| Course | DPH 805 Organizational and Systems Leadership in Public Health |
|---|---|
| Module | Module 6 |
| Paper type | Public health financing paper |
| Length | About 1,054 words, 6 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | Doctor of Public Health |
| Updated | September 2026 |
Free sample paper for DPH 805 Module 6
Paying for Change: Financing Public Health and the Economics of Reorganization
Student Name
Doctor of Public Health Program, Aspen University
DPH 805: Organizational and Systems Leadership in Public Health
Instructor Name
Month Day, Year
Paying for Change: Financing Public Health and the Economics of Reorganization
Leadership decisions are also financial decisions. Reorganizing a health department, launching a new program or ending an old one changes costs, revenues and risks. This paper examines the financing picture for public health and the economics of a proposed change in a composite county health department: creating a cross-cutting team for data analysis and community health workers funded partly by shifting resources from categorical programs.
The Funding Picture
Public health's share of US health spending fell from 2002 to 2014, and per-capita spending declined after 2008 (Himmelstein & Woolhandler, 2016). Much remaining funding arrives as categorical grants tied to specific diseases, leaving core capacities such as data systems, communications and community engagement underfunded.
Foundational Capabilities
Foundational capabilities are the cross-cutting skills every department needs. A study of 16 local health departments using a uniform chart of accounts found per-capita spending on these capabilities ranged from $1.10 to $26.19, with a median of $7.67, with spending higher in bigger, better-funded and accredited departments (Singh et al., 2020). The composite department spends about $4 per resident, below the median.
The Proposed Change
The department proposes a six-person cross-cutting team: two data analysts serving all programs and four community health workers who support chronic disease, maternal health and immunization outreach in the highest-need neighborhoods. Currently, each program funds fragments of these roles, leading to duplication and gaps. Program managers helped design the team so that each program's needs would be met.
Costs and Benefits
The table summarizes the economics of the change.
| Item | Annual amount | Notes |
|---|---|---|
| New team salaries and benefits | $480,000 | Six positions |
| Offsetting reallocations from programs | $310,000 | Portions of existing grant-funded roles |
| Net new cost | $170,000 | Sought from county general fund |
| Expected savings from reduced duplication | $45,000 | Outreach materials, overlapping events |
| Expected new revenue | $90,000 | Medicaid billing for community health worker services |
| Net cost after savings and revenue | $35,000 | Before health benefits |
Return on Investment
Beyond budget effects, the change aims to improve outcomes. Masters and colleagues pooled studies of public health programs in wealthy countries and reported a median return on investment of about 14 to 1, with especially high returns for health protection and legal interventions (Masters et al., 2017). Community health worker programs linked to chronic disease care have shown reduced emergency visits, which benefits health systems and payers.
Braiding and Blending Funds
Categorical grants often restrict how funds can be used. Braiding keeps funding streams separate but coordinates them to support one team, with careful time tracking. Blending pools funds into one stream, which some funders allow. The department will braid funds, charging each program for the share of team time it uses, and negotiate with state funders for more flexibility.
Cost Analysis Methods
Cost analysis will track time spent by team members on each program, direct costs and outcomes such as outreach contacts and referrals completed. Cost-effectiveness can then be expressed as cost per client connected to care or per emergency visit avoided, which boards and funders find meaningful.
Financial Risks
Risks include grant reductions, Medicaid billing taking longer than expected, audit findings if time tracking is weak and pressure to cut the new team in a budget crisis. Mitigation includes a phased start, a reserve for the first year, strong timekeeping systems and early wins to demonstrate value. The finance manager will review time records monthly during the first year.
Making the Economic Case
Leaders must translate economics into terms boards understand: net cost, expected savings, outcomes for residents and alignment with county priorities. A one-page summary with a clear request, supported by local data and a return-on-investment estimate, is more persuasive than a long report.
Economics of Change Management
Organizational change carries hidden costs: staff time for training, temporary productivity dips and potential turnover among staff whose roles change. Budgeting for these transition costs, and involving staff in design, reduces resistance and protects the investment.
Economic Evaluation Options
Cost-effectiveness analysis compares costs with outcomes in natural units, such as blood pressure controlled. Cost-benefit analysis converts outcomes to dollars. Return-on-investment analysis compares financial returns to costs. For a board decision, a simple cost-effectiveness estimate plus budget impact is often most useful.
Equity and Financing
Financing decisions affect equity. Categorical funding may follow political attention rather than need, leaving some communities underserved. The cross-cutting team would be deployed first to the neighborhoods with the highest burden, and financial reports would show spending by neighborhood.
Stakeholder Perspectives on Cost
Program managers may worry about losing staff time; finance officers worry about audit risk; the board worries about new costs. Addressing each concern explicitly, with time tracking, reserve funds and phased implementation, builds support.
Lessons for Leaders
Leaders need financial literacy to advocate effectively. Understanding budgets, grant rules and cost analysis allows leaders to design changes that are financially sustainable and to speak credibly with finance officers and elected officials.
