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[ Recorded presentation ] Recorded presentation

State funding formulas for local public health

Margaret A. Potter, MS, JD and Tiffany Fitzpatrick. Center for Public Health Practice, University of Pittsburgh Graduate School of Public Health, Forbes-Allies Center, Suite 210, 3109 Forbes Avenue, Pittsburgh, PA 15260, 412-383-2400, potterm@edc.pitt.edu

This paper addresses the lack of nationally applicable classifications of state formulas for the funding of local public health activities – a deficit that has inhibited the development of an evidence-base for best practices and policy alternatives. The purpose is to lay a foundation for classifying state funding of local public health by systematically reviewing previously reported classification methods and by describing the funding formulas currently in use within selected states. Our thirty-year literature review of state-local public health systems relevant to financing local units has revealed alternative state classification systems based on: organizational type (centralized/decentralized); local control over programs and funding (high/low); legal authority for essential services; state/local distribution of public health responsibilities (top-down vs. bottom-up); use of performance-based funding; and proportion of local budget administered by state. Using a cross-section of these classifications, we selected seven states for in-depth review of formulas in use for funding local public health agencies including: per-capita allocations, state matching grants, federal block grants, federal competitive grants and earmarks, performance-based funding, state mandated funding “floors,” and population-density formulas. A case study for each state was developed from published sources and validated through the key-informant interviews. The case study analysis considers whether any particular essential services are associated with particular funding formulas; whether particular program types (i.e., block grants for maternal/child health programs) are associated with particular funding formulas; whether geographic areas are associated with particular funding formulas; and whether indicators of population health or agency performance are associated with particular funding formulas.

Learning Objectives: At the conclusion of this presentation, audience members will be able to

Keywords: Financing, Public Health Service

Presenting author's disclosure statement:

Any relevant financial relationships? No

[ Recorded presentation ] Recorded presentation

Financing Public Health Services: Research and Practice

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA