1043: PHIG Funds Critical Services in New Hampshire

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This is Public Health Review
Morning Edition for Tuesday,

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December 16th, 2025.
I'm John Sheehan with news from

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the Association of State and
Territorial Health Officials.

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Today, another installment of
the FIG Impact report showcasing

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the Public Health Infrastructure
Grant, or FIG, and how public

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health colleagues across the
nation are using it to improve

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the US public health system.
Today, ASTO Member Patricia

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Tilley, she serves as the
Associate Commissioner of the

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New Hampshire Department of
Health and Human Services, where

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she describes big funding as
having been a game changer.

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You know, at our core, our job
is to assess the ever evolving

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world around us.
And it is clear we need robust,

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dynamic, modern data systems and
infrastructure that give us real

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time access to the real needs of
our communities.

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And it isn't good enough anymore
to precisely and slowly monitor

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and analyze change.
We need real time data access

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not just across infectious
diseases, but in every pocket of

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our work.
And we need the people to act on

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that information.
So like many states, we've used

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Fig to modernize our laboratory
capacity for both environmental

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health well as infectious
diseases.

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We've been building out our
immunization information systems

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to provide the best customer
service for both our healthcare

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providers and for the public.
And we're actively building a

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21st century environmental
health module which is focusing

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on lead poisoning and
radiological health and food

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safety and and supports for our
town based local health

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officers.
With FIG funding has come useful

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lessons.
The biggest lesson is how to not

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boil the ocean.
The flexibility of the funds is

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incredibly helpful for planning
and supporting critical services

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that never quite fit within the
context of a specific federal

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grant.
FIG really stands out in a

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public health agency like ours,
where 85% of the budget is from

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federal grants.
FIG smooths out the edges and

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provides support for critical
infrastructure that doesn't

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always fit in a box of other
funding.

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You know, we are always are
reminded that we can't do

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everything and there is no room
for duplication.

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But FIG really helps us connect
the dots.

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It's allowed us to not only
modernize our data, but it has

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allowed us to carefully plan for
what's most important for New

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Hampshire.
The Big's impact is felt

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locally, and New Hampshire has
used it to build local capacity.

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Based on our experience during
the pandemic, we invested in a

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state medical surge planner to
be our central coordinator to

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partner with healthcare
facilities and manage system

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shocks.
And so this planner recently

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worked with one of our most
northern and most rural

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hospitals right there on the
Canadian border to help work on

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their medical surge plan so that
they can respond to disasters

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even in those really remote
areas of the state.

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The local community up there
doesn't have access to high paid

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consultants.
It doesn't have, it's not

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connected to a big healthcare
system.

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But with our added capacity that
was supported by FIG, we could

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assist in them bringing their
teams together, bringing in the

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local community to make sure
that they were ready for it,

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anything that could happen.
We've also supported our two

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city health departments to
invest in additional local

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strategic planning to focus
where state plans don't always

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translate into the next steps
for them in their community.

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And we've also supported
important resources like

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community health workers that we
know that can be so impactful in

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those communities.
For me, what I think is one of

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the most interesting places
where we've focused is we've

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leveraged FIG with other
environmental health funding to

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replace hardware in childcare
facilities to reduce lead in

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their water.
So the environmental health

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funding pays for the hardware
and the plumbing and those

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direct services, but FIG
supports a public health staff

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member to coordinate outreach
with childcare facilities, all

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of which reduces the lead
exposure for for our youngest

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kids in our tiniest towns as
well as our our big cities.

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As ever, the need for
sustainable funding and public

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health is a constant.
There has never been a more

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important time for sustainable,
for consistent, for flexible

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resources.
You know, every jurisdiction,

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massive or tiny has unique needs
and local context and cookie

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cutter approaches disease by
disease.

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They just don't always work.
So in a tiny resource

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constrained live free or die
state like New Hampshire, we

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have really appreciated and will
continue to need the flexibility

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of resources that support robust
dynamic modern data systems and

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structure.
We need to understand our real

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time needs of our communities
and assess those changes to not

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just the long term trends, but
the near term evolutions which

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continue to happen.
Then FIG really supports the

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resilience of states like ours
to manage the ebbs and flows of

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federal and state policies and
it has helped us keep our

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service focus on servicing our
communities and our neighbors

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with the infrastructure they
expect.

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It is incredibly important to
have that consistency as we

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plan.
We do not function only in grant

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periods or in budget awards.
We need to be able to think

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strategically over years, and so
opportunities that we have had,

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like FIG, help us connect those
dots, help us maintain that

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vision so that we can think
about public health over the

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course of multiple years.
Asked a member.

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Patricia Tilley is the associate
commissioner of the New

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Hampshire Department of Health
and Human Services.

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You can learn about the Public
Health Infrastructure grant and

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the work that's underway by
visiting the FIG website.

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We have a link in the show
notes.

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This has been another FIG impact
report, part of the Public

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Health Review MORNING Edition.
I'm John Sheehan for the

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Association of State and
Territorial Health Officials.