System Transformation

Contact Info
Center for Public Health Practice
651-201-3880
health.ophp@state.mn.us

Contact Info

Center for Public Health Practice
651-201-3880
health.ophp@state.mn.us
LPHA, MDH, SCHSAC

Funding for Foundational Public Health Responsibilities

Transforming the public health system in Minnesota

This webpage will be regularly updated with grant management processes and other instructions related to the grant.

During the 2023 session, the Minnesota Legislature allocated community health boards a total of $9,844,000 and tribes $535,000 to fulfill foundational public health responsibilities. This is ongoing, annual funding to strengthen local and tribal public health in Minnesota and is for foundational public health responsibilities first. For the full text of relevant statutes, see Minn. Stat. chapter 145A.131.

On this page
Eligible costs
Awards, invoices, and reporting
Webinars and office hours
Funding formula
Local match
Frequently asked questions

 

Eligible costs

Expenditure guide: Information on the Foundational Public Health Responsibilities (FPHR) Grant funding can be found in this document: Foundational Public Health Responsibilities Grant Expenditure Guide - Updated April 2024 (PDF). This document will be updated on an ongoing basis. Check frequently for updates.

Summary of activities within foundational public health responsibilities: Funding can be used to fulfill foundational public health responsibilities as defined in this factsheet: Foundational Public Health Responsibilities - National Headlines, Minnesota Activities (PDF).

Statute source: Minn. Stat. §145A.131  

Frequently asked questions related to eligible costs: 

 

Awards, invoices, and reporting

Community health boards can view their award amount funding here: 

Invoice template: Foundational Public Health Responsibilities Grant invoice (XLS)

 

Webinars and office hours

Webinar: Foundational Public Health Responsibilities Grant Rollout: This webinar covers an overview of the grant, how you'll share your workplan and budget with MDH, invoice information, and time for questions and answers. The meeting information, recording (when available), and slides can be found here: Webinar: Foundational Public Health Responsibilities Grant Rollout.

Webinar: Foundational Public Health Responsibilities Framework Overview: This recorded webinar can help you understand the framework of foundational public health responsibilities (capabilities and areas) and determine the scope of activities when designing your Foundational Public Health Responsibilities Grant workplan. 

Related: Community of practice for foundational public health responsibilities

 

Funding formula

On December 14, 2023, the Commissioner of Health approved the following funding formula recommended by State Community Health Services Advisory Committee (SCHSAC):  

  • Base annual funding of $115,000 to each community health board
  • Allocate 60% of remaining funds based on social vulnerability index (SVI)
  • Allocate 40% of remaining funds based on capacity to community health boards serving fewer than 100,000 people  

This means that, overall, 59.6% of the foundational funds are allocated to base funding, 24.3% to social vulnerability index, and 16.2% to capacity.

Read the SCHSAC Foundational Public Health Responsibilities Workgroup report.

Frequently asked questions related to the funding formula:

 

Local match

Community health boards must provide a match of at least 75% of the new foundational public health responsibilities funding, as is required for the Local Public Health Grant.  

The match sources are the same for the Local Public Health Grant. This includes the following as described in MN Statute 145A.131, Subd 2: (b) Eligible funds must be used to meet match requirements. Eligible funds include funds from local property taxes, reimbursements from third parties, fees, other local funds, and donations or nonfederal grants that are used for community health services described in section 145A.02, subdivision 6. 

Frequently asked questions related to match funds: 

 

Frequently asked questions

When will we know what community health boards can spend this funding on?  

This funding should be spent on foundational public health responsibilities as defined in the Foundational Public Health Responsibilities - National Headlines, Minnesota Activities fact sheet. Foundational public health responsibilities are the minimum package of public health responsibilities that governmental public health should deliver to communities, which should be available everywhere for public health to work anywhere. It includes foundational capabilities and foundational areas that must be available to all people served by the governmental public health system and that meet one or more of the following criteria:

  • Foundational responsibilities that are mandated by federal or state laws;
  • Foundational responsibilities for which the governmental public health system is the only or primary provider of the service, statewide; and
  • Population-based foundational responsibilities (versus individual services) that are focused on disease prevention, protection, and health promotion.  

Foundational capabilities are cross-cutting skills, abilities, and knowledge needed in any governmental public health system to provide basic public health protections. Foundational areas are the more familiar topic-specific public health programs or responsibilities aimed at improving the health of a population.

How will MDH share changes and updates with us?  

MDH will notify you of updates and important information via email, meetings, the CHS-PHN email list, and this webpage.

Do community health boards need to apply for these funds?  

No. The funding is noncompetitive, and there is no application. Community health boards will be allocated funding based on the foundational public health responsibilities funding formula noted above.  

Is the foundational public health responsibilities funding one-time funding? 

No. The foundational public health responsibilities funding is base funding and an annual appropriation that the commissioner and SCHSAC hope will grow in the future.  

This funding is a down payment on Minnesota’s public health system.  MDH and SCHSAC recognize that current funding levels are not sufficient to meet the needs of Minnesota's statewide public health system and are committed to advocating for its growth over time.  

Who is eligible for the foundational public health responsibilities funding?  

Community health boards. Tribes will receive funding for Tribal public health infrastructure separately.

Can the same match be used for both the LPH Grant and the FPHR Grant?

No. The match cannot be used for both the LPH Grant and the FPHR Grant. The matching funding sources can be the same; however, they cannot be counted twice. For example, if your LPH Grant award is $100,000 and your FPHR Grant award is $100,000. You need to have a 75% match for $200,000 (or $150,000 in matching funds). With this example, you have $175,000 to spend on the award and the match, but only $100,000 needs to be spent on FPHR, and the $75,000 can be spent on other community health services.

Does the match funding need to be used for foundational public health responsibilities activities or grant duties?

No, the overall goal of PH system transformation is a system where state or federal funds support foundational activities and that local funds be used to support “community specific services.” For this reason, the local match can be used to support those “community-specific services.” That said, we realize that current state funding is not enough to fully support foundational public health responsibilities. For this reason, community health boards can use the match to support foundational public health responsibilities if they choose. 

If we cannot spend all our money, what is the match? Do we match the 75% of what we can spend or the award?

You would need to match 75% of the FPHR funds you spend. 

Can these funds be carried forward? 

FPHR funds remaining as of December 31, 2024, may be carried forward; however, these carry-forward funds must be spent by June 30, 2025. 

Are national conferences an allowable expense? 

It would depend on how conference content relates to foundational public health responsibilities (FPHR) work and how staff attending intends to use conference learnings to advance local FPHR work. You can discuss these requests with the FPHR Grant manager, Heather Myhre: heather.myhre@state.mn.us. Any national conference would require prior approval for out-of-state travel.

How does the foundational public health responsibilities funding relate to public health system transformation efforts?  

In the 2021 legislative session, the Minnesota Legislature allocated resources to support the first steps of public health systems transformation. In 2023, the Joint Leadership Team submitted a progress report and a list of recommendations: Transforming Minnesota’s Public Health System for the 21st Century: Report to the Legislature (PDF).  

The foundational public health responsibility funding was developed based on a recommendation that more funding be allocated to community health boards to carry out foundational public health responsibilities.  

Who helped decide the funding formula? What did they use to inform their decision?  

The SCHSAC Foundational Public Health Responsibility (FPHR) Funding Workgroup created the formula based on principles all group members agreed upon, including base funding, social vulnerability index, and a capacity factor, with an eye toward reporting and accountability mechanisms.

