Public Health Finance

The sustainability of the governmental public health system depends on the financial health of state and local public health agencies. This is a challenge because public health programs and services are often provided in fiscally strapped environments (e.g., government revenue declines, budget reductions, economic recessions, unfunded mandates). NACCHO's research and engagement with local health departments (LHDs) across the country provides a national perspective on the local public health financial situation. This website provides resources to help LHDs sharpen their big picture understanding of local public health finance and enhance their individual organizational financial health.

501(c)(3) Decision Guide for Local Health Departments in Community Health Coalitions

The goal of this decision guide is to increase local health departments’ (LHDs’) knowledge of the advantages, disadvantages, and considerations of formalizing a community health coalition under 501(c)(3) nonprofit status through the Internal Revenue Service (IRS) to assist with their community health improvement (CHI) efforts.

Innovation Snapshots and Webinar Series

NACCHO conducted a systematic literature review to uncover various ways in which local health departments and their partners use innovative financing approaches to address their community health needs, or to address limited funding. Additionally, NACCHO conducted key informant interviews with local health departments nationwide to develop a deeper understanding of these methods and gather case examples of each.

The Innovation Snapshots describe the benefits, considerations, and case examples of the funding mechanisms.

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    501(c)(3) Backbones for Community Health Coalitions

    This strategy involves establishing a coalition under 501(c)(3) nonprofit status or adopting a nonprofit administrative backbone.

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    501(c)(3) Backbones for Community Health Coalitions

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    Cross-jurisdictional Sharing

    This strategy involves collaborating across jurisdictions to deliver essential public health services.

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    Cross-jurisdictional Sharing

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    Local Foundations

    This strategy involves working with local foundations to provide alternative, more flexible funding to LHDs to meet community needs.

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    Local Foundations

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    Participatory Budgeting

    This strategy centers on involving community members in making decisions about how and where funding is allocated to meet community needs.

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    Participatory Budgeting

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    Community Based Organizations

    This strategy involves partnering with community based organizations to expand program access to more communities.

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    Community Based Organizations

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    Blending and Braiding

    This strategy involves combining funding streams to increase support for a goal or initiative.

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    Blending and Braiding

    This three-part webinar series features presentations from the local health departments featured in the Snapshots who describe their work and tips for implementing the innovations.

    With support from the Centers for Disease Control and Prevention (CDC), NACCHO worked with JP Leider, PhD and Jason Orr, MPH to conduct interviews and develop case studies of three local health departments to understand how the federal grants and cooperative agreements from the CDC make their way to local health departments across the country. These case studies discuss the importance of characterizing requirements and synthesize learnings on delivering upon agreements and the impacts of facilitating and impeding requirements.

    A multi-county health department in the Southeast region of the United States, serving a largely rural population greater than 200,000.

    A midwest region of the United States, serving a semi-urban population greater than 200,000.

    A local health department serving an urban population greater than one million.

    Join the Local Public Health Finance Community of Practice (CoP)!

    The purpose of the CoP is for local health department finance staff to connect with their peers, share resources, discuss common challenges, and provide insight into the needs of local public health finance nationwide.

    The CoP meets quarterly. To learn more and register for upcoming meetings, join the Virtual Community.

    Elearning course pic

    Public Health Infrastructure

    eLearning courses and programs to build financial knowledge

    eLearning courses and programs to build financial knowledge and skills to support public health

    Public Health Infrastructure

    eLearning courses and programs to build financial knowledge

    Public Health Infrastructure

    What is a UCOA?

    This website offers consistent financial reporting that helps make the evidence-based case for public health funding decisions.

    Public Health Infrastructure

    What is a UCOA?

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    For more information on public health finance, you can email phisteam@naccho.org.

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