Arthritis Grassroots Advocacy Efforts Prove Effective
Tuesday, July 21, 2015
Last July, the Senate Labor, Health and Human Services and, Education and Related Agencies (Labor-HHS) Appropriations Bill was released. To many people’s surprise, it recommended a reduction in CDC-funded State Health Department Arthritis programming from $13.148 million to $805,000.
CDC reports arthritis is the most common cause of disability affecting 52.7 million, or 1 in 5, adults in the United States. President Obama’s FY15 budget called for level funding from FY14 to FY15 at $13.148 million. NACDD recommended an increase to $22.550 million.
The pending elimination of $12.343 million in federal funding would impact almost 16 years of arthritis activities coordinated through the National Center for Chronic Disease Prevention and Health Promotion (CDC Chronic Disease Center) Division of Population Health’s center-wide Arthritis Program operations. Including significant cuts or elimination of one or more of the 12 CDC-funded state arthritis programs and multiple contracted national partnership activities including those with NACDD.
Lead NACDD Public Health Consultant for arthritis activities, Mari Brick, learned of the impending cuts just a few days after the in-person CDC Arthritis Program grantee meeting last July in Atlanta, GA. Knowing the severity of the cuts and their impending effect, Brick knew time was of the essence and sent a Call-to-Action to the NACDD Arthritis Council during its August 2014 monthly conference call. The NACDD Arthritis Council consists of the 12 CDC-funded state Arthritis Programs and other state health departments interested in arthritis activities. The Call-to-Action explained the situation and asked for rapid input from Council members in the form of Success Stories that would help shape the picture of arthritis funding in the 12 states (NY, PA, RI, MI, MT, MO, SC, UT, OR, CA, KY and KS).
It was explained to the council members that the NACDD “What’s Working in Chronic Disease Prevention and Control” database of success stories, was ready to launch. The newly gathered arthritis stories would be some of the first available through the database. A concern was whether states could gather the information and enter the stories into the database before November. That was the time when a Washington, D.C. based advocacy group, made up of NACDD, YUSA, Arthritis Foundation, NRPA, and others, was planning legislative visits to discuss the potential cuts in funding. Success stories would be critical to the visits.
In addition to the usual time constraints faced by smaller state chronic disease programs, the arthritis programs were in the midst of end of budget year reports due to CDC by early October. The conundrum they faced was palatable.
The following is a compilation of interviews with Brick and, the NACDD Government Affairs Forum, led by David Hoffman, describing the series of events that unfurled to save the arthritis funding.
Q: How did the state arthritis programs resolve the competing deadlines of both the end of year progress reports and the need for state success stories to assist with the efforts in D.C?
Brick described that, “On our September call, the Council membership identified a course of action that I would develop a timeline of how we’d get the success stories done along with a template that they would use to populate the information.”
“After speaking with the Council, the first person I called was Peggy Yen, (NACDD Public Health Consultant and the Association’s Success Story Writer) to discuss this particular need and to get her expertise on how best to achieve it. Peggy provided excellent guidance on what legislators want to know and what to collect from states”
“From there I spoke with Natasha McCoy, to learn about the new NACDD success story database called “What’s Working in Chronic Disease.” I used the What’s Working in Chronic Disease submission template; honing it down to a format that would work for the arthritis programs for this specific legislative(?) challenge.” she went on to say. “The template developed for the states included the state specific public health issue, a brief description of the program’s activities to date, and the impact that the funded program has had on the state’s adult population with arthritis. As part of a timeline that accompanied the template, each state was asked to provide bullets for the sections of the template.”
“The other thing that happened, after consulting with the Arthritis council leadership group, was that I asked the CDC program if they would extend the deadline for the progress report due to this new request of the states. As a result, they very generously extended the deadline by two full weeks which gave the states the needed time to pull together their information for the success stories. We were fortunate that CDC had the flexibility to change the deadline and appreciate the wisdom in their decision. Without that, I’m convinced, we would not have been able to accomplish the success stories.”, she said.
Q. Was the “What’s Working” database template well-received by the state programs?
“Obviously there were some questions as the states compiled their information into the template. Questions arose about how best to show the impact of the state program so that it would resonate with legislators and their staff, but through email and some phone conversation with individual state program coordinators, we were able to identify the best ways to do it.” said Brick.
