CALIFORNIA ALLIANCE FOR PREVENTION FUNDING CHEAC Annual Meeting October 21, 2018
THE CHALLENGE ➢ 2010: ACA and the creation of the Prevention and Public Health Fund followed by threats to ACA and raids on the Fund ➢ Creating a sustainable flow of funding to support prevention of noncommunicable disease and injury and promote health equity in California ➢ Is this possible?
SOME HISTORY 2010: ACA and the Creation of the Prevention and Public Health Fund 1990
CAPF PROGRESS TO DATE ➢ Developed bill in 2016 - made it through assembly and partway through Senate with bipartisan support ➢ Funded 4/2017- 4/2019 ➢ Consolidated and engaged 18 partner organizations ➢ Held 1 st legislative briefing in January 2018
PROGRESS TO DATE ➢ Produced paper with legal analysis of creating a Wellness Trust in CA ➢ Produced literature review of ROI from prevention ➢ Produced fact sheets on ROI and models of State Wellness Trusts ➢ Finalized draft proposal ➢ Begun outreach
ELEMENTS OF A CALIFORNIA WELLNESS TRUST PROPOSAL Funding Source Governance Structure Operational Principles Allocation Criteria
REVENUE SOURCES – TOP CANDIDATES ➢ Soda tax ➢ Alcohol tax
CA has very low taxes on alcohol compared to other states Type Ranking Price/gallon - Wine 49 th $.20 Spirits 34 th $3.30-$6.60 Beer 31 st $.20
OTHER REVENUE OPTIONS THAT WERE CONSIDERED ➢ Fee on health insurers ➢ Tobacco legal settlement funds ➢ Fee on medical providers ➢ Community benefits ➢ Bonds
PROPOSED GOVERNANCE STRUCTURE ➢ State wide commission with spending authority ➢ Members appointed by state elected officials. Will include, but not be limited to: the state health officer, LHDs, a representative of residents who experience health inequities, and community-based equity and primary prevention advocates and experts. ➢ Small administrative entity to manage the work
PROPOSED GOVERNANCE STRUCTURE (CONT.) ➢ To ensure coordination of local efforts, LHDs will staff an existing, or form a new community health coalition. All local organizations that are awarded funding must participate in their county’s coalition.
Operational Principles ➢ Funding should support policies, systems environmental changes and community programs that work outside of health care settings to make California's communities more conducive to health.
Operational Principles (cont.) ➢ Funds should be distributed and coordinated among: local health departments; community-based, regional and statewide nonprofit organizations; and state government according to established criteria. ➢ Funds must benefit all Californians and promote greater equity and health, reaching residents from urban to rural areas, young and old, and across California’s diverse races and ethnicities.
Operational Principles (cont.) Moneys in the fund shall be used to address social, environmental, economic and behavioral determinants of chronic disease and injury at any phase of the life cycle, and to close gaps in health outcomes and inequities, including, but not limited to strategies that: Promote healthy diets, improved access to healthy foods, and • healthy food environments Promote physical activity and a safe, physical activity promoting • environment Prevent unintentional and intentional injury • Prevent harmful use of substances including tobacco, alcohol, and • drugs Address the social determinants of chronic disease • Support evidence- based or evidence- informed • practices that are include community priorities and experience.
The Central Challenge: How to build a winnable proposal and campaign?
CURRENTLY PLANNED NEXT STEPS ➢ Share proposal at regional convenings across the state ➢ Attract hospitals, clinics, unions ➢ Engage non-traditional partners – Teacher Associations, Parent Groups, Farmers, Sports Celebrities, Youth Groups, Private sector, others ➢ Conduct media advocacy
CURRENTLY PLANNED NEXT STEPS ➢ Create local network of champions for prevention funding who can move policy makers from their base ➢ Be part of any state health reform proposal in 2019 ➢ Hold 2nd legislative briefing ➢ Identify legislative champions and draft legislation
Potential Roles for LHDs ➢ Support Regional Convenings ➢ Be champions for the idea ➢ Engage your local representatives, BOS, and other potential stakeholders and supporters ➢ Contribute technical expertise to help answer key questions ➢ Other?
For More information Contact: Tracey Rattray tracey.rattray@phi.org Lynn Silver lsilver@phi.org Go to: www.ca-allianceforpreventionfunding.org
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