Workgroup membership was formed with the following criteria:  

  • Co-chaired by an elected official and a local health director from two different community health boards
  • At least four elected officials
  • CHS administrator or local health director from each of the seven Local Public Health Association regions, who will be responsible for communicating with and gathering input from other administrators and directors from their region
  • Representation from a variety of community health board governance and organizational structures
  • Maximum of 15 participants
  • Staff support and technical expertise from MDH’s Community Health Division and Center for Public Health Practice

Nick Kelley (Bloomington Public Health Administrator) and De Malterer (Waseca County commissioner) co-chair the workgroup.  

For more information about this workgroup, including meeting notes and a full roster of members, visit: Standing and active SCHSAC workgroups.  

What guiding principles did this workgroup use to determine the funding formula?  

  • Every community health board should get enough funding to make meaningful progress on Foundational Public Health Responsibilities.
  • The funding formula should take into account that not everyone has the same opportunity to be healthy across our state.  
  • The funding formula should help alleviate variation in capacity across our system. 

What is the social vulnerability index, and how is it used in the foundational public health responsibilities funding formula?  

The social vulnerability index (SVI) is a tool to identify socially vulnerable communities. The SCHSAC workgroup obtained SVI scores from the CDC’s Agency for Toxic Substances and Disease Registry (ATSDR): CDC/ATSDR Social Vulnerability Index (SVI) | Place and Health | ATSDR. The most current data is from 2020.  

Methods:  

The CDC assigns each county an SVI of 0 to 1, with 0 being the lowest vulnerability and 1 being the highest. Community health boards receive a score based on their quartile ranking. Multi-county community health boards receive the score based on their highest SVI county.

Social Vulnerability Index Ranking, Quartiles, and Scores 

  • For city-based CHBs, MDH staff recorded SVI rankings by census tract for each community health board. The community health board was assigned the SVI score associated with their highest-ranking census tract. MDH then recorded the census tracts in the remaining parts of Hennepin County. Hennepin County’s SVI is based on the highest-ranking remaining census tract.  
  • The method for including SVI for foundational public health responsibilities funding is consistent with the scoring used for Public Health Emergency Preparedness funding.  

Community health boards can view their SVI score here: Social Vulnerability Index Scores for Community Health Boards (PDF)

How does capacity factor in the funding formula work?  

The SCHSAC Foundational Public Health Responsibilities Funding Workgroup felt strongly that the funds should help alleviate capacity variation across the state’s public health system. To guide this approach, the workgroup recommended using a capacity measure in the foundational responsibilities funding formula based on findings from the 2022 cost and capacity assessment conducted by the University of Minnesota: health departments serving more than 100,000 people scored higher in their ability (capacity) to fully implement foundational public health responsibilities.  

As such, the workgroup’s funding formula includes the following:  

  • If a multi-county community health board had any counties with over 100,000 people, it did not receive the capacity funding.  
  • If a multi-county community health board did not have any counties over 100,000 people, it received the capacity funding. This was true even if the total population of the community health board exceeded 100,000 people. This is because the 2022 cost and capacity assessment was conducted at the local health department level, not the community health board level.
  • Single-county, single-city, or county-city community health boards only received capacity funding if they serve less than 100,000 people.  

Why doesn’t the foundational public health responsibilities funding formula include additional funds for multi-county community health boards?  

The SCHSAC FPHR Funding workgroup voted against including a specific multi-county variable in the recommended funding formula, primarily because members did not see alignment between this approach and the guiding principles developed for this funding. Other reasons included:  

  • The workgroup believes a large base will make a more meaningful difference in our ability to fill in the patchwork of capacity than a multi-county incentive.
  • There are other funding sources available to foster multi-county and cross-jurisdictional collaboration, including the Minnesota Public Health Infrastructure Fund. No funding source discourages collaboration across jurisdictions.
  • Breaking up small amounts of money even further is not in the interest of small health departments. Money alone does not incentivize collaboration.  
  • These new funds give us an opportunity to question the things we’ve always done and do things differently.

What specifically changed in statute regarding this funding during the 2023 legislative session?  

