Harder for Us, Easier for Them: Key Strategies to Improve Administrative Burden

July 21, 2026 | Melissa Touma

This brief is a companion to the blog Harder for Us, Easier for Them: How Wisconsin Is Reducing Administrative Burden on Local Health Departments, summarizing the key strategies and considerations that states can replicate to improve the administrative burden of grant management on local and tribal health departments.

Start with Internal Structure and Put Relationships at the Center

• Anchor implementation of grant activities through the lens of customer service and use it as a decision‑making filter.
• Place grant management functions within offices that focus on building relationships and alignment with local systems.
• Use these relationships to test communications, scopes of work, and process changes before final decisions are made.
• Encourage teams to question administrative requirements explicitly by asking “why”?

Engage the Public Health Workforce to Set Funding Priorities

• Broadly engage the public health workforce through a participatory budgeting process to invite ideas for funding priorities straight from the field.
• Translate shared priorities into collaborative, system‑level investments rather than funding individual ideas.

Innovate Through Contracting: Paying Tools and Services Directly

• Identify trusted partner organizations that already have strong relationships with local health departments, such as state-wide associations.
• Write sole‑source or contracting language broadly enough to allow fiscal agent responsibilities.
• Use centralized purchasing strategically for shared tools, memberships, or services that would otherwise require numerous small transactions.

Move Resources Faster Through Regional Granting

• Use predefined regions or existing collaborative structures to simplify eligibility and selection for regional granting.
• Replace competitive Request for Applications with a minimal selection or self‑selection process when appropriate.
• Allow regions to identify a fiscal host based on capacity and local trust, rather than state designation.

Maintain Oversight Without Over-Managing

• Shift oversight upstream by strengthening state‑level documentation, policies, and staff capacity rather than increasing local reporting.
• Develop clear procedures for staff to apply allowability rules consistently across programs to reduce ambiguity and ad hoc decision‑making.
• Treat frequent issues, questions, or follow‑ups as cues for quality improvement, rather than grounds for adding requirements.