The nation’s local health departments (LHDs) are the cornerstone of the public health system. As essential parts of the communities they serve, LHDs play a critical role in clinical service provision, population health services, and emergency preparedness. They also function as the principal connectors across and among tribal, regional, and state public health departments, knitting together a more cohesive, integrated, national public health system. However, the COVID-19 pandemic tested the resiliency of LHDs as they scaled up communications, testing, contact tracing, and immunization. Stressors of the COVID-19 response highlighted longstanding issues that NACCHO has documented through our seven national surveys of LHDs: lack of timely, actionable; lack of nimble hiring, training, and retention systems; inability to sustain critical programs and policies in the face of competing demands; and the urgent need to tackle health inequities through sustained engagement with the most impacted communities. Response efforts also took a toll on staff, with LHDs experiencing pervasive harassment and staff reporting significant mental health concerns.
To address these issues, the National Association of County and City Health Officials (NACCHO) proposes using its strategic, three-tiered capacity building assistance (CBA) framework under the CDC Notice of Funding Opportunity (NOFO) CDC-RFA-PW-24-0080: Strengthening Public Health Systems and services through National Partnerships to Improve and Protect the Nation’s Health (Category A: Local Health Departments). NACCHO is the membership organization for the more than 3,300 LHDs across the United States and is the only entity that represents all of local public health, from small, rural LHDs to large urban agencies. For 30 years, NACCHO has consistently strengthened the nation’s LHDs in ways that meet the goals and five strategic areas of this NOFO. NACCHO’s CBA drives LHD practice through demonstration sites, in-person and virtual trainings, peer mentorship programs, and tools and resources LHDs use daily. NACCHO’s extensive knowledge of LHD diversity—across factors including size, funding, governance, and rurality/urbanicity—makes it the most trusted provider of CBA for all LHDs.