Estimating the financial resources needed for local public health departments in minnesota: A multimethod approach

Objective: This study presents a model for determining total funding needed for individual local health departments. The aim is to determine the financial resources needed to provide services for statewide local public health departments in Minnesota based on a gaps analysis done to estimate the funding needs. Design: We used a multimethod analysis consisting of 3 approaches to estimate gaps in local public health funding consisting of (1) interviews of selected local public health leaders, (2) a Delphi panel, and (3) a Nominal Group Technique. On the basis of these 3 approaches, a consensus estimate of funding gaps was generated for statewide projections. Setting: The study includes an analysis of cost, performance, and outcomes from 2005 to 2007 for all 87 local governmental health departments in Minnesota. Participants: For each of the methods, we selected a panel to represent a profile of Minnesota health departments. Main Outcome Measures: The 2 main outcome measures were local-level gaps in financial resources and total resources needed to provide public health services at the local level. Results: The total public health expenditure in Minnesota for local governmental public health departments was $302 million in 2007 ($58.92 per person). The consensus estimate of the financial gaps in local public health departments indicates that an additional $32.5 million (a 10.7% increase or $6.32 per person) is needed to adequately serve public health needs in the local communities. Conclusions: It is possible to make informed estimates of funding gaps for public health activities on the basis of a combination of quantitative methods. There is a wide variation in public health expenditure at the local levels, and methods are needed to establish minimum baseline expenditure levels to adequately treat a population. The gaps analysis can be used by stakeholders to inform policy makers of the need for improved funding of the public health system.