Resource Mobilization and Sustainability: Funding the Future of Public Health Programs

A brilliant program design means nothing without resources to implement it. And a well-funded launch means little if the program can't sustain itself.

This week addresses the fundamental questions: Where does the money come from? How do we keep it coming?

Budgeting Fundamentals

The Budget as Moral Document

A budget isn't just accounting—it's a values statement. Where money goes reveals what an organization truly prioritizes, regardless of what mission statements claim.

Budget reveals:

• Who gets paid (and how much)
• What activities actually happen
• Where resources concentrate
• What's deemed expendable

Budget Categories

Personnel:

• Salaries for program staff
• Based on FTE (Full-Time Equivalent)
• Include all positions needed

Fringe Benefits:

• Health insurance, retirement
• Typically calculated as percentage of salary
• Often 25-40% of salary

Other Than Personnel Services (OTPS):

• Supplies and materials
• Equipment
• Consultants and contracts
• Travel
• Communication
• Participant incentives

Indirect Costs:

• Organizational overhead
• Facilities, administration, utilities
• Calculated as rate (often 10-30% of direct costs)

Budget Development Process

1. Start with activities: What does the program do?
2. Identify resources needed: What's required for each activity?
3. Price resources: What does each resource cost?
4. Calculate totals: Sum by category
5. Apply indirect rates: Add organizational overhead
6. Review and adjust: Align with funding limits

Budget Justification

Each line item needs narrative explanation:

Weak Justification:

"Supplies: $5,000"

Strong Justification:

"Supplies ($5,000): Includes curriculum materials for 150 participants ($15/person = $2,250), cooking demonstration supplies for 12 sessions ($100/session = $1,200), blood pressure monitors for screening events (5 @ $150 = $750), and general office supplies ($800)."

Common Budget Errors

• Underestimating fringe: Organizations often forget full benefits cost
• Missing indirect: Funders may allow indirect costs you're not claiming
• Unrealistic salaries: Too low (staff turnover) or too high (questioned)
• Insufficient supplies: Programs run out of materials
• No contingency: Zero buffer for unexpected costs

Innovative Finance: Social Impact Bonds

Beyond Traditional Grants

Grants have limitations:

• Competitive and uncertain
• Often short-term
• Fund activities, not outcomes
• Limited scaling potential

Social Impact Bonds (SIBs) / Pay for Success offer an alternative model.

How Social Impact Bonds Work

1. Private investors provide upfront capital for program delivery
2. Service providers implement evidence-based interventions
3. Independent evaluator measures outcomes
4. Government repays investors (with return) only if outcomes are achieved
5. If outcomes aren't achieved, investors lose their investment

Key Elements

Payable Outcomes:

• Specific, measurable results
• Government saves money if achieved
• Savings justify repayment with return

Risk Transfer:

• Risk shifts from government to investors
• Government pays only for results
• Investors conduct due diligence on program effectiveness

Rigorous Evaluation:

• Independent assessment required
• Randomized or quasi-experimental design
• Clear counterfactual comparison

Suitable Programs

SIBs work best for programs that:

• Address costly social problems
• Have strong evidence base
• Generate government savings
• Can be rigorously evaluated
• Have clear causal pathways

Examples:

• Early childhood education (reduces special education costs)
• Recidivism reduction (reduces incarceration costs)
• Chronic disease prevention (reduces healthcare costs)
• Homelessness prevention (reduces emergency service costs)

Limitations

• Complex to structure
• Transaction costs can be high
• Requires government willingness
• Not suitable for all programs
• Evaluation challenges

Grant Writing Strategy

Understanding Funder Priorities

Before writing, research the funder:

Foundation Analysis:

• Mission and theory of change
• Historical funding patterns
• Geographic focus
• Population priorities
• Typical grant sizes
• Multi-year funding availability

Federal Grant Analysis:

• Agency priorities and strategic plans
• Funding opportunity announcement (FOA) requirements
• Review criteria and weighting
• Success rates and competition

Standard Grant Components

Specific Aims / Executive Summary:

• One page maximum
• Clear problem statement
• Proposed solution
• Expected outcomes
• Why this team

Significance / Need:

• Magnitude of problem
• Impact on target population
• Gap your program addresses
• Why now

Innovation:

• What's new about your approach
• How this advances the field
• Unique contributions

Approach:

• Detailed methodology
• Theory of change
• Logic model
• Timeline
• Evaluation plan

Alignment Strategy

"Align your mission with their priorities, not the other way around."

