This month, we continue our exploration of definitions, focusing on the term foundational. Defined as “the natural or prepared ground or base on which some structure rests,” when translated into public health services, we are talking about the suite of skills, programs and activities that must be available everywhere for the health system to function equitably, anywhere. Add to that the need to describe public health services in a manner that allows costs to be ascribed, and the foundational public health services (FPHS) model was born.

The model consists of both foundational areas, which are substantive areas of expertise or program-specific activities, and foundational capabilities, which are the cross-cutting skills and capacities needed to support the foundational areas. The model further leaves space for community-specific programming that is based on local needs, often referred to as additional important services, and vary from community to community.

Thus the model addresses both the infrastructure and programming needed to support a responsive and sustainable agency. Systems and agencies across the country are using the model to encourage support for funding and to articulate or consider their role in a changing landscape as public health departments’ focus may shift toward, or away from, provision of population based services.