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Concept to Action Making Health Academic Home Concept to Action

Concept to Action

Using Coordination, Partnerships, and Leadership to Plan and Implement CSHPs

Developing State Infrastructure: Essential Elements

Responding to Public Policy Challenges Facing Health and Education


Related Initiatives

Roles for Everyone

Action Steps

Current 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 government’s 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 functions.

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 CSHP initiatives.
  • 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 children’s 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 training initiatives.

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 and programs
  • 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:

New Mexico
New York
North Carolina
South Carolina
South Dakota
West Virginia



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