The Prevention and Public Health Fund United Methodist Church March 15, 2103 Richard Hamburg Sue Pechilio Polis Overview About Trust for America’s Health The Prevention and Public Health Fund: Background, overview, funding, and how it’s working. Key PPHF programs including the Community Transformation Grants (CTGs) How the faith community is engaged and future opportunities About TFAH: Who We Are Trust for America’s Health (TFAH) is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority. Building the Case for the Investment in Community Prevention Initially released in July 2008 Sen. Tom Harkin (D-IA) called it “the report he had been waiting for.” Key finding: an investment of $10 per person per year in proven community-based prevention programs could save the country more than $16B annually within 5 years. This is a return of $5.60 for every $1 invested. Prevention for a Healthier America: Financial Return on Investment? With a Strategic Investment in Proven Community-Based Prevention Programs to Increase Physical Activity and Good Nutrition and Prevent Smoking and Other Tobacco Use INVESTMENT: $10 per person per year HEATH CARE COST NET SAVINGS: RETURN ON INVESTMENT (ROI): $16 Billion annually within 5 years $5.60 for every $1 How do we make the healthy choice the easy choice? Individuals, communities, schools, faith institutions, employers must help to assure: We have the information we need We can access healthy foods We can find safe places to play and exercise We promote smoke free environments We create a culture of health Impetus for the Faith-Based Community Religious leaders have historically played a critical role in addressing the nation’s social challenges, especially in protecting children, seniors and other vulnerable populations. Allowing people to lead fuller lives through the prevention of chronic disease is a natural extension of these efforts. ACA & Public Health Pillars for public health in health reform: Universal coverage, including first $ coverage of clinical preventive services National Prevention Strategy Reliable funding stream through creation of a Prevention Fund (mandatory appropriation) to support: Core public health functions Community prevention Public health workforce Public health and prevention research Prevention and Public Health Fund (PPHF) Prevention and Public Health Fund: now $12.5 billion over next 10 years (reaching full $2 billion level in FY2022) $2.25 billion already allocated for FY10-12, $1 billion annually for FY20132017. FY11 PPHF Cooperative Agreement / Grant Awards by State (By Award Amount) NH $3.0M VT $4.0M $11.8M $1.3M $2.4M $11.6M $5.6M $1.2M $1.8M ME $5.8M $10.7M $25.0M $7.0M $1.9M $5.9M $7.7M $3.5M $2.3M $4.6M $11.0M $5.2M $1.0M $5.9M $3.4M $6.6M $5.4M $5.1M $2.9M $13.3M $6.1M $4.1M NJ $5.3M DE $1.3M MD $9.2M DC $6.4M $4.0M $9.2M $6.8M $2.7M $4.0M $5.6M $3.2M $41.4M $5.4M MA $15.8M RI $2.4M CT $6.2M $4.5M $9.2M Key: Total Award Amounts by State $18.5M $3.5M $8.5M <$5M $5-10M $11-15M >$15M Totals include awards to states, cities/counties, tribes, and partners ($358.8M). Awards to territories ($4.3M) are excluded. 1Programs included (16 total): National Public Health Improvement Initiative (NPHII), Epidemiology and Laboratory Capacity Program (ELC), Emerging Infections Program (EIP), Healthcare Associated Infections (HAI), Immunization, Prevention Research Centers (PRCs), Public Health Prevention Research, Chronic Disease State Grants, Tobacco Quitlines, Community Guide, Public Health Workforce, Community Transformation Grants (CTG), Racial and Ethnic Approaches to Community Health (REACH), Environmental Public Health Tracking (EPHT), Division of Nutrition, Physical Activity, and Obesity (DNPAO), Prevention Fund Overview Preventing disease and injury by making healthy choices the easy choices is the most effective, common-sense way to improve health and reduce health costs for families and businesses. The Prevention and Public Health Fund gives us a chance to turn our sick care system into a health care system by bringing communities together on innovative projects that will help reverse the obesity epidemic and bring health costs down. Congress should not make any further attempts to reduce, eliminate or divert its funding. The Prevention Fund is the first federal funding source dedicated to public health and prevention. This year, the Fund will invest $1 billion in every state to allow communities to move forward on proven, effective ways to keep Americans healthier and more productive. Over the course of the next 10 years the Fund will invest a total of $12.5 billion in crosscutting prevention programs that have the potential to transform our public health system. The Fund is supporting new programs such as Community Transformation Grants, a National Tobacco Education