In this episode and as part of our PHIG Impact Report series, Amy Perkins of the Wisconsin Department of Health Services talks about how the state is rethinking public health infrastructure funding to make life easier for local and tribal health departments.
In this episode and as part of our PHIG Impact Report series, Amy Perkins of the Wisconsin Department of Health Services talks about how the state is rethinking public health infrastructure funding to make life easier for local and tribal health departments. Amy explains how Wisconsin is using the Public Health Infrastructure Grant (PHIG) to reduce administrative burden, decentralize funding management, and prioritize flexibility over red tape. Amy discusses practical strategies like housing PHIG within a partnership-focused office, streamlining grant processes, supporting accreditation by directly covering PHAB fees, and quickly moving funds through regional service and resource-sharing grants. Amy also shares what she’s hearing from the field: how flexible funding is helping health departments sustain staff, invest in professional development, strengthen foundational capabilities, and better respond to community needs.
This work is supported by funds made available from the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS), National Center for STLT Public Health Infrastructure and Workforce, through OE22-2203: Strengthening U.S. Public Health Infrastructure, Workforce, and Data Systems grant. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.
About the PHIG National Partners - Public Health Infrastructure Grant
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This is Public Health Review
MORNING Edition for Tuesday,
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January 6th, 2026.
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 episode of the
FIG Impact Report with Amy
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Perkins, Public Health
Infrastructure Grant Manager in
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the Division of Public Health
for the Wisconsin Department of
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Health Services.
Amy talks about how the state is
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using public health
Infrastructure grant funds to
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rethink public health
infrastructure and shift
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administrative burdens off of
local and tribal health
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departments.
Yeah.
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So in Wisconsin, we took the
requirement of reducing
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administrative burden to heart
right away through the Public
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health infrastructure grant.
The first step was really taken
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by our state health officer who
chose to house the grant in our
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internal office that's
responsible for the
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relationships and partnerships
with the other sort of primary
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players in our governmental
public health system, our SAECHO
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and then our local and tribal
health departments.
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Beyond the obvious components of
granting that you can sort of
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tug on to reduce administrative
burden, we've also done other
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things strategically with
communications with our sub
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recipients and contractors,
really deepening our
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understanding as a grant
management team of
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administrative burden and of
course our approach to
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procurement and purchasing
authority decisions.
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We've really tried to prioritize
our intended impact and
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determine how we can achieve
those impacts without adding
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burden.
Whenever possible.
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Our office and our grant
management team really follow
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the mantra of harder for us,
easier for them, so making sure
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that we are requiring as little
as possible from the folks that
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we're trying to support.
And part of that has involved
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decentralizing management of FIG
funds.
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Can you tell us more about that
and what exactly that means?
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Yeah.
Most of the funding in our
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Division of Public Health is
both managed and utilized within
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the same Bureau and office.
So aside from a couple offices,
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most bureaus and offices
directly manage the majority of
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the funding that also supports
their work.
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So with the nature of FIG funds
requiring that we consider what
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foundational work we want to do
to support our statewide
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governmental public health
system as a whole, that really
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precludes the opportunity to say
this is the money within this
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office and it supports just this
office.
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So while the program itself,
where I sit is in our Office of
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Policy and Practice alignment,
which we lovingly refer to as
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OPA, we have leadership and
strategic advisors from across
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our Division of Public Health,
and we financially support
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positions and initiatives in
other bureaus and offices.
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So we're able to support a wide
variety of initiatives through 1
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funding source by empowering
colleagues and other bureaus and
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offices to work with us in
whatever way makes the most
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sense based on their capacity
and skill sets.
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So sometimes we're relatively
hand hands off with a given
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programmer initiative, we just
provide funding strings, we
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monitor spending.
Whereas other times, if there's
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a program or initiative that
doesn't have that, you know,
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internal capacity or expertise,
we're really hands on.
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We help with everything from
procurement or purchasing
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authority to scope of work
development in negotiation, all
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the way through progress
reporting and monitoring.
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And you've also taken steps to
make accreditation easier using
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FIG funds.
Yeah.
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So supporting accreditation and
accreditation readiness is
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something that Wisconsin has
done for our local and tribal
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health departments for quite a
while.
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So it wasn't something new with
the start of FIG, but we wanted
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to support accreditation in a
more active way rather than just
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passively by making it an
allowable expense for our local
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and tribal health departments.
So in Year 2, late 2023, we
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prioritized providing a more
direct type of accreditation
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support and included a dedicated
line item in our budget.
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The initial idea was to pay for
fees on behalf of health
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departments.
It took us a while to figure out
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exactly operationally how to
implement that sort of the
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initial idea.
The status quo approach is to
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grant funding through existing
agreements.
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So we have our pass through
agreements with our local and
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tribal health departments.
Sort of the the cleanest,
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clearest idea that we got as a
recommendation internally was to
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tack the funding on to those
agreements.
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However, in doing that we would
have had to modify.
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We have now we have 95 local and
tribal health departments in
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Wisconsin.
We would have had to modify the
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agreements.
So that's multiplying everything
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by 95 to do that.
So we really tried to push and
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find a new way to do it and a
way that was prioritizing the
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impact on the local and tribal
health departments less so than
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just getting the dollars out the
door.
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So eventually we were able to
actually pull together a focus
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group of local health department
leaders with the help of our
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SAECHO and we asked them for
their input.
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And so having that conversation
really helped us understand not
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just why they they agreed with
us that they didn't want to have
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to go through that granting
process, but they also gave us
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helpful context and, you know,
real experience for then arguing
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for a different approach.
So what we ended up doing was
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developing and getting a sole
source waiver approved so we
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could establish a direct
financial contracting
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relationship with FAB.
So we have a sole source waiver,
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we have a dedicated scope of
work and contract with FAB, the
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Public Health Accreditation
Board and we're able to pay fees
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on behalf of our local and
tribal health departments.
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You've also learned some lessons
around getting money out the
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door quickly.
The regional granting program
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was able to move $2,000,000 with
a streamlined selection process.
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So how did how did Fig's goals
kind of help help establish
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that?
Yeah.
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So the the granting program
you're referencing is a regional
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service and resource sharing
granting program.
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So that's one of one of three
initiatives that we funded
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through a participatory
budgeting like process that we
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implemented early in 2025.
So we surveyed governmental
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public health staff for ideas on
ways to strengthen public health
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infrastructure and developed a
budget based on that
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information.
So some form of service and
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resource sharing was the most
common idea submitted in that
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process.
We knew we wanted to resource
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that idea in some way.
And then by structuring it as a
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regional granting program, we
knew we'd be able to move
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relatively quickly to get those
funds out the door and start
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making an impact sooner.
So we use what's called a
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minimal selection process in our
state, and we've used that a
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couple times before in the
infrastructure grant.
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So we're familiar with the
process, the requirements, the
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documentation.
The five recipients of this
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granting program, who we would
call fiscal hosts, are required
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to work within the regions to
develop work plans that target 2
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areas of opportunity within the
foundational Public Health
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Services framework.
So we've identified those areas
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through our statewide
infrastructure assessment.
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And beyond the efficient
allocation of funding, like you
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said, key benefits to this
approach were I would say the
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first one was piloting
collaborations that we can use
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to inform and maybe answer or
start to answer broader system
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design questions and
opportunities in our state.
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So what are ways that we can
build infrastructure not just
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within the scope of the
infrastructure grant, but
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broadly how can we strengthen
our system approach, the way
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that we fund the work that we
do, the way that we implement
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the work in better, more
efficient ways, more cost
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effective ways, things like
that.
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So it's sort of a pilot
opportunity.
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It's also an opportunity to
empower the health departments
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who are intended to be affected,
their service populations that
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are intended to be affected by
this program to make the
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decisions about what exactly
they do.
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So we have a relatively broad
scope of work that says this is
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the work that you need to do
here, sort of the big, big
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picture parameters, the
requirements of the actual
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agency receiving the funds.
And from there, they have to
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work collaboratively within
their regions to develop a
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project.
So we don't have details yet as
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to what each project will
include, but we're expecting 5
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relatively unique projects
across the state that are all
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focused on these sort of areas
of opportunity within the FPHS
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framework.
Finally, Amy, what have you been
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seeing at the local level at at
the department level through
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through sort of rolling out
these these changes?
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Yeah.
I would say the overly
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categorical nature of public
health funding means that health
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departments often lack the
funding that they need to
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support foundational work that
they'd like to do, but they
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don't have sources that can
accommodate that flexibility.
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So because FIG is focused on
foundational capability work, we
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mainly hear appreciation for our
efforts to be transparent and
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accessible.
The flexibility, of course, in
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terms of allowable expenses and
the flexibility to be able to
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adjust work plans depending on
unique needs and priorities of a
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local health department.
So we hear things about
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appreciation for being able to
hire new staff, but also support
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and sustain existing staff,
provide professional development
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opportunities, provide
opportunities for staff to
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engage with community members
directly, to participate in
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coalitions, to participate in
strategic planning efforts,
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things like that.
So all of those are sort of ways
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that the infrastructure grant
funding supports the operational
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needs in order to let the health
department staff focus on those
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community impacts, things that
are more foundational area or
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programmatic in nature, while
FIG supports the foundational
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capabilities.
Amy Perkins is the public health
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infrastructure grant manager in
the Division of Public Health
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for the Wisconsin Department of
Health Services.
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This has been another FIG impact
report from Public Health Review
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Morning Edition.
I'm John Sheehan for the
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Association of State and
Territorial Health Officials.
