Health Department HAI/AR Programs

Key points

  • CDC funds a network of 64 health department Healthcare-associated Infections and Antimicrobial Resistance (HAI/AR) Programs to detect, prevent and respond to HAI/AR.
  • Programs improve and protect healthcare safety and promote quality of care for all.


CDC provides technical expertise and funding to HAI/AR Programs in 64 state, local and territorial health departments.

HAI/AR Program goals are to:

  • Prevent the emergence of and control the spread of HAIs and related AR threats.
  • Advance the detection, response and containment of antimicrobial resistance (AR) within healthcare settings.
  • Promote antibiotic stewardship (AS), the practice of measuring and improving how providers prescribe antibiotics and patients use them.
  • Protect patients and healthcare personnel.
  • Improve healthcare safety and quality.

Why it matters‎

On any given day, about one in 31 hospital patients has at least one HAI.

Each year, more than 2.8 million antimicrobial-resistant infections occur in the U.S. More than 35,000 people die as a result.

It costs more than $4.6 billion a year to treat infections caused by antimicrobial-resistant germs.

CDC estimates that U.S. doctors' offices and emergency departments prescribe about 47 million antibiotic courses each year for infections that don't need antibiotics.1

Program priorities

CDC-funded HAI/AR Programs conduct activities in five important areas. Examples include:

HAI/AR response and prevention

  • Prevent the emergence and contain the spread of novel and targeted healthcare-related multidrug-resistant organisms (MDROs).
  • Respond to HAI outbreaks, including COVID-19.
  • Assess healthcare facility infection prevention and control (IPC) practices, recommend solutions and address gaps.
  • Use data-driven prevention strategies to improve IPC in healthcare settings.
  • Improve response and prevention coordination between partners like labs, local health departments, licensing entities, healthcare facilities and academic institutions.

Antibiotic stewardship

  • Help healthcare facilities launch and improve antibiotic stewardship.
  • Track and report antibiotic use, including equity-related gaps.
  • Coordinate stewardship with academic institutions, regulatory agencies, payors, healthcare systems, health departments and more.
  • Improve stewardship in newer healthcare services, like telehealth.

Participation in and support of CDC's Antimicrobial Resistance Laboratory Network (AR Lab Network)

  • Support comprehensive AR testing for HAIs as part of the AR Lab Network.
  • Submit isolates (samples) of interest to AR Lab Network regional labs or CDC for testing as required.
  • Train and guide laboratory personnel testing for AR among HAIs.

Infection prevention and control education and training

  • Improve healthcare workers' knowledge of current IPC best practices and strategies through programs like Project Firstline.
  • Coordinate IPC education for local health departments, academic institutions and healthcare organizations.
  • Conduct, analyze and leverage healthcare facility needs assessments to provide training that addresses knowledge gaps.

Increased participation in and use of the National Healthcare Safety Network (NHSN)

  • Help healthcare facilities enroll and report into NHSN.
  • Monitor and use data to inform public health efforts and interventions.
  • Establish data use agreements with local health departments to enable their use of NHSN.
  • Partner with academic institutions to validate studies of patient HAI data and improve prevention efforts with their findings.
Keep Reading: NHSN


Since August 2019, recipient health departments used CDC funding to:

  • Engage more than 15,000 healthcare workers in antibiotic stewardship.
  • Train more than 100,000 healthcare workers in infection prevention and control (IPC).
  • Conduct more than 65,000 IPC assessments in healthcare facilities.
  • Support more than 120,000 outbreak responses in healthcare facilities.

Recipient spotlight

Kansas addresses staffing shortages with CDC support

Kansas' Department of Health and Environment (KDHE) HAI/AR Program has become a nationally recognized model for other health departments. Within the past few years, they have been able to:

  • Grow from a team of three to 24 highly trained members.
  • Conduct five times more IPC assessments in 2022 versus 2019.
  • Foster stronger relationships with healthcare partners.
  • Improve infection prevention in healthcare facilities.
  • Increase staff HAI/AR specialization.
  • Receive recognition from Council of State and Territorial Epidemiologists (CSTE), Pew Charitable Trust, the Association of State and Territorial Health Officials (ASTHO), and more.

Health departments like KDHE use CDC funding to better serve their communities, creating a safer healthcare system for all.


In 2009, the United States Department of Health and Human Services (HHS) Steering Committee for the Prevention of Healthcare-Associated Infections published the HHS Action Plan to Prevent Healthcare-Associated Infections. It is a roadmap for HAI prevention in acute care hospitals. The plan outlined expanded roles for health departments including coordinating, assisting, monitoring HAI/AR tracking, and prevention and response activities. CDC manages funding to health departments to help expand their contributions in these key areas as well as support implementation of the National Action Plan to Combat Antibiotic-resistant Bacteria, 2020-2025.

Funding sources

CDC administers HAI/AR Program funding through the CDC's Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases Cooperative Agreement (ELC). The HAI/AR Program is one of the largest ELC Core Area Programs.

Between 2020 and 2022, CDC distributed more than $1 billion of COVID-19 supplemental appropriations to strengthen and equip health departments to prevent and fight infections like COVID-19 in healthcare facilities.

Funding recipients

Recipients include:

  • All 50 state health departments.
  • Six local health departments: Chicago, the District of Columbia, Houston, Los Angeles, New York City and Philadelphia.
  • Eight U.S. territory or affiliate health departments: American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Palau, Puerto Rico, Republic of the Marshall Islands and the U.S. Virgin Islands.

To learn more about a recipient health department's HAI/AR Program or to contact their HAI/AR Program Manager, visit their website by clicking the map below.


Recipient resources

  1. CDC. Antibiotic Resistance Threats in the United States, 2019. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 2019.