Glossary and Resources for the Local Health Department Strategy
Governance: Public health governance structures indicate the relationship between state health agencies and regional/local public health departments. Governance structures vary from state to state and are typically classified by centralized, decentralized, shared, or mixed. The NACCHO 2019 National Profile of Local Health Departments classifies governance structures as the following:
- Centralized Governance/State Governed: LHDs are units of the state health agency and are primarily led by employees of the state. The state retains authority of most fiscal decisions.
- Decentralized Governance/Locally Governed: LHDs are units of local government. LHDs are primarily led by employees of local government and the local government retains authority over most fiscal decisions.
- Mixed Governance: LHDs have more than one governance type
- Shared Governance: LHDs are governed by both state and local authorities. LHDs may be led by employees of the state or local government. If they are led by state employees, then local government has authority to make fiscal decisions and/or issue public health orders.
Local Health Department (LHD): an administrative or service unit of local or state government concerned with health and carrying out some responsibility for the health of a jurisdiction smaller than the state. Please note: for convenience, throughout the strategy we will refer to any local health entities who have responsibility for HAI/AR prevention, control, and response as local health departments (LHDs) even though your jurisdiction may refer to them as other entities.
Local Jurisdiction: The government or legal body that has the authority to make legal pronouncements and administer justice to individuals and companies who are conducting transactions within a given geographical location.
Size of Population Served: The NACCHO 2019 National Profile of Local Health Departments classifies small, medium, and large LHDs as the following:
- Small Populations: LHDs serving populations of less than 50,000 people, typically within small counties, cities, or towns.
- Medium Populations: LHDs serving populations between 50,000 and 500,000 people.
- Large Populations: LHDs serving populations of more than 500,000 people, typically serving a county or multiple counties.
Operational Capacity: The internal capacity at LHDs, including their staffing, resources, infrastructure, policies, and other foundational components that enable LHDs to perform HAI/AR activities.
Partner Networks: Any HAI/AR collaboration between two or more partners working to advance HAI/AR program effectiveness and sustainability.
Programmatic Activities: The programmatic activities at LHDs represents the day-to-day HAI/AR activities that LHD staff conduct. This includes surveillance, prevention, containment, and response for HAI pathogens and stewardship.
Association for Professionals in Infection Control and Epidemiology (APIC)
APIC is a professional association for infection preventionists (IPs) with more than 15,000 members. They work to advance the science and practice of infection prevention and control and offer a variety of infection prevention resources.
CDC HAI Resources
The Centers for Disease Control and Prevention (CDC) is committed to protecting patients and healthcare personnel from adverse healthcare events and promoting safety, quality, and value in healthcare delivery. Preventing healthcare-associated infections (HAIs) is a top priority for CDC and its partners in public health and healthcare. The CDC website contains information on HAI data, types of infections, guidance documents, and more.
CDC Antibiotic/Antimicrobial Resistance (AR/AMR) Resources
CDC leads the U.S. public health response to combat antibiotic resistance, a threat that can continuously emerge and spread across the world. CDC’s Antibiotic Resistance Solutions Initiative invests in national infrastructure to detect, respond, contain, and prevent resistant infections across healthcare settings, communities, the food supply, and the environment (water, soil). The CDC website contains information on AR, actions to fight AR, data, and more.
Core Competencies for Public Health Professionals
The Core Competencies for Public Health Professionals are a consensus set of knowledge and skills for the broad practice of public health, as defined by the 10 Essential Public Services. Developed by the Council on Linkages Between Academia and Public Health Practice (Council on Linkages), the Core Competencies reflect foundational or crosscutting knowledge and skills for professionals engaging in the practice, education, and research of public health.
Council for Outbreak Response: Healthcare-Associated Infections and Antimicrobial-Resistant Pathogens (CORHA)
The Council for Outbreak Response: Healthcare-Associated Infections (HAIs) and Antimicrobial-Resistant Pathogens (AR) works to improve practices and policies at the local, state, and national levels for the detection, investigation, control, and prevention of HAI/AR outbreaks across the healthcare continuum.
Council of State and Territorial Epidemiologists (CSTE)
CSTE offers an abundance of resources that have been developed to support practicing epidemiologists in a wide range of areas, including infectious disease.
Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC) Cooperative Agreement
Since 1995, the Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC) Cooperative Agreement has been critical to U.S. health departments’ ability to combat infectious diseases. While beginning with only 10 recipients, that number incrementally grew, reaching the current complement of 64 jurisdictions in 2012. For a quarter-century, the ELC cooperative agreement has provided hundreds of millions each year to all 50 states, several large local health departments, and U.S. territories and affiliates to detect, respond to, control, and prevent infectious diseases.
National Association of County and City Health Officials (NACCHO) HAI/AR Resources
NACCHO has developed several tools and resources dedicated to helping local health departments prevent and control HAIs. Their HAI webpage includes several tools and resources, webinars, and perspectives from the field.
National Healthcare Safety Network (NHSN)
CDC’s National Healthcare Safety Network is the nation’s most widely used healthcare-associated infection tracking system. NHSN provides facilities, states, regions, and the nation with data needed to identify problem areas, measure progress of prevention efforts, and ultimately eliminate healthcare-associated infections. In addition, NHSN allows healthcare facilities to track blood safety errors and important healthcare process measures such as healthcare personnel influenza vaccine status and infection control adherence rates.
- NHSN Data Use Agreements (DUA) Standard Operating Procedure (SOP) [PDF – 2 Pages]
- DUA FAQs for Health Departments and Facilities
- Recording | NHSN Overview Presentation to BLOC COVID-19 Demonstration Site Project
Nursing Home & Long-Term Care Facility Strike Team and Infrastructure Project Guidance [PDF – 12 Pages]
As part the American Rescue Plan Act of 2021, ‘Nursing Home & Long-term Care Facility Strike Team and Infrastructure Project’ provides funding to assist ELC recipients with supporting long-term care facilities during their response to SARS-CoV-2 infections, and also to build and maintain the infection prevention infrastructure necessary to support resident, visitor, and facility healthcare personnel safety. Nursing homes (skilled nursing facilities and nursing facilities) are the primary target for these funds. Other infectious diseases and conditions may be reasonably addressed to the extent they are in support of or related to work to control the spread of SARS-CoV-2. Monitoring the indicators associated with these activities will assist state, local, and territorial health departments to better understand and meet the needs of these facilities, as well as help define the scope and magnitude of infectious disease outbreaks in these settings.
CDC’s Project Firstline is a collaborative of diverse healthcare and public health partners that aims to provide engaging, innovative, and effective infection control training for millions of frontline U.S. healthcare workers as well as members of the public health workforce. Project Firstline’s innovative content is designed so that—regardless of a healthcare worker’s previous training or educational background— they can understand and confidently apply the infection control principles and protocols necessary to protect themselves, their facility, their family, and their community from infectious disease threats, such as COVID-19.
NACCHO’s Infection Prevention and Control Living Learning Network
NACCHO is developing a new Living Learning Network (LLN) to support local health department staff looking to build subject matter expertise related to infection prevention and control (IPC). The goal of this network is to bolster local health department capacity related to IPC by creating space for peer discussions, hosting expert presentations, and sharing CDC’s Project Firstline training materials. Meetings will occur on a bi-monthly schedule for one hour, starting in February 2022. LLN participants will also have access to a closed LLN group page within the NACCHO Virtual Communities platform where they may pose questions for group discussions as well as access and share resources. All local health departments are invited to participate and there is no limit to the number of staff from each health department that may join. If you are interested, complete this form to sign up to participate. For more information or questions, please email NACCHO at email@example.com.
Strengthening HAI/AR Program Capacity (SHARP) [PDF – 22 Pages]
As part the American Rescue Plan Act of 2021, ‘Strengthening HAI/AR Program Capacity’ supplement funds provide critical resources to state, local, and territorial health departments in support of a broad range of healthcare infection prevention and control (IPC) activities and epidemiologic surveillance related activities to detect, monitor, mitigate, and prevent the spread of SARS-CoV-2/COVID-19 in healthcare settings. These funds are managed through the ELC Cooperative Agreement and may also reasonably address other conditions in healthcare settings, such as healthcare associated infections (HAIs) and antimicrobial resistance (AR), which rely upon the same fundamental IPC and epidemiologic surveillance approaches that are used to detect, monitor, mitigate, and prevent the spread of SARS-CoV-2/COVID-19 in healthcare settings.
Success Framework for HAI/AR Partner Networks
The success framework guides users through questions aligned to four partner network stages to develop partner networks or identify areas for improving partner networks. The four partner network stages are:
- Determine Priorities
- Plan Approach
- Implement Activities
- Measure and Adjust
The following list catalogs available trainings referenced throughout the strategy that may be of use to your LHD.
- Antibiotic Prescribing and Use: Continuing Education and Resources | CDC
- Certificate of Training in Infection Prevention in the Long-Term Care Setting | APIC
- Certification of Infection Prevention and Control | CBIC
- Core Elements of Antibiotic Stewardship | CDC
- Health Equity Guiding Principles for Inclusive Communication | Gateway to Health Communication | CDC
- Health Equity and Social Justice Training Program | NACCHO
- NHSN Training | CDC
- NHSN Antimicrobial Use and Resistance (AUR) Option Training | CDC
- Nursing Home and Assisted Living Infection Prevention Training | CDC