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Public health needs, service delivery, funding strategies and the conceptual frameworks that drive progress in health outcomes are transforming rapidly. With chronic disease as the primary cause of morbidity and mortality and the expansion of the insured population, public health agencies must evolve to adapt and meet the needs of partners, payers and the community in efforts to improve health. West Virginia's 49 local health departments, serving 55 counties, have significant variation in administrative costs; collection, reporting and delivery of public health data and services; and revenue generation, suggesting that services and funding may not be effectively targeted statewide and according to consistent evidence-based standards. These challenges are reflected nationally and are not unique to West Virginia. Nevertheless, with West Virginia's uncertain fiscal climate and our significant health challenges, it is critical for both state and local government to use public funds efficiently and effectively, with as little overhead as possible and with targeted investments in programs that are proven to improve health. In April 2015, the Bureau for Public Health assembled a Public Health Impact Task Force (PHITF) to produce recommendations that would modernize the public health system in West Virginia (Figure 1a & Figure 1b). The PHITF was comprised of a broad and diverse group of key stakeholders including local health departments. More than seventy percent (70%) of local health departments participated in the meetings and all local health departments, as well as the West Virginia Association of Local Health Departments (WVALHD), had the opportunity to propose ideas and solutions. Six (6) core concepts were outlined by the Bureau and unanimously adopted by the PHITF membership and were closely aligned with key concepts presented by the WVALHD. Figure 1a: PHITF Recommendations Figure 1b: PHITF Recommendations The recommendations serve as recognition of and a commitment to needed changes at both the local and state level. To access materials from the PHITF process click here. The Bureau's Center for Local Health supported the PHITF process and is now leading efforts to implement the recommendations. For a high-level summary of projects tied to each PHITF recommendation, please review individual initiatives in detail be clicking on the links below. CrossROADS Initiative Fact Sheet Final PHAST Chart of Accounts Recruiting Pack Basic Public Health Services FY 2017 Program Plan State Guidance