing of tools and resources as well as program and project-based efforts.
The health equity goal of the grant funding will support local equity advancements in the community, improve data and health literacy, and provide access to participate in a national health equity working group to share best practices. In addition, PHS will expand the provision of forums and opportunities for direct access, conversation, and engagement with communities to identify and understand key health needs, gaps, and opportunities. Through the Strengthening U.S. Public Health Infrastructure, Workforce, and Data Systems grant, PHS will have the opportunity to be part of a national consortium of experts on health equity with other local health departments and the CDC. Acceptance of this grant funding allows for a more robust public health workforce to advance health equity, diversity, and inclusion in San Diego County. Grant funds will also assist the County’s public health workforce to receive training in the ten essential services, foundational capabilities, and core competencies, including equity skills such as data literacy, health literacy, cultural responsiveness, and racial equity.
Sustainability Impact Statement
Today’s action supports the County of San Diego (County) Sustainability Goal #1 to collaborate with community partners and advocate for environmental justice for communities that have been disproportionately impacted by pandemics, such as COVID-19, by expanding the provision of forums and opportunities for direct access, conversation, and engagement with communities and populations to identify and understand key health needs, gaps, and opportunities. Additionally, today’s action supports Sustainability Goal #2 to provide just and equitable access to services and Sustainability Goal #4 to protect health and wellbeing of everyone in the region by sustaining the capacity of the County Health and Human Services Agency, Public Health Services to support the region during public health emergencies or infectious disease outbreaks.
Fiscal Impact
Funds for this request are included in the Fiscal Year (FY) 2026-28 Operational Plan in the Health and Human Services Agency. If approved, this request will result in estimated costs and revenue of $2,217,517 in FY 2026-27 and estimated costs and revenue of $925,437 in FY 2027-28. This additional grant funding of $3,799,610 would bring the total grant award to $10,128,225. The funding source is the Centers for Disease Control and Prevention’s Strengthening U.S. Public Health Infrastructure, Workforce, and Data Systems grant. There will be no change in net General Fund cost and no additional staff years.
Business Impact Statement
N/A
Details
Advisory Board Statement
The Health Services Advisory Board recommended approval of the recommendations at their meeting on July 21, 2026.
Background
The COVID-19 pandemic accentuated the disparities and gaps in the U.S. public health infrastructure and demonstrated the critical importance of a strong public health system for future public health emergencies. A robust U.S. public health system depends on multiple factors, some of which include sufficient and sustained funding, expanded preparedness for future public health emergencies, and a diverse, well-trained, and supported workforce. The Centers for Disease Control and Prevention (CDC) developed the Strengthening U.S. Public Health Infrastructure, Workforce, and Data Systems grant (PHIG) to address some of these factors. All program work conducted as part of this grant falls under two strategies: Strategy A1: Workforce and Strategy A2: Foundational Capabilities. All work done as part of this grant has been grounded on three key principles: 1) Data and evidence driving planning and implementation; 2) partnerships playing a critical role in grant program success; and 3) the imperative to continue to direct these resources in a way that supports diversity and health equity.
The County of San Diego (County) Health and Human Services Agency (HHSA), Public Health Services (PHS) utilizes this grant to secure additional years of support for staff years currently funded through the Epidemiology Laboratory Capacity Enhancing Detection Original & Expansion grant (ELC), as approved by the San Diego County Board of Supervisors (Board) on September 15, 2020 (7) and April 6, 2021 (5). The ELC funding is one-time COVID-19 funding and will end on July 31, 2026. This funding provides resources needed to build a sustainable workforce, recruit and retain appropriate staffing levels, provide necessary training to ensure staff have the tools necessary to do their jobs efficiently and position our local health jurisdiction to respond more efficiently to a public health crisis, such as COVID-19. The flexibility of this grant allows us to focus on the specific needs of the County of San Diego and the community we serve.
Under Strategy A2: Foundational Capabilities, the County is improving infrastructure systems, processes, and policies by strengthening the public health foundational capabilities. PHS is achieving this goal through the following three CDC key activity areas:
1. Accountability/performance management/agency accreditation. PHS applied for reaccreditation in 2022 and will use the grant period to strengthen its accreditation status and process and prepare for the next round of reaccreditation.
2. Organizational administrative competencies. PHS will continue to assess its foundational capabilities of financial management, contract, and procurement services, including facilities and operations, and information technology services. The assessments will be used to inform, develop, and implement plans to improve the administrative competencies across PHS.
3. Community partnership. PHS will continue working collaboratively across the county to strengthen and align the Community Health Worker model aimed at identifying, prioritizing, and addressing key health needs during public health emergencies.
Additionally, this grant provides the unique opportunity to address the gaps identified during the COVID-19 pandemic, particularly as they relate to mobilizing during future public health emergencies and addressing inequities. Activities proposed under Strategy A1: Workforce -have resulted in short-term outcomes of increased hiring of diverse public health staff and improved employee wellness; and intermediate outcomes of an increased size of the public health workforce and higher retention of public health staff.
PHS, supported by the PHIG, is expanding opportunities for future public health professionals by partnering with local colleges and universities. Recent efforts include hosting a public health orientation for medical residents, completing a pilot internship program with 15 students, and establishing more than 20 partnerships with schools across the region. PHS also took part in major career events-reaching over 300 students at California State University San Marcos-and continue to engage students through high school outreach activities.
PHIG resources have helped PHS strengthen employee training, leadership development, and engagement. This included improved key training programs, boosted completion rates, expanded virtual and on‑demand options, and achieved 98% completion of FEMA-required courses. These resources also support the Training Champions group, staff development efforts, and tools that track training progress. In addition, PHIG supports leadership resources and employee engagement activities like surveys and focus groups to better support staff. These efforts, backed by staff development tools and employee feedback, help ensure the PHS team is well‑prepared, supported, and equipped to protect community health and respond effectively to emerging needs
Activities proposed under Strategy A2: Foundational Capabilities will continue to support current short-term outcomes of improved organizational systems and processes, and intermediate outcomes of stronger public health foundational capabilities.
This strategy supports several key activities, including creating an annual Public Health Advocate Camp for high school students, strengthening PHS accreditation processes, and improving emergency preparedness through partnerships like the Regional Disaster Healthcare Coalition. PHS also works with community partners to plan events such as an excessive heat conference.
In addition, PHS continues to enhance the ability to analyze data and inform public health decisions, aligning with national accreditation standards. The Spatial Epidemiology Team provides population health data to support Board of Supervisors initiatives.
The PHIG supports 78 staff, including 15 positions under Strategy A2. These roles span several professional areas, such as public health nursing, epidemiology and data analysis, laboratory science, emergency medical services, program and community health coordination, staff development, information technology, and administrative support. Together, these teams help strengthen the County’s ability to serve the community.
Today’s action requests the Board authorize the acceptance of an estimated $3,799,610 in additional funding from CDC for PHIG-Strategy A2: Foundational Capabilities, for a revised cumulative total of $10,128,225 for the period of December 1, 2022, through November 30, 2027. This additional funding of $3,799,610 is a result of supplemental funding available by funder.
Linkage To The County Of San Diego Strategic Plan
Today’s proposed action supports the Equity (Health) and Community (Quality of Life) initiatives in the County of San Diego’s 2026-2031 Strategic Plan, as well as our commitment to the regional Live Well San Diego vision of healthy, safe and thriving communities. This is accomplished by ensuring that San Diego County is able to respond to future emergencies by developing and strengthening the public health workforce.
Respectfully submitted,
ebony n. shelton
Chief Administrative Officer
Attachment(s)
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