Campaign, and new strategies to reduce hospital associated infections. It is also supporting grants to allow every state to begin to build core, comprehensive capacity to address common risk factors and determinants of health. PPHF Funding By Agency Approximately $800 million to CDC; $37 million to HRSA; $88 million to SAMHSA; $50 million Office of the Secretary; smaller amounts to AOA and AHRQ 69% of funding to states in 2010-11 Of the state dollars in 2010-11, $429 million to infrastructure and workforce; $222 million to community prevention; $156 million to clinical prevention; and $52 million to research and tracking Selected CDC PPHF FY 2012 Investments Investment Area Amount Community Transformation Grants $226m Immunization $190m Tobacco Prevention $83m Worksite Wellness $10m Public Health Infrastructure $40.2m Environmental Laboratories $40m Healthy Weight Taskforce $ 5m Healthcare Surveillance $35m Public Health Workforce $25m REACH $40m Healthcare Associated Infections $11.75m Diabetes $10m Early PPHF Successes CDC supported a national tobacco education campaign, including the airing of Tips from Former Smokers, the first federally funded national, paid-media campaign. In a 12 week period, the quitline received more than 365,000 calls, and there were 630,000 unique visitors to the website, up 428 % from the previous year. The New Mexico Department of Health is increasing access to physical activity opportunities for over 50,000 children by creating active outdoor school spaces for public use during non-school hours The University of Rochester Medical Center has implemented a program to provide intensive clinical and community prevention services, including the Diabetes Prevention Program, to more than 700,000 people. HRSA supported 24 Mental and Behavioral Health Training Grants to institutions of higher learning to increase social workers and psychologists prepared to serve high-need populations. Prevention Fund: Broad support from multiple sectors Over 780 local, state and national organizations including hundreds of traditional public health groups, but also: Faith-based groups – National Council of Jewish Women, United Church of Christ, Ascension Health, Justice and Witness Ministries, Adventist HealthCare, Inc. Medical providers – American Academy of Pediatrics, American College of Cardiology, American Nurses Association National advocacy groups – AARP, USPIRG, Families USA Business groups – National Business Coalition on Health, Small Business Majority, Pacific Business Group on Health Policymakers – US Conference of Mayors, National Association of Counties Community Transformation grants – True community-based prevention Requires detailed plan for policy, environmental, programmatic and infrastructure changes to promote healthy living and reduce disparities Create healthier school environments, including healthy food options, physical activity opportunities, promotion of healthy lifestyles Develop and promote programs targeting increased access to nutrition, physical activity, smoking cessation and safety Highlight healthy options at restaurants and food venues NOT limited to chronic diseases or one disease at a time Leadership teams for capacity building and represent over 900 organizations over the 60 grants in FY2011. This includes 24% public health, 19% healthcare; 14% education; 14% agriculture/food services; plus faith-based, parks and rec. housing and business groups. CTGs in practice – Community Engagement Awarded competitively, based on proposals Available to state and local health departments, nonprofits, national networks of community-based organizations and tribal organizations At least 20% of funding to go to community prevention programs in rural and frontier areas Applicants must define concrete, achievable targets for meeting prevention goals, and specific objectives to reduce health disparities Applicants must demonstrate the ability to coordinate with multiple community sectors – i.e. transportation, faith-based, businesses, education, etc. to achieve broad-based participation in community prevention activities. CTG Funding Funding allocated for Fiscal Year 2011/2012: Total of $145 million, including $103 million awarded to 61 states and communities, serving 120 million Americans 26 capacity-building grants ($147,000 - $500,000) 35 for implementation of evidence and practice-based programs ($500,000 - $10 million) $4.2 million to national networks, APHA, Asian Pacific Partners for Empowerment, Community Anti-Drug Coalition, National Farm to School Network, ALA, REACH Coalition, and YMCA. $70 million to 40 communities under 500,000 population. CTG Goals CTG National Goals Five year, measurable performance goals: Reduce death and disability due to tobacco use by 5%; Reduce the rate of obesity through