Following the Money

Abstract

This article describes the nature and utility of fiscal analysis in evaluating complex community interventions. Using New York University's evaluation of the Robert Wood Johnson Foundation's Urban Health Initiative as an example, the authors describe issues arising in defining and operationalizing constructs for fiscal analysis. The approach's utility is demonstrated in the use of interim findings to help redefine the program's goals for resource allocation, to modify its theory of change to include greater emphasis on state-level action, and to emphasize the importance of local public schools as resource centers and intervention targets. The fiscal analysis also provides new insights into the limitations of "preventive" versus "corrective" spending categories and helps make goals for such functional reallocation more realistic. The authors discuss limitations of fiscal analysis due to available data quality, the extent of cooperation needed from public officials to collect relevant data, and the level of expertise needed to interpret the data.

Evaluation of the SB 1041 Reforms to California's CalWORKs Program: Background and Study Design

“…Using the data about staffing and budgets that we obtain for the six focal counties, we plan to further document the effects of SB 1041 through a "follow the money" analysis that explicitly examines how counties change how they allocate staff and other resources in response to the mandate to implement SB 1041 (Brecher et al, 2005). Such an analysis goes beyond asking managers and staff about their plans and intentions; it more objectively documents how those plans affect actual resource decisions within the fiscal constraints facing counties and their CalWORKs agencies.…”

Health Services Research and the City

“…For example, in the U.S. it is common to distinguish northeastern rust-belt, de-industrializing cities from the rapid growing sun-belt cities of the southwest. Alternatively, the U.S. Department of Housing and Urban Development (HUD, 1999b) distinguished a set of "double trouble" cities due to their high unemployment, significant population loss, and/or high poverty rates; and the RW Johnson Foundation's urban health initiative has selected five "distressed cities" for specific interventions and evaluations of their effectiveness (Weitzman, et al, 2002;Brecher, et al, 2004).…”