This white paper presents a framework to assist hospital and health system boards in making prudent, affordable capital allocation deci-sions not just today, but for years to come. We hope and expect that today's economic crisis will eventually diminish such that credit at reasonable rates is once again available, that the stock markets will recover such that investment balances will increase from today's levels, and that hospitals and health systems will start to feel more confident about their future and be more willing to invest capital. The tips and approaches outlined in this white paper are useful and applicable both today and under a (hoped for) more favorable economic environment.