Posts Tagged ‘Community Transformation Grants’

The Changing Nature of Public Health: National Public Health Week and the County Health Rankings

Friday, April 6th, 2012

It has been an interesting couple of weeks for those of us concerned with improving the health of our communities. The last half of March had us celebrating the second anniversary of the Affordable Care Act and listening to the oral arguments before the U.S. Supreme Court about its future. And this week the focus shifts to yet another critical aspect of our goals for better health: the expanding definition of public health. April 2-8 marks the American Public Health Association’s annual National Public Health Week, focused on the theme of “A Healthier America Begins Today: Join the Movement.” And on April 3rd, the University of Wisconsin Population Health Institute released the 2012 County Health Rankings, which show us in detail that where we live matters to our health.

So even though they don’t involve chanting crowds on the National Mall and intense questioning from Justice Kennedy, National Public Health Week and the County Health Rankings send a clear message: acting to improve health involves multiple sectors and the way we measure health must be expanded. This year, National Public Health Week highlights the importance of prevention and wellness, including the contribution made by the Affordable Care Act (ACA). The ACA is not just about the health care system; it also supports public health and includes several initiatives aimed at breaking down the siloes between our health care “system” and public health by creating incentives and policy tools to drive collaboration. The law includes the National Prevention Strategy, which is a prevention framework that tackles issues such as health disparities, encouraging healthier behaviors, and creating healthy environments for work and play. And, the ACA requires non-profit hospitals to collaborate with public health partners and communities in identifying and addressing pressing community health needs, as part of their core community benefit requirements.

With National Public Health Week, the County Health Rankings, and the National Prevention Strategy all in the mix, the next question is, “what should be done to improve a community’s health?” The County Health Rankings model shows that there are a multitude of things we should all be doing to make our communities healthier. Some actions are clearly identified with health, like programs to help people quit smoking or outreach to increase the number of people getting screened for cancer or heart disease. However, the County Health Rankings model also includes a variety of other issues rarely discussed as part of health, like strengthening our education system or creating stable jobs in our community. Both research and experience show that these issues contribute to community health, and community advocacy is essential in taking action to address them.

For example, New Mexico Voices for Children is using funding from the Robert Wood Johnson Foundation’s Roadmaps to Health Community Grants to help communities and decision makers understand and support public policies and practices that promote both early education and health. In Springfield, Massachusetts, Partners For a Healthier Community is using also using a Roadmaps to Health Community Grant to create the Wellspring Initiative, which is engaging large local institutions, like insurance companies and hospitals, to support a new community-owned business that can create new jobs for local residents.

These organizations and others supported by the Roadmaps to Health Community Grant are hard at work on issues like education, income and employment, family and social supports, and community safety, knowing full well that addressing those issues will ultimately improve the health of their communities. They are a part of the changing definition of public health, like many other organizations across the country. The County Health Rankings, National Public Health Week, and the National Prevention Strategy are pieces of the larger movement to improve health in our communities, and we are seeing their impact every day.

– Phillip Gonzalez,  Program Director
Roadmaps to Health Community Grants 

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Protecting Prevention Funding Is Key to Controlling Health Costs

Thursday, April 14th, 2011

As House Republicans hammered away this week at federal spending, they took another whack at the Prevention and Public Health Fund. But if their goal is really saving money, they just hit their thumb instead of the proverbial nail.

The Affordable Care Act established the Prevention Fund and allocated $15 billion over the next decade to help shift the focus of our health system from treating diseases to preventing illness. The ultimate goal is improving the health of Americans and reducing long-term health costs. Already, the Fund is supporting state and local initiatives to reduce obesity, cut tobacco use, prevent HIV/AIDS and train more public health workers.

This year, it will also fund the Community Transformation Grants, an innovative program to support local efforts to reduce chronic disease and health disparities. Expanding prevention initiatives is one third of the package needed to control health care spending, along with reducing waste and occasional bad care in Medicaid and Medicare, and cutting prices and high administrative costs in the private sector.

