The first five topic areas of this document recommended specific actions. The topics of Program Sustainability and Cost Justification are general and apply to all aspects of a MHF program. MHF programs often get off to a good start but then struggle over time. Challenges to program sustainability include changes in policies and projects when management changes, a lack of cost justification, and limited program integration. The ideas presented here help sustain multiple MHF initiatives and provide a straightforward consideration of cost justification.