nutrition and physical activity interventions by 5%; Reduce death/disability due to heart disease and stroke by 5%. Examples of CTG Grants Full implementation • • • • • • Capacity Building Alaska: Southeast Alaska Regional • Health Consortium Florida: Broward Regional Health • Planning Council • Illinois Department of Public Health • Maryland Department of Health and Mental Hygiene • Massachusetts Department of Public Health (to serve state minus large counties) & Massachusetts Department of Public Health (to serve • Middlesex County) New York: The Fund for Public Health • in New York & University of Rochester Medical Center Alaska: Yukon-Kuskokwim Health Corporation Michigan: Spectrum Health Hospitals Mississippi: My Brother's Keeper Inc. New Mexico: Bernalillo County Office of Environmental Health Ohio: Austen BioInnovation Institute and Public Health-Dayton and Montgomery County Virginia: Fairfax County Department of Neighborhood and Community Services Washington: Confederated Tribes of The Chehalis Reservation & Sophie Trettevick Indian Health Center 22 CTG Small Community Awards - 2012 • • • • • • • • • • • • • • • • • • • • Cherokee Nation (Oklahoma) Community Health Councils (California) County of Sonoma (California) St. Helena Hospital Clear Lake (California) County of Santa Clara (California) Nemours Hospital for Children (Delaware) DC Department of Health Miami-Dade County School Board (Florida) Tanner Medical Center (Georgia) Chicago Public Schools (Illinois) Quality Quest for Health of Illinois Welborn Baptist Foundation (Indiana) YMCA of Wichita (Kansas) Microclinic International (Kentucky) Linking the Parish (Louisiana) Maine General Medical Center (Maine) Maine Development Foundation Maine Health Healthy Acadia (Maine) Institute for Public Health Innovation (MD) • • • • • • • • • • • • • • • • • • Prince Georges County (Maryland) Pioneer Valley Planning Commission (MA) YMCA Southcoast (Massachusetts) Central Michigan District Health Department Minneapolis Heart Institute Foundation (MN) Ozarks Regional YMCA (Missouri) Clark County School District (Nevada) Health Research Inc. /NYS Dept. of Health The Lima Family YMCA (Ohio) Indian National Council of Governments (OK) Little Dixie Community Action (Oklahoma) Northeast Oregon Network (Oregon) City of Beaverton (Beaverton) YMCA of Greenville (South Carolina) Project Vida (Texas) Seattle Children’s Hospital (Washington) Inland Northwest Health Services (WA) West Virginia University Research Corporation 23 CTGs in Practice Maryland CTG Overview: The Maryland Department of Health and Mental Hygiene is receiving $1,945,289 to serve the entire state of Maryland minus large counties, an estimated population of 1,900,000 including a rural population of over 300,000. Work will focus on expanding efforts in tobacco-free living, active living and healthy eating, and quality clinical and other preventive services. Key Sectors Engaged – Business, community-based orgs, education, faith-based, an public health: Subgrants awarded to multiple groups, including faith-based organizations including; Union Bethel African Methodist Church Bethel AME Church St. James AME Zion Church CTGs in Practice Fairfax County, VA CTG Overview: The Fairfax County Department of Neighborhood and Community Services in Virginia is receiving a $499,559 planning award to build capacity to support healthy lifestyles in large county of Fairfax, an estimated population of over 1,000,000. Work will target tobacco-free living, active living and healthy eating, quality clinical and other preventive services, social and emotional wellness, and healthy and safe physical environments. Key Sectors Engaged – Leadership Team includes business, education, foundations, parks and recreation, planning and transportation and faith-based organizations including; GRACE ministries of United Methodist Church What’s Ahead: Challenges to the Prevention Fund PPHF: Why defend it? Mandatory nature – only source of assured new funding in tight fiscal times Source of $ for transformative change, like CTGs What’s the objection? It’s part of the ACA Mandatory = contributes to deficit Being used to backfill cuts in discretionary funding Claim that Congress has no control over how spent What Can We Do? Take at least one action; Join the supporters list for the PPHF &/or recruit other organizations Schedule in-district meetings with Members of Congress Send a letter Blog or write an op-ed/Letter-to-the-Editor Report back! For more information Please visit www.healthyamericans.org to view the full range of Trust for America’s health policy reports. Or www.healthyamericans.org/health-reform for health reform implementation information. Can also contact rhamburg@tfah.org to sign up for our Wellness and Prevention in Health Reform Digest Thank you!