Transcript 2013 Program Overview - Healthy Schools Network

Health and a New
Presidential Term
Jeffrey Levi, PhD
Coalition for Healthier Schools Meeting
January 8, 2012
Context
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Health policy driven by Affordable Care Act
(ACA) implementation
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Is it about insurance and cost containment?
Is it a new vision for creating/addressing health?
New expectations of public health
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Working across silos
Providing an ROI
National Prevention Council=
Setting a Larger Table for Health
Bureau of Indian Affairs
Department of Labor
Corporation for National and Community
Service
Department of Transportation
Department of Agriculture
Department of Veterans Affairs
Department of Defense
Environmental Protection Agency
Department of Education
Federal Trade Commission
Department of Health and Human
Services
Office of Management and Budget
Department of Homeland Security
Office of National Drug Control Policy
Department of Housing and Urban
Development
White House Domestic Policy Council
Department of Justice
National Prevention Strategy
Healthy and Safe Environments
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Education sector:
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“Implement policies and practices that promote
healthy and safe environments (e.g., improving
indoor air quality; addressing mold problems;
reducing exposure to pesticides and lead;
ensuring that drinking water sources are free from
bacteria and other toxins; implementing and
enforcing tobacco free policies).”
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National Prevention Strategy, page 17
National Prevention Council
Commitments
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Consider prevention and health within departments
and encourage partners to do so voluntarily as
appropriate.
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Increase tobacco free environments within its
departments and encourage partners to do so
voluntarily as appropriate.
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Increase access to healthy, affordable food within
its departments and encourage partners to do so
voluntarily as appropriate.
Create health equity through HIAP
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Addressing social determinants of health
requires new partnerships
National Prevention Council/National
Prevention Strategy as a federal base
Building new constituencies for HIAP—and
accessing new resources
Building social capital through engagement
and policy/programmatic change
Prevention and Public Health Fund
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Funding levels
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now $12.5 billion over next 10 years
$2.25 billion already allocated for FY10-12
$1 billion annually for FY2013-2017
Reaches full $2 billion level in FY2022
Support new and innovative public health
programs
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Also making up for cuts in public health base
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
Environmental Public Health Tracking
$ 35m
Healthcare Surveillance
$35m
Public Health Workforce
$25m
REACH
$40m
Healthcare Associated Infections
$11.75m
Diabetes
$10m
CDC Environmental Health
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Budget cuts have meant setbacks for federal
environmental health efforts
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CDC/National Center for Environmental Health has lost
25% of funding since 2009
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Near elimination of the lead control program
Dwindling state resources as well
Bleak outlook for 2013 and beyond in light of
Budget Control Act discretionary caps
CDC Health Tracking Network
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Top-notch data set for primary research exploring the connections
between environment and health
Received $35 million from Prevention and Public Health Fund in FY
2011 and FY 2012
Has supplanted and supplemented the program to add existing data sets to
the network that are critical for children’s environmental health,
including:
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Asthma
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Childhood cancers
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Developmental disabilities
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Lead
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Socioeconomic conditions
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
MA $15.8M
RI $2.4M
CT $6.2M
$5.9M
$7.7M
$3.5M
$2.3M
$11.0M
$5.2M
$3.4M
$4.6M
$1.0M
$5.9M
$6.6M
$5.4M
$5.1M
$3.2M
$13.3M
$41.4M
$6.1M
$4.1M
$9.2M
$6.8M
$2.7M
$4.0M
DE $1.3M
MD $9.2M
DC $6.4M
$4.0M
$5.4M
$2.9M
$5.6M
NJ $5.3M
$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), and Preparedness and Emergency Response Research Centers (PERRCs) / Preparedness and Emergency
Response Learning Centers (PERLCs).
12
Community Transformation Grants
$900 million over 5 years
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Building capacity to implement evidence- and practice-based
policy, environmental, programmatic, and infrastructure
changes to prevent chronic disease
Supporting implementation of interventions across five broad
areas:
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Tobacco–Free Living
Active Living and Healthy Eating
Community-Clinical and Other Preventive Services
Social and Emotional Wellness
Healthy and Safe Physical Environment
CTGs as a model
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Creating health locally
Public-private partnerships/coalitions
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Implementation and capacity building
New relationships with health system (ACC,
community benefit
Health grants are not just for health
departments—also local education agencies
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Creating context for healthy choice
Other “partnerships” in ACA
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Accountable Care Organizations
Medicaid Health Homes
School based clinics
FQHC expansion
Community benefit requirements
New partnerships with health
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Structural integration of prevention and public
health—from Accountable Care
Organizations/Medicaid Health Homes to
Accountable Care Communities
Making the ROI case for prevention – within the
health system and more broadly
Inclusion of prevention/public health funding as part
of any global budget initiatives
Expand use of new tools such as community benefit
Cross-sector partnerships
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Federal Reserve Bank and community
reinvestment programs
Adding overt health goals to existing federal
initiatives
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Sustainable Communities
Promise Neighborhoods
Change in the context of hard fiscal
times
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Status quo is not an option
Breaking down silos
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Within public health/between environmental
health and public health
Across agencies and sectors: Health in All
Policies
New Partnerships – leverage resources so all have
a better chance of achieving their goals
Decentralized decision making
Four years, four goals
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Creating health equity by building the culture of
“health in all policies”
Prioritizing prevention – especially community
change/prevention – as part of the redesign of the US
health care system and how it is financed
Restructuring health programs and agencies to break
down silos and reflect new health infrastructure
Providing a stable base of funding for state and local
public health
For more information
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www.healthyamericans.org
Wellness and Prevention Health Reform
Digest:
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https://tfah.wufoo.com/forms/register-for-thedigest/
[email protected]