Establishment of local lead agencies – 7/31/09

Q: Nevada currently has two sources of tobacco control funds:  CDC funds that come directly to Nevada State Health Division and MSA dollars which are managed by a grants management unit through the DHHS that fund 16 tobacco control entities, i.e. coalitions, health districts, smoking cessation.  During the last legislative session a bill was passed that would transfer the MSA dollars from DHHS to the Tobacco Prevention and Education Program thus “braiding” the funds.  Our intention is to establish four local lead agencies to cover the state (three of those are already established health districts).  Their responsibility will be to provide tobacco control services to their community. The state health department will be responsible for surveillance and evaluation, training, and administering the grant to the cessation helpline.

We are seeking any written information or guidance on how other states may have established their “Local Lead Agencies”.  This could include org charts, policies, flow charts, lessons learned, advice, etc.

A:

1. Alabama - Our system doesn't match the set up in Nevada.
    
2. California - LLA Guidelines: See the Local Lead Agency Guidelines document and appendices (2007-2010) that all LLAs (who represent all 61 health departments in CA) use to develop their 3 year plans. Since LLAs are funded through an allocation, the document is a guideline and not an RFA.  We're in the process of writing our 2010-2013 Guidelines, which will be released mid-October.
    
   Communities of Excellence in Tobacco Control (CX) Modules 1-4: (scroll down to Tobacco Control Information for Local Programs for links to these documents).  These documents/modules provide guidance to all our LLAs to conduct their needs assessment prior to developing their 3 year plans.
    
   CTCP Policy Manual: The "CTCP Policy Manual" provides policies and guidelines for all local projects (LLAs and Competitive Grantees) as they conduct their 3 year plans. It includes items such as program requirements (definition of specific activities, coalition responsibilities, sponsorship definition, technical assistance information, materials development, etc), administrative requirements (equipment, staffing, communication, etc), specific LLA responsibilities, and evaluation.
    
   OTIS Evaluation Guide: all local projects are required to submit their plans in the Online Tobacco Information System (OTIS), including their evaluation plan. The guide for this requirement can be found here under the "Evaluation Publications" subheading.
    
   "Tell Your Story: Guidelines for Preparing a Complete, High Quality Final Evaluation Report": this document provides guidance to LLAs on how to prepare their final evaluation reports for each objective they submit in their plans. It can be found under the same link for the OTIS Evaluation Guide.
    
   California Tobacco Control Program Infrastructure: This PowerPoint slide gives a graphical representation of how CTCP is structured and where LLAs fall within the whole program.
    
3. Louisiana - In Louisiana, the state’s Department of Health and Hospitals’ Tobacco Control Program also receives funds from CDC‐OSH and some MSA dollars (which are now on different budget cycles). Like your “Local Lead Agency,” we have regional COMMUNITY PARTNERS (9 regions, 9 Community Partners). Within our program, we have one staff member who monitors the grants under our Statewide Community Partnership Grants Program. Each Community Partner receives a “statement of work” that reflects our comprehensive tobacco control and prevention programs at the local level. They also work very closely with our partners on Regional Coalitions. An electronic copy of this “statement of work” is available upon request; please email tcn@astho.org.
    
4. Oklahoma - We require local coalitions to select the lead agency. In some cases the result is a consortium of counties (sort of regional since it would be multiple counties coming together) and in others it’s a lead agency serving one county.
    
   Lead agencies under our grant programs are selected by local coalitions committed to working on comprehensive tobacco control. We typically accept only one application per county or tribal coalition or consortium and a consortium of coalitions representing multiple counties, tribes, or counties and tribes may apply under one application if this is an appropriate option for the counties and/or tribes involved. Any private not-for-profit or public entity may serve as the Applicant Organization/Lead Agency for the coalition or consortium under the grant program.
    
   The Applicant Organization/Lead Agency must be selected by a local coalition. No one single agency type is designated by TSET for the community program. TSET recognizes that different organizations may assume this responsibility in different counties or tribal nations. Evidence of this selection (such as coalition or consortium meeting minutes reflecting a majority vote) must be submitted as part of the grant application.
    
   Under the grant program each Applicant Organization/Lead Agency must work with one or more coalitions to serve a minimum of one county, one tribal nation, or a consortium of counties and/or tribes with a total population of 15,000 or more Oklahoma residents. Coalitions that have previously served only one portion of a county or tribe may be expanded during the term of the grant to cover the minimum geographic area and population size required. All applicant organizations must complete the “Non-Acceptance of Tobacco Funds Certification”.
    
   Although the Lead Agency plays a critical coordination and leadership role in the implementation of the grant, the coalition is the heart or engine of the community program. It is through the collaborative efforts of this diverse group of committed organizations – each bringing its resources and energies to bear on the issue – that the work is accomplished and the goals are achieved. Coalition member organizations are responsible for selecting the Lead Agency prior to the grant award, and for supporting the work of the Lead Agency and Coalition throughout the life of the grant. Coalition member organizations’ first order of business is to implement a working structure and operational framework to support the accomplishment of tobacco control. Coalitions are encouraged to expand their partnerships to assure active participation from a variety of organizations representing various sectors and populations in the community, including but not limited to: health, public health, social services, business, education, law enforcement and faith-based, minority, and youth organizations.
    
5. Utah - Please see Tobacco Prevention and Control in Utah - Annual Report.

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