257091 Quantifying the resource allocation process at state health agencies

Monday, October 29, 2012

JP Leider, PhD , Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Jessica Young, MS , Office of Public Health Practice & Training, Johns Hopkins School of Public Health, Baltimore, MD
Beth Resnick, MPH , Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
State health agencies are faced with many constraints while making resource allocation decisions - politics, finances, as well as statutory and regulatory mandates, among others. The aim of this project is to quantify the frequency and impact of common actions occurring in the resource allocation process at state health agencies, and examine differences and similarities that present across agencies and position types. As part of a national, web-based survey of state public health leaders, respondents were asked several questions regarding the resource allocation process. In total, 207 respondents (67% response rate) responded to the survey. At each state, several positions were contacted to complete the survey, including the CEO, CFO, Senior Deputy, Legislative Liaison, and the heads of Environmental Health, Preparedness, and Maternal Child Health. The data suggest that state public health leaders are highly consultative internally while making resource allocation decisions, but also frequently engage with the governor's office and the legislator - much more so at the executive level than the division/bureau level. Forty-one percent of respondents indicated they never or rarely use economic analyses or decision/prioritization tools, respectively, when making resource allocation decisions. Respondents also indicated that some activities occur with some frequency, but only affect their division or agency's budget around the margins - for instance, shifting funds from one population to another, adding activities or even eliminating activities. However, respondents said increasing and decreasing funding for certain activities both occurs frequently and has a moderate impact on the agency or division budget. Along with open-ended responses, these data suggest agencies continue to ‘thin the soup,' or prefer cutting broadly to cutting deeply. These and other findings offer quantification of important, varied practices affecting budget and priority setting that have not been well-described to-date for state health agencies.

Learning Areas:
Administration, management, leadership
Program planning
Public health administration or related administration
Public health or related research

Learning Objectives:
Identify salient differences in resource allocation processes across executives and division heads. Discuss the consequences of these differences to public health practice.

Keywords: Financing, Practice

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As part of a team, I conceptualized, conducted and analyzed the research in question, am a doctoral student trained in quantitative and qualitative methods. I have been working in systems research since 2010.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.