The Prevention and Public Health Fund United Methodist Church March 15, 2103 Richard Hamburg Sue Pechilio Polis.

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?

INVESTMENT: $10 per person per year

HEATH CARE COST NET SAVINGS:

$16 Billion annually

within 5 years

RETURN ON INVESTMENT

(ROI):

$5.60 for every $1

With a Strategic Investment in Proven Community-Based Prevention Programs to Increase Physical Activity and Good Nutrition and

Prevent Smoking and Other Tobacco Use

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 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 FY2013-2017.

FY11 PPHF Cooperative Agreement / Grant Awards FY11 PPHF Cooperative Agreement / Grant Awards by State (By Award Amount)by State (By Award Amount)

$4.1M

$3.5M

$11.6M $10.7M

$7.0M

$9.2M

$1.0M

$5.6M

$5.9M

$2.4M

$5.1M

$3.4M $4.6M

$3.2M

$4.0M

$8.5M

$5.9M

$2.3M $5.2M

$1.9M

$6.6M

$5.4M

$18.5M

$1.3M

$1.8M

$3.5M

$5.4M

$6.1M

$7.7M

$11.0M

$41.4M

$2.7M $4.5M $9.2M

$13.3M

$25.0M

Key: Total Award Amounts by State

<$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),

and Preparedness and Emergency Response Research Centers (PERRCs) / Preparedness and Emergency Response Learning Centers (PERLCs).

CT $6.2M

DC $6.4M

DE $1.3M

ME $5.8M

MD $9.2M

MA $15.8M

NH $3.0M

NJ $5.3M

RI $2.4M

VT $4.0M

$4.0M

$1.2M

11

$5.6M

$11.8M

$6.8M$2.9M

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 cross-cutting 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

22

CTG Small Community Awards - 2012

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 [email protected] to sign up for our Wellness and Prevention in Health Reform Digest

Thank you!