“Once the first draft was pulled together, I sent it back to the program coordinator who reviewed and edited as needed and sent it back to me to finalize. It took a couple of back and forth emails exchanges before things were ready for submission into the What’s Working database.”
“I also went back to Peggy with the first few stories to get her point of view on them and make any changes that she suggested. At that point, I began to enter the completed stories that I had into the What’s Working database. This was probably mid-October so we were well on track to have them ready to go by the middle of November.”
Q. What was the final result of the Success Stories?
“They turned out fantastic” according to Brick. “They really give a glimpse of all the good things that the arthritis program is doing in its state. The overarching themes of the Stories were about expanding the availability of the chronic disease self-management program; the use of CDC funds to monitor burden of arthritis, coordination of activities with other chronic disease programs and/or other state agencies, and the promotion of self-management education and physical activity. Best thing is that anyone can view and download them from the What’s Working site just be going to it.”
“But at the time, we had to get them to the group in Washington, D.C. that scheduled visits members of both the Senate and House Appropriations committees so we created a Google Docs file and I uploaded the 11 finalized success stories into it. Everyone on the group had access to them day or night just by going into the file.” This included Hoffman as well as the Cornerstone Government Affairs group in Washington, who received and distributed the printed stories from Hoffman.
Cornerstone, along with other NACDD partners in Washington like YUSA and the Arthritis Foundation, scheduled visits with legislators and their staff highlighting the important work provided by state arthritis programs and shared the success story from that particular state’s congregational delegation with the request that they write to appropriators to reinstate the funds.
Q. Is there a causal link between NACDD’s efforts and funds returned for FY15 and FY16 budget?
“Absolutely”, said Hoffman. “Last October (2014) the federal government funded a Continued Resolution, or CR as it is commonly known, of the FY 2014 spending levels. The CR expired on December 11, so a one-week CR extension was needed to allow passage by both chambers”.
On December 9, 2014, Congress passed a compromise $1.013 trillion appropriations package, the Consolidated and Further Continuing Appropriations Act of 2015, dubbed the “CRomnibus”. The bill was signed into law on December 17. It included a final Arthritis budget of $9.5998, a 27% cut to the prior year’s $13.148 million appropriation, returning $8.793 million to the CDC Arthritis Program for its fiscal year 2015 budget.
“The critical success was the restoration of cuts to the Arthritis program in the draft Senate bill, which would have reduced the program from $13.1 million in fiscal year 2014 to $800,000. Through an intensive advocacy campaign in collaboration with other stakeholders, NACDD succeeded in restoring the Arthritis funding level to $9.6 million.”, said Hoffman. “The states gave us good quality information quickly with the success stories making the difference.” This example shows how NACDD “takes advantage of our resources with Cornerstone to make a difference on these issues.”
CDC, NACDD and states work together each year to monitor funding for chronic disease prevention and control efforts; especially proposed changes with potential to significantly affect community services, CDC-funded programming and jobs. NACDD and associated NACDD Consultants, councils and partners advocate for chronic disease prevention and control. “NACDD being an active partner with CDC; both really needed to work together on this, things CDC does and can’t do that NACDD does really well.” said David Hoffman.
The White House released President Obama’s FY 2016 budget proposal on February 2, 2015, with a broader funding line that includes arthritis increased by $3.5 million, back up to $13 million. However, the Senate and House recommend $9.598 and $13.148 million respectively. “The NACDD Legislative and Policy Committee continues to work closely with Cornerstone Government Affairs to keep NACDD priorities in the forefront.”, Hoffman noted.
- NACDD Lead Arthritis Consultant informed of Senate funding cuts in August 2014
- Received guidance and suggestions from NACDD Arthritis Council's steering committee
- NACDD Arthritis Consultant received guidance on developing success stories and posting to the new NACDD What's Working" database. Peggy Yen, NACDD Public Health Consultant, provided guidance on developing Success Stories specific to what legislators want to know and what to collect from states
- Learned about new "What's Working" success story database from Natasha McCoy, NACDD Public Health Consultant and success story template based on database requirements
- Discussed situation, Call-to-Action, template and time on September arthritis council call
- States given 1-2 weeks to respond
- November - December 2014 NACDD sends success stories to advocacy group and CDC
- December 2014, Congress passes $9.6 million budget for arthritis funding