The COVID-19 pandemic exposed and accelerated a staffing crisis in public health that continues to reverberate. The de Beaumont Foundation's 2024 public health workforce report estimated that state and local health departments lost approximately 56,000 positions between 2008 and 2020, and while pandemic emergency funding temporarily reversed some of those losses, many positions created with temporary funding have since been eliminated as COVID-era appropriations expired.
The result is a public health workforce operating at reduced capacity even as demands — routine disease surveillance, immunization programs, chronic disease initiatives, maternal health programs, and emergency preparedness — remain at or above pandemic-era levels.
Disease Surveillance Data Reporting
Communicable disease surveillance is one of the most documentation-intensive functions in public health. Case reports submitted by healthcare providers, laboratories, and hospitals must be logged, reviewed for completeness, entered into state and national surveillance systems (such as the CDC's National Notifiable Disease Surveillance System), and followed up on for missing data.
A VA supporting surveillance functions can handle the administrative layer of this workflow: logging incoming case reports, sending data completion requests to reporting providers, entering validated data into surveillance systems, and generating standard summary reports for epidemiologists. This work is high-volume and time-sensitive — delays in surveillance reporting can compromise outbreak detection.
The CDC's Public Health Informatics and Technology Program has consistently identified data entry backlogs as a factor that degrades surveillance system timeliness, particularly at local health departments with limited staff.
Community Health Program Administration
Local health departments run dozens of programs simultaneously: WIC nutrition services, immunization clinics, lead poisoning prevention, tobacco cessation, and maternal and child health home visiting, among others. Each program requires scheduling, participant outreach, record maintenance, and reporting.
A VA assigned to community program administration can manage clinic appointment scheduling, send participant reminders, maintain program enrollment records, coordinate with partner organizations for referral documentation, and compile program activity data for monthly and quarterly reports. For immunization programs, a VA can manage the inventory request and lot number documentation process that supports both program delivery and CDC reporting requirements.
The Association of State and Territorial Health Officials has noted in its workforce capacity analyses that program coordination functions are frequently understaffed relative to program delivery, creating a chronic documentation backlog that puts funding compliance at risk.
Federal Grant Compliance: CDC, HRSA, and Title X
Public health departments are among the most heavily grant-funded units of local government. Funding from CDC cooperative agreements, HRSA maternal and child health grants, Title X family planning funds, and FEMA preparedness grants all carry distinct reporting, financial management, and programmatic compliance requirements.
A VA supporting grant management can maintain a multi-grant compliance calendar, coordinate quarterly financial report preparation with the department's fiscal staff, draft programmatic progress report narratives from program manager input, and manage correspondence with CDC and HRSA project officers. The ability to maintain organized, up-to-date grant files significantly reduces the stress of site visits and monitoring reviews.
Improper cost allocation remains a leading finding in HHS OIG audits of public health grant recipients. A VA maintaining current budget-versus-actual tracking for each award helps prevent the drift that leads to disallowed costs.
Workforce Economics in Public Health
Public health departments compete for administrative staff against hospital systems, healthcare companies, and technology firms, all of which offer higher salaries and more competitive benefits packages. According to the Bureau of Labor Statistics, median annual wages for administrative positions in local government public health are approximately $41,000 — well below comparable private sector roles.
Virtual assistants provide a cost-effective supplement to in-house administrative capacity that does not require competing in this difficult labor market. Departments can scale VA support to match program activity cycles — heavier during flu season and immunization campaign periods, lighter in other months.
Public health administrators exploring VA support for surveillance, program coordination, or grant management can learn more at stealthagents.com.
The Longer-Term Opportunity
As public health departments rebuild workforce capacity in the coming years, the most effective model will likely combine a smaller core of highly trained public health professionals with flexible administrative support — including VAs — for the routine documentation work that those professionals should not be spending their time on.
The goal is not to reduce the professional workforce but to give it the administrative infrastructure that allows it to function at its intended capacity.
Sources
- de Beaumont Foundation, Public Health Workforce Study 2024
- Association of State and Territorial Health Officials, Workforce Capacity Survey 2024
- CDC Public Health Informatics and Technology Program, Surveillance System Timeliness Assessment, 2023