Sustainability Strategies for Specific Issues

Strategies for sustainability may vary by health topic. For example, different strategies may depend on whether a program is trying to sustain the program, activities in the program, a program coordinator, or other staff, or partnerships involved in the program.

There are several strategies for achieving sustainability of community health programs. Successful programs have involved partnerships and coalitions at their core. They also have support from the community being served. Having support from multiple groups and individuals can help to increase investment in the program, share organizational functions, and diversify funding streams.

Several important strategies for achieving sustainability include:

• Strengthening partnerships: Partnerships have the greatest potential to make an impact on rural communities. Building synergy between organizations with common goals has the potential to increase visibility of the program and stress the importance of health messages.
• Building capacity: Training program staff to meet defined levels of proficiency in a given topic ensures that the skills and knowledge needed for program implementation are available to improve community health and wellness. Train-the-trainer models can help ensure that the knowledge and skills gained through trainings is shared and retained in the community.
• Diversifying funding streams: Programs should be supported by more than one funding source. Funding sources can include revenue or reimbursement, leveraging existing resources, grants, and fundraising. To generate revenue, some rural programs request participant or employer fees. Other programs have sought reimbursement through state Medicaid programs or accountable care organizations (ACO), leveraged resources from organizations like governmental agencies or hospitals, sought one-time or renewable grants, and participated in fundraising activities.
• Informing organizational or structural changes: Evaluation findings can inform the decision of which program elements should continue to be provided and by whom. Some rural communities choose sustainability plans that scale down operations, decrease the number of program offerings, participants, and services offered, or distribute responsibilities to willing coalition members.
• Developing effective messaging: Communication and messaging strategies can have a lasting impact on health topics by raising awareness and creating a conversation causing people to rethink their behaviors and decisions.

Some community programs may seek reimbursement for certain activities. For more information, see the Reimbursement for Services section of the Care Coordination Toolkit and the Funding and Sustainability Module of the Community Health Workers Toolkit.