Structuring a framework for public health performance-based budgeting: a Georgia case study

The ability of public health to meet its functional mandates of assessment, assurance, and policy development footline is driven by the system's capacity to meet basic financing needs. To do so, state and local public health leaders must be able to articulate financing needs in terms that are understandable to policy makers and that link funding to anticipated community impact, benefit, and performance. "Rational" budgeting demands imposed by performance-centered budgeting in the states have proved particularly challenging for public health programs. This Georgia-based case study explores one approach for program budgeting in state and regional public health systems and finds the framework to be normatively sound and appropriately descriptive of the "core functions" of public health. The structure clearly distinguishes between personal health services and population health and allows for the future establishment of measurable program targets, an essential feature of a performance-centered budgeting system.