The Fiscal Mapping Process

A Strategic Planning Tool for Sustainable Financing of Evidence-Based Treatment Programs in Youth Behavioral Health Services

Alex R. Dopp, Marylou Gilbert, Maddison North, Monique Martineau, Jeanne S. Ringel

ToolPublished Aug 10, 2023

Cover: The Fiscal Mapping Process
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Long-term sustainment of evidence-based treatment (EBT) programs is essential to address behavioral health problems in youth, but the limited and fragmented funding available to behavioral health service agencies makes sustainment difficult. RAND researchers led a team that developed a strategic planning tool, called the Fiscal Mapping Process, to help youth behavioral health service agencies identify funding needs and objectives for an EBT program and develop, implement, and sustain a plan for obtaining that funding.

The Fiscal Mapping Process focuses on developing two key capacities for sustaining EBT programs: funding stability and strategic planning. The tool can be used with any youth behavioral health EBT program, but it contains resources for two treatment models used in pilot testing: parent-child interaction therapy for disruptive behavior problems in youth ages 2–7 and trauma-focused cognitive behavioral therapy for traumatic stress symptoms in youth ages 3–18. Evaluation is ongoing, but initial findings suggest that the Fiscal Mapping Process improved the strategic planning and funding stability capacities of service agencies that pilot-tested it.

In addition to the tool itself, which is in the format of a Microsoft Excel workbook, the researchers created the Quick-Start Guide for the Fiscal Mapping Process, which orients users to the tool's features, provides a glossary of key terms, and answers frequently asked questions about the tool. A description of the tool's development is provided in the companion report, The Fiscal Mapping Process: Development of a Strategic Planning Tool for Sustainable Financing of Evidence-Based Treatment Programs in Youth Behavioral Health Services.

Fiscal Mapping Process Orientation Video

Transcript

Alex Dopp, Fiscal Mapping Developer and Coach, RAND Corporation

If you work at a behavioral health service agency, you no doubt have worked incredibly hard to fund the high-quality treatments that your agency provides. But what happens down the road? How can agencies plan beyond your current funding to ensure that your programs can continue?

Our team created a tool called the Fiscal Mapping Process that helps service agencies create a plan for this very thing—financial sustainment. This video will help orient you to the tool before you start using it.

The Fiscal Mapping Process involves five steps: One, identify resources needed for an evidence-based treatment program; two, specify funding objectives; three, brainstorm possible financing strategies; four, complete the fiscal map linking financing strategies to objectives; and five, monitor progress.

Marylou Gilbert, Fiscal Mapping Developer and Coach, RAND Corporation

The tool itself is an Excel document that is organized into eight tabs. So, let's take a quick look at how the tool can help you manage each of the five steps. Just keep in mind that although there is an order to the Fiscal Map steps, you’ll probably be moving back and forth among the steps—and the tabs, as well. This will be an iterative process and ongoing, and that’s okay.

First, we have the Overview tab, which provides a brief description plus general tips and instructions. The Program Detail Resources tab includes info on how to choose an evidence-based treatment program and team members for fiscal mapping. The Fiscal Map tab is your workspace for completing the steps which are laid out left to right. Throughout this tab, yellow indicates required fields and the light gray area is for optional notes. Note that as you scroll down, there's also a handy completion checklist and status bar along the bottom of each step, which can help you track your team's progress. The next two tabs have fictional completed examples for treatment programs, followed by three tabs with resources for completing steps one, two, and three.

The examples and some resources focus on parent-child interaction therapy and trauma-focused cognitive behavioral therapy. But fiscal mapping can be used with a variety of youth behavioral health treatment models.

Let's look at the PCIT example to see how the tool is filled out. In step one, you specify which resources are needed and the outlook for sustaining each. Next, you write out funding objectives and document factors that help or hinder each objective. This is a very flexible step, but at least three fully described objectives are usually needed. In step three, you select financing strategies that are currently being used and other strategies to be explored with details for each. Step four copies your objectives and strategies from the earlier steps. Your task is to specify what percentage of each objective is covered by each strategy and designate if an objective has been met. Step five provides space for planning next steps. And finally, the budgeting worksheet is an optional section to help detail your program budget. This does require proficiency with Excel formulas.

Alex Dopp, Fiscal Mapping Developer and Coach, RAND Corporation

Now that you've gotten a tour of the tool, take some time to read through all the tabs, the report that details our development process, and our Quick Start guide, which includes a glossary and frequently asked questions. We hope this video inspires you to get started with this Fiscal Mapping Process. Please be in touch to let us know how it goes.

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Dopp, Alex R., Marylou Gilbert, Maddison North, Monique Martineau, and Jeanne S. Ringel, The Fiscal Mapping Process: A Strategic Planning Tool for Sustainable Financing of Evidence-Based Treatment Programs in Youth Behavioral Health Services. Santa Monica, CA: RAND Corporation, 2023. https://www.rand.org/pubs/tools/TLA2678-1.html.
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