Following the lead of three other states, a coalition of 20 statewide organizations is advocating for the creation of a California Wellness Trust to provide sustained funding for public health prevention, arguing that strategic investment in upstream prevention will protect rather than deplete government coffers.
The California Alliance for Prevention Funding (CAPF) has created a draft proposal to support the establishment of a statewide mechanism to assure long-term, sustainable funding of local and state initiatives to promote health equity and prevent the leading causes of illness, injury and premature death in California.
CAPF argues that a California Wellness Trust could keep people from needing care in the first place, make healthcare dollars go further, and improve lives. It noted that Minnesota, Oklahoma and Massachusetts have created innovative funding mechanisms to invest in prevention and are seeing significant results in reducing chronic disease and injury.
CAPF gets funding support from the Blue Shield of California Foundation, Gordon and Betty Moore Foundation and the Robert Wood Johnson Foundation. It notes that prevention efforts have been funded in California, but support has been insufficient, sporadic and siloed. Stop-and-go funding leaves public health departments, nonprofits and community partners in the lurch, having invested their time and commitment in projects only to have them end before the work can come fully to fruition, the organization says.
The proposal suggests that funding should support policies, systems and environmental changes and community programs that work outside of healthcare settings to make California's communities more conducive to health. “Funds should be distributed and coordinated among: local health departments; community-based, regional and statewide nonprofit organizations; and state government according to established criteria,” it says.
The draft proposal suggests funds should be used to address social, environmental, economic and behavioral determinants of chronic disease and injury 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; and
• support evidence-based or evidence-informed practices, as well as innovative approaches and that are shaped by community priorities and experience.
After legal analysis of potential new revenue streams, CAPF recommends using a tax on one or more products that are major contributors to chronic disease and/or injuries as a funding source for a California Wellness Trust. CAPF added that it is also open to other alternatives of sustained funding.
Examples of potential revenue sources include an excise tax on sugary beverages, a sales tax on alcohol and an excise tax on alcohol.
The draft proposal suggests dividing the funds this way:
• Local health departments 45%
• California Department of Public Health 5-10%
• Local nonprofits 30%
• Regional state and nonprofits 10%
• Administrative entity 5-10%
On May 7 CAPF is holding a webinar to go into the draft proposal in more detail and get feedback.
