|Concept to Action
Using Coordination, Partnerships, and Leadership to
Plan and Implement CSHPs
Developing State Infrastructure:
to Public Policy Challenges Facing Health and Education
State and Local Initiatives
Developing State Infrastructure: Essential Elements
The term "infrastructure" refers to the framework that
supports an organization or system.
Every state has a structure or bureaucracy to carry out governments
education, health, social services, mental health, and other child-serving
functions. Proponents can build a CSHP infrastructure by mapping
the common programs across these agencies and then collectively
carrying out the planning, program implementation, and evaluation
The goal is to institutionalize CSHPs through such infrastructure,
so that CSHPs become an integrated, self-sustaining part of the
fabric of health and education bureaucracies, able to continually
operate in the face of changes in the socio-political environment.
The attached chart
shows an example of a state CSHP infrastructure.
Several elements must be in place in order to establish and maintain
a state infrastructure:
- Leadership and staff commitment. The heads
of the key state agencies (commissioners, superintendents, directors)
must establish the purpose, structure, and function of the collaborative.
To support the infrastructure, they must appoint and fund a staff
team of qualified personnel at a senior level who are responsible
for overseeing and coordinating the process and allocating financial
resources for this purpose.
- Resources. Resources must be available
to administer the CSHP infrastructure and to provide for the development
and continued functioning of state and local CSHP activities and
initiatives. In addition to direct financial resources, such as
funds to enable cross-agency programming, other resources are
also needed: human resources, including support staff; consultants
and contractors; technology resources, such as hardware and software;
data and data systems and sources; and external supports, such
as volunteers, philanthropic agencies, and community groups.
- Authorization: Legal and regulatory support.
State-level decision-makers must adopt laws, regulations, policies,
and procedures to authorize, facilitate, support, and strengthen
- Interagency cooperation. State agencies must
develop joint implementation plans that coordinate administrative
duties and activities as well as inter-related initiatives and
projects in the community. Mid-level agency staff should meet
together regularly to implement these plans and report back to
both senior staff and the legislative branch.
- Collaboration and linkages. Government
and non-governmental organizations and coalitions must work together,
building strategic alliances on common causes, facilitating advocacy
efforts, and increasing community capacity
- Ongoing monitoring and assessment. Working
collaboratively, state agency and non-governmental organization
staffs must assess the scope of health problems in children and
youth and the status of available resources, and then develop
and apply measures to determine the impact of CSHP activities
on childrens health.
- Marketing and communications. Collaborators
must develop and utilize promotional strategies that explain CSHPs
to multiple audiences.
- Professional preparation. Colleges, universities,
professional associations, and state agencies must develop and
offer training programs and professional development opportunities
to equip local school staff to provide health education and services
to children and youth. These should encompass interdisciplinary
The combination of these elements produces a state CSHP infrastructure
that does the following:
- Assures efficient use of resources
- Eliminates program gaps and overlaps
- Provides needed programs to students and communities
CDC/DASH Infrastructure States
CDC/DASH funding for the development of infrastructure in state
governments is a key strategy for improving health and education
outcomes for children and youth. CDC currently funds 21 state departments
of education and health to carry out infrastructure functions.
With this funding, state and local departments of education and
health are able to do a variety of important things:
- Provide high-level staff in both agencies to coordinate, support,
and evaluate local school health programs
- Build a training and development system for health and education
professionals at the state and local levels to improve policies
- Convene organizations committed to improving the health of young
people to develop and coordinate strategies for communicating
the importance of CSHPs.
While it is anticipated that all states will eventually have such
infrastructure funding, at present just these states participate: