Connecting the Dots: Leveraging Community Benefit Programs with City Leadership

 “When you look at maps of neighboring communities and ZIP codes and see significant disparities in life expectancy within a couple of miles – sometimes blocks – you’re compelled to advance policies to address those gaps in a meaningful way.” – Mayor David Baker of Kenmore, Washington.

Mayors and other city leaders address health issues every day, and they need a variety of strong partnerships to fully leverage the assets in their cities. (Getty Images)

Mayors and other city leaders address health issues every day, and they need a variety of strong partnerships to fully leverage the assets in their cities. (Getty Images)

This is a guest post by Nancy Zuech Lim and Sue Pechilio Polis. The post was originally published on Health Progress, the journal of the Catholic Health Association of the United States.

We know community benefit programs work with a variety of local partners, including faith-based organizations, nonprofits, local health departments, even other hospitals. But another type of critical partner is often overlooked: local city leaders.

Where we live, work, learn, grow, play and pray impacts our health and well-being. These, and the wider set of forces and systems shaping the conditions of daily life, are known as the social determinants of health. According to the World Health Organization, “conditions such as environment, housing, economy and policies impact the health and well-being of our communities.” Access to meaningful educational and economic opportunities vary by place and ultimately affect how long and how well we live – and mayors and city leaders play a pivotal role in ensuring access to those opportunities.

To be truly healthy, one not only needs high quality health care but also access to high quality early childhood programs, good schools, good jobs, affordable housing, safe and active transportation options, places to play, and healthy foods. Mayors and other city leaders address these issues every day, and they need a variety of strong partnerships to fully leverage the assets in their cities.

Hospitals and city officials can work together to address the social determinants of health and well-being through policy, structural and environmental changes in order to ensure sustainable improvements for city residents. Here are the steps they can take on three different levels:

  1. Individual and family level: build awareness of healthy behaviors, address barriers, and support ways that basic needs can be met.
  2. Neighborhood and community level: build communities that decrease barriers to ensure the healthy choice is the easy choice in every neighborhood.
  3. Policy level: promote policies that support healthy choices and healthy behaviors. Because community benefit programs are moving beyond hospital walls, the time is ripe for hospitals to further align efforts with city leaders and departments. Conducting Community Health Needs Assessments (CHNAs) together to identify priority health needs and develop implementation strategies is one way for hospitals and city leaders to build a fruitful and ongoing partnership. Some hospitals already are collaborating with city leaders and other community partners. A few examples:
  • Baton Rouge, Louisiana Mayor Melvin L. “Kip” Holden, through his Healthy City Initiative, brought together area hospitals such as the Baton Rouge General Medical Center, Lane Regional Medical Center, Our Lady of the Lake Regional Medical Center, the Surgical Specialty Center of Baton Rouge, and Woman’s Hospital to conduct a joint CHNA and implementation strategy, putting them on a course for greater collaboration to address systematic issues that influence health.
  • Spartanburg Regional Healthcare System municipal leaders and community partners took a holistic view of health in South Carolina and worked together to address all health indicators, including education, housing, access to healthy food, and economic stability. Together, they won the 2015 Robert Wood Johnson Culture of Health Prize in recognition of their progress in making changes that led to improvements in the health and well-being of local residents.
  • Vincent Hospital Frankfort in Indiana works with city and county leaders and community partners as part of the Healthy Communities of Clinton County Coalition. The coalition works to improve health through policy, system and environmental changes, complete streets and tobacco-free programs.
  • The D.C. Healthy Communities Collaborative is a local partnership among four District of Columbia hospitals (Children’s National Health System, Howard University Hospital, Providence Health System and Sibley Memorial Hospital), four Federally Qualified Health Centers (Unity Health Care Inc., Community of Hope, Mary’s Center and Bread for the City), and two ex-officio members (the D.C. Primary Care Association and the D.C. Hospital Association) that conducted a joint CHNA in the nation’s capital. In collaboration with the D.C. Department of Health, the collaborative is developing an implementation strategy to address the priority health needs in the District of Columbia.
  • Saint Thomas Health, Nashville, Tennessee, collaborates with Metro Nashville Public Schools to provide the Saint Thomas Health Scholars Program, a free program for selected high school seniors to promote health care careers through mentoring and training for the medical assistant certification exam.
  • Trinity Health, based in Livonia, Michigan, created the Transforming Communities Initiative that uses a wide variety of funding mechanisms for direct community health improvement in awarded locations.

Further examples of health systems working with city leaders to address affordable and healthy housing are: Bon Secours Baltimore Health System, Saint Agnes Healthcare in Baltimore, Nationwide Children’s Hospital in Columbus, Ohio, and Children’s National Health System in Washington, D.C.

Successful efforts in this arena start by developing key partnerships that include city officials. Here are a few tips for community health care organizers:

  • Share with your mayor/city leaders. Share your CHNA, implementation strategy and community benefit report with your mayor, councilmembers, local school superintendent, and health department director. Offer to provide key city officials with an overview of your CHNA process, community benefit programs, and the community support you provide.
  • Know your city’s plans and priorities. Become familiar with your city’s master plan, school wellness plan, and health department plan. Listen to your mayor’s State of the City address. Lincoln, Nebraska’s “Taking Charge” program is an example of a city using its budgeting process to improve community health and well-being. The program uses an outcomes-based budgeting and evaluation process that identified community priorities and set outcome goals.
  • Meet and discuss. Meet with city leaders to learn more about their efforts to improve health and well-being. Share and discuss how social determinants affect the health and well-being of your community. Consider using key resources like County Health Rankings & Roadmaps and Community Commons to map by ZIP codes the areas of greatest need. Highlight areas of focus that overlap and initiatives that complement city goals.
  • Assess together. Share information and assessment processes. Consider working towards one needs assessment for the city, and look for other ways you may be able to collaborate and leverage resources.
  • Align efforts to improve health and well-being. Build on each other’s strengths and expertise, and work together to address barriers to healthy lifestyle behaviors, health care and the social determinants of health. Look for ways your programs and efforts may support each other’s goals and initiatives.

Interested in learning more about social determinants of health? Click here to view a short video by Julie Trocchio, senior director, community benefit and continuing care, in CHA’s Washington, D.C. office.

About the authors:

nancy_lim_125x150Nancy Zuech Lim is a community health and benefit consultant with the National League of Cities on the Institute for Youth, Education and Families’ Early Childhood Success portfolio. She can be reached at lim@nlc.org.

 

sue_polis_125x150Sue Pechilio Polis is the Director of the Health and Wellness team in NLC’s Institute for Youth, Education and Families. She can be reached at polis@nlc.org.

The Secret to a Healthier City: Sharing Data

To be effective and strategic in their decision-making, city leaders striving to build a culture of health need diverse, usable, high-quality data sources that are integrated, timely, relevant and geographically precise.

“In Cincinnati, partnerships, shared expertise, and data integration have helped us as we seek answers to complex problems. Indeed, I have come to learn that seeking consultation from a housing expert may prove just as valuable to my patients and families as would a consultation from a cardiologist or gastroenterologist.” - Dr. Andrew Beck, pediatrician at Cincinnati Children’s

“In Cincinnati, partnerships, shared expertise, and data integration have helped us as we seek answers to complex problems. Indeed, I have come to learn that seeking consultation from a housing expert may prove just as valuable to my patients and families as would a consultation from a cardiologist or gastroenterologist.” – Dr. Andrew Beck, Cincinnati Children’s Hospital

This post was co-authored by Peter Eckart, Alison Rein and Nick Wallace.

Data can be a powerful tool for understanding issues, making smarter decisions, and improving results – and city leaders can help build a culture of health by supporting the collection, access and use of data to establish programs and policies that improve both economic and population health through education, transportation, housing and other critical issues.

However, collecting and using data from multiple sources and sectors is challenging, and is often hampered by the organizational, cultural, and budgetary silos that pervade municipal government. Data collected by local hospitals, the department of health, and the Mayor’s office are not often shared with one another due to real or perceived legal restrictions, turf issues, and lack of capacity. While opening access to data and allowing it to be integrated with other data types and sources is not yet the norm for city leadership, a few cities have modeled the extraordinary benefits of such efforts.

Community Health Peer Learning Program (CHP) grantee, Cincinnati Children’s Hospital Medical Center, has embarked on an effort to identify “hot spots” where the incidence of disease, such as asthma, is especially high. Between 2009 and 2011, children from low-income areas in Hamilton County were 88 times more likely to be admitted into the hospital for emergency asthma treatment than children from high-income areas. Pinpointing the disparities at the neighborhood level has allowed the hospital to partner with the Cincinnati Health Department to more effectively link at-risk children to home inspectors that can help to identify the existence of potential health hazards. The hospital has also built a medical-legal partnership with the Legal Aid Society of Greater Cincinnati to pursue legal advocacy when dealing with noncompliant landlords. Thus, home hazards like lead, pests, and mold have been mitigated, new roofs have been installed on several buildings and new heating and air-conditioning units have been put in. The community also recently received a $29 million grant from HUD to accelerate the rehab in one at-risk neighborhood.

Dr. Andrew Beck, a pediatrician at Cincinnati Children’s, notes, “Hospitals and social service agencies, public and private, seek to promote health and wellness among those they serve. We seek the same goal, but we generally work separately. In Cincinnati, partnerships, shared expertise, and data integration have helped us as we seek answers to complex problems. Indeed, I have come to learn that seeking consultation from a housing expert may prove just as valuable to my patients and families as would a consultation from a cardiologist or gastroenterologist.”

The example from Cincinnati makes it clear that leaders should be intentional about nurturing and encouraging a culture of data sharing across various organizations and sectors. Building these sometimes difficult but necessary data sharing relationships is core to All In: Data for Community Health, a nationwide learning collaborative that aims to help communities build capacity to address the social determinants of health through multi-sector data sharing. The two founding partners of All In, Data Across Sectors for Health (DASH) and the CHP Program recently presented together on NLC’s Culture of Health Web Forum Series. The BUILD Health Challenge and the Colorado Health Foundation’s Connecting Communities and Care have also become partners in All In, which now collectively represents 50 local data sharing projects across the country.

Here are just a few lessons from the All In learning collaboration that may be useful to cities in the early stages of multi-sector data sharing:

  1. Relationships are critical to moving data integration forward: Sharing data is as much about relationships as it is about technology. Everything that we know about making collaborations work – developing a shared understanding of the problem, willingness to work together, building trust, communicating clearly, creating a shared governance – applies even more to data sharing partnerships.
  2. Effective data sharing is a considerable time investment, and requires laser-like focus on the problem statement: It can take several years to get people to the table, build meaningful relationships, learn how other sectors operate, and develop data sharing agreements. Creating an environment for data sharing that supports and sustains this commitment requires gaining buy-in from partners and key community stakeholders to ensure their dedication to the driving purpose and continued participation over the long haul.
  3. Data can be used both to identify and characterize city challenges, and to effectively target limited city resources: City officials often know they have an issue, but data are critical for determining scale and scope, and for understanding root causes. Similarly, once these challenges are better understood, interventions are often based on the knowledge that integrated data permits better targeting of city services (e.g., lead poisoning abatement, falls prevention, city planning), and more efficient use of scarce resources.

While there is no roadmap for this complex work of building multi-sector partnerships to share data, there are several resources available to city leaders who want to learn from others who have been down a similar path.

  • Thirty cities nationwide are engaged in the National Neighborhood Indicators Partnership (NNIP), a peer network of open data intermediaries. The NNIP shares lessons from local partners to help strengthen capacity for data-driven decision-making.
  • Github is an open source hub that contains many technical tools for sharing data that can be adapted by others.
  • What Works Cities is a national initiative designed to accelerate cities’ use of data and evidence to improve results for their residents.
  • DASH’s Environmental Scan provides a nationwide snapshot of the current state of multi-sector data sharing initiatives for community health. AcademyHealth will soon release a scan of the national program offices supporting these initiatives.
  • The All In Data for Community Health learning collaborative regularly shares news and resources to help guide and advance the field of multi-sector data sharing for health. Sign up for the monthly newsletter to get updates.

Not sure where to access data? Check out some useful data tools for cities, including Community Commons, County Health Rankings & Roadmaps, The National Equity Atlas, and the 500 Cities Project.

City leaders play a critical role in building lasting multi-sector partnerships that help unleash the full potential of local data. As city leaders innovate and experiment, it’s critical that they share their challenges and successes. If we are agile and open to learning from others, we can maximize data infrastructure investments to achieve greater collective impact.

About the authors:

peter_eckart_125x150Peter Eckart, M.A., is Co-Director of Data Across Sectors for Health at the Illinois Public Health Institute.

 

alison_rein_125x150Alison Rein, M.S., is Senior Director of the Community Health Peer Learning Program at AcademyHealth.

 

nick_wallace_125x150Nick Wallace is an Associate for Health and Wellness at NLC’s Institute for Youth, Education, and Families.

The Opioid Epidemic: How Cities Are Fighting Back

The most notable success was achieved thanks to a considerable push from city and county leaders during the last days of the Congressional session.

One of the many resources available on NLC’s opioid action web page is profile of the city of Seattle’s diversion program for low-level offenders, which allows police officers to redirect individuals engaged in drug use or prostitution to community-based public health and social services rather than to jail and prosecution. (Getty Images)

Opioid overdoses and deaths continue to be the leading cause of accidental death in America. However, city leaders can take some comfort that 2016 closes with several significant successes that should ensure progress on this public health crisis in 2017.

The most notable success, the sum of $500 million appropriated by the federal government to support opioid addiction treatment, was achieved thanks to a considerable push from city and county leaders during the last days of the Congressional session. The bipartisan votes in both houses of Congress demonstrate that the scope of this public health nightmare extends to all parts of this country – urban, suburban, and rural – and impacts all ages, incomes, genders, races, and ethnicities.

The legislative advocacy success came quick on the heels of the November 17 release of, A Prescription for Action: Local Leadership in Ending the Opioid Crisis.” This joint report from the National League of Cities (NLC) and the National Association of Counties (NACo) is the culmination of a year of work by a task force of city and county leaders.

NLC and NACo agreed to launch the joint task force in February 2016. The membership included both elected and appointed city and county officials from across the Unites States. The members brought a strong background in medicine as well as criminal justice, among other fields.

Providing a perspective on behalf of the entire 22-member task force, the two co-chairs, Mayor Mark Stodola, Little Rock, Arkansas (NLC First Vice President) and Judge Gary Moore, Boone County, Kentucky said, “Although news outlets often provide little more than a running tally of the epidemic, leaders at the local level experience the human costs of this public health crisis one life at a time. It is our duty to act with urgency to break the cycles of addiction, overdose, and death that have taken hold in so many corners of this nation.”

 

As part of the launch of the task force report, NLC and NACo created a new web portal. In addition to providing resources to cities and counties, we are encouraging local officials to make a pledge to lead on opioid action in their communities and to work in partnership with other leaders at the local, state, and federal levels. The pledge campaign announcement is included as part of an archived webinar delivered by city and county task force members on December 15, 2016.

In addition to the special web portal created for the task force, NLC maintains a collection of resources on its own website. These resources include the drug control strategy from Huntington, W.V., the Seattle-King County Police Diversion Program, and the opioid report developed by the Massachusetts Municipal Association on behalf of communities in that state.

Brooks, J.A. 2010About the author: James Brooks is NLC’s Director for City Solutions. He specializes in local practice areas related to housing, neighborhoods, infrastructure, and community development and engagement. Follow Jim on Twitter @JamesABrooks.

Top 5 Most Popular NLC Blog Posts of 2016

This year saw a number of posts that reached thousands of readers and were shared widely on social media. Here are the top five, in no particular order.

7 Ways City Leaders Can Address Racial Inequities
City leaders must step up to take the lead with their police departments and community members to address racial inequities in their respective cities and towns.

10 Innovative Ways to Attract Millennials to Your City
Philadelphia is a city that has implemented a set of successful policies aimed at attracting and retaining talent in the last decade. During that same period, the city’s population grew by 100,000.

Four Bad Habits to Avoid at City Council Meetings
Learning these principles and avoiding these bad habits will improve your meetings — and your decision-making.

5 Ways Parks Provide a Return on Investment
Parks and public spaces are an integral part of the atmosphere and culture of a city or town. More than that, though, they have a massive positive financial impact – one that is generally overlooked.

5 Things Mayors Can Do to Create Healthier Communities
NLC’s new report, Addressing Health Disparities in Cities: Lessons from the Field, provides lessons learned and examples of actions that mayors and other city leaders are taking to intentionally address childhood obesity-related health disparities.

Paul Konz headshotAbout the author: Paul Konz is the Senior Editor at the National League of Cities.

Seven Cities Work with NLC to Build Early Learning Communities

City teams heard from a panel of three national experts about the area where workplace and economic support policies intersect with early childhood education.

(Getty Images)

The earliest years of life are critical to a child’s development. High-quality education and development for children from birth to age five not only promotes physical and social-emotional health and a strong foundation for success in school and life, it also helps build strong local economies and thriving communities. (Getty Images)

Earlier this month, NLC’s Institute for Youth, Education, and Families (YEF Institute) brought local leaders from seven cities together in Washington, D.C. as part of its City Leadership for Building an Early Learning Nation initiative, supported by the Bezos Family Foundation. The meeting gave local leaders from cities committed to becoming early learning communities the opportunity to hear from experts on many of the key issues they are grappling with in their efforts to ensure every young child thrives and reaches their potential.

Participating cities included San Francisco; Portland, Maine; Kansas City, Missouri; Minneapolis; Pittsburgh; Jacksonville, Florida; and Dayton, Ohio, which have been part of NLC’s Early Learning Nation initiative since July 2015.

City teams heard from a panel of three national experts about the area where workplace and economic support policies intersect with early childhood education. Emily Martin, general counsel and vice president for Workplace Justice for the National Women’s Law Center, discussed the ways in which conditions of low-wage jobs – which often include unpredictable and non-traditional schedules and low pay – make it very challenging for families to secure stable child care arrangements. Michelle McCready, chief of policy at Child Care Aware of America, laid out data from Child Care Aware’s recently released Parents and the High Cost of Child Care report, and discussed how early care and education is unaffordable for families in nearly every state. Heidi Goldberg, director of Economic Opportunity and Financial Empowerment in the YEF Institute, spotlighted innovative city efforts to set families up for economic success, including NLC’s newly formed Economic Mobility and Opportunity Task Force.

Julie Holland, Education Advisor to Mayor Sly James of Kansas City, Missouri, reflects on what she learned from the session on creating family-friendly policies to support young children.

On the meeting’s second day, the seven cities were joined by 10 communities from the Center for the Study of Social Policy’s Early Childhood-LINC network for a discussion on promoting racial equity in early childhood systems. Lindsay Allard Agnamba, executive director of School Readiness Consulting, and Michelle Molitor, founder of the Fellowship for Race & Equity in Education, facilitated a series of small group conversations on how participants can leverage their roles in city government to promote racial equity. Participants committed to taking action steps to promote upon returning to their cities.

Charmaine Webster, Preschool Promise Program Manager at Learn to Earn Dayton, in Dayton, Ohio, shares her takeaways from the session on racial equity.

The convening also featured Ellen Galinsky, executive director of Mind in the Making at the Bezos Family Foundation. Watch Galinsky lay out her vision for an Early Learning Nation.

Through the City Leadership for Building an Early Learning Nation initiative, NLC will continue to work with these city leaders toward the goal of building an Early Learning Nation by 2025. If you’re interested in learning more, contact Alana Eichner at NLC’s Institute for Youth, Education and Families at eichner@nlc.org.

About the author: Alana Eichner is the Early Childhood Associate in NLC’s Institute for Youth, Education, and Families.

What Cities Need to Know About the Booming eSports Industry

The world of professional, competitive video gaming is expanding at a rapid pace – and you might be surprised to learn that cities stand to benefit from its growth.

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Twitch streamers (professional competitive video gamers) gather at the White House for its first-ever competitive gaming event on Monday, December 12, 2016.

This post was co-authored by Angelina Panettieri and Courtney Bernard.

This week, more than 220,000 people tuned in to watch the first-ever White House eSports event on Twitch. For those not familiar with the video game industry, this event may prompt a few questions – namely, what are eSports and Twitch? Why is this a draw for so many people? And what could this mean for my community?

NLC staff were on-site for the event, and we’ve compiled the top things every city leader needs to know about the fast-growing industry set to generate $1 billion within the next few years.

eSports are everywhere – and the industry is expanding rapidly.

eSports – a term that refers to professional, competitive video gaming – are increasingly popular spectator events driving major investment and interest. Enthusiasts around the globe attend events in person or stream content with online platforms like Twitch, which has nearly 10 million daily active users. Spectators watch gamers play everything from multiplayer online battle arena (MOBA) games to strategy games.

Currently, 14 percent of Americans follow eSports. To put that into perspective, eSports spectators actually outnumber those watching the World Series or NBA Finals. And while there are hundreds of millions of people across the country that already watch eSports, even more are playing video games – 49 percent of American adults, to be exact.

The rising popularity of video games and eSports is driving major consumer brands like Coca-Cola, ESPN and American Express to invest in the industry. As the competitive gaming industry continues to evolve, analysts expect audience and revenue growth to accelerate rapidly.

eSports events could drive tourism for cities.

The widespread appeal of eSports make events and tournaments a potentially major draw for tourism, both here at home and abroad. eSports events are selling out stadiums, convention centers and other large venues around the globe. In 2015, there were 112 major eSports events, and they generated $20.6 million in ticket revenues.

In the United States, these events have become a major draw for tourism in cities like Los Angeles and New York. The projected growth trend for eSports suggests that many other cities can leverage the phenomenon to boost tourism and engage members of the community.

The eSports boom has already drawn the attention of traditional sports team owners and franchises. For example, Golden State Warriors co-owner Peter Guber and Washington Wizards majority owner Ted Leonsis recently joined forces to acquire eSports franchise Team Liquid, and the Philadelphia 76ers purchased two eSports teams as well. Partnerships and acquisitions like these could lead to huge opportunities for local eSports expansion.

eSports enthusiasts in your city need robust broadband infrastructure.

In order to leverage this booming new industry, cities need to ensure their broadband infrastructure is up to snuff. While a number of federal programs have targeted the homework gap and the need for students to have access to broadband both at school and at home, cities should not ignore a similar recreation gap for entertainment streaming services. City residents increasingly expect access to broadband at home, whether they use it for work or play. A 2015 study found that a fiber optic internet connection increases the value of a home by as much as an additional fireplace or half-bath.

Online gaming and streaming activities are driving the need for reliable, low-latency broadband service in the home. While broadband infrastructure continues to expand, the percentage of Americans choosing to purchase broadband remains near 70 percent of households. If leaders in your community – and residents – are struggling to see the value of a robust broadband infrastructure, eSports and online recreation may be the missing link.

About the authors:

Angelina Panettieri is the Principal Associate for Technology and Communication at the National League of Cities. Follower her on twitter @AngelinainDC.

 

Courtney Bernard is the Senior Communications Associate in NLC’s Center for City Solutions and Applied Research. Follow her on Twitter @cbernard916.

Arrested Development: Adolescent Development & Juvenile Justice

As part of our efforts to promote professional development among city leaders, we often feature TED Talks focused on cities, community issues or local government. This week’s talk is presented by Elizabeth Cauffman, Professor and Chancellor’s Fellow in the Department of Psychology and Social Behavior at the University of California, Irvine.

A 9th grader charged with assault for a spitball. A 12-year-old sentenced to life in prison. These are the types of cases that Elizabeth Cauffman has focused her career on. She asks the fundamental question: are adolescents different from adults in ways that require different treatment under the law? In her talk, Elizabeth discusses how we can approach this question in a matter that is fair within our society.

