A Uniform Chart of Accounts: Strengthening Public Health Practice and Research Through Standardized Financial Data

Betty Bekemeier, Elizabeth Heitkemper, Dana L. Zaichkin, Greg Whitman, Simone R. Singh, Jonathon P. Leider

Research output: Contribution to journalArticlepeer-review


Context: The COVID-19 pandemic made the long-standing need for a national uniform financial reporting standard for governmental public health agencies clear, as little information was available to quantify state and local public health agencies' financial needs during the pandemic response. Such a uniform system would also inform resource allocation to underresourced communities and for specific services, while filling other gaps in practice, research, and policy making. This article describes lessons learned and recommendations for ensuring broad adoption of a national Uniform Chart of Accounts (UCOA) for public health departments. Program: Leveraging previous efforts, the UCOA for public health systems was developed through collaboration with public health leaders. The UCOA allows state and local public health agencies to report spending on activities and funding sources, along with practice-defined program areas and capabilities. Implementation: To date, 78 jurisdictions have utilized the UCOA to crosswalk financial information at the program level, enabling comparisons with peers. Evaluation: Jurisdictions participating in the UCOA report perceptions of substantial up-front time investment to crosswalk their charts of accounts to the UCOA standard but derive a sense of valuable potential for benchmarking against peers, ability to engage in resource allocation, use of data for accountability, and general net positive value of engagement with the UCOA. Implications for Policy and Practice: The UCOA is considered a need among practice partners. Implementing the UCOA at scale will require government involvement, a reporting requirement and/or incentives, technical assistance, financial support for agencies to participate, and a means of visualizing the data.

Original languageEnglish (US)
Pages (from-to)E69-E78
JournalJournal of Public Health Management and Practice
Issue number3
StatePublished - May 1 2023

Bibliographical note

Funding Information:
This work was supported by the Robert Wood Johnson Foundation (grants #73787 and #75301).

Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.


  • financial accounting
  • Foundational Public Health Services
  • managerial accounting
  • public health departments
  • public health finance

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't


Dive into the research topics of 'A Uniform Chart of Accounts: Strengthening Public Health Practice and Research Through Standardized Financial Data'. Together they form a unique fingerprint.

Cite this