Prevention Institute Is Reimagining the Way We Allocate Public Funds

Prevention Institute wants equity to be baked into the way we design, implement and evaluate public programs and policies.

During the coronavirus pandemic, we saw that social determinants of health—your race and ethnicity, where you live and work, your immigration status, the quality of your food and water, proximity to medical care, access to the internet and green spaces—all directly affected your health and economic outcomes.

For example, Black and Latino Californians were more likely to contract coronavirus because they are overrepresentated in low-wage, essential jobs and were at a greater risk of workplace exposure. Immigrants made up nearly 60% of coronavirus-related deaths in the highest-risk industries. Undocumented workers were especially vulnerable because they had limited access to unemployment benefits and other safety net programs.

Lack of green spaces in Black communities contributed to the racial gaps in infections rates. Severe air quality was linked to higher mortality from the virus, and Black and Latino Californians were 40% more likely to be exposed to air pollution. Black and Latino renters were two times more likely to experience rent-related hardships. Low-income folks were more likely to die from COVID; nationally, one in three COVID-19 deaths were tied to health insurance gaps.

A true recovery from the pandemic must address—and redress—these longstanding racial and health inequities that the pandemic brought into sharp focus. The state has received $43 billion in flexible state and local recovery funds via the American Rescue Plan Act plus $45 billion in federal infrastructure dollars. Those are unprecedented amounts that could make a real difference in our communities.

According to our grantee Prevention Institute, this is a landmark opportunity for our state to ensure that its investments accelerate progress toward building a more equitable state. Their solution: Embed health equity and racial justice into public funding programs at every stage so that resources and power are more fairly distributed, and investments are improving material conditions in historically marginalized communities.

ARPA is our once-in-a-generation opportunity to embed health equity and racial justice in public funding programs at every stage.
Juliet Sims, Prevention Institute

Finally, an Opportunity to Invest in Our Communities. Let Us Not Waste It.

“ARPA is a once-in-a-generation opportunity to embed health equity and racial justice in public funding programs at every stage. The US Treasury, which set the guidelines for the funding, strongly focused the recovery investments on addressing health inequities. They set a tone that strategically linked this money with equity,” said Juliet Sims, associate program director at Prevention Institute.

The mishandling of the CARES Act funds in 2020 showed, once again, that the system for public funding must be transformed. Instead of investing in communities most impacted and ravaged by the pandemic, many local governments, most famously Sacramento, diverted majority of their CARES funds to law enforcement. By the time the community-based organizations and residents organized and started asking questions about the relief funds, the money was all gone.

“When it comes to how money is allocated in communities, that has historically been a very opaque process. There are powerful players at the table shaping those decisions. In many cases, decisions are made before community organizations and residents have the opportunity to understand what's happening and weigh in,” said Sims.

If designed and implemented with equity “baked in,” state and local public investments can address the inequitable community conditions and the structural and systemic barriers to health equity. ARPA funds are the perfect start.

Prevention Institute’s brilliant brief, “Designing and Implementing Public Funding Programs for a Just Recovery in California,” recommends in clear terms how to operationalize equity at each phase of a public funding program, from the moment it is conceived and designed to how it’s implemented and measured. Policy makers, governmental administrators, and community stakeholders now have a blueprint for how to build an equitable funding measure from the ground up.

A Seat at the Table Is Not Enough. Nonprofits Need to Be Strategic Partners.

Embedding equity in the very design of public programs and policies is one of the key equity strategies that Prevention Institute outlined in their paper. Right now, equity and racial justice are, for the most part, an afterthought.

"A lot of times, we pass something quickly and say that we’ll figure out the details later. ‘We'll send it to a department, they will figure it out.’ Part of budgeting for equity is being upfront and clear about equity in the design of the policy proposal.”

Another equity strategy they outlined is ensuring that the highest need communities have a seat at the table and the power to influence public funding decisions.

“It's not enough to talk about community engagement or community perspectives. We need leadership and decision making to be sitting with communities that face inequities. And to do that, we need to share and shift power so that communities themselves can determine what their priorities are,” said Sims.

