This transcript is auto-generated and may contain inaccuracies.

Avia Mason:
At this time, it is my pleasure to introduce Sarah Willson. She is the Director of the Missouri Department of Health and Human Services. Director Willson brings a wealth of valuable experience to DHSS, given her background as a practicing nurse and healthcare executive. Her healthcare career has been defined by advocating for advancing quality care, developing efficiencies, and improving outcomes for patients. Thank you for being here with us and welcoming us to Missouri, Director Willson.

Sarah Willson:
Well, I want to say truly from a Missourian, welcome to the Great State of Missouri, the Show Me State, whether you’ve traveled from across the country or across the river. I’m truly glad to be with you here today. It’s an honor to host the special convening of public health professionals doing such important and impactful work in our great state.

As I look around this room, seeing hundreds of faces of my peers working to strengthen and improve their public health system at the local, state, and national levels, I’m inspired that our collective dedication and passion for public health will help us forge a new frontier in public health.

A frontier denotes a starting place, a boundary beyond which the extent of our learning, innovation, and growth seems endless. It is also marked by the beginning of an unfamiliar landscape that we must learn to navigate using our skills, resources, and tools in ways we have not previously, as well as developing new ones.

Our theme, “Gateway to Growth,” is a perfect phrase to capture the system-level work we are engaged in and the new frontier before us. While we’re framed by the iconic Gateway Arch, we are a state of innovation.

The Gateway Arch is a testament to our rich history of bold improvements. Missouri served as the launching point of the westward expansion, the Lewis and Clark expedition, the Oregon Trail, and the Pony Express. This is the ideal place for public health professionals to convene, explore, and launch big, bold ideas.

Our state has much to offer. While you’re here, be sure to enjoy the beautiful sights of St Louis, just a few miles away. Forest Park offers cultural institutions, like the St. Louis Art Museum, the Muny Theater, and the world-class St Louis Zoo. All available at no cost. And just one fun fact for you, the Gateway Arch is America’s smallest National Park at only 91 acres.

In May, this area suffered widespread tornado destruction. The EF3 tornado tracked more than 20 miles through the urban areas of Greater St Louis. Sadly, the first deadly tornado in the city since the 1950s, for many, public health isn’t the first thing that comes to mind whenever these types of disasters strike, but public health was and is in action here.

Our local and state health departments were well represented at the Disaster Assistance Centers, providing support to survivors, partners, and enhancing health care efforts. We also assisted with data analysis from air sampling efforts and monitored for concerning health trends at local hospitals. We delivered pallets of personal protective equipment, provided guidance on environmental cleanup, and made safety recommendations for debris removal crews and citizen cleanup efforts.

On the regulatory side, we issued waivers that ultimately helped ensure no interruption to impacted citizens’ prescriptions, senior living residents, meals, and WIC participants’ food benefits.

No matter the emergency, public health is always working behind the scenes to protect the health and safety of our communities.

The Public Health Infrastructure Grant (PHIG) represents a historic investment in public health, offering a groundbreaking source of funding where we’ve been empowered to make the improvements that work best for our communities.

This flexibility has been a critical asset to our agency, and I’m sure my peers feel the same way. With PHIG support, we’re able to pursue the elements of transformation and systems-level improvements. PHIG is truly an investment in our local, state, and national infrastructure that empowers public health experts to think and act big.

PHIG has allowed us to move public health forward, to build a stronger and more resilient public health system. Yet, with the dawning of the end of PHIG and the current funding challenges, the art of the possible is a growing realization, where we must focus on what is achievable and realistic, rather than striving for an ideal or potentially unattainable outcome.

In Missouri, we’ve implemented broad and systemically impactful initiatives to amplify the impact of this funding. Today, we’re redefining what’s possible, and in a big way, by blending funding sources and working across divisional and departmental lines, we’re maintaining that momentum built in the early years of the grant to keep our projects rolling with a focus on the outcomes.

We all know, the pandemic exposed some harsh truths about the state of our public health system in Missouri. We lost 50% of our public health agency administrators during the pandemic, and those who remained experienced unprecedented levels of burnout and moral injury.

Our aging data systems were stretched beyond their limits, and any inefficiencies in our operations were magnified by the sheer volume of work we faced. We needed a significant investment in our workforce and our data systems. We needed to improve our operations and be able to illustrate the impact of this investment for our citizens. As I’m sure many of you see the same needs in your jurisdictions, Missouri really needed to build the system beginning at the local level.

