Statewide Association Performance Improvement Training and Technical Assistance Support Initiative
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Since 2020, NACCHO, with support from the National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce at the Centers for Disease Control and Prevention (CDC PHIC) has provided statewide public health associations with tailored training and technical assistance (T/TA) to help local health departments strengthen their infrastructure, systems, and performance improvement efforts. This initiative enhances state-level organizations' capacity to support LHDs in advancing community and public health priorities.
““[This opportunity] has provided so much value and [has allowed us to focus on] specific things we want to pursue that don’t fit into our annual budget. For the past two years [this opportunity has] been there to fill in those gaps and help us move forward strategically, rather than just guess at what it is we should be doing.””
– North Carolina Institute for Public Health
Over 90% of LHDs that received T/TA noted that they would be able to apply what they learned from the T/TA to their performance and systems improvement work, specifically stating that the T/TA allowed them to:
- Feel confident in applying the knowledge and/or strategies provided during the training to their current work.
- Enhance their knowledge of supervisory skills within the health department setting.
- Provide new insight to them as a Quality Improvement leader.
Below is a story from the field shared by a former grantee, highlighting how this initiative has impacted local health departments across their state:
All previous and current grantees are a part of a growing Community of Practice (CoP) -- creating a space for relationship and partnership building, peer-to-peer networking, mentorship, and sharing of best practices for training and technical assistance implementation.
Take a look at the map below to see where our CoP members are located.

The following are examples of performance and systems improvement categories of work that past participants in this initiative have focused on:
- Accreditation
- Change Management
- Community Health Assessment/Community Health Improvement Plan (CHA/CHIP)
- Health Equity
- Performance Management
- Quality Improvement
- Strategic Planning
- Workforce Development
These topics have been covered through a variety of T/TA offerings, such as:
- Expanding and disseminating training modules statewide
- Trainings for current and newly appointed health equity staff
- The development of an equity self-assessment and the compilation of equity
- Related resources informed by LHD focus groups
- Toolkits (e.g., Public Health Administrators Toolkit and Public Health System Orientation Toolkit)
- Virtual events focused on moral distress and creating a more resilient public health workforce
- Trainings and learning communities related to accreditation, PHAB standards, quality improvement, CHA/CHIP, and communicating data
- Systems and performance improvement content experts to speak at conferences, forums, and trainings geared toward LHDs
Here are a few publicly available resources developed by statewide public health associations participating in this initiative: