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.

Public Health Infrastructure

Financial Strategic Planning Fact Sheet

This fact sheet describes findings and recommendations from interviews with two local health departments about their financial strategic planning.

Public Health Infrastructure

Financial Strategic Planning Fact Sheet

Public Health Infrastructure

Local health Department Funding Experiences

The Local Health Department Funding Experiences white paper highlights the challenges and dynamics of public health funding at the local level.

Public Health Infrastructure

Local health Department Funding Experiences

Public Health Infrastructure

Grants Management Quick Reference Guide

Outlines key policies, procedures, tools, and compliance elements to include in your Grants Management Quick Reference Guide.

Public Health Infrastructure

Grants Management Quick Reference Guide

Innovation Snapshots and Webinar Series

The Innovation Snapshots describe the benefits, considerations, and case examples of seven funding mechanisms that local health departments use to address local community needs and limited funding. NACCHO conducted a systematic literature review and key informant interviews with local health departments to learn about these methods: 501(c)3 Backbones for Community Health Coalitions, Cross-Jurisdictional Sharing, Community Based Organizations, Budgeting, Braiding and Blended Funding, and Local Foundations.

NACCHO hosted a three-part webinar series with presentations from the local health departments featured in the Snapshots to describe their work and tips for implementing the innovations.

The goal of the 501(c)3 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. Download the Decision Guide and view the accompanying webinar via the link below.

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Innovation Snapshots

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

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Innovation Snapshots

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Public Health Innovative Funding Webinar Series

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

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Public Health Innovative Funding Webinar Series

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501(c)3 Decision Guide and Webinar

This decision guide outlines considerations for formalizing a community health coalition under 501(c)(3) nonprofit status through the IRS.

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501(c)3 Decision Guide and Webinar

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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Join a Listening Session on July 9, 23, or 30, 2026.

Jun 22, 2026 | Shannon Duffy

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See a report of current local health department stockpiling infrastructure and...

Jun 22, 2026 | Shannon Duffy

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NACCHO Awards $60,000 to Support Breastfeeding and Early Childhood Nutrition

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Request for Applications: 2026-2027 Wastewater Monitoring Mentorship Program

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Jun 18, 2026 | Rebecca Rainey

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For more information on public health finance, you can email [email protected].

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