Funding for Foundational Public Health Responsibilities (FPHR Grant)

This funding should be spent on foundational public health responsibilities as described at Definitions, Criteria, and Standards for Foundational Public Health Responsibilities. 

Foundational public health responsibilities are the minimum package of public health responsibilities that governmental public health should deliver to communities, which should be available everywhere for public health to work anywhere. It includes foundational capabilities and foundational areas that must be available to all people served by the governmental public health system and that meet one or more of the following criteria:

• Foundational responsibilities that are mandated by federal or state laws;
• Foundational responsibilities for which the governmental public health system is the only or primary provider of the service, statewide; and
• Population-based foundational responsibilities (versus individual services) that are focused on disease prevention, protection, and health promotion.

These definitions were developed cooperatively over 18 months by a cross-cutting workgroup of state and local subject matter experts. To learn more about their process, visit: How Do We Define "Foundational Public Health Responsibilities" in Minnesota?

No. The funding is noncompetitive, and there is no application. Community health boards will be allocated funding based on the foundational public health responsibilities funding formula noted above.  

No. The foundational public health responsibilities funding is base funding and an annual appropriation that the commissioner and SCHSAC hope will grow in the future.  

This funding is a down payment on Minnesota’s public health system. MDH and SCHSAC recognize that current funding levels are not sufficient to meet the needs of Minnesota's statewide public health system and are committed to advocating for its growth over time.

Community health boards. Tribes will receive funding for Tribal public health infrastructure separately.

No. The match cannot be used for both the Local Public Health Grant and the FPHR Grant. The matching funding sources can be the same; however, they cannot be counted twice. 

For example, if your Local Public Health Grant award is $100,000 and your FPHR Grant award is $100,000. You need to have a 75% match for $200,000 (or $150,000 in matching funds). With this example, you have $175,000 to spend on the award and the match, but only $100,000 needs to be spent on foundational public health responsibilities, and the $75,000 can be spent on other community health services.

No, the overall goal of public health system transformation is a system where state or federal funds support foundational activities and that local funds be used to support “community specific priorities.” For this reason, the local match can be used to support those “community-specific priorities.” That said, MDH and SCHSAC realize that current state funding is not enough to fully support foundational public health responsibilities. For this reason, community health boards can use the match to support foundational public health responsibilities if they choose. 

You would need to match 75% of the FPHR Grant funds you spend. 

FPHR Grant funds remaining as of December 31 may be carried forward into the next calendar year; however, these carry-forward funds must be spent by June 30 of that next calendar year. 

Public health system funding that is steady, ongoing, flexible, and equitably distributed can help Minnesota’s public health departments plan wisely and do their jobs well, so people in Minnesota can be as healthy as possible. Sustainable funding helps the public health system move from a funding cycle that swings unpredictably between panic (more funding) and neglect (less funding) to a funding cycle that’s stable and predictable. This makes public health efforts more efficient and effective and, as a result, public health departments can better cooperate with people and organizations to address community health issues.

The FPHR Grant was developed based on a recommendation that more funding be allocated to community health boards to carry out foundational public health responsibilities.  

In 2023-2024, the SCHSAC Foundational Public Health Responsibilities (FPHR) Funding Workgroup created the formula to account for base funding, Social Vulnerability Index, and a capacity factor, with an eye toward reporting and accountability mechanisms.

The workgroup was co-chaired by leaders from local public health and SCHSAC, and members used the following principles to guide their work in determining a funding formula: 

• Every community health board should get enough funding to make meaningful progress on foundational public health responsibilities.
• The funding formula should take into account that not everyone has the same opportunity to be healthy across our state.  
• The funding formula should help alleviate variation in capacity across our system. 

To read the workgroup's full report and view a member roster, visit: Building a Strong Foundation for Health from Border to Border: Final Report of the SCHSAC FPHR Funding Workgroup (PDF).

The Social Vulnerability Index (SVI) is a place-based index, database, and mapping application developed by the CDC, designed to identify and quantify communities experiencing social vulnerability. Social vulnerability refers to the demographic and socioeconomic factors (such as poverty, lack of access to transportation, and crowded housing) that adversely affect communities as they encounter hazards and other community-level stressors. These stressors can include natural or human-caused disasters (such as tornadoes or chemical spills) or disease outbreaks (such as COVID-19).

The Social Vulnerability Index (SVI) was created to help public health officials and emergency response planners identify and map the communities that will most likely need support before, during, and after a hazardous event, such as a natural disaster, disease outbreak, or chemical spill. SVI indicates relative vulnerability by ranking places on 15 social factors, including unemployment, minority status, and disability, and combining the rankings into a single scale from the 0th percentile (lowest vulnerability) to 100th percentile (highest vulnerability) (source: Chicago Department of Health and University of Illinois-Chicago).

Methods:  

• The Centers for Disease Control and Prevention (CDC) assigns each county an SVI of 0 to 1, with 0 being the lowest vulnerability and 1 being the highest. Community health boards receive a score based on their quartile ranking. Multi-county community health boards receive the score based on their highest SVI county.

Social Vulnerability Index Ranking, Quartiles, and Scores: 

• For city-based community health boards, MDH staff recorded SVI rankings by census tract for each community health board. The community health board was assigned the SVI score associated with their highest-ranking census tract. MDH then recorded the census tracts in the remaining parts of Hennepin County. Hennepin County’s SVI is based on the highest-ranking remaining census tract.  
• The method for including SVI for foundational public health responsibilities funding is consistent with the scoring used for Public Health Emergency Preparedness funding.  

