Resources to Support Sustainability in Public Health

As public health confronts workforce shortages and declining investment, leaders must work strategically to sustain both the workforce and effective programs for the long term. With funding through the Public Health Infrastructure Grant, Trailhead and HRSA Region 8 partners are identifying strategies and resources to support sustainability efforts in three key areas:

Staff

Programs

Funding & Finance

At the regional convening for the Public Health Infrastructure Grant, Trailhead discussed sustainability strategies and insights with public health leaders across HRSA Region 8, including Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming. The following key themes, strategies, and resources emerged from these discussions.

Staff Sustainability Resources

Strong teams and supported staff are the foundation of effective public health programs. Public health leaders from HRSA Region 8 offered insights on how to better support teams, highlighting the following themes:

  • Be Transparent and Communicate: 

    Staff value honesty, regular feedback, and updates about roles and expectations. 

  • Support Wellbeing

    Balance work-life needs, support professional development, and prioritize wellness. 

  • Be Flexible and Adapt:

    Support remote options, flexible structures, and be responsive to change. 

  • Build a Positive Culture:

    Maintain a culture of mutual support, connection, and joy.

  • Drive Decisions with Data:

    Expect leaders to use data for decision-making and accountability.

  • Develop a Staff Engagement Framework: Schedule quarterly check-ins to discuss wellbeing, growth goals, and feedback.
  • Conduct Annual Position Audits: Review job descriptions each year to ensure they are up to date and equitable.
  • Implement a Professional Growth Fund: Offer reimbursement for education or training and pair staff with mentors. Invest in your team’s development.
  • Promote a Culture of Transparency: Share organizational updates, financial status, and data dashboards openly.
  • Flexible Work Policy: Formalize guidelines for hybrid and remote work arrangements.
  • “Joy in Work” Initiative: Celebrate small wins, encourage team recognition, and integrate reflection practices into meetings regularly.

Program Sustainability Resources

Thoughtful program planning, partnerships, and design help ensure long-term impact. Public health leaders from HRSA Region 8 offered insights on approaches to support program sustainability, highlighting the following themes:

  • Align Programs with Your Mission and Strategic Goals: 

    Programs should connect directly to the organization’s strategic goals and community needs. 

  • Be Innovative and Responsive:

    Encourage new ideas and adaptability to opportunities that emerge. 

  • Practice Collaboration and Systems Thinking: 

    Working together across departments and forming partnerships is crucial.

  • Be Efficient and Focused:

    Streamline efforts, reduce duplication, and focus on high-impact activities using Lean Management principles.

  • Learn and Improve:

    Commit to training staff, program evaluation, and ongoing development. 

  • Regularly Review and Strengthen Programs: Evaluate all programs annually for alignment, impact, and resource use. Sunset or scale programs as needed.
  • Create Cross-Functional Planning Teams: Include staff from multiple departments or teams in program design and decision-making.
  • Pilot Programs: Understand the needs and gaps that are being filled by the program and determine if the community is ready to engage.
  • Implement Lean Management: Provide staff training on efficiency tools and process improvement.
  • Engage Community Members and Boards: Involve community members and Board members to ensure programs reflect organizational priorities and community needs, and keep the Board well-informed.
  • Coordinate with Partners: Identify key stakeholders and develop shared projects to avoid duplicating program work.

Funding and Finance Sustainability Resources

Funding and financial management are essential to sustaining public health work. Public health leaders from HRSA Region 8 shared insights on securing funding and maintaining the financial sustainability of key public health programs, highlighting the following themes:

  • Be Transparent and Communicate: 

    Have clear, open discussions about the organization’s financial health and decisions that impact staff and programs.

  • Prioritize Strategic Growth and Sustainability

    Diversify funding, explore earned income and Fee-for-Service (FFS), and build reserves.

  • Build Strong Partnerships Between Finance and Programs:

    Collaborate regularly to ensure budgets align with program goals.

  • Shift Mindsets:

    Move from scarcity thinking to collaborative resource sharing.

  • Clarify Regulatory and Structural Requirements:

    Define braided and blended funding models and provide clear guidance on indirect cost allocations.

  • Hold Monthly Finance Collaboration Meetings: Create space for finance, program, and leadership teams to align goals and review progress.
  • Develop a Sustainability Roadmap: Outline steps for diversifying funding, including private and fee-for-service opportunities.
  • Use a Financial Transparency Dashboard: Share simplified visuals of financial status, reserves, and major funding sources with staff and Board members.
  • Establish a Rainy-Day Fund: Support organizational stability and experimentation.
  • Provide Training on Braided/Blended Funding Models: Ensure staff understand compliance, tracking, and flexibility under funding regulations.
  • Shift the Culture Around Resources: Facilitate workshops on abundance mindset, collaboration, and shared accountability.

  • The 2023 Colorado Public Health Workforce Gaps & Needs Assessment was conducted to understand workforce needs in Colorado, gather missing data through a new survey, and integrate existing and new information to define the current state of Colorado’s public health workforce and guide future development.
  • Explore how Trailhead created a new messaging platform to clearly convey the organization’s unique role as a public health institute in Colorado, helping to strengthen funding opportunities and support long-term sustainability.

Thank You to Our Partners

This work is made possible through the collaboration and insight of public health colleagues Association of State and Territorial Health Officials (ASTHO), Centers for Disease Control and Prevention (CDC), Colorado Department of Public Health and Environment, Denver Department of Public Health and Environment, Montana Public Health Institute, National Network of Public Health Institutes (NNPHI), North Dakota Department of Health and Human Services (NDDHHS), Public Health Institute at Denver Health, Rocky Mountain Public Health Training Center, Trailhead Institute, Utah Department of Health and Human Services, South Dakota Department of Health, and Wyoming Department of Health – Public Health Division.