Advocates Want Legislature to Spend Tobacco Agreement Funds on Prevention

They’re also enlisting the support of coordinated care organizations to help them sway legislators next year

October 11, 2012 -- Tobacco use is the number one cause of preventable death in Oregon and comes with an expensive bill. The Tobacco Master Settlement Agreement, signed by Oregon and 45 other states in 1998, was supposed to help the state recover some of the states’ tobacco-related healthcare costs. According to the Oregon Partners for Tobacco Prevention, formerly known as the Tobacco Free Coalition of Oregon, the state has yet to use the Tobacco Master Settlement Agreement funds as they were intended, something they hope will change when the legislature convenes next February.

Since Oregon signed that agreement, the state has spent or committed the majority of its share of the settlement dollars, $1 billion to date, on debt service. In 2015, those commitments will expire and the money will be available for other uses. The Oregon Partners for Tobacco Prevention, a statewide not-for-profit corporation representing businesses, advocacy groups, and people seeking a tobacco-free Oregon, hopes the state will finally dedicate those funds toward their original intended use and that the state’s newest players, Coordinated Care Organizations (CCOs), will be supportive.

“The Oregon Partners for Tobacco Prevention is interested in restoring the original intent of the law,” said Stephanie Tama-Sweet, director of government relations for the American Heart Association of Oregon. “We see CCOs being a key partner (in this effort).”

The Oregon Partners for Tobacco Prevention is still working on its specific recommendations but plans to recommend that all of Oregon’s Tobacco Master Settlement Agreement money (approximately $120 million starting in 2013-15) be used for healthcare and prevention efforts with a focus on chronic diseases and the other major cost drivers in the health care system. It considers reducing tobacco use and easing the financial and social burden of tobacco-related diseases key to the success of healthcare transformation. The question is, will CCOs actively get behind such a recommendation?

The CCOs are focused on prevention and helping people manage chronic conditions, while being held accountable for health outcomes of the people they serve, which is among the accountability metrics being developed by a task force of the Oregon Health Authority.

A looming question is whether these CCOs will advocate using the Tobacco Settlement Agreement funds for education and prevention when, ultimately, their bottom line is at stake?

That’s the position held by the All Care Health Plan which covers Josephine, Jackson and Curry counties in southern Oregon, according to Cynthia Ackerman, director of health management services and government programs officer.

“We’ve been so busy trying to stop it (tobacco use),” Ackerman said, ““It would be helpful if there were extra funds targeted for CCOs in this area since so many costly chronic conditions, loss of life years are directly attributed to tobacco use. However, I see our CCO’s role as being one of advocacy as well as aggressively attacking tobacco use in our prevention programs.”

Dr. Patrick Luedtke, a member of Trillium Community Health Plan’s board of directors, also sees advocacy as an appropriate role for a CCO.

“I think we need to try and decrease tobacco use in whatever way we can,” Luedtke said.

But Luedtke cautioned that he couldn’t speak about whether Trillium would take a political stance on using Master Tobacco Settlement Agreement funds for education and prevention.


The Lund Report is doing a series of articles on tobacco prevention. Please contact Joanne Scharer – joanne dot scharer at gmail dot com – with story ideas.

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