Boldly Opening Doors to Better Chances and Improved Healthcare

A BOLD grant was awarded to a program by MedsPLUS in collaboration with the Lister Hill Center for Health Policy and Jenkins Public Health Consulting.

By Miriam Calleja


The Building Opportunities for Lasting Development (BOLD) grant awarded by The City of Birmingham’s Department of Innovation and Economic Opportunity (IEO) accepts proposals from organizations, businesses, and public or private entities to provide programs or services to promote economic development to Birmingham residents. IEO aims to foster an ecosystem that thrives on innovation and opportunity. They provide resources to nurture talent, establish infrastructure to support the growth of women, minorities, and disadvantaged businesses, and focus on developing small businesses. Now in its sixth year, the BOLD funding program aims to create partnerships with community organizations that share IEO’s vision of making Birmingham a model of an inclusive and resilient economy.

BOLD’s objectives include overcoming barriers in development and prioritizing certain geographic areas that are deemed disadvantaged and that may often be overlooked. Working with data-driven and innovative approaches, they aim to provide funds for sustainable development.

One of the grants this year was awarded to MedsPLUS Consulting, an independent pharmacy and healthcare consulting firm that has a history of serving minority communities in Birmingham, particularly those who feel they have been mistreated and marginalized by mainstream healthcare and government systems.

The BOLD grant will provide finances for a two-pronged approach.

Three individuals will be trained to become community health workers, and a diabetes education service will be set up for sixty Birmingham residents. The project aims to overcome various barriers to employment opportunities by training workers to become pharmacy technicians who specialize in diabetes management while also setting them up for employment, which includes instruction such as resume writing and LinkedIn profile setup. It also targets the education of diabetes patients themselves.

The collaborators in this project are Dr. Dashauna Ballard, a Postdoctoral Fellow at the Lister Hill Center for Health Policy at the University of Alabama at Birmingham (UAB) who did her Ph.D. in Health Education and Health Promotion, MedsPLUS Consulting, and Jenkins Public Health Consulting (JPHC).

Dr. Dashauna met Dr. Pauline Long and Dr. Jennifer Campbell from MedsPLUS Consulting by chance over a year and a half ago at a Birmingham city meeting. Since then, they’ve collaborated and applied for a few grants together. They were able to prepare two scientific presentations when Dr. Pauline and Dr. Jennifer had the idea of a pilot program to offer a culturally-tailored diabetes self-management, education, and support services to the public. According to the American Diabetes Association, diabetes is a significant problem in Alabama, including Birmingham. Around 15% of Alabamians have diabetes, and less than 7% of people with diabetes have any formal diabetes education.

Overcoming Barriers

Dr. Dashauna set out to investigate the barriers that patients with diabetes face when taking care of their disease. She was able to boil it down to three main barriers. Even though diabetes education is available at health centers, hospitals, and doctors’ offices, many patients are not taking advantage of what is available. For many patients, the biggest hurdle was physically getting to the appointments, especially if they lived in the suburbs or couldn’t get into the city to be present for their appointments. Parking and transportation were the second type of issue they faced. Thirdly, there was a lack of knowledge on the accessibility of diabetes education. It became clear that diabetes education needed to be available closer to home. And so, for example, the service could be accessed from libraries within the community if these were found to be active sites in the chosen neighborhoods.

This is when their third collaborator, Jenkins Public Health Consulting, will come in. Brittaney Jenkins, CEO at JPHC, is a Certified Health Education Specialist and Public Health Practitioner who will engage and communicate with the specific community. This is a crucial step in detecting where help is needed most. They will assist in recruiting individuals for the health worker program and engage the community to recruit participants for the diabetes education sessions.

To conduct this pilot study, MedsPLUS culturally tailored a standardized program by the Association of Diabetes Care Education Specialists (ADCES). As part of the norms for the project, Drs. Jennifer, Pauline, and Dashauna agreed to have participants address them by their first name as a means of building rapport and trust in the communities for which they will be working. Dr. Dashauna and the Lister Hill Center for Health Policy then translated their pilot program work into research presented at scientific conferences. Dr. Dashauna completed the background research and processed the literature review so that the information obtained through the program could be published.

The project aims to get several research publications that will establish evidence-based benefits from their pilot program and then scale it up to help more people across the state of Alabama. The background research found evidence to justify the project’s structure and methodology. When the program launches this January 2024, Dr. Dashauna will oversee the data management, the quality of data collected, and how that data is reported. Her role is to ensure success, i.e., that the project achieves what it sets out to do so that more patients with diabetes can be educated and empowered, and more health workers can be set up to work in the field.

Better Opportunities

The three community health workers will be chosen from the Birmingham area. They will benefit from a twelve-month apprenticeship to get health worker training and become licensed pharmacy technicians by the end of the program. MedsPLUS will then either employ the workers or set them up for meaningful employment elsewhere in the same field. While no healthcare background will be required since MedsPLUS will be conducting the training, the individuals will be chosen on criteria that assess their soft skills, an essential and sometimes overlooked aspect of healthcare.

“This type of apprenticeship will allow them to see the community health worker side and the pharmacy technician side and to get professional development so that they can go on to do what they would like to do,” said Dr. Pauline, referring to the case study they made for their grant, of a young recently-graduated high schooler from one of these geographical areas, who is not sure what to do next in career terms.

The training will be conducted by Connection Health, a non-profit organization that recruits, trains, and deploys community health workers. When the individuals have completed 120 hours of training and become entry-level health workers, they will start their diabetes training through the Association of Diabetes Care and Education Specialists (ADCES). These two phases will prepare them to go into communities and assist pharmacists or diabetes educators with facilitating their courses. In the fourth quarter of 2024, they will undergo professional development training to get their pharmacy technician license.

A Promising Future

This project is an excellent example of how community engagement can help change different populations’ health prospects. By coming together, the Lister Hill Center for Health Policy at UAB, MedsPLUS Consulting, and Jenkins Public Health Consulting have employed their specific skills to improve countless people’s lives through skilled outreach. This robust program is a promising start that will elevate the quality of life of many. And this is just the beginning. Once the research shows improvement, the three players can scale their program to help more individuals across Birmingham obtain health worker training and control their diabetes for improved health.

Cool Green: Together, we gather strength

Together, we gather strength.

A partnership of teams brings fantastic news for the livability and health of Birmingham!

By Miriam Calleja


When we think about our health, we often focus on factors such as diet, exercise, sleep, stress reduction, and medication. While these things are undoubtedly important, we often overlook our natural environment’s impact on our well-being. Trees provide critical benefits to human health, including cleaner air, reduced stress, and protection from the sun’s heat. Often, areas that are less dense in trees coincide with areas of race or ethnicity-based discrimination.

In a recent development, three organizations in Birmingham, Alabama, have joined forces in a project that positively impacts public health and the environment. The Jefferson County Department of Health, the University of Alabama at Birmingham’s Lister Hill Center for Health Policy, and the program Cool Green Trees, which functions under CAWACO RC&D Council, a non-governmental organization (NGO) and local non-profit, have come together to improve the well-being of Birmingham residents and mitigate the potential damage caused by storms in one fell swoop. This is how it happened.

What can one woman with conviction and a vital purpose do? She can do a lot. But with some help, she can do much more.

Meet Francesca Gross, a natural scientist who has been working in nonprofits for the past 25 years and the Program Manager at Cool Green Trees. For several years, Francesca has had a specific purpose: to bring together urban conservation and the world of human health. This purpose took a significant turn when she met Ariann Nassel, a scientist and geospatial data specialist from the Lister Hill Center for Health Policy at the University of Alabama, Birmingham.

Ariann and Francesca, using their particular expertise, could take the project to its next goal post by making a visual science-based narrative using data on the EnviroAtlas boundary for the Birmingham area obtained through the Environmental Protection Agency (EPA). The StoryMap helped them (and us) visualize air quality, flooding issues, and summer urban heat island effects on a map of the Birmingham area.

