Is What I Do “Foundational”?

When it comes to understanding how our work fits into the Foundational Public Health Responsibilities (FPHR) framework, it’s important to understand what “foundational” really means. This is relevant to all of us, especially as MDH transitions their reporting requirements in 2026. The framework doesn’t describe our work as being Foundational or non-Foundational, it describes it as a Foundational capability/area or a Community-specific Service. Community-specific Services are an incredibly important part of the FPHR framework, as shown below. 

Image from the Public Health Accreditation Board (PHAB).

Foundational refers to the capabilities (skillsets or “foundational infrastructure”) and areas (population-based health programs and services) that are a part of the “minimum package” of public health operations. This is what every public health department must ensure so that no matter where you live, you have access to the same level of public health protections.  

Community-specific Services are local programs and services that are unique to your community. They are not any more or less important than the foundational capabilities and areas. They are services that may be needed from governmental public health in your community, but perhaps not necessary for governmental public health in another community. 

Here are some examples provided by PHAB: 

• Immunization Program 

  • Surveillance of vaccine preventable diseases: Foundational Area – Communicable Disease Control 

  • Vaccine administration: Community-specific Service 

• Car Seat Program 

  • Analysis and reporting of child passenger related injury data: Foundational Area – Chronic Disease and Injury Prevention 

  • Car seat distribution and car seat safety checks: Community-specific Service 

• Lead Prevention Program 

  • Convening cross-system partners to establish a plan for eradicating lead in old homes: Foundational Area – Environmental Health 

  • Lead abatement in homes and blood lead screenings/testing – Community-specific Service 

Why does this matter? 

There have been some great posts recently about how to talk about public health (see Jenna’s posts Imagine This and A Guide for Public Health Storytelling). Understanding the FPHR is critical to messaging public health effectively and being able to advocate for the work we do. It’s important that we’re not selling ourselves short, so avoid the term “non-foundational”, and start using the term “Community-specific Service.” We’re probably providing that service because there was a strategic assessment of services offered in the community and discussions within our agency, and with community partners, about who is best positioned to offer those services. Our Community-specific Services are valuable, important, and support the health and wellbeing of the people we serve. The FPHR framework is aligned with this, not in opposition to it. 

Not sure how your work fits into the FPHR framework? Use this guide from PHAB on page 7 to start identifying your work within the Foundational Areas, Foundational Capabilities, and Community-specific Services. You can also review the FPHR fact sheet for definitions. When MDH reporting requirements come our way, you’ll find this activity will help put you ahead!