DHFAC Meeting Minutes
March 27, 2000
Special Meeting on Tobacco Control Plan
Attendees:
- Janet Arns
- Ellen Barker
- Sen. Patricia Blevins
- Martha Bogdan
- Fred Breukelman
- Gretchen Broadwater
- Deborah Brown
- Yvonne Bunch
- Rep. Deborah Capano
- Lori Christiansen
- Joseph DiPinto
- Thomas Grabowski, Sr.
- Suzanne Raab-Long
- Lolita Lopez
- Chris Manning
- Rita Marocco
- Eileen McGrath
- George Meldrum
- Paul Silverman
- Charles Simpson
- Rob Simmons
- Bill Stevenson
- Jeff Taschner
- Ulder Tillman
- Valerie Woodruff
Introduction:
The HFAC Special Meeting on Tobacco Control Plan and Budget was held by the HFAC to provide a forum for discussion about the tobacco control plan and budget currently being considered by the Health Fund Advisory Committee. Participating in the meeting were members of the Health Fund Advisory Committee, designates from key state agencies involved in the development of the plan and representatives of community groups.
The meeting began with a "status" report of the current plan before the HFAC and with an update from Jeff Taschner, Policy Advisor for the Department of Public Safety on recent Supreme Court rulings regarding tobacco enforcement. Specifically, Mr. Taschner stated that the Supreme Court recently ruled that the FDA does not have jurisdiction to regulate tobacco, thereby eliminating FDA funding to states for tobacco control. Mr. Taschner stated that whereas the Department of Public Safety had originally requested $100,000 through the current plan, given the Supreme Court's ruling, DPS will now need to request at least $280,000.
Brainstorming Exercises:
To efficiently and inclusively elicit everyone's opinions on the plan (both positive and negative), attendees, except those who directly participated in the development of the proposed plan/budget, were asked to offer their answers to two questions:
- "What do you like about the proposed tobacco control plan and budget?; and
- "What are your questions/concerns about the proposed tobacco control plan and budget?
The following are the categories into which answers were grouped.
Positive Aspects of Proposed Tobacco Plan
"It's Comprehensive"
The majority of positive comments about the proposed tobacco plan addressed its comprehensive approach to tobacco control. The three main themes regarding comprehensiveness that emerged were:
- General Comments re: Comprehensive Plan
- Incorporating all of the CDC's Best Practices:
- Focus on Prevention, Cessation and the Impact of Chronic Diseases
"It's Community-Based"
In addition to comments about the plan's comprehensiveness, many comments were offered regarding the incorporation of community-based programs into the plan.
"It's Youth-Oriented and School-Based"
Participants further commented that the plan is a good one because it focuses on youth with primary efforts through schools.
"It Includes Evaluation"
Many participants commented that they supported the plan's evaluation component and felt that this component is one that adds to the plan's strength.
Questions and Concerns about Proposed Tobacco Plan
General Concerns
General questions regarding the goals of the plan were raised as were questions about the plans sustainability (e.g. funding over time).
Funding Levels
Concerns were raised about the funding amount of the plan as well as allocation within certain "Best Practice" areas. Specifically, concerns were raised about:
- Overall funding amount
- Funding for enforcement
- Funding for cessation
- Funding for school-based programs
- Funding for evaluation Funding
- Funding for counter-marketing and public education
Allocation of Funds: Govt. Growth v. Community-Based
Concerns regarding and the perception of a reliance on state agencies in the proposed plan were raised as were concerns about using tobacco funds to supplant state General Fund responsibilities. The emergent themes of these concerns were:
- Need for more community-based programming
- Avoidance of supplanting General Fund/State Responsibilities in proposed budget
- Justification of need to create new FTE positions
Duplication of Programs/Expenditures
A number of concerns were raised regarding duplication of programs. Specifically, questions and concerns focused on ensuring that programs would not duplicate existing efforts.
Evaluation
Questions were raised regarding how the overall plan will be evaluated and how that evaluation will be coordinated between the state and private entities.
School-Based Programs
Few questions were raised about the relationship between the plan and school health curricula.
Need for Evidence-Based Programs
Comments were offered suggesting that programs implemented be based on "good science" and evidence, while some questions were raised about a specific program (cessation quit-line) and evidence of its effectiveness.
Other Questions
Few questions were raised that did not fit into the above themes, ranging from specific questions about line items to concerns about the nomenclature of programs/initiatives (all questions and comments were referred to the Division of Public Health).
Discussion:
After questions and concerns were raised and grouped, it appeared to the group that whereas there were many concerns, primarily they seemed to be around the allocation of funds and around the issues of governmental growth v. community-based program. It was felt that these issues needed to be discussed first, as the discussion may have some impact on other issues, such as funding levels within different best practice areas.
Specifically, the discussion centered on how the plan will be operationalized; that is, on the plan's "process." Questions regarding how the money will flow through state agencies to the community were raised, as were those justifying the need for new full time employees. Responses from the Division of Public Health clarified that it was the intention of the Division that funds would be passed to the community through requests for proposals, and the community would implement most of the activities. Moreover, it was suggested that new employees would provide the community agencies with technical assistance and coordination, and establish important activities such as comprehensive chronic disease and cancer programs.
Members of the HFAC requested a revised version of the plan which overviews its "process." The Division of Public Health agreed to work with the state agencies represented, as well as community groups, to re-work the plan/budget to more accurately illustrate the flow of allocated monies - through state agencies to the community - and indicate the function of additional FTE's. It was agreed that a "process-oriented" plan/budget would be presented for discussion before the HFAC at its next meeting.
At the conclusion of this discussion, other outstanding issues were raised, including:
- the need for an adequate amount of funding to ensure that program evaluations are conducted thoroughly and longitudinally;
- the strong need for a counter-marketing and public education campaign and its concomitant funding requirements; and
- the plan's need for clearly-stated goals.
The meeting adjourned at 4:35pm.
