Four Strategies to Advance Administrative Preparedness in Public Health

July 08, 2025 | Kelsey Tillema, Annie Evans

As the landscape of governmental public health preparedness continues to shift, the importance of evaluating readiness remains a critical priority for health agencies. This includes examining administrative and financial readiness to accommodate timely changes to budgets, staffing, and contracts. The following four strategies may be valuable to health agencies to evaluate internal processes for use during emergencies.

1. Practice Makes Progress

Exercises can be used to review the effectiveness of administrative policies and procedures. Practicing administrative and financial operations in an exercise scenario can expose gaps and inefficiencies that may hinder response in a real crisis. Not only do these exercises unveil common pitfalls, but they can also increase capacity to streamline processes and practice procedures before a crisis occurs. Administrative exercises may also fulfill agency requirements for the CDC’s Public Health Emergency Preparedness cooperative agreement.

There are several existing resources and partners available to help health agencies create an administrative preparedness exercise. Federal partners (CDC, FEMA, ASPR) can provide feedback, recommendations, and ensure alignment with funding agreement requirements. To further support these efforts, CDC has awarded funding to ten institutions as part of a five-year cooperative agreement to establish Regional Centers to promote readiness for public health threats, which may include resources relevant to administrative preparedness training and exercise.

Additionally, maintaining relationships with regional Public Health Training Centers, local universities, and other external partners in your response community can help simulate a realistic scenario of what communications and procedures may be needed during an emergency. The National Association of State Procurement Officials (NASPO) offers guidance, tools, and exercise materials that may assist in creating administrative exercises. Notable resources include Strategies and Techniques for Successful Emergency Preparedness Toolkit for State Government Operations, Emergency Preparedness Guide, and the Procurement Tabletop Exercise Playbook for Emergency Response, to name a few.

2. Streamline using Technology, Tools, and Checklists

Creating efficient systems can provide much-needed space for health agencies to respond more rapidly during an emergency. Standardizing routine administrative tasks can provide streamlined and familiar structure in high-stress, unprecedented situations. Prepping easily understandable job action sheets, forms for tracking resources and timekeeping, and checklists for processes such as procurement, surge staffing, and memorandums of understanding are a few ways to streamline administrative functions. New technology can provide more effective ways to share information, so upgrading and leveraging software to optimize coordination and communication is essential. Using digital forms and user-friendly templates can ensure better quality documentation and communication, and reduce burden and time spent on manual processes in a crisis. Together, these tools not only streamline response efforts but also support clearer decision-making and the ability to assess performance after an emergency.

3. Prioritize Process Improvement

Continuous process improvement is also important to ensure administrative challenges identified through exercises and past responses are addressed. Ensuring that plans, processes, and policies are streamlined, efficient, and rapid can help set health agencies up for success when faced with an unprecedented situation. Whether reviewing emergency operations or continuity of operations plans, staff contacts, financial protocols, having a system in place for ongoing evaluation is essential. Cultivating an environment of process improvement can enhance health departments’ ability to use staff more efficiently, standardize communication protocols, and make room for rapid response and accountability.

Using a quality improvement system or framework can help manage this process. There are many existing systems that may work for health agencies including the Plan-Do-Check-Act method, using a prioritization matrix (automatic Word download), or even ASTHO’s Guide on Conducting an Administrative Policy Assessment. ASTHO has several tools that can be adapted to a preparedness context including the Process Improvement Readiness Assessment, and the Policy Assessment and Gap Analysis Tool. Regardless of the model, health agency decision-makers should be involved to thoroughly review all data and feedback from current processes and receive status updates on changes made.

4. Collaborate for Success

Collaboration with both internal and external stakeholders is core to effective administrative preparedness. Key health agency staff involved in preparedness, financial systems, and administrative processes should be involved in decision-making and process improvement initiatives. Developing and maintaining relationships across different departments can enhance coordination, communication, and trust within the health agency. Meeting regularly to discuss department and program roles can facilitate resource sharing, leadership buy-in, and support continuity of institutional knowledge. Regular connection with external partners that might be involved in a response, such as vendors, health care providers, educational institutions, and others, can also help to maintain readiness to quickly turnaround contracts or initiate administrative procedures during an emergency. Including these partners in planning and exercise opportunities can build trust and consistent communication.

Finally, national partners exist and are there to assist. Whether it’s ASTHO, NASPO, or the National Association of County and City Health Officials (NACCHO), national associations provide technical assistance to state, territorial, and local jurisdictions, and can provide timely insight and connections to peers on administrative preparedness best practices.

Conclusion

Advancing administrative preparedness is more than assessing plans, it is also strengthening partnerships, reviewing current systems, and testing what processes create barriers in different scenarios. By exercising administrative procedures regularly, leveraging technology, applying best practices, creating a culture of process improvement, and learning from internal and external peers, health agencies can be ready to manage the processes needed to stand up an effective response.

To discuss administrative preparedness with ASTHO further, reach out to preparedness@astho.org.

Other Resources

• Admin Prep Strategies by NACCHO
• Admin Prep Legal Guide by NACCHO
• Admin Prep Exercise Guide by NACCHO
• Emergency Procurement and Risk Management by National Association of State Procurement Officials