1043: PHIG Funds Critical Services in New Hampshire

JOHN SHEEHAN: 

This is Public Health Review Morning Edition for Tuesday, December 16, 2025. I'm John Sheehan, with news from the Association of State and Territorial Health Officials.

Today, another installment of the PHIG Impact Report showcasing the Public Health Infrastructure Grant, or PHIG, and how public health colleagues across the nation are using it to improve the U.S. public health system. Today: ASTHO member, Patricia Tilley. She serves as the associate commissioner of the New Hampshire Department of Health and Human Services, where she describes PHIG funding as having been a game-changer.

PATRICIA TILLEY: 

You know, at our core, our job is to assess the ever-evolving world around us, and it is clear we need robust, dynamic, modern data systems, and infrastructure that give us real-time access to the real needs of our communities. And it isn't good enough anymore to precisely and slowly monitor and analyze change. We need real-time data access, not just across infectious diseases, but in every pocket of our work, and we need the people to act on that information. So, like many states, we've used PHIG to modernize our laboratory capacity for both environmental health, as well as infectious diseases. We've been building out our immunization information systems to provide the best customer service for both our healthcare providers and for the public, and we're actively building a 21st-century environmental health module, which is focusing on lead poisoning, and radiological health, and food safety, and supports for our town-based local health officers.

SHEEHAN: 

With PHIG funding, has come useful lessons.

TILLEY: 

The biggest lesson is how to not 'boil the ocean.' The flexibility of the funds is incredibly helpful for planning and supporting critical services that never quite fit within the context of a specific federal grant. PHIG really stands out in a public health agency like ours, where 85% of the budget is from federal grants. PHIG smooths out the edges and provides support for critical infrastructure that doesn't always fit in a box of other funding. You know, we are- always are reminded that we can't do everything and there is no room for duplication, but PHIG really helps us connect the dots. It's allowed us to not only modernize our data, but it has allowed us to carefully plan for what's most important for New Hampshire.

SHEEHAN: 

PHIG's impact is felt locally, and New Hampshire has used it to build local capacity.

TILLEY: 

Based on our experience during the pandemic, we invested in a state medical surge planner to be our central coordinator to partner with health care facilities and manage system shocks. And so, this planner recently worked with one of our most northern and most rural hospitals right there on the Canadian border to help work on their medical surge plan so that they can respond to disasters even in those really remote areas of the state. The local community up there doesn't have access to high-paid consultants. It doesn't have- it's not connected to a big health care system, but with our added capacity that was supported by PHIG we could assist in them, bringing their teams together, bringing in the local community to make sure that they were ready for anything that could happen. We've also supported our two city health departments to invest in additional local strategic planning, to focus where state plans don't always translate into the next steps for them in their community, and we've also supported important resources like community health workers that we know that can be so impactful in those communities. For me, what I think is one of the most interesting places where we focused is we've leveraged PHIG with other environmental health funding to replace hardware in child care facilities to reduce lead in their water so, the environmental health funding pays for the hardware and the plumbing and those direct services. But PHIG supports a public health staff member to coordinate outreach with child care facilities, all of which reduces the lead exposure for our youngest kids in our tiniest towns as well as our- our big cities.

SHEEHAN: 

As ever, the need for sustainable funding and public health is a constant.

TILLEY: 

There has never been a more important time for sustainable, for consistent, for flexible resources. You know, every jurisdiction, massive or tiny, has unique needs and local context, and cookie-cutter approaches, disease by disease, they just don't always work. So, in a tiny resource-constrained 'Live Free or Die' state like New Hampshire, we have really appreciated and will continue to need the flexibility of resources that support robust, dynamic, modern data systems, and structure. We need to understand our real-time needs of our communities and assess those changes to not just the long-term trends, but the near-term evolutions, which continue to happen. PHIG really supports the resilience of states like ours to manage the ebbs and flows of federal and state policies, and it has helped us keep our service focus on servicing our communities and our neighbors with the infrastructure they expect. It is incredibly important to have that consistency as we plan, we do not function only in grant periods or in budget awards. We need to be able to think strategically over years, and so, opportunities that we have had like PHIG help us connect those dots. Help us maintain that vision, so that we can think about public health over the course of multiple years.

SHEEHAN: 

ASTHO member, Patricia Tilley, is the associate commissioner of the New Hampshire Department of Health and Human Services. You can learn about the Public Health Infrastructure Grant and the work that's underway by visiting the PHIG website. We have a link in the show notes. This has been another PHIG Impact Report, part of the Public Health Review Morning Edition.

I'm John Sheehan for the Association of State and Territorial Health Officials.