But Republicans in Congress have repeatedly targeted the fund for repeal, or attempted to take its funding for other purposes. Yesterday, amid claims that the money provides a “slush fund” for Health and Human Services Secretary Kathleen Sebelius, the Republican-controlled House voted 236 to 183 to repeal the fund and rescind all money not already spent. This struck a political blow against the Affordable Care Act, but if the repeal were to pass the Senate and get signed by the president, it would leave the country sicker – from both diseases and rising health costs.

Fortunately, President Obama and Senate Democratic leaders understand that prevention can both save lives and save money.  Senate President Harry Reid and Senator Tom Harkin, chairman of the Senate Health, Education, Labor and Pensions Committee and the father of the fund, are not likely to bring the repeal bill to the Senate floor for a vote. Also yesterday, the White House issued a statement  indicating that the President would likely veto any attempt to eliminate the Fund.  The “statement of administrative policy” said repeal “could worsen the nation’s health and increase system costs.” Indeed. The prevention funding is also key to expanding jobs and improving the health and productivity of America’s workers.

There continues to be some risk that money from the Fund will be used to pay for existing prevention efforts, rather than the new initiatives envisioned by Harkin and others. The Fund escaped a direct cut in the compromise plan to fund the federal government for the rest of this fiscal year, despite $38 billion taken from other programs. However, there remains the unfortunate possibility that the Obama administration may tap the Fund to replace some of the $730 million cut from the Centers for Disease Control and Prevention.

The bottom line: It remains important to educate all members of Congress about the long-term savings that result from reducing chronic diseases, and the important role the Prevention Fund plays in our nation’s long-term financial health. 

- Alice Dembner, Deputy Policy Director

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Posted in Affordable Care Act implementation, Health disparities, Uncategorized | 1 Comment »

Toward Better Health for People of Color

Friday, April 8th, 2011

Focusing unprecedented federal attention on the barriers to good health for people of color, the US Department of Health and Human Services unveiled a two-part plan today of federal and community strategies designed to move the nation toward health equity. The plans mark an important step forward. The impact will depend on how strategies are implemented on the ground.

The goal is to reduce health disparities such as the fact that black babies are twice as likely to die in their first year as white babies, Hispanics die of diabetes at 1.4 times the rate of whites, and Asian-Americans are far more likely to contract Hepatitis A than whites. The causes of these problems run deep, far beyond access to insurance coverage or health care. They include the jobs we get, the places we live and the quality of schools for our children.

Part one is HHS Action Plan to Reduce Racial and Ethnic Health Disparities , which coordinates health equity measures in the Affordable Care Act, Healthy People 2020 and other existing federal initiatives. It sets out five broad goals, ranging from expanding access to health care to diversifying the health workforce. Specific steps include implementing the long-awaited Community Transformation Grants, creating an online registry of medical interpreters for patients who don’t speak English, expanding the use of community health workers in the Medicaid program, and expanding preventive dental care for children.

HHS Assistant Secretary Howard Koh called it “the most comprehensive federal effort ever to address racial and ethnic disparities.”

Part 2 is the National Stakeholder Strategy for Achieving Health Equity, which provides a second set of goals and strategies for initiatives and partnerships designed to foster community-level engagement. This strategy was developed over several years through local, regional and national meetings called the National Partnership for Action. The document details 20 strategies ranging from training youth to be health leaders to ensuring the availability of health data on underserved populations. It calls for the formation of 10 regional health equity councils to coordinate and galvanize the work, and promises to provide local communities with technical assistance and tool kits to move forward.

Given the bruising budget battles underway in Washington, no new money is attached to the plans. The federal work will draw on existing funding, including money currently under siege from the Affordable Care Act – another reason to defend that funding. For the most part, the local initiatives will need to find their own resources. Fortunately, the stakeholder strategy lays out hundreds of objectives which could be the basis for local organizing and could be attractive to local funders.

– Alice Dembner, Deputy Policy Director

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Community Transformation Grants get a green light, but dangerous cuts loom

Thursday, February 10th, 2011

Put your community prevention planning in high gear! After months of waiting, federal officials yesterday announced $145 million will be distributed nationally this year in Community Transformation Grants. This will make a significant investment in systemic change at the local level to reduce health disparities and chronic diseases. The Centers for Disease Control and Prevention, which will distribute the grants, is finalizing details of exactly what they will fund and how the money will be distributed. Grants are expected to support innovative projects that involve broad coalitions of stakeholders in communities across the nation.

The $145 million is a first-year installment in what is designed to be a multiyear program to get at underlying causes of illness and inequities, including social, economic and environmental factors. The money comes from the Prevention Fund established in the Affordable Care Act. The $750 million in FY11 Prevention Fund spending was announced yesterday by HHS, and followed by a detailed listing of how the money would be allocated. It’s great to see this money going out to the states and local communities, even as Republicans in Congress propose ways to cut funding for all aspects of the ACA. You can help protect the Prevention Fund by publicizing the funds that are already helping your community. See the new state-by-state lists of FY10 funding put out yesterday by HHS.

Speaking of those cuts, on Tuesday, the House Appropriations Committee proposed billions of dollars in cuts to “discretionary” programs this year alone, including some that could have significant impacts on communities of color and low-income neighborhoods. Those cuts include $1.3 billion from community health centers, which traditionally have fared well under Republicans, and which provide primary care to billions of low-income families at relatively low cost. It’s important to realize that a cut of this size would reverse the growth in federally qualified health centers supported so far through the ACA. That growth is explicitly designed to provide additional primary care services needed as millions of Americans get health insurance for the first time.

Other proposed cuts include $758 million from WIC, $210 million from the maternal and child health block grants, $405 million from community services block grants, and $96 million from substance abuse and mental health services. These cuts are by no means certain, and members of Congress need to hear about the damaging effects they would have.

– Alice Dembner, Deputy Policy Director

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The grants are coming! The grants are coming!

Monday, January 31st, 2011

Word came last week from the Obama administration that the Community Transformation Grant program will begin “very soon,” despite the discussion of federal budget freezes. Speaking at the Families USA Health Action conference, an official said the administration is committed to the grants. The program, authorized in the Affordable Care Act, is designed to promote innovative community strategies to prevent chronic diseases and address health disparities. Grants will be awarded on a competitive basis to state and local agencies, state and local nonprofits, tribes, and networks of community-based organizations.

The administration said the federal Centers for Disease Control and Prevention is putting the final touches on a request for grant applications. No word yet on how big the program – or the individual grants – will be. Money for the grants is coming from the national Prevention Fund, established and funded with $15 billion over 10 years in the ACA. Because the Prevention Fund was already appropriated by Congress, it will not be subject to the spending freeze that the President announced on Tuesday night. However, the Fund could still be targeted for cuts by Republican members of Congress, who have previously tried to use it to pay for other priorities.

Other news you can use: keep your eye out for state-by-state fact sheets on Healthcare.gov detailing what the Prevention Fund is already paying for. These will be helpful in talking to Members of Congress about the importance of the Fund.

– Alice Dembner, Deputy Policy Director

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Prevention Fund Saved!

Wednesday, September 15th, 2010

Through the collective efforts of advocates of many different stripes across the country, we staved off an attempt yesterday to gut the new Prevention and Public Health Fund, a critical part of national health reform.

An amendment from U.S. Senator Mike Johanns, a Nebraska Republican, was defeated 46-52 in a procedural vote on the Senate floor. That amendment to the Small Business Jobs and Credit Act would have used the bulk of the $15 billion Prevention Fund to pay for a change in business tax-reporting rules.

As a result, the Prevention Fund will be available to support national, state and local programs to make Americans healthier, reduce racial and ethnic health disparities, and to help control soaring health costs in the long run. President Obama has already allocated $500 million from the fund and another $750 million is slated to be spent in the 2011 fiscal year. The Community Transformation Grants, designed to help local communities address the social and economic causes of poor health, are one of the innovative programs slated to be supported through the Prevention Fund.

We thank the hundreds of national and state organizations that raised their voices in support of the Prevention Fund. We will likely need to remain vigilant to protect the fund from future attempts to grab it for other purposes. But for now, we can celebrate.