Research suggests that city policies using law enforcement to address offenses by youth and young adults may be doing more harm than good. To learn more about how some cities use diversion or deflection to steer young adults who offend into services and hold them accountable for their actions, connect with the Institute for Youth, Education, and Families’ City Leadership to Reduce the Overuse of Jails for Young Adults initiative.

Paul Konz headshotAbout the Author: Paul Konz is the Senior Editor at the National League of Cities.

Two Reasons Why the 21st Century Cures Act is Good for Cities

The passage of the bill is an important step towards ensuring federal support for local efforts to address substance abuse and mental health needs, particularly when it comes to fighting the opioid epidemic.

According to the CDC, "more people died from drug overdoses in 2014 than in any year on record. The majority of drug overdose deaths (more than six out of ten) involve an opioid. And since 1999, the rate of overdose deaths involving opioids (including prescription opioid pain relievers and heroin) nearly quadrupled."

The 21st Century Cures Act provides $1 billion of critical funding to communities combatting the opioid crisis. According to the CDC, more than 60 percent of drug overdose deaths involve an opioid. And since 1999, the rate of overdose deaths involving opioids (including prescription opioid pain relievers and heroin) has nearly quadrupled.

This post was co-authored by Yucel Ors and Stephanie Martinez-Ruckman.

Today the U.S. Senate passed the 21st Century Cures Act with overwhelming bipartisan support. The comprehensive health bill does many things, including reshaping how the Food and Drug Administration regulates drugs and medical devices and providing new funding for cutting-edge research on disease. But the bill does much more – in ways that impact cities and their communities.

  1. The 21st Century Cures Act provides $1 billion of critical funding to communities combatting the opioid crisis.
    The Cures Act builds on the programs authorized in the Comprehensive Addiction and Recovery Act (CARA) by providing $1 billion over two years for grants to state and local governments to supplement opioid abuse prevention and treatment programs. Areas covered include:
  • Prescription drug monitoring programs
  • Implementing prevention activities
  • Training for health care providers

In November, the National League of Cities (NLC) and the National Association of Counties (NACo) City-County National Task Force on the Opioid Epidemic released the report, “A Prescription for Action: Local Leadership in Ending the Opioid Crisis.” The report provides recommendations for how local officials should address the opioid crisis and explores how cities and counties can strengthen collaboration with each other and state, federal, private-sector and nonprofit partners.

The passage of The Cures Act, in combination with CARA, are important legislative steps toward combatting the opioid crisis from a local level.

  1. The Cures Act addresses substance abuse and mental health needs.
    Cities have long been advocating for reforms to the mental health and criminal justice systems to better address substance abuse and mental health needs. Local elected officials have been leaders in the effort to reduce the criminalization of mentally ill persons, and NLC has made it a priority to advocate for legislation that would help local governments continue to make significant reforms to the criminal justice and mental health system.

The Cures Act addresses many of the criminal justice and mental health system reforms for which NLC has been advocating:

  • Second Chance Act amended to allow state and local governments to use reentry demonstration project grant funds for the provision of mental health treatment and transitional services (including housing) for mentally ill offenders who are re-entering the community
  • Drug Court Grant Program amended to allow state and local governments to use their existing grant funds to include targeted interventions for individuals who have both a mental health and substance abuse disorders
  • Byrne Justice Assistance Grant (JAG) Program changed to enable local law enforcement to use to funds for the creation of mental health response and corrections programs, including police crisis intervention teams
  • Community Oriented Policing Services Grant Program (COPS) amended to allow local law enforcement to use funds for specialized mental health response training
  • Federal mental health court grant funds can now be used for the creation of court-ordered outpatient treatment programs to prevent the escalation of mental health crises

On the bill’s passage, NLC President and Cleveland, Ohio, Councilmember Matt Zone said, “The Cures Act goes a long way to lay the groundwork for strong partnerships at every level of government – and it is our hope that before the 114th Congress adjourns it will appropriate the necessary funding authorized in the legislation.”

We are encouraged that Congress has taken a major step towards addressing one our nation’s greatest epidemics and is making it possible for local governments to make significant advances towards reforming the criminal justice system and combating the opioid epidemic. NLC looks forward to working closely with Congress and the Federal government to ensure the programs authorized in the 21st Century Cures Act and CARA help local governments build stronger and safer communities.

About the authors:

Yucel-OrsYucel (“u-jel”) Ors is the Program Director of Public Safety and Crime Prevention at the National League of Cities. Follow Yucel on Twitter at @nlcpscp.

 

Stephanie Martinez-Ruckman is the Program Director for Human Development at the National League of Cities. Follow Stephanie on Twitter @martinezruckman.

Children’s Savings Accounts: How Cities are Helping Families Save for College

Every family should have the opportunity to save for their children’s future, but this is simply not the reality for many low- and moderate-income families.

CGI America2From left to right: Laura Owens, ‘I Have a Dream’ Foundation; Heidi Goldberg, National League of Cities, Michael Sherraden, Center for Social Development at Washington University; San Francisco Treasurer José Cisneros; St. Louis Treasurer Tishuara Jones; Governor John Hickenlooper; and Andrea Levere, CFED President onstage with President Bill Clinton for the announcement of the Campaign for Every Kid’s Future at CGI America. (photo: CGI)

The National League of Cities is proud to join CFED and over a dozen other partners in launching the Campaign for Every Kid’s Future. Announced this week on stage with President Bill Clinton at the CGI America Conference in Denver, the Campaign will work to ensure that 1.4 million children have a savings account for college by 2020.

Children’s Savings Accounts (CSAs) are a proven two-generation strategy for helping children and their families move up the economic ladder. Higher education — the surest route to economic success — is within reach when conversations about college happen at an early age. In fact, evidence shows that children with a savings account in their name are three times more likely to enroll in college and four times more likely to graduate, even if they have as little as $500 or less in that account. CSAs, particularly locally-led CSA programs, often include the following components:

  • A savings account,
  • Parent/guardian engagement in helping with deposits,
  • Incentives to save, such as cash matches, and
  • Financial education for children and their parents/guardians.

In addition to our partnership with CFED on the Campaign for Every Kid’s Future, we’re launching a new project to work with cities to help them plan, develop and implement locally-led CSAs. These cities will have the opportunity to connect with each other and with experts in the field to develop their own blueprints for local action in developing or enhancing CSA programs.

As President Bill Clinton eloquently noted in his opening remarks, there are no silver bullets, but there are thousands of actions we can take that, in the aggregate, can improve the lives of children and families. Implementing a CSA program is one such action. President Clinton recognized the need to highlight successful local actions and initiatives at high-profile events such as CGI America, with the hope that other cities will take what they learn and replicate programs in a way that works for them.

And there are many communities interested in replicating CSA programs, according to a recent NLC scan of local financial inclusion efforts. Our latest report, City Financial Inclusion Efforts: A National Overview, highlights the results of our scan and reveals that emerging financial inclusion strategies, such as CSAs are currently under discussion or in development in cities across the country.

There are several cities already actively engaged in this work, some of whom, such as San Francisco and St. Louis, have signed on as partners to the Campaign for Every Kid’s Future.

In 2010, San Francisco Treasurer José Cisneros started Kindergarten to College (K2C), the first publicly funded, universal children’s college savings account program in the U.S. K2C provides a college savings account with a $50 deposit for every child entering public kindergarten in the city. In St. Louis, Treasurer Tishaura Jones’ office is launching the St. Louis College Kids program this fall. Based on San Francisco’s model, every public and charter school kindergartner in St. Louis will receive a savings account with an initial $50 deposit from the City of St. Louis Treasurer’s Office to help families save for their children’s education.

Heidi-Headshot
About the Author:
Heidi Goldberg is the Director for Economic Opportunity and Financial Empowerment in the NLC Institute for Youth, Education, and Families. Follow Heidi on Twitter at @GoldbergHeidi.

An Interview with NLC Executive Director Clarence Anthony on Race, Equity & Leadership

Clarence AnthonyNational League of Cities CEO & Executive Director Clarence Anthony, seen here speaking at NLC’s Congressional City Conference in March. (Jason Dixson)

The tragedies that have occurred in Ferguson, New York City, Baltimore, and other communities throughout America have rightly sparked conversation about the social, cultural, racial and economic factors that affect the everyday lives of city residents – particularly minorities, at-risk youth, and the poor. What can cities do to promote equality and economic opportunity for people of all races, ethnicities, ages and economic backgrounds?

When tragedies like this occur, it not only erodes the relationship between the police and the community, it highlights the fact that there is a growing economic disparity that city leaders in America must recognize and address. High unemployment rates and low graduation rates among citizens in cities, towns and villages shows that certain neighborhoods have prospered while others have not. It’s important that city leaders understand that you have to engage with, and design initiatives for, all constituents in every neighborhood.

For example, city leaders must focus on creating vibrant downtowns while developing inclusive and affordable housing in neighborhoods. This type of approach to public policy will create more engaging cities where citizens can live, work and raise their families within the community that they call home. One way we can accomplish this is to create incentives so that the private sector will hire from within the community. When city leaders promote this type of growth, cities benefit and residents become vested in their community.

Cities should also examine the appointment process for city advisory boards and councils. For example, a planning and zoning commission that doesn’t reflect the ethnic, racial or gender diversity of the city is not truly representative of that city. From parks and recreation departments and advisory councils to tourist development councils and workforce boards, every policy board that advises the elected leadership should represent the diversity of that city. It can be done, but you’ve got to be very strategic and intentional, and have a real commitment to making sure that every segment of the population is represented.

These are just a few of the concrete steps that cities can take to ensure that their communities are equally represented in government. If a community is under-represented, and its needs are not served, then its residents will not be vested in the city as a whole. They won’t feel like the city is their home. And then you’ll see the tragic events that have happened in countless cities across the nation continue to occur. All of these cities have people who feel that they are not part of a community; that they are not “real” citizens with a voice in government. And they will find other ways to make their voices heard.

So there can’t be a disconnect between municipal authority and the people it represents.

You have to have that connection. You have to include them in the governance process, in the community process. I was just at a conference in Philly – Cities United – and it had a panel of young African American men, and their message was “Don’t talk at us; talk to us, and with us.” Many of them were in their mid-twenties, and public policy and programs are being designed for them – but without their input. That has to change. You have to include them in the development of the community in which they live.

The root causes of the recent tragedies are complex and nuanced. Two distinct events consistently stand out, however: the death of a young black male as a result of an interaction with police, and the violent public response that subsequently occurred. What steps can city leaders and local elected officials take to address the potential for these tragedies to occur in their cities?

There has to be an acknowledgement that there are still challenges in communities throughout America when it comes to race relations – specifically, race relations with police departments. Something must occur to strengthen trust between the minority community and police in cities throughout America. At this point, unfortunately, we are starting to see police being targeted in reprisal; community trust continues to erode. We must start a conversation of understanding and partnership – and that conversation must be led by city leaders. The elected officials who are members of the National League of Cities are exactly that type of group; they’re city leaders who strive to create a bridge between police and communities, so that real conversations can occur.

In addition, I think city leaders should start to re-examine – and implement, wherever possible – community policing policies that provide for a real understanding of the communities they serve; there must be understanding to have a relationship with the community. Once you have that relationship, you’ll be able to engage. So city leaders must be able to look at how they’re investing their resources and what kind of progress is being made throughout the community as a whole. When city leaders acknowledge that they have diversity in the community, and they create opportunities to bring people throughout the community together, that creates relationships and real conversations.

This is happening in some communities, but we need it to happen everywhere. The questions involving black males in America focus on more than just police relations – they take into consideration the high unemployment rate, the low high school graduation rate, and the level of poverty that exists in cities throughout America, among other factors. The takeaway is this: city leaders have to focus on improving engagement and relations in their communities. We have to look at how we provide creative and innovative techniques to reach the African American community so that we can achieve our goal of making true connections that are lasting and productive. It will take hard work and partnerships with our educational system and the private sector – and on the law enforcement side, those same partnerships need to develop, focusing on education and training on how to value diversity and how to communicate across cultures.

The change we need will not occur overnight; it will take patience and time to build the trust that our cities deserve. We need to spur conversation, in an effort to reach a certain level of trust and understanding between police and communities. The National League of Cities is quickly becoming a nexus of conversation about race, equity and leadership in American cities. That conversation is long overdue.

Do you see the Cities United event in Philadelphia as one of the forums for that conversation?

Yes. I think Cities United is not only a forum for that conversation, but an excellent tool to help elected officials get the technical expertise they need to deal with the larger issues involved. For example, Cities United provides consultants that help city leaders respond to the challenges faced by American cities that we’ve discussed today.

How does the National League of Cities’ lead that conversation?

Our REAL initiative is a very important tool and resource for city leaders. It’s designed to help them address racial tensions in their communities and create meaningful conversations around racial diversity and equity issues. REAL stands for Race, Equity And Leadership – and the piece that we really have to elevate is the piece on leadership, because our members are the ones who are responsible for governance in American cities.

Earlier, you posed the question, “What should city leaders do if something like this happens?” The challenges we’ve spoken about today are especially difficult challenges for any city leader to face, and it’s the responsibility of the National League of Cities to develop best practices around these issues, give city leaders the space to discuss the challenges they face with a network of peers, and then provide them with the tools they need to manage the situation if something like what happened in Baltimore or Ferguson occurs in their community.

I wish I could sit here and tell you that this will be the last time that tragedies like these will occur. But the reality is that, until a systematic strategy is in place to bring about full economic participation as well as improved relations between police and the communities they serve, these tragedies could happen in any city in America. City leaders are standing up and saying, “we need to fix these issues before something like this occurs in our community.” That’s a conversation that needs to be had. We’re going to start seeing city leaders begin to deal with the injustices, the inequality, and the creation of opportunities for all of their citizens.

And that’s what we have to do: we have to build a city in which everyone is a participant, where all citizens feel like they can raise their kids, and live and work and play in a safe and vibrant environment. You don’t call a place home when you don’t have a system of governance that supports you. Right now, I think that’s one of the biggest challenges American cities face. But if we can rise to that challenge, I think we’ll have more people out on the streets saying “Hey, this is our neighborhood; we own this.” We have to create cities that all citizens can call home.

Paul Konz headshotAbout the Author: Paul Konz is the Senior Editor at the National League of Cities.