Most often, it is deeply-rooted community-based organizations that are best positioned to advocate for their communities. These organizations have lived experience and know what their communities need, but they do not have the budgets or the technical expertise to do so effectively, or consistently. In order for CBOs to act as true strategic partners to the policymakers and governmental officials, they need to be supported—and adequately funded.

"We want to see a real effort at funding. We want to see governments start to fund community organizations to carry out as partners and as leaders the work that they are, in many cases, already doing but on a shoestring budget.

Community organizations are already doing the day-to-day work of implementing programs and policies in their communities. Governments can direct greater funding to support these efforts, ensuring funding flows to residents and communities that face the greatest inequities.

A Healthy Civic Society Is a Prerequisite for Equitable Public Investments.

Early on in the pandemic, Prevention Institute saw that communities that did not have already existing community-based organizations or coalitions ended up not getting adequate relief and recovery funds allocated to community-identified health equity priorities. That's because there was weren’t groups organized and mobilized to advocate for shared needs.

But, in places where those organizations and coalitions already existed, incredible things happened. An example is Napa Valley's coalition called Community Leaders Coalition.

They had been working together for a few years before the pandemic hit, focusing on addressing the gaps they saw in their community, especially related to health and wellbeing of documented and undocumented immigrants.

When the ARPA funds came, they were able to quickly get in touch with their local county partners and local elected officials and influence the budget. Because of their advocacy, they aligned over $3 million of the recovery dollars that came into the county with their coalition’s priorities.

“Because of their preexisting work together, they were able to organize and address immediate, unmet needs in the areas of mental health, homelessness, child care, food access, support for seniors, and tenant protections. They could do it because they had an established set of partners and together they could jump into the conversation with a set of aligned values and goals in place,” said Juliet Sims.

Prevention Institute is proud of having been able to support the Community Leaders Coalition over the years by providing them with resources, equity-oriented technical assistance, capacity building and advocacy training, and helping them track and understand the complex and detailed policy work.

"It takes resources to follow the policy process and the budgeting process. When community-based organizations have those resources, they are a strategic partner to the local governments, but can also hold them accountable by asking for transparency in the process and in the investments,” explained Sims.

Private Funders Play an Important Role.

Ultimately, the ARPA and the federal infrastructure funds will come and go, but the long-term goal is to transform the system of public funding and shift power to the communities. And this is where private funders have the greatest opportunity to intervene.

“ARPA is one mechanism that's here right now, it's timely and can help accelerate what we already want to see happen in California's communities. We want the residents and the communities most impacted by racial and health inequities to have a stronger voice and a seat at the table. Private funders have a responsibility and opportunity to intervene and help in this process,” explained Sims.

Private funders can fund the behind the scenes work of the community-based organizations, such as technical assistance, capacity building, and communications support around how budget processes work and how to get involved in them.

“The private funding can provide the support for local organizations to organize and to track the process and weigh in. The local organizations know what is needed and they are connected to the residents. They just need support and funding to be a part of the process,” said Sims.

“Also, private funding can put community members on a pathway to becoming local leaders. We definitely see that in communities where coalitions get funding support and are able to engage in years-long work advocating for community priorities. We often see folks who are involved in that ending up running for city council or joining boards. That’s because this is an opportunity for community members to see that they have the power to inform this process."

Transforming public funding by private funders takes other forms as well. Cal Wellness made a $1.5 million board grant in 2022 to the Community Economic Mobilization Initiative. CEMI is a philanthropic pooled fund housed at the Sierra Health Foundation that is providing funding to community-based organizations across the state for training and technical assistance on how to advocate for the ARPA and infrastructure act funding.

In this clip, Sims talks about Los Angeles County, where the government itself took the initiative to embed equity into their ARPA allocations. The initiative is lead by Dr. D'Artagnan Scorza, now government official but previously a leader of a Los Angeles community organization, Social Justice Learning Institute.

Prevention Institute Is Reimagining the Way We Allocate Public Funds

Finally, an Opportunity to Invest in Our Communities. Let Us Not Waste It.

A Seat at the Table Is Not Enough. Nonprofits Need to Be Strategic Partners.

A Healthy Civic Society Is a Prerequisite for Equitable Public Investments.

Private Funders Play an Important Role.

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