We distributed more than the required funding level to our local partners and maximized the flexibility so that they could customize support systems. We’re thankful to our federal and national partners for the support through PHIG to make all of this happen in our state. I wanted to showcase some of the legacy building work going on in Missouri as we pursue long-term, lasting, impactful initiatives to support local partners.

Missouri has two PHIG awardees, awardee jurisdictions, the Kansas City Health Department and the state as a whole. The first area of investment is a credit is critical, which is our workforce. Missouri has 115 local public health agencies that utilize PHIG to enhance their workforce, supporting around 700 public health positions in Missouri in the last grant cycle.

We’ve established pipeline programming to attract and develop the next generation of public health professionals, creating a paid internship, placing students from a wide array of geographies and agencies across the state. We’ve dedicated support to expand our long-term study, to analyze the health of the health care and public health workforce statewide, building a foundation for future expansion and a basis for additional investments in our cross-industry workforces.

By investing in public health professionals, we’re addressing burnout and building a strong foundation for our people. Through leadership development offerings, professional development resources, and a suite of mental health resources, we’ve created a system of support.

I mentioned the need to improve our operations. Luckily, we have access to a world-class framework to achieve these improvements at scale, through public health accreditation.

Through an innovative approach to accreditation support, we’ve built some impressive momentum towards elevating operations and public health agencies across the state of Missouri.

With limited support for accreditation in the past, pursuing or achieving accreditation was a maybe-someday wish list for them, or a wish list item for most of our local partners. We were amazed by the number of jurisdictions that jumped at the opportunity to make improvements as soon as we offered resources. This really proves that with the right support, public health agencies can and will tackle the aspirational to serve our citizens with increased quality and accountability. It is the goal that accreditation will someday be the baseline in Missouri.

Another area of significant investment is our data landscape. Our systems were strained, exposing the need for interoperable, scalable, and reliable data systems. We’re investing in bid projects that build our infrastructure for the future and will have a lasting impact. Additionally, these improvements are allowing us to link information across departments, to fully consider the physical, social, and behavioral health needs of our citizens in practice and policy.

Last, but certainly not least, we’ve built a strong foundation for the future through new and strengthened partnerships. PHIG presented an opportunity to enhance communication and relationships with our local partners.

We’ve never worked closer together at the state and local levels, and we’ve been able to build an actual statewide network of public health professionals working towards the same bright future.

Due to restrictions around hiring at the state level, the department pursued innovative ways to administer this funding and pivoted to establish connections with our public health institutes, national partners, and academic institutions. We found ways to blend state funding with federal sources to incentivize our local agencies to participate in PHIG initiatives with a goal of building a multi-level approach to sustain change.

Of course, one of the most valuable assets of our PHIG work so far is our strong partnerships and relationships with national partners. We’re working closer than ever with the Public Health Accreditation Board, National Networks of Public Health Institutes, the Public Health Foundation, and the Association of State and Territorial Health Officials, not to mention our hands-on partnership with our CDC project officer.

We’re so thankful for the relationships this work has built, and we’re committed to maintaining this momentum for years to come. As mentioned, while the PHIG funding is groundbreaking and much needed, we must be focused on the future and working toward a more sustainable funding model in our state, using the foundational public health services framework.

Missouri ranks 51 of 51 jurisdictions in per capita state funding dedicated to public health at just $7 a person. Even if we doubled that amount, we would still be in 51st place. Increasing our reliance on federal funding is not a sustainable model, and it’s not sustainable for the future of Missouri.

By addressing how much it would take to bring all jurisdictions in Missouri to that foundational level of service delivery, we’re preparing a strategy to boost funding from local and state sources to make long-term investments in public health.

While it is an honor for Missouri to host this convening and deliver opening remarks, I would be remiss if I did not mention my personal pride in having three presentations on the agenda from our Missouri team members, who promised me that they would cheer loudly.

Please join me in supporting our teams as we share our impacts around accreditation, data modernization, and our impressive evaluation framework. This is our chance to learn from one another, to be inspired, and to return home with new tools and a renewed sense of purpose.

Thank you for the opportunity to host this convening in the great state of Missouri. I hope you all get a chance to enjoy the beautiful city of St Louis and spend some time connecting with the exceptional members of our Missouri team who are present here today. Thank you.