What You Value is What You Budget

The North Carolina Institute for Public Health (NCIPH) recently finished a pilot course strengthening the connection between local health department finance and program staff through an interactive strategic skills training known as Strategic Scholars. The program follows a national model developed and implemented by the Centers for Disease Control and Prevention (CDC) and the National Network of Public Health Institutes (NNPHI) that trains two-person local health department teams: one team member represents finance and administration, and the other represents programming. This process enables team members to discuss their learning and share how it applies to their work. It helps establish a common language and understanding between the two sides which ultimately leads to an increase in financial and resource management skills, leadership skills, communications skills, and management of teams. The pilot course was funded through a grant from the Blue Cross and Blue Shield of North Carolina Foundation.

One of the main goals of this effort was to bridge the cause and effect of budgets and programming and bring both sides closer to their mission. It was a learning opportunity to bring financial and administration people into the fold with project people.

“We wanted them to be able to learn together, open each other’s minds, and do things together to make everything run smoother,” said Steve Orton, senior fellow for public health leadership at NCIPH.

Overall, the program focused on budget management training. Often public health professionals who work in the field do not have to do budget management. However, they should keep it in mind because they influence how the budget is expended and can help determine where to make adjustments to increase reach and impact. The Strategic Scholars course provides participants with a background on budgeting and contracts, teaches them what to do once funding has been allocated, and offers guidance on how best to manage those funds, especially within the constraints of funder guidelines.

“It’s more than just math or even a budgeting class. There’s a lot of strategy and project management involved,” explained Ki’yonna Jones, a training associate with the North Carolina Institute for Public Health.

Building bridges

It’s not uncommon for the finance and administration professionals in health departments to stay in their siloes—and program and project managers often do the same. Jones said it can be challenging to connect the two sides despite them being inextricably linked. Bridging program and budget sides was one of the most significant long-term benefits of this pilot course.

“We wanted to drive home the point of why the two sides need to talk and understand each other,” said Jones. “When starting a new program, [program managers] need to partner with the financial person so that the budget tells the program’s story.”

Jones said they wanted to show how connecting these two sides can create a more initiative-taking approach to budgeting because it strengthens programs and helps build a strong partnership between finance/administration teams and programmatic staff.

“Having people work together in this way keeps the big picture in view,” said Jones. “We can easily get too focused on maintaining our silos. Building these partnerships keeps everyone focused on the mission of improving public health.”

The nuts and bolts of pilot

The Strategic Scholars Course employs a community of practice cohort model and multiple learning modalities. The budget and financial management content is delivered to the scholars through the Building Expertise in Administration & Management (BEAM) program. BEAM is an online certificate program in budget and financial management developed by the University of Miami’s public health and business programs, the de Beaumont Foundation, and other leading organizations.

The course also includes coaching from subject matter experts and participants initiate a project in their agencies for real-world application of the material.

“Altogether, the added support helped ensure learning is happening and address gaps in knowledge before they become too large,” said Orton “There were accountability measures, peer learning, peer sharing, so there’s a deeper understanding of the content and applying it to real life when you have a coach.”

According to Orton, public health professionals often attend training that does not fully engage them, which is an especially significant challenge to overcome with web-based programs. Incorporating a shared project into the Strategic Scholars course created more profound learning and real-life application.

Impact and application

NCIPH encourages public health leaders to explore this type of engaging, cross-sector training to meet the future needs of the workforce. Getting leaders to recognize the interconnectedness between the budget and project management will enable them to lead by example. Implementing these concepts into organizational culture and procedures in health departments can have huge impacts on organizational communication and effectiveness.

Health departments face a dual funding challenge—the amount and the availability. Many health departments have experienced periods of being resource deficient. They can triage where to send their limited resources, but there’s a unique challenge on the other end of that spectrum. Jones said it’s important to be able to strategize with project managers when there’s a sudden influx of funding, especially when it has a deadline to be spent.

“There are times when funding is made available, and they need to hurry up and spend it by a certain date,” said Jones. “If they have these skills in mind, and these partnerships in place, they can be proactive and allocate those resources in a way that leverages impact and sustainability.

By creating a partnership and open line of communication between finance professionals and project managers, health departments can ask—and answer—the right questions. That level of connection and communication creates opportunities for projects waiting for the right amount of funding. Jones emphasized that these connections and understandings across different areas in the organization only lead to better outcomes for the community and public health in general.

“When health departments become stronger financially and programmatically, it’s a stronger organization,” she said. “It creates a stronger entity that is united to better serve their community.”

Future training

The pilot allowed NCIPH to gain insight into how various course structures and pacing elements contributed to participant learning. They found that application projects are helpful in building skills but when and how to introduce that project is crucial. If a project is brought in too early, learners may approach it with previous methods instead of using new knowledge gained from the training.

Additionally, NCIPH learned that web-based training significantly improves with peer-to-peer learning and coaching. Striking the right balance of time between each meeting is also crucial because community-building may be stalled when there’s too much time between webinars.

NCIPH plans to incorporate these lessons in future courses because the program created such a strong connection of collaboration between finance and administrative and programmatic staff. That kind of connection will foster a better public health environment for entire communities.


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