Community health boards can view their SVI score here: Social Vulnerability Index Scores for Minnesota Community Health Boards (PDF).

The SCHSAC Foundational Public Health Responsibilities Funding Workgroup felt strongly that the funds should help alleviate capacity variation across the state’s public health system. To guide this approach, the workgroup recommended using a capacity measure in the foundational responsibilities funding formula based on findings from the 2022 cost and capacity assessment conducted by the University of Minnesota: health departments serving more than 100,000 people scored higher in their ability (capacity) to fully implement foundational public health responsibilities.  

As such, the workgroup’s funding formula includes the following:  

• If a multi-county community health board had any counties with over 100,000 people, it did not receive the capacity funding.  
• If a multi-county community health board did not have any counties over 100,000 people, it received the capacity funding. This was true even if the total population of the community health board exceeded 100,000 people. This is because the 2022 cost and capacity assessment was conducted at the local health department level, not the community health board level.
• Single-county, single-city, or county-city community health boards only received capacity funding if they serve less than 100,000 people.  

The SCHSAC FPHR Funding workgroup voted against including a specific multi-county variable in the recommended funding formula, primarily because members did not see alignment between this approach and the guiding principles developed for this funding. Other reasons included:  

• The workgroup believes a large base will make a more meaningful difference in our ability to fill in the patchwork of capacity than a multi-county incentive.
• There are other funding sources available to foster multi-county and cross-jurisdictional collaboration, including the Minnesota Public Health Infrastructure Fund. No funding source discourages collaboration across jurisdictions.
• Breaking up small amounts of money even further is not in the interest of small health departments. Money alone does not incentivize collaboration.  
• These new funds give us an opportunity to question the things we’ve always done and do things differently.

The statutory reference is the Local Public Health Act: Sec. 145A.131 MN Statutes. See below for an overview of the changes to existing statutory language. Strikeouts are deleted language, and underscores are added language. 

Revisions to 145A.131

Minnesota Statutes 2022, section 145A.131, subdivision 1, is amended to read:

Subd. 1.

Funding formula for community health boards.

a.) Base funding for each community health board eligible for a local public health grant under section 145A.03, subdivision 7, shall be determined by each community health board's fiscal year 2003 allocations, prior to unallotment, for the following grant programs: community health services subsidy; state and federal maternal and child health special projects grants; family home visiting grants; TANF MN ENABL grants; TANF youth risk behavior grants; and available women, infants, and children grant funds in fiscal year 2003, prior to unallotment, distributed based on the proportion of WIC participants served in fiscal year 2003 within the CHS service area.

b.) Base funding for a community health board eligible for a local public health grant under section 145A.03, subdivision 7, as determined in paragraph (a), shall be adjusted by the percentage difference between the base, as calculated in paragraph (a), and the funding available for the local public health grant.

c.) Multicounty or multicity community health boards shall receive a local partnership base of up to $5,000 per year for each county or city in the case of a multicity community health board included in the community health board.

d.) The State Community Health Services Advisory Committee may recommend a formula to the commissioner to use in distributing funds to community health boards.

e.) Notwithstanding any adjustment in paragraph (b), community health boards, all or a portion of which are located outside of the counties of Anoka, Chisago, Carver, Dakota, Hennepin, Isanti, Ramsey, Scott, Sherburne, Washington, and Wright, are eligible to receive an increase equal to ten percent of the grant award to the community health board under paragraph (a) starting July 1, 2015. The increase in calendar year 2015 shall be prorated for the last six months of the year. For calendar years beginning on or after January 1, 2016, the amount distributed under this paragraph shall be adjusted each year based on available funding and the number of eligible community health boards.

f.) Funding for foundational public health responsibilities must be distributed based on a formula determined by the commissioner in consultation with the State Community Health Services Advisory Committee. These funds must be used as described in subdivision 5. 

Minnesota Statutes 2022, section 145A.131, subdivision 2, is amended to read:

Subd. 2.

Local match.

a.) A community health board that receives a local public health grant shall provide at least a 75 percent match for the state funds received through the local public health grant described in subdivision 1 and subject to paragraphs (b) to (d)(f).

b.) Eligible funds must be used to meet match requirements. Eligible funds include funds from local property taxes, reimbursements from third parties, fees, other local funds, and donations or nonfederal grants that are used for community health services described in section 145A.02, subdivision 6.

c.) When the amount of local matching funds for a community health board is less than the amount required under paragraph (a), the local public health grant provided for that community health board under this section shall be reduced proportionally.

d.) A city organized under the provision of sections 145A.03 to 145A.131 that levies a tax for provision of community health services is exempt from any county levy for the same services to the extent of the levy imposed by the city.

Minnesota Statutes 2022, section 145A.131, subdivision 5, is amended to read:

Subd. 5.

Use of funds.

a.) Community health boards may use the base funding of their local public health grant funds as described in subdivision 1, paragraphs (a) to (e), to address the areas of public health responsibility and local priorities developed through the community health assessment and community health improvement planning process.

b.) Except as otherwise provided in this paragraph, funding for foundational public health responsibilities as described in subdivision 1, paragraph (f), must be used to fulfill foundational public health responsibilities as defined by the commissioner in consultation with the state community health service advisory committee. If a community health board can demonstrate foundational public health responsibilities are fulfilled, the board may use funds for local priorities developed through the community health assessment and community health improvement planning process.