TOBACCO CONTROL RESOURCE PROGRAM

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TOBACCO CONTROL RESOURCE PROGRAM County of San Diego Health and Human Services Agency Public Health Services - Maternal, Child, and Family Health Services June 15, 2017 Health Services Advisory Board Meeting

OVERVIEW About TCRP 1. 1990 - HHSA Tobacco Control Resource Program (TCRP) was established after the passage of Proposition 99 (the Tobacco Tax Initiative) in 1988. 2. The current Fiscal Year 16-17 TCRP budget is $511K for : Salaries and Benefits of 1.05 FTE ($138K) Operating and Indirect costs ($27K) Contracted Services ($346K) 3. Tobacco remains the leading cause of preventable death, disease, and disability. 4. The estimated cost of smoking in San Diego County is $474 per resident.

OVERVIEW Outcomes Participation in 54 community meetings training and presentations to over 500 adults and youth engaged in tobacco control activities Over 200 hours of Technical Assistance provided to tobacco control advocates and community members. Adoption of a smoke-free outdoor dining policy by the City of Oceanside. Adoption of a policy restricting the use of electronic smoking devices by the City of Lemon Grove, wherever smoking and tobacco use is prohibited. Implementation of: a local Behavioral Health Regional Training the San Diego Law Enforcement Roundtable.

OVERVIEW Outcomes Implementation of a local Tobacco Treatment Specialist Certification Training for county-contracted Behavioral Health Services contractors Implementation of the countywide Communities of Excellence in Tobacco Control needs assessment Implementation of the Healthy Stores for a Healthy Community Campaign data collection including a media event the assessment of 387 retail stores 14 key informant interviews 304 public opinion polls

LEGISLATION PROP 56 California Healthcare, Research, and Prevention Tobacco Tax of 2016 Passed by California voters in November 2016 Increased the tax by $2.00 per pack of cigarettes Revenue will be allocated to physician training prevention and treatment of dental diseases Medi-Cal tobacco use prevention research into cancer, heart, and lung diseases, and other tobaccorelated diseases school programs focusing on tobacco use prevention and reduction

REQUEST BOARD LETTER Vote to support the following actions: 1. Waive Board Policy B-29, Fees, Grants, Revenue Contracts Department Responsibility for Cost Recovery, which requires full cost recovery of revenue contracts. 2. Approve the Tobacco Tax Health Education Revenue Agreements from the California Department of Public Health for July 1, 2017 through June 30, 2021 for an approximate four year total of $12,660,516 or an annual amount of $3,165,129

REQUEST BOARD LETTER Vote to support the following actions: 3. Authorize HHSA to pursue future funding opportunities to fund efforts for tobacco prevention, education, enforcement, and control. 4. Authorize the Director, Department of Purchasing and Contracting, to issue Competitive Solicitations, and upon successful negotiations and determination of a fair and reasonable price, award contracts for a term of up to one year, with four option years, and up to an additional six months if needed, and to amend the contracts as needed, to reflect changes to services and funding.

FUNDING FUNDING SOURCE: California Department of Public Health On February 9, 2017, the State notified the TCRP of its intent to allocate new funds up to $2,872,729 for the one-year term of 7/1/17 through 6/30/18, with annual funding anticipated to continue at a similar level for the following three-year allocation term of 7/1/2018 through 6/30/2021. As a result of the Governor s May Revise Budget, allocation may increase up to $3,165,129 annually.

PRIORITY AREAS Four priority areas of the California Tobacco Control Program Limit tobacco promoting influences; Reduce exposure to secondhand smoke, tobacco smoke residue, tobacco waste, and other tobacco products; Reduce the availability of tobacco; and Promote tobacco cessation. TCRP Scope of Work Objectives in the FY 2017-2018 work plan include: Smoke-free outdoor dining policies Tobacco retail licensing policies Updating existing ordinances to match the State definitions of Smoking and Tobacco Products Inclusion of tobacco control elements in Building Codes/General Plans/Permitting Processes Integrating tobacco cessation and tobacco-free policies in behavioral health treatment programs

CHALLENGES AND SOLUTIONS Smoke-free Outdoor Dining (SFOD): Misperception that it s bad for business and assumption that a law already exists. Solution: Educate with data, focus on customer preferences, and define benefits of policy. Tobacco Retailer Licensing (TRL): Lack of enforcement and compliance monitoring; misperception that enforcement is the State s responsibility; dealing with a powerful industry that is organized, politically influential, and deeppocketed. Solution: Inform with data, provide model policies, and assist with compliance checks and funding opportunities

CHALLENGES AND SOLUTIONS Smoking and Tobacco Products Definitions (Def): Misperception that the updated State definitions apply to all laws. Solution: Identify opportunities to inform and educate jurisdiction staff. Tobacco Elements in General Plans (GP): Uncharted waters and complex variations with plans amongst jurisdictions. Solution: Identify opportunities to inform and educate jurisdiction staff. Cessation in Behavioral Health Settings (BH): Facilitating a cultural shift and dispelling many long-held myths and obtaining nicotine replacement therapies for treatment programs. Solution: Provide sustained education and increase training resources; continue development of partnerships across County departments.

CONTACT INFORMATION QUESTIONS? Thomas R. Coleman, M.D., M.S. Chief, Maternal, Child, and Family Health Services Thomas.Coleman@sdcounty.ca.gov (619) 692-8819 Irene Linayao-Putman, M.P.H. Community Health Program Specialist Irene.Linayao-Putman@sdcounty.ca.gov (619) 692-5514