The Washington State Association of Counties, the collective voice of Washington’s counties for over one hundred years.

Foundational Public Health Services (FPHS)

The Problem

Washington’s governmental public health system has a critical and unique public safety role that is focused on protecting and improving the health of families and communities. Demand for public health services has increased with the changing nature of preventable diseases, the resurgence of “historical” diseases, and the surge of new public health threats; but there is also inequitable funding for services across the 35 local health jurisdictions.

The Solution

In 2015, the Washington State Department of Health and representatives of local health jurisdictions (LHJs), the Washington State Association of Counties, and other public health partners initiated work to develop a set of public health programs and services that every citizen should have access to – the Foundational Public Health Services (FPHS). The goal is to have a responsive and sustainable public health system and ensure healthy and economically vital communities across Washington. In 2018, local health jurisdictions, the State Department of Health, and the State Board of Health completed an assessment that produced a cost-estimate for fully funding FPHS. That estimate is $450 million a biennium.

Government Public Health System

The Request

The FPHS budget decision package for the 2019-2021 legislative session focuses on critical work in communicable disease control, environmental public health, and assessment and seeks to fund the governmental public health system. This package, for $100 million/ biennium, includes efforts such as:

  • Stabilizing LHJs to adapt and be nimble to changing public health issues such as Hepatitis C, wildfire smoke, and childhood lead poisoning.
  • Innovative approaches to service delivery, like the Washington State Tuberculosis Collaborative Network, making best use of public health technical experts.
  • Keeping kids safe by testing more at-risk kids for lead exposure and partnering with state and local agencies to find and replace fixtures leaching leads into school drinking water.
  • Helping growing counties across the state keep up with communicable disease cases by streamlining disease investigations and improving follow-up times.

Why This Helps Counties

Local governments and communities highly value public health. Often, local revenue is used to fund state required programs and services. With fully funded FPHS, local governments are empowered to use local revenue to implement public health services that address local contexts and health needs unique to their health jurisdiction. FPHS funding also provides stability for LHJs in funding services that are easily impacted by unpredictable events such as outbreaks, economic changes, and natural disasters.

Our Work Continues

Awarded in the 2017 Biennium Budget, an initial one-time investment of $12 million was allocated to the governmental public health system. Local health jurisdictions (LHJs) used a $10 million allocation to reinforce their local needs in communicable disease investigation, surveillance, and control as well as pilot three shared service projects that emphasized multi-jurisdictional sharing.

$12 Million Initial Investment:

Spending Detail Year 1 ($6M)

Piloted Shared Service Projects

Currently, statewide work includes developing the public health system implementation plan, assigning accountability measures, honing new and existing service delivery models, and aligning FPHS work to other statewide health initiatives including opiates, suicide prevention, and homelessness. Locally, FPHS funding has supported improvements in local health jurisdictions including:

  • Kitsap County: Improved response to communicable disease by streamlining disease tracking and assessment. This has helped staff improve client access to disease treatment and have faster disease follow-up to mitigate the severity of disease outbreaks.
  • Adams County: Provided essential training to new staff, enabling a swift and local response to communicable disease investigation in foodborne illness, tuberculosis, and STDs.
  • Pierce County: Working with local and state healthcare partners, the State Department of Health and the Centers for Disease Control and Prevention, the health department investigated a Hepatitis C outbreak. In total, the department notified 2,800 people, facilitated testing of exposed individuals, and identified 13 cases of confirmed disease.
  • Benton and Franklin Counties: Improved response for all infectious disease reports and eliminated a backlog of case reports, increased local tuberculosis response, and developed a food safety priority system to improve food safety efforts for over 1,300 permitted establishments.