– Alice Dembner, Policy Manager

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Posted in Health disparities, national health reform | 1 Comment »

Senate proposal would gut funding to make Americans healthier and reduce health disparities

Thursday, August 19th, 2010

Update: Due to response to this blog post, we would like to share additional information with those who are interested in signing-on to the letter. If you would like to sign-on, please contact Trust for America’s Health by e-mailing rhamburg@TFAH.org.

A short-sighted proposal from U.S. Senator Mike Johanns, a Nebraska Republican, would gut the brand-new $15 billion Prevention and Public Health Fund, created as part of the health reform law, to pay for a change in business tax-reporting rules. The Prevention Fund was established to support national, state and local programs to make Americans healthier and reduce racial and ethnic health disparities. President Obama has already allocated $500 million from the fund.

Johanns’ amendment is slated for a vote on Sept. 14, the day after Congress returns from August recess, and has some strong business backing. Learn more about this strike at a key component of health reform on a 1 p.m. call tomorrow hosted by Community Catalyst and three partner organizations.

The Prevention Fund is key to our long-term health, to controlling soaring health costs, and to advancing health equity. Among the programs Johanns’ proposed amendment would wipe out are the innovative Community Transformation Grants. These grants are designed to help local communities address health disparities and reduce chronic diseases by promoting healthy living and tackling the social and economic causes of poor health. They are also the main avenue in the health reform law for addressing the root causes of health disparities, such as poor availability of healthy food and exposure to environmental hazards.

The Johanns amendment could also threaten initiatives to increase vaccination against disease, as well as millions of dollars a year in state grants to reduce obesity and tackle other public health problems. Congress envisioned all of these being supported by the Prevention Fund, which dedicates $15 billion over 10 years to beef up the tiny portion of health spending now devoted to preventing illness.

Johanns proposed the amendment to a bill (H.R. 5292, the Small Business Jobs and Credit Act) that would create a loan fund and tax breaks for small businesses.  His amendment would overturn a portion of the health reform law that requires business to provide more detailed reporting to the Internal Revenue Service about services and materials they buy. Small businesses, in particular, are concerned that the new reporting would be a burden, and passage of the amendment is a real possibility.

To offset the loss of tax revenue created by his proposal, Johanns would tap $11 billion from the Prevention Fund – all of the money allocated for the fund from 2010 through 2017. He would also weaken another critical component of health reform – the requirement that everyone who can afford health insurance must obtain it, or pay a penalty. Our partners at the Center on Budget and Policy Priorities have written a detailed analysis of the proposal.

Community Catalyst is signing onto a letter to Congress opposing the gutting of the Prevention Fund, and we urge other organizations to do the same. We also recommend contacting Senators directly to let them know that the Prevention Fund should not be up for grabs. Two small business organizations, Small Business Majority and Main Street Alliance, are also speaking out against the attack on the Prevention Fund, with Main Street saying it would “seriously undermine the improved access and cost containment goals of health reform.”

Ironically, Johanns’ attempt to wipe out the Prevention Fund comes just as Congress is considering separate measures to allocate hundreds of millions of dollars from the fund to the Community Transformation Grants for fiscal year 2011. Rules for the competitive grant program are still being developed, but the health reform law says the grants should go to state and local governments and community-based organizations for changes in policies, programs, environment and infrastructure including increasing access to nutritious foods, creating parks, and creating healthier school environments.

Senator Bill Nelson, a Florida Democrat, is offering an alternative that helps small businesses without harming the Prevention Fund. It scales back, rather than eliminates, the new tax reporting requirement, and funds the change by ending a tax break for the nation’s five large oil companies.  Nelson’s amendment is also slated for a vote on Sept. 14. Both this and Johanns’ amendment need 60 votes to pass, and the votes could be close.

It’s crucial to the success of health reform to beat back the Johanns amendment and send a message to others who would try to hijack the Prevention Fund for other purposes.

– Alice Dembner, policy manager

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Posted in Health disparities, national health reform | 1 Comment »