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Funding of State Coalitions and Culture Change

Attending to Financial Issues 

Featured funding resources include coalition examples of civil monetary penalty (CMP) fund use. Pioneer Network gratefully acknowledges the state coalitions, CMS and The Long Term Care Community Coalition for providing their documents for our website distribution. To share your coalition resources, contact Cathy Lieblich at
cathy.lieblich@pioneernetwork.net or 312-224-2568.

"Attending to Financial Issues" is one of the Key Elements to coalition success. Part of this activity includes determining ways to raise revenue for coalition activities. Some state coalitions have been successful at accessing civil monetary penalty (CMP) funds to support coalition activities. The resources below include information on CMP funding from state coalitions, a CMS letter describing how states may use CMP funds, and a 2006 study of states' use of CMP funding.

Increasing Transparency & Consumer Participation in States' Uses of Nursing Home Civil Monetary Penalty Funds - The Long-Term Care Community Coalition's report on this project in which the LTCCC worked with consumer and long-term care ombudsman (and in some states, the culture change coalition) in four states to help them participate in the awarding of CMP funds in their states. The specific goals of the project were to increase consumer involvement and public transparency in handling of CMP expenditures for nursing home projects in the four states and to change state funding practices in these states toward increasing the funding of projects tailored to benefit residents that will have a significant impact on them. (funded by The Commonwealth Fund and The Retirement Research Foundation)

Funding for Innovation: A Review of State Practices with Civil Monetary Penalties The Long Term Care Community Coalition's summary of findings from a 2006 study of states' use of CMP funds with recommendations for state and federal governments and strategies for stakeholders (funded by The Commonwealth Fund). 

Use of Civil Money Penalty (CMP) Funds by States September 2011 Centers for Medicare & Medicaid Services (CMS) Memorandum clarifying states must obtain CMS approval for the use of any CMP funds through either:  Categorical Approval: The use has been identified by CMS via written policy as an acceptable use that does not require prior approval. See Section D for the initial list of categorically-approved uses, or; Prior Approval: States must receive prior approval from CMS for any CMP use that is not currently on the list of pre-approved categorical uses.

Use of Civil Money Penalty (CMP) Funds by States and Reporting of CMP Funds Returned to the State June 2009 Centers for Medicare & Medicaid Services Memorandum clarifying how CMPs may be directed and used by States, and sharing suggestions of innovative projects and activities that have already been undertaken with CMP funds in some States.

Use of Civil Monetary (CMP) Funds by States Memorandum discusses "Appropriate CMP Fund Use" including culture change efforts.

Tips for CMP Legislation includes California Culture Change Coalition's tips for drafting CMP legislation and getting it passed. 

Factsheet: Civil Monetary Penalties: An Opportunity for Funding Innovation in Nursing Home Care describes the California legislation and provides helpful background on CMP funds use.

California CMP Assembly Bill is the resulting legislation of efforts by the California Culture Change Coalition.

Illinois Grant Request for CMP Funds is the Illinois Pioneer Coalition's grant request describing the use of funds, projects objectives and goals.

Coalition Networking Calls Summaries of networking calls for CMP Funds for State Coalition Activities and Raising Revenue from Conferences.