This academic-nonprofit collaboration also caught everyone’s attention. For the first time, residents, the city council, the neighborhood presidents, and, as it turns out, funders were listening and understanding the impact trees had on their city… and their health.

The first financial aid came in thanks to Francesca and her liaison with Mark Wilson, former Jefferson County Department of Health director. This was precisely what the department wanted: an insight into how natural systems directly affect human health. This funding meant that Cool Green Trees was now not only a dream but a viable program.

Three didn’t make a crowd in this collaboration. This trio could move the project even further. Most recently, Cool Green’s StoryMap was used to get a substantial amount of money from the US Forest Service Urban and Community Forestry grant, which was specifically looking at urban forests. The partners for this grant include Ruffner Mountain Nature Coalition, Jefferson County Department of Health, and the City of Birmingham. The data on human health by the US Forest Service tallied with that of EnviroAtlas obtained through the EPA, so there was a solid launchpad to start with.

On top of that, the health department offered a startup sum and an unprecedented five years of funding. This will ensure that the Cool Green – Lister Hill Center for Health Policy UAB – Jefferson County Department of Health partnership can continue improving community livability and health for Birmingham’s residents for years to come.

As Helen Keller said, “Alone we can do so little; together we can do so much.”

Policy Watch: US House of Representatives Proposes Significant Spending Cuts to CDC, Public Health Funding

Kimberly Randall | August 15, 2023

ATLANTA, GA – Exterior of the Center for Disease Control (CDC) headquarters


Each year, the House of Representatives and Senate pass a series of legislation that determine the funding for the federal agencies operating in the US government. Funding is broken down into two categories – mandatory (63%) and discretionary (30%) – determined by whether the funding is tied to specific laws. The remaining budget is dedicated to interest repayment on federal loans.

The budget discussions traditionally begin with the President’s Budget Request (PBR), a formalized plan from the executive branch outlining the President’s suggested funding and taxes for the following fiscal year. Then, respective House and Senate committees produce budget bills that will be discussed, reconciled, and voted on in committee before being sent to the chamber floor. According to the Congressional Budget Act of 1974, the budget is to be voted on by April 15th for the following fiscal year, which begins on October 1st. However, many times this process takes longer. 

For the fiscal year 2024 (FY24), President Biden officially requested $144 billion in discretionary spending, an 11.5% ($14.8 billion) increase from FY23, for Health and Human Services, through which the majority of public health funding is funneled. The official budget statement claims that the budget increase is expected to expand healthcare access, lower medical costs, increase funding for cancer research, increase access to behavioral health programs, support rural health programs, and improve nutrition and food safety. 

Proposed Legislation 

As Congress begins budget discussions for FY24, the House Appropriations Committee released the Fiscal Year 2024 bill for the Labor, Health and Human Services, Education, and Related Agencies Subcommittee. In the draft, several federal agencies are suggested to see a decrease in funding. The bill, named the Fiscal Year 2024 Labor, Health and Human Services, Education and Related Agencies Appropriations Bill, contains significant spending cuts to programs related to public health infrastructure and eliminates federal funding for family planning, HIV prevention, and gun violence research. 

According to the Appropriations Chair, Kay Granger (TX), the proposed budget legislation is intended to “restore fiscal responsibility and reduce the scope of social spending by $60.3 billion from the FY23 enacted level, eliminating 61 (support) programs” in addition to funding biomedical research on cancer, Althzeimers, opioid use, and other chronic and rare diseases. The legislation also looks to increase funding in rural health by way of telehealth programs, healthcare workforce recruitment programs, and specialized education funding. 

FY23 Enacted Budget (millions) FY24 Presidential Request (millions) FY24 Proposed Budget (millions)
Immunization and Respiratory Diseases $919 $1,256 $326
HIV/AIDS, Viral Hepatitis, STI, TB $1,391 $1,545 $1,171
Emerging and Zoonotic Infections Disease $751 $846 $708
Chronic Disease Prevention and Health Promotion  $1,430 $1,814 $797
Birth Defects, Developmental Disabilities, Disability and Health  $206 $223 $205
Environmental Health $247 $421 $130
Injury Prevention Control $761 $1,352 $730
Public Health Scientific Services $754 $962 $654
Occupational Safety and Health  $363 $363 $247
Global Health  $693 $765 $370
Public Health Preparedness Response $905 $943 $735
Crosscutting Activities and Program Support $724 $1,039 $231
Buildings and Facilities $40 $55 $40


In the United States, most public health activities are carried out by state and local government agencies, and a large portion of the CDC’s annual budget is distributed via grants and cooperative agreements to these departments. In FY19, over 55% of the CDC’s annual budget was granted to state and local public health agencies and has significant influence on state and local budgets. 

In 2022, the Alabama Department of Public Health received $129,863,407 from CDC grants, with millions more going to The University of Alabama, The University of Alabama at Birmingham, Auburn University, and Tuskegee University for research in various areas. Reductions in the federal CDC budget will trickle down to impact local programs, including child vaccinations, staffing, and research. The table below represents a hypothetical look at the budget differences between funded programs in 2022 and a proportional budget in line with the FY24 proposed House budget. 

FY23 Grants Awarded (Alabama) Proportional Budget Estimate
Immunization and Respiratory Diseases $4,500,225 $1,597,580 


HIV/AIDS, Viral Hepatitis, STI, TB $13,988,137 $11,776,613 


Emerging and Zoonotic Infections Disease $2,248,081 $2,096,864


Chronic Disease Prevention and Health Promotion  $13,587,018 $7,573,404


Birth Defects, Developmental Disabilities, Disability and Health  $6,557,429 $6,524,642


Environmental Health $404,616 $212,990


Injury Prevention Control $7,174,096 $6,882,110


Public Health Scientific Services $727,445 $630,986


Occupational Safety and Health  $1,949,377 $1,326,356


Public Health Preparedness Response $9,437,092 $7,664,806


Crosscutting Activities and Program Support $5,528,735 $1,764,219


The potential budget cuts come on the tails of a significant loss of funding following the Fiscal Responsibility Act of 2023, where an estimated $1.7 billion in secured funding was recessed. The CDC released a statement that multi-year funded projects would not receive the remainder of their grants: “We can confirm that the last two years of funding is no longer available to CDC for jurisdiction awards. Funds previously awarded are not impacted.” 

Next Steps 

The House of Representatives Appropriations Committee will continue to debate the contents of the bill, amending as necessary. Once the committee agrees on the House bill, party leaders will meet to reconcile it with the Senate bill. 

The Senate Appropriations Committee has already passed an appropriations bill for FY24 in a 26-2 vote, providing $117 billion in funding for the Department of Health and Human Services. The Senate released an official statement in late July regarding the sister legislation in the House: 

It is unclear how this legislation will proceed through the legislative process, given vastly different topline funding levels under consideration in the Senate and House, which has yet to advance its version of this legislation through the full House Appropriations Committee.

A full list of House Appropriations Committee members can be found here, two of which represent Alabama. 

Stay Informed 

Want to learn more about public health policy, funding, and advocacy? Check out the Advocacy Portal on the American Public Health Association’s website. 

Official updates from Congress can be found on the House of Representatives Appropriations Committee website

Cool Green

Ariann Nassel, our Director of Geospatial Data Visualization, partnered with Cawaco RC&D Council and The Nature Conservancy in 2020 to develop Cool Green: Healthy Greening and Stormwater Opportunities for Jefferson County, Alabama. This web map application assisted representatives of the broader Cool Green project by providing an interactive narrative that eventually led to the Jefferson County Department of Health funding a public health improvement program in targeted areas that would benefit from planting trees. These areas predominantly have populations that are at risk of being negatively impacted by extremes in day and nighttime temperatures; trees will help to mitigate the effects of urban heat in these areas.

Check out the project by clicking this link!