Estimating the Costs of Foundational Capabilities for the Nation's Public Health System


The Institute of Medicine’s 2012 report on public health financing called for the convening of expert panels to identify the components of a “minimum package” of public health services and cross-cutting capabilities that should be available in every U.S. community to protect and improve population health, and to identify the resources required to make these services universally available across the country.  With support from the Robert Wood Johnson Foundation, an expert panel convened as the Public Health Leadership Forum developed a consensus set of Foundational Public Health Services (FPHS) delineating skills and capabilities that every state and local public health agency should have in place in order to protect and improve health status across the American population.  This study uses data from a diverse cohort of local and state public health agencies to estimate: (1) the current costs incurred by local and state agencies in implementing FPHS; (2) the expected costs that would be incurred by local and state agencies in fully attaining the FPHS recommendations as articulated by the Public Health Leadership Forum; and (3) the resource gap (shortfall) between current and expected costs that would require new resources to fully meet FPHS recommendations.   
NOTE: This is an unedited working paper and all errors and omissions are the responsibility of the authors. An earlier version of this manuscript was presented at the National Institutes of Health 8th Annual Conference on the Science of Dissemination and Implementation in Health, December 14-15, 2015, Washington, DC. A later version of this manuscript is currently under review at the journal Health Services Research. We thank members of the Public Health Leadership Forum and Resolve for helpful guidance and feedback on this research.


Journal Article
Submitted to Health Services Research
Mays GP, Mamaril CB