Presenting to the Board
The presentation would open with the problem, fragmented outreach and weak data capacity, then show the team's design, the net cost, expected savings and revenue, projected outcomes and the risks with mitigation. It would end with a specific request and a promise to report results after one year.
Longer-Term Financing Strategy
Beyond this change, the department needs a strategy for stable funding of foundational capabilities: advocating for state foundational funding formulas, seeking flexible local revenue and pursuing partnerships with hospitals whose community benefit spending could support shared priorities.
Transparency
Publishing an annual financial report showing funding sources, spending by program and neighborhood, and outcomes helps build trust with the board and the public and supports future funding requests.
Scenario Analysis
The team modeled three scenarios: if Medicaid billing starts in six months, the net cost falls to about $35,000; if it takes eighteen months, the first-year net cost rises to about $125,000; and if a key grant is cut, the team would shrink to four positions while protecting community health worker roles. Scenarios help the board understand risk.
Conclusion
Public health financing is constrained and fragmented, leaving cross-cutting capacities underfunded. The proposed team addresses this by reallocating categorical funds, seeking modest new county funding and generating revenue through Medicaid billing, with a net cost of about $35,000 a year before health benefits. Careful braiding, cost tracking and a clear economic case allow leaders to finance change responsibly.
References
Himmelstein, D. U., & Woolhandler, S. (2016). Public health's falling share of US health spending. American Journal of Public Health, 106(1), 56-57. https://doi.org/10.2105/AJPH.2015.302908
Masters, R., Anwar, E., Collins, B., Cookson, R., & Capewell, S. (2017). Return on investment of public health interventions: A systematic review. Journal of Epidemiology and Community Health, 71(8), 827-834. https://doi.org/10.1136/jech-2016-208141
Singh, S. R., Bekemeier, B., & Leider, J. P. (2020). Local health departments' spending on the foundational capabilities. Journal of Public Health Management and Practice, 26(1), 52-56. https://doi.org/10.1097/PHH.0000000000000922
What the DPH 805 Module 6 instructions ask for
Aspen's catalog for DPH 805 includes managing the business of public health and the economics of change, and because the sixth module's instructions are not public, this paper works through the finances of a real-world style reorganization. Financing assignments typically ask you to describe funding sources, analyze the costs and benefits of a change and explain how you would make the case to decision makers. Present numbers in a table. Separate reallocations from new money. Include savings and new revenue. Discuss risks and scenarios. Address rules for combining funding streams. Show how you would explain the economics to a board. Include a short summary a board member could read in two minutes.
How this DPH 805 Module 6 example is built
Seventeen headings organize close to 1,050 words; a three-column table lists costs, offsets, savings, revenue and net cost. The paper sets the funding picture and foundational spending, describes the proposed team and presents the table, then covers return on investment, braiding and blending, cost analysis, risks, the economic case and change costs. Economic evaluation options, equity, stakeholder perspectives, lessons for leaders, board presentation, scenario analysis, long-term strategy and transparency follow. A margin comment explains why national funding context comes first. The ending summarizes how leaders can finance change responsibly. Each number in the table matches a sentence in the narrative. A board presentation outline shows how the analysis would be used.
DPH 805 Module 6 rubric: what earns full marks
Financing papers are graded on accurate figures, clear logic from costs to net impact, understanding of funding rules and persuasive communication to decision makers. This paper cites research on public health's shrinking slice of total health spending, a review of returns on public health investment and a study of foundational capability spending in APA format. The cost table is internally consistent. Scenarios show risk awareness. Braiding is explained correctly. Graders value analyses that a finance officer would find credible. Discussing equity in how funds are spent, and planning transparent annual reporting, shows that financing serves the department's mission. A longer-term strategy beyond this change shows strategic thinking.
Common DPH 805 Module 6 mistakes, and how to avoid them
A frequent mistake is presenting costs without offsets or revenue, which overstates the ask. Another is ignoring grant rules on how staff time can be charged. Show gross and net costs. Explain time tracking. Present at least two scenarios. Keep the board summary to one page. When budget vocabulary is new to you, a tutor can explain direct, indirect and in-kind costs with examples. Close with the specific request you would make. Label every cost as recurring or one-time. Explain assumptions behind revenue estimates. Show what happens if a funding source is delayed. Present spending by neighborhood if you can. Keep technical terms to a minimum in board materials. Short is better.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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DPH 805 Module 6 questions, answered
What does DPH 805 Module 6 usually ask for?
Aspen's DPH 805 covers financing and the economics of change, so a financing analysis of a proposed change is a typical assignment. Check your classroom prompt.
What is braiding of funds?
Coordinating separate funding streams to support one effort while tracking and reporting each stream separately.
What are foundational capabilities?
Cross-cutting capacities such as data, communications, community partnership and leadership that every health department needs.
Where can I find a free DPH 805 Module 6 sample paper?
Read the financing paper here, with a table showing costs, offsets, savings, revenue and net cost of the change.
How is the economics of change analyzed in DPH 805 Module 6?
By comparing new costs with reallocations, savings and new revenue, estimating returns and risks, and presenting a clear case to decision makers.