1. The Secretary of DHHS should appoint a national commission to consider if an accreditation system would be useful for improving and building state and local public health agency capacities. If such a system is deemed useful, the commission should make recommendations on how it would be governed and develop mechanisms (e.g., incentives) to gain state and local government participation in the accreditation effort. Membership on this commission should include representatives from CDC, the Association of State and Territorial Health Officials, the National Association of County and City Health Officials, and nongovernmental organizations (Chapter 3).

Finding: Research is needed to guide policy decisions that shape public health practice. The committee had hoped to provide specific guidance elaborating on the types and levels of workforce, infrastructure, related resources, and financial investments necessary to ensure the availability of essential public health services to all of the nation’s communities. However, such evidence is limited, and there is no agenda or support for this type of research, despite the critical need for such data to promote and protect the nation’s health.

  1. CDC, in collaboration with the Council on Linkages between Academia and Public Health Practice and other public health system partners, should develop a research agenda and estimate the funding needed to build the evidence base that will guide policy making for public health practice (Chapter 3).

Finding: Effective interagency collaboration on health issues at the federal level is crucial but difficult because of the specialized nature of agency structures and responsibilities. Furthermore, many agencies not traditionally associated with health issues make policy and manage programs with potential implications for health. More effective coordinating structures are needed to reduce obstacles to the effective use of federal regulatory and standard-setting powers in health. Mechanisms are needed to develop collaborative relationships and to harmonize regulations within DHHS, across federal agencies, and among federal state and local governments to assure effective action for protecting the population’s health.

  1. The Secretary of DHHS should review the regulatory authorities of DHHS agencies with health-related responsibilities to reduce overlap and inconsistencies, ensure that the department’s management structure is best suited to coordinate among agencies within DHHS with health-related responsibilities, and, to the extent possible, sim-

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