| Course | D623 Public Health Finance and Funding |
|---|---|
| Task | Task 1 |
| Paper type | Program budget and funding plan |
| Length | About 1,100 words, 5 pages |
| Format | APA 7 |
| School | Western Governors University (WGU) |
| Program | Master of Public Health |
| Updated | September 2026 |
Free sample paper for D623 Task 1
A Clinic on Wheels, Line by Line: Comparing Funding Sources, Building a Two-Year Budget and Evaluating the Budgetary Needs of a Composite County's Mobile Vaccination Unit
Student Name
Leavitt School of Health, Western Governors University
D623: Public Health Finance and Funding, Task 1
Course Instructor
Month Day, Year
A Clinic on Wheels, Line by Line: Comparing Funding Sources, Building a Two-Year Budget and Evaluating the Budgetary Needs of a Composite County's Mobile Vaccination Unit
The Initiative
Vaccination coverage among U.S. kindergartners has slipped. For the 2023-24 school year, coverage for required vaccines fell below 93%, compared with about 95% before the pandemic, and exemptions rose to 3.3%, with 14 jurisdictions reporting that more than 5% of kindergartners had an exemption (Seither et al., 2024). Clearwater County, a composite county whose population is roughly 210,000, has seen similar declines, concentrated in rural areas far from clinics and in neighborhoods with many uninsured families. The county health department proposes a mobile vaccination unit that would visit schools, rural community centers, farmworker housing and senior centers, offering childhood catch-up vaccines and adult vaccines such as influenza and Tdap, with a target of 6,000 doses a year.
Mobile clinics can reach people fixed clinics miss. During the COVID-19 pandemic, six mobile health clinics in South Carolina delivered more than 12,000 vaccine doses to 8,545 people at 149 sites; 44.2% of those served were uninsured, and use was greater in communities facing access barriers (Rennert et al., 2024).
The Economic Case
Finance officers and funders will ask whether the unit is worth its cost. The broader evidence on childhood vaccination is strong: among about 117 million U.S. children born from 1994 to 2023, routine childhood vaccinations are estimated to prevent about 508 million lifetime illnesses, 32 million hospitalizations and 1,129,000 deaths, with net savings of about $540 billion in direct costs and $2.7 trillion in societal costs (Zhou et al., 2024). A mobile unit does not create those benefits by itself, but it extends them to children and adults who would otherwise be missed. At the projected 6,000 doses a year, the unit's second-year cost works out to about $60 per dose delivered, including staff, travel and overhead. That figure gives the county a benchmark to compare with its fixed clinics and to track as the unit matures, since cost per dose should fall as scheduling improves and sites are chosen more carefully.
Comparing Funding Sources
Five funding sources were compared on amount, flexibility, reliability and fit.
| Source | What it can pay for | Flexibility | Reliability | Fit |
|---|---|---|---|---|
| Federal immunization funds through the state cooperative agreement | Vaccine for underinsured adults and some operations | Low; restricted to immunization activities and federal rules | Uncertain; recent cuts to pandemic-era funds | Good for vaccine and staff time |
| Vaccines for Children program | Free vaccine for eligible children | None; vaccine only | High | Essential for childhood doses |
| Regional foundation grant | One-time capital, including the vehicle | Moderate | One-time | Best source for start-up costs |
| Hospital community benefit contribution | Operations | High | Annual, renewable | Good for staff and operating costs |
| Billing insurers for adult vaccines and administration fees | Operations | High | Depends on collections | Supports sustainability |
The comparison shows that no single source can support the unit. Capital costs fit a one-time foundation grant, vaccine for children must come from the federal program, and operations should combine a hospital contribution, federal immunization funds and billing revenue, so that the loss of any one source does not end the program.
The Budget
The two-year budget follows standard principles: it separates personnel from other direct costs, one-time capital from ongoing costs and direct from indirect costs, and it states every assumption. Personnel costs include salary and 30% for benefits. Indirect costs are charged at a 15% rate on modified total direct costs, which exclude equipment items costing more than $5,000.
| Line item | Assumption | Year 1 | Year 2 |
|---|---|---|---|
| Registered nurse, 1.0 FTE | $71,000 salary plus benefits; 3% raise in year 2 | $92,000 | $94,800 |
| Medical assistant, 1.0 FTE | $44,600 salary plus benefits | $58,000 | $59,700 |
| Driver and logistics, 0.5 FTE | Part-time position | $28,000 | $28,800 |
| Outreach coordinator, 0.5 FTE | Schedules sites and partners | $36,000 | $37,100 |
| Vehicle, retrofitted | One-time equipment | $260,000 | $0 |
| Vaccine refrigerator and data loggers | One-time equipment | $12,000 | $0 |
| Laptops and mobile connectivity | Three devices under $5,000 each | $8,000 | $1,200 |
| Fuel and maintenance | About 18,000 miles a year | $24,000 | $25,000 |
| Vehicle insurance | Quoted | $9,000 | $9,300 |
| Medical supplies | About $2.50 per dose | $15,000 | $15,000 |
| Outreach materials and translation | English and Spanish | $6,000 | $4,000 |
| Adult vaccine not otherwise covered | Uninsured adults | $40,000 | $40,000 |
| Indirect costs | 15% of modified total direct costs | $47,400 | $47,200 |
| Total | $635,400 | $362,100 |
Revenue follows the funding comparison. In year one, the foundation grant covers the $280,000 in equipment, the hospital contributes $150,000, federal immunization funds provide $100,000, and billing is projected to collect $90,000 as the unit ramps up, leaving about $15,400 for the county's general fund. In year two, the hospital contribution and federal funds continue at the same levels and billing rises to about $126,000, producing a small surplus of about $13,900. Children's vaccine supplied through the federal program does not appear in the budget because it is provided in kind.
Evaluating the Budget
The budget balances on paper, but evaluation reveals four risks and needs. First, billing revenue is the least certain line. It assumes that 70% of billed adult vaccines are collected and that the unit reaches its dose targets; if collections fall to 50%, year two would show a deficit of about $22,000. The department needs billing capacity, either a trained staff member or a contract, and should track collections monthly. Second, the program depends on the hospital's contribution, which is renewed annually. A three-year memorandum of understanding would make the budget far more reliable. Third, federal immunization funding has recently been cut in some programs, and the department should not treat it as permanent; a contingency plan should identify which sites would be reduced if it fell. Fourth, the budget omits vehicle replacement. A mobile unit lasts roughly ten years, so the department should set aside about $26,000 a year in a replacement reserve, beginning in year two with the projected surplus and additional county funds.
The evaluation also points to the department's broader needs. Its immunization work depends heavily on categorical and one-time funds, and it lacks the billing infrastructure that would let it recover costs from insurers across all its clinical services. Investing in that capacity would benefit the mobile unit and the department's fixed clinics alike.
References
Rennert, L., Gezer, F., Jayawardena, I., Howard, K. A., Bennett, K. J., Litwin, A. H., & Sease, K. K. (2024). Mobile health clinics for distribution of vaccinations to underserved communities during health emergencies: A COVID-19 case study. Public Health in Practice, 8, 100550. https://doi.org/10.1016/j.puhip.2024.100550
Seither, R., Yusuf, O. B., Dramann, D., Calhoun, K., Mugerwa-Kasujja, A., Knighton, C. L., Kriss, J. L., Miller, R., & Peacock, G. (2024). Coverage with selected vaccines and exemption rates among children in kindergarten: United States, 2023-24 school year. Morbidity and Mortality Weekly Report, 73(41), 925-932. https://doi.org/10.15585/mmwr.mm7341a3
Zhou, F., Jatlaoui, T. C., Leidner, A. J., Carter, R. J., Dong, X., Santoli, J. M., Stokley, S., Daskalakis, D. C., & Peacock, G. (2024). Health and economic benefits of routine childhood immunizations in the era of the Vaccines for Children Program: United States, 1994-2023. Morbidity and Mortality Weekly Report, 73(31), 682-685. https://doi.org/10.15585/mmwr.mm7331a2
What the D623 Task 1 instructions ask
The first D623 task asks you to plan the financing of a public health initiative. You will usually describe the initiative, make the economic case, compare funding sources, build a budget and evaluate budgetary needs and risks. Figures may be illustrative. Evaluators expect sources compared on clear criteria, a budget organized by standard principles, revenue matched to allowable uses and an honest evaluation of which lines are uncertain. A budget that balances only because every revenue line is optimistic will not meet the evaluation aspect. Showing which source pays for which cost, and why, demonstrates the financial judgment the course is built around. Show which source pays which cost.
How this D623 Task 1 example is built
The plan opens with the initiative and the coverage data that justify it. The economic section summarizes evidence on the value of childhood vaccination for funders and finance officers. A table compares five sources, from a foundation grant to federal immunization funds and billing, and a paragraph explains why no single source is enough. The budget table separates personnel, other direct costs and indirect costs, and one-time capital from ongoing costs. A revenue section matches each source to the costs it can cover. The evaluation section names four risks, such as billing and staffing, with responses. The conclusion states what the unit needs to be sustained after year two.
Where the D623 Task 1 rubric puts the marks
D623 Task 1 aspects are scored competent, approaching competence or not evident. An initiative aspect asks for a clear description and need. An economic aspect rewards evidence of value. A funding comparison aspect looks for sources compared on criteria. A budget aspect wants standard categories and consistent figures. A budget evaluation aspect asks which lines are uncertain and what the initiative needs. Evaluators check arithmetic and notice when revenue is described as collections rather than charges, and they expect vaccination coverage data and economic evaluations to be cited. Clear budget tables with labeled categories and years make the numbers easy to check. A conclusion that states what the initiative needs after the first funding period shows the long view that finance officers expect.
D623 Task 1 help: what sends it back
D623 budgets lose marks when revenue is optimistic. Use collections, not charges, and say what share you expect to collect. Funding sources may be listed without fit; explain which costs each can pay for. Budget categories can be mixed, so separate personnel, other direct and indirect costs, and one-time from ongoing. The evaluation may only restate the budget; name risks and responses. Last, plan for year three, since grants end and evaluators want to see how the initiative continues. Show the arithmetic behind each line, such as salary multiplied by the share of time worked on the unit. Label all figures as estimates if they are illustrative. Explain indirect costs, since many funders cap them, and describe how the budget would change if one source fell through.
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D623 Task 1 questions, answered
Are the D623 figures real?
No. The budget figures are illustrative, created to show the method. The coverage data and research on the economic value of childhood vaccination cited are real. Label illustrative figures clearly.
What is a cooperative agreement in D623?
A form of federal funding in which the agency is substantially involved in the work, unlike a grant. Many state and local immunization programs are funded this way.
Should D623 use collections rather than charges?
Yes. Charges are what is billed; collections are what is received. Budgets built on charges overstate revenue, so the sample assumes a collection rate and flags it as a risk.
How many funding sources should D623 compare?
Follow your instructions. The sample compares five, which shows that a mix of one-time and ongoing sources is needed to support both equipment and staff. Each source should fit the costs it covers.
Where can I find a free D623 Task 1 sample paper?
The mobile vaccination budget and funding comparison are published above with notes. Send the initiative your D623 paper funds, and a first custom budget plan costs nothing.