The statutory reference is the Local Public Health Act: Sec. 145A.131 MN Statutes. See below for an overview of the changes to existing statutory language. Strikeouts are deleted language, and underscores are added language. 

Revisions to 145A.131

Minnesota Statutes 2022, section 145A.131, subdivision 1, is amended to read:

Subd. 1.

Funding formula for community health boards.

a.) Base funding for each community health board eligible for a local public health grant under section 145A.03, subdivision 7, shall be determined by each community health board's fiscal year 2003 allocations, prior to unallotment, for the following grant programs: community health services subsidy; state and federal maternal and child health special projects grants; family home visiting grants; TANF MN ENABL grants; TANF youth risk behavior grants; and available women, infants, and children grant funds in fiscal year 2003, prior to unallotment, distributed based on the proportion of WIC participants served in fiscal year 2003 within the CHS service area.

b.) Base funding for a community health board eligible for a local public health grant under section 145A.03, subdivision 7, as determined in paragraph (a), shall be adjusted by the percentage difference between the base, as calculated in paragraph (a), and the funding available for the local public health grant.

c.) Multicounty or multicity community health boards shall receive a local partnership base of up to $5,000 per year for each county or city in the case of a multicity community health board included in the community health board.

d.) The State Community Health Services Advisory Committee may recommend a formula to the commissioner to use in distributing funds to community health boards.

e.) Notwithstanding any adjustment in paragraph (b), community health boards, all or a portion of which are located outside of the counties of Anoka, Chisago, Carver, Dakota, Hennepin, Isanti, Ramsey, Scott, Sherburne, Washington, and Wright, are eligible to receive an increase equal to ten percent of the grant award to the community health board under paragraph (a) starting July 1, 2015. The increase in calendar year 2015 shall be prorated for the last six months of the year. For calendar years beginning on or after January 1, 2016, the amount distributed under this paragraph shall be adjusted each year based on available funding and the number of eligible community health boards.

f.) Funding for foundational public health responsibilities must be distributed based on a formula determined by the commissioner in consultation with the State Community Health Services Advisory Committee. These funds must be used as described in subdivision 5. 

Minnesota Statutes 2022, section 145A.131, subdivision 2, is amended to read:

Subd. 2.

Local match.

a.) A community health board that receives a local public health grant shall provide at least a 75 percent match for the state funds received through the local public health grant described in subdivision 1 and subject to paragraphs (b) to (d)(f).

b.) Eligible funds must be used to meet match requirements. Eligible funds include funds from local property taxes, reimbursements from third parties, fees, other local funds, and donations or nonfederal grants that are used for community health services described in section 145A.02, subdivision 6.

c.) When the amount of local matching funds for a community health board is less than the amount required under paragraph (a), the local public health grant provided for that community health board under this section shall be reduced proportionally.

d.) A city organized under the provision of sections 145A.03 to 145A.131 that levies a tax for provision of community health services is exempt from any county levy for the same services to the extent of the levy imposed by the city.

Minnesota Statutes 2022, section 145A.131, subdivision 5, is amended to read:

Subd. 5.

Use of funds.

a.) Community health boards may use the base funding of their local public health grant funds as described in subdivision 1, paragraphs (a) to (e), to address the areas of public health responsibility and local priorities developed through the community health assessment and community health improvement planning process.

b.) Except as otherwise provided in this paragraph, funding for foundational public health responsibilities as described in subdivision 1, paragraph (f), must be used to fulfill foundational public health responsibilities as defined by the commissioner in consultation with the state community health service advisory committee. If a community health board can demonstrate foundational public health responsibilities are fulfilled, the board may use funds for local priorities developed through the community health assessment and community health improvement planning process. 

Who can I contact for more information about the foundational public health responsibility funding?

Please contact the Center for Public Health Practice at health.ophp@state.mn.us for more information.

Tags
Last Updated: 10/18/2024