Strong proposals show:

• How your program advances funder goals
• Why you're the right organization
• How this fits their portfolio
• Evidence supporting your approach

Weak proposals show:

• How the funder can help your organization
• Everything you want to do
• Loose connection to funder priorities

Review Criteria Response

Address every criterion explicitly:

| Criterion | Our Response | |-----------|--------------| | Significance | Section 2 addresses... | | Innovation | Section 3 demonstrates... | | Approach | Section 4 details... | | Investigator | Section 5 establishes... |

Reviewers shouldn't have to hunt for evidence you meet criteria.

Sustainability Frameworks

Beyond Financial Sustainability

Program sustainability encompasses multiple domains:

Financial Sustainability: Diverse, reliable funding streams

Organizational Sustainability: Internal capacity, leadership, systems

Partnership Sustainability: Relationships with key collaborators

Community Sustainability: Local ownership and support

Political Sustainability: Policy environment and advocacy

The Program Sustainability Assessment Tool

Eight domains of sustainability:

1. Environmental Support: External conditions supporting program
2. Funding Stability: Established, consistent financial resources
3. Partnerships: Connections to organizations supporting mission
4. Organizational Capacity: Internal skills and resources
5. Program Evaluation: Systematic assessment of effectiveness
6. Program Adaptation: Ability to adapt and improve
7. Communications: Strategic dissemination of program information
8. Strategic Planning: Process for long-term direction

Sustainability Planning

For each domain:

• Assess current status (strength/vulnerability)
• Identify gaps and threats
• Develop strategies to strengthen
• Assign responsibility
• Set timeline

Funding Diversification

Don't rely on single funding source:

Diversification Strategies:

• Multiple foundations
• Mix of government and private funding
• Fee-for-service revenue
• Social enterprise components
• Individual donors
• Corporate partnerships

Rule of Thumb: No single funder should represent more than 30-40% of total budget.

The Social Impact Pitch

Beyond Grant Writing

Public health leaders must be compelling advocates—in board rooms, legislative hearings, and funder meetings. The Social Impact Pitch is your verbal proposal.

Pitch Structure

The Problem (30 seconds):

• Compelling statement of need
• Human impact, not just statistics
• Why this matters

The Solution (45 seconds):

• What you're proposing
• How it works
• Evidence it's effective

The Innovation (30 seconds):

• What's new about your approach
• Why this is better than alternatives

The Business Model (45 seconds):

• How much it costs
• Where funding comes from
• What sustainability looks like

The Team (30 seconds):

• Why you're the right people
• Relevant experience and credibility

The Ask (15 seconds):

• Specific request
• Clear next steps

Storytelling Over Statistics

"Data makes people think. Stories make people feel. People act on feeling."

Data alone:

"Diabetes affects 12% of our population, costing $2.3 million annually in emergency care."

Data with story:

"Maria is one of 15,000 people in our county living with uncontrolled diabetes. Last year, she visited the ER four times—at $5,000 per visit—for problems that could have been prevented with proper management. Multiply that by thousands of Marias, and you understand why our county spends $2.3 million on diabetes emergencies. Our program finds the Marias before they end up in the ER."

Practice and Refinement

Pitch delivery matters as much as content:

• Time your pitch (aim for 3-5 minutes)
• Practice with different audiences
• Anticipate questions
• Refine based on feedback

Course Navigation

• Week 1: Systems Thinking
• Week 2: AI-Augmented Needs Assessment
• Week 3: Human-Centered Design
• Week 4: Logic Models
• Week 5: Intervention Design
• Week 6: Agile Implementation
• Week 7: Resource Mobilization (You are here)
• Week 8: Evaluation & Storytelling