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APHA Scientific Session and Event Listing

Recorded presentation

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

1)Compare selected states on the bases of consistencies and innovations in financing local public health activities and programs;
• Correlate the organizational characteristics of the public health systems and the funding formulas used for local public health programs and activities; and
• Recognize potential associations between funding approaches and such system characteristics as program types, population health, and performance effectiveness.

Keywords: Financing, Public Health Service

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation