National Alliance For Healthy Communities

Having just “closed” an estimated $42 billion budget deficit in February through a combination of spending cuts and tax hikes, the State of California now faces an additional $8 billion deficit for fiscal year 2009-10, as projected by the Legislative Analyst’s Office.

Californians should be disturbed by the magnitude of the ongoing problem. Losing so much revenue in such a short time frame illustrates just how detrimental state government has been to California’s economic prosperity. State government was living a whopping 33% above its means.

The $50 billion deficit spans two fiscal years (2008-09 and 2009-10), translating to an average shortfall of about $25 billion a year. With annual general fund expenditures now hovering around $100 billion, the deficit suggests that California’s budget should be sized at a more reasonable level of $75 billion a year.

Consider the following: Most economists now agree that the United States as a whole entered the current recession over a year ago, back in December of 2007. But, interestingly, not all states experienced this same fate. Six states actually managed to avoid slipping into the recession as late as January 2009. This analysis suggests that California’s recession began in March 2007.

California is a high tax state.

Please note, statements and opinions expressed are solely those of their respective authors and may not represent the views of The National Alliance for Healthy Communities or its employees thereof. The National Alliance for Healthy Communities is not responsible for the accuracy of any of the information.

The political happenings in Los Angeles when the President came to town and was greeted by the governor at a town hall meeting.

President Obama spoke positively about the initiatives supported by Governor Schwarzenegger in California’s May special election. The main initiative creates a spending limit. So the President is praising the idea of a spending limit at the time he is offering record setting trillion dollar budgets and enormous spending packages through his stimulus program.

At the same time, Governor Schwarzenegger heaped warm praise on the President and his handling of the economy. Part of the president’s economic package includes tax cuts for many Americans. Governor Schwarzenegger’s recently passed budget included tax increases for all Californians.

One thing that was figured out is how to easily pass a tax increase by a two-thirds vote and have the public agree. Get the legislators angry at one group of people and make sure the voters are just as angry at those same people. The tax on the AIG executives who received bonuses passed by an overwhelming 328 to 93 vote.

So who are the people angry enough at in California that the Legislators could get the two-thirds vote to tax and get no protest? Well, there’s the Legislators themselves. Legislators got only about 20-percent approval ratings in recent polls. Imagine the Legislators passing a tax increase and getting no protests.

Please note, statements and opinions expressed are solely those of their respective authors and may not represent the views of The National Alliance for Healthy Communities or its employees thereof. The National Alliance for Healthy Communities is not responsible for the accuracy of any of the information.

The National Alliance for Healthy Communities does not want to create fear or rain on the parade of funds that have and will becoming available for communities to do public works projects.

The reality is that the responsibilities, significant responsibilities or association with accepting any funds that are either Federal, State or Regional. The oversight this time around will be greater than ever before.

In the recent meetings we had in DC, it was made very clear to us that the federal government will be monitoring the investment of federal dollars by local government agencies. The federal government agencies that will monitor the dollars have been given a very strict structure and protocols for oversight. The rationale is fairly simple: restore public trust in the federal government and the funds become a true stimulus rather the a bailout.

Through the Stimulus package you and your city have great opportunities.  At the same time you face extreme challenges in accountability.  Most communities will be trying  to do the right thing for the right reasons, but often times that is not enough.  Much like the IRS at audit time, if you look hard enough and deep enough you will find a financial error, be it intentional or negligent. In the case of the federal dollars, whether it comes out of the 2009 budget or the Stimulus funds, one misstep could result in a loss of all your community’s federal funds.  In addition, the budget for 2010 is now on the table and your community could face challenges in the upcoming budget.

The Alliance staff has spent decades working with government agencies on accountability issues and what we have learned  to avoid errors.  We all need to focus on what we do best.  The projects in communities are significant and manageable. But, what studies have shown is that the key is to bring in project managers who know and understand the funds process, protocols and regulations.  City staff can do an amazing job, but with the protocols the feds have, you need micro-management and the ability to fully understand the nature of the regulations and guidelines.

Through our research, we have found only a few firms that actually can manage the full spectrum of a public works project from the shovel to the auditing; and the always present politics.  The Alliance has completed the auditing of these companies from a past performance perspective, and in a short time certified one or more of these firms.

The President’s plan for the average community is similar to the legislation proposed in years past by Democrats.  We are not here to editorialize or criticize, we are here only to provide you with the facts to prepare you for whatever action you need to take for your community .

The plan provides significant new opportunities for the small and medium size farmer, but takes away certain funding for a larger business.  This change in funding can greatly affect the employment base of a community and the quality of life.  Does this mean what the President wants he will get?   Probably not.  What it does mean is that there will be changes. With change comes opportunities and challenges.  The National Alliance for Healthy Communities will be monitoring the process as the legislation goes through the Congressional hearing process.  There will be changes, some will be macro in nature and others will be focusing on regions, type of agriculture, etc.  If your community is dependent on agriculture, you need to get involved now and get your concerns vented .

Remember, the National Alliance for Healthy Communities, www.nafhc.org, is a California non-profit public benefit corporation and takes positions on policy issues, but not political issues.  Our concerns relate to maintaining or improving the quality of life in communities throughout the country.

The Alliance is only reporting on the facts, not whether they are good or bad.  The President’s proposal is a total revamping of the healthcare delivery system.  Some call it Universal Healthcare, others call it simply healthcare for all Americans. Whatever you call it, change is on the way.  Wall Street is already commenting on the proposals of the Administration as health plan stocks such as Aetna and Humana have dropped significantly from where they were … a year ago.

What is the vision?  The vision is simple: Every American has the absolute right to affordable, able to access and quality healthcare.  

What does this mean?  It means that programs like MediCaid and Medicare will be expanded to cover more people and more products.  This increases access to insurance.  Then the idea is to allow people choices.  They can keep what they have or they can buy into the federal system which would be similar to the benefits federal employees receive.   

What the facts show now is that premiums continue to rise as health plans attempt to cover losses. Reimbursements to doctors are being reduced so the return to health plans is greater.  What is also occurring now is less doctors are becoming primary care doctors, which means access to primary care is more challenging.  Managed care doctors work on a ratio of 2200 patients per doctor and often incentives are provided for not seeing patients. As there becomes less doctors, the patient load will increase and the compensation will decrease.  Therefore, the facts justify some change. What Congress will review is what type of change should occur and whether is should be in phases.

How does this affect your community?  Many communities have large hospitasl and a strong medical presence.  These communities will see significant economic changes.  Communities who have little healthcare have great opportunities now and will have more as these changes occur.

Did you know that there are government loan funds at 3% interest available to assist medical clinics as well as grant funds available in the federal budget?  Money is available to provide medical groups economic incentives to go into rural communities like Sanger, California and other communities.

Programs that can be centered around a medical clinic could include funding for the clinic, staffing, a mobile health unit (exam room), teleMed and more. This is a primary focus of the Alliance. It can lead to funding for jobs, increased economics for a community and much more.

NAFHC is partnering with Chivas USA to create youth Soccer Clinics throughout  Southern California. The event, open to Youths, features drills, tips and techniques by AYSO Certified Coaches. A special guest  appearance from a pro Chivas USA player and a healthy eating habits session will be held on site. NAFHC is currently creating alliances with other professional sports teams in addition to Chivas USA.

The NAFHC hosted The Riverside Health Summit and High Desert Health Summit. Partnering with community leaders from across the region to engage in an Executive Exchange with featured key-note speakers and Q&A with Herb Schultz, Senior Advisor to Governor Arnold Schwarzenegger. 

NAFHC is expanding the summit program to other parts of California and the U.S.

The Healthy Woman is the first ever comprehensive women’s health guide from the U.S. Department of Health and Human Services Office on Women’s Health—the nation’s leading experts in women’s health.

The Healthy Woman covers a wide range of topics, from heart disease, stroke, cancer and diabetes, to healthy aging, pregnancy, respiratory health and nutrition.  It also includes personal stories, tips for communicating with your doctor, a how-to-guide for reading medication labels and a screening chart.

Click here to find out more:
www.womenshealth.gov/the-healthy-woman