Using Tobacco Taxes

An update by three physicians, all members of the Children and Families Commission in their respective counties, on local use of funds from Proposition 10.

Proposition 10 is funded by a tax on cigarettes and other tobacco products. Eighty percent of the funds are divided among California's 58 counties. The funds are administered by a Children and Families Commission in each county, and each commission is required to develop a strategic plan prior to disbursing funds.

The Sacramento County Children and Families Commission, on which I serve, has been working diligently over the past year to develop a community-based vision and mission for early childhood development and to create a strategic plan that will meet the priorities of young families throughout the county. Last spring, the Commission held 23 community forums involving 448 participants and 24 community organizations, facilitated by the Public Health Institute and Sacramento ENRICHES, to develop the following vision and mission.

VISION: Sacramento will have strong and inclusive communities, safe and healthy families, and valued children who can realize their potential and enjoy productive and fulfilling lives.

MISSION: The Sacramento County Children and Families Commission is committed to supporting the healthy development of children prenatal to age five, the empowerment of families, and the strengthening of communities.

The community input also outlined four core components that apply to our efforts: accessible and affordable, culturally-competent, community-driven, and responsive to special needs. The visioning report can be obtained on the Internet or from the Commission.

The Commission is developing a strategic plan which should be completed this September. Three task forces-on healthy children, school readiness and strong families-are analyzing data on proven programs to promote early childhood development, and on the strengths and needs of Sacramento County. The task forces will put forth specific strategies to address the needs and strengths of young children, their families and communities.

The Commission is also creating a detailed plan for evaluating these strategies to ensure accountability. The proposed strategic plan will be presented at a public hearing prior to completion. I call on members of the medical society who care for children to contribute your knowledge and expertise to the strategic plan.

The Children and Families Commissions present a unique opportunity for physicians and other community leaders to help young families in their communities. Sacramento County alone will receive approximately $17 million this year, and the county commissions throughout the Valley are working to coordinate their efforts. With most funds distributed at the county level, the county medical society and individual physicians can have a major impact on the well-being of children under 5 years.

Please feel free to contact me with your ideas and suggestions regarding Proposition 10. You can also obtain additional information on our activities by contacting Lin Batten, Executive Director, at 916-929-1657. I look forward to hearing from you!

r.pan@ucdmc.ucdavis.edu

By Bette Hinton, MD

THE MISSION of the Yolo County Children and Families Commission is to assist our community to raise children who are healthy and ready to learn. Although our resources are much smaller than the larger metropolitan areas (approximately $1.5 million per year), we will strive to maximize their impact through matching with other funds or services.

Yolo County has a strong nine-member commission and all members have been actively involved in developing a strategic plan in concert with the community. Public input/civic engagement meetings have been held throughout the county. Attendance and participation by private citizens has been exceptional.

The strategic plan is finished and public hearings for further input are being held throughout the county. Our funds are currently targeted for the following outcomes:

1. Decrease child abuse and neglect, and domestic violence (15%).
   
   
2. Decrease substance abuse in households with young children (20%).
   
   
3. pIncrease community respect for all cultures, and increase the cultural competence of services for children and families (5%).
   
   
4. Increase the number of 5 year olds "ready to learn" when entering kindergarten (8%).
   
   
5. Increase children 0-5 who have a specific source of on-going, comprehensive health care and who receive recommended primary care at appropriate intervals (35%).
   
   
6. Increase the supply of quality, affordable child care tailored to geographic areas (17%).
   
   

These funding percentages are approximate. Some funds will also remain with the Commission for public policy and advocacy work which, in the first year, will target the child care area.

The Commission is an excellent venue for physicians and others to become involved in the well being of children in our communities. Yolo County physicians who wish to participate may call me at 530-666-8645 or our Children and Families Commission office at 530-666-8820.

Bette.Hinton@ccm.yolocounty.org

By Jeffery Rabinovitz, MD

THE EL DORADO COUNTY Families and Children First Commission was established December 8, 1998. Our Board of Supervisors established a nine-member commission consisting of the director of the county mental health department, the director of the county public health department, a member of the county Board of Supervisors, a representative from what is now the Sierra Sacramento Valley Medical Society, an education representative recommended by the county Superintendent's Council and four persons appointed by the four Supervisors not on the Commission.

With our membership intact, we began a seemingly endless series of meetings. Many of us attended state commission conferences meant to give us insight into our purpose. Our early meetings were mainly procedural.

Eventually, we would need to come up with a Strategic Plan. In early 1999 this looked like a daunting task. We moved slowly, giving us a chance to get to know each other and feel comfortable with our varied styles. Our first real accomplishment was creating vision and mission statements. It was important to have consensus on these statements. This was the beginning of a process needed to tackle the more difficult job of creating the Strategic Plan and eventually choosing programs for funding.

While our deliberations continued, the people of El Dorado County continued to smoke and by the end of 1999 we had over $1.2 million that we would be able to access.

We began moving toward a Strategic Plan, holding countywide meetings with various representatives of agencies as well as interested parents. Initially we tried to determine how to access the diverse community that is El Dorado County. On the map we stretch out across highway 50 and up highway 49, but a rather large mountain gets in the way of our east and west sides.

We began a series of focus groups to learn what people perceived as barriers to children being ready for school mentally and physically. With the data, we grouped our goals into three areas: healthy children, strong families and children entering kindergarten ready to learn. We used working groups of parents and providers to come up with indicators for these goals and strategies to achieve success, which were then put together to create a first rough draft of our strategic plan.

At our August 14, meeting we reviewed the plan, as a commission, for the first time. Modifications were made and the plan will be sent to the community for further comment. In early October we will finalize the Strategic Plan and send it on to the Board of Supervisors and the state Commission. We will then be prepared to send out RFPs based on prioritizing various parts of the Plan. We hope to begin allocating our funds sometime in early 2001.

To date we have spent a limited amount of money on setting up various work group meetings, and administrative costs for our various consultants and staff people. In July, we hired an executive director.

The truly hard work is ahead, as we begin the process of fulfilling our vision and mission statements. Fortunately, the time spent together has given us the ability to do this. I hope to be able to report to you early in 2001 how El Dorado County is spending our Prop 10 funds.

jjrabinovitz@pol.net