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Rhode Island Launches Participatory Budgeting Process for Health Investments

As a part of work to advance health equity and strategically address social determinants of health, the Rhode Island Executive Office of Health and Human Services (EOHHS) and the Rhode Island Department of Health (RIDOH) are announcing today the launch of a Participatory Budgeting pilot project. This project is being undertaken in collaboration with two Health Equity Zone (HEZ) partners (health.ri.gov/hez).

Participatory budgeting is a democratic process that allows community members to directly decide how to spend part of a public budget. Following a structured process, residents in each community will have the opportunity to come together to identify community needs, generate ideas on how to meet them, and then vote directly on how to spend public funds to address upstream social determinants of health and racial inequities. Winning projects will then be announced and implemented.

Between July 1, 2022 and June 30, 2024, $900,000 will be allocated by two Health Equity Zones (HEZs) – Central Providence Opportunities HEZ (CPO-HEZ), supported by the backbone agency ONE Neighborhood Builders, and Pawtucket Central Falls HEZ, backed by Local Initiatives Support Corporation (LISC). Each HEZ will receive $450,000. Additionally, Central Providence Opportunities HEZ will deepen its impact by investing an additional $550,000 in private grant funding. The Central Providence community will, therefore, have a total of $1 million to invest through its Participatory Budgeting process.

"At EOHHS and the agencies under our umbrella, we are committed to active engagement opportunities for the communities we serve," said Rhode Island Executive Office of Health and Human Services' Acting Secretary Ana Novais. "What makes participatory budgeting different from traditional budgeting and decision-making processes is that it creates intentional space at the table for those who experience systemic racism and income inequality. It gives community members true decision-making power over real money."

"Health disparities result from underlying factors in our physical, social, political, and economic environments," said Interim Director of Health Utpala Bandy, MD, MPH. "It's exciting to see a project like this take root in Rhode Island. Not only do I look forward to seeing the innovative projects and solutions that come out of this work to promote health equity, but also how resident participation in the process itself enhances community cohesion, health, and wellbeing. Healthy communities are connected and collaborative communities."

Initiatives utilizing participatory budgeting have taken place in Rhode Island with great success.

"Participatory Budgeting has played such an important role in Central Falls for the past few years," said Central Falls Council President Jessica Vega. "Providing a space where residents are encouraged to think critically on how to improve the quality of life for their community. Rhode Island Executive Office of Health and Human Services' initiative of scaling up Participatory Budgeting through the Central Falls/Pawtucket and Central Providence HEZ is exciting, timely, and important to improve the health and promote equity in our communities."

New community leaders develop and emerge from the process, like Karen Figueroa, 2021 graduate of Central Falls High School and current first year student at Salve Regina University, who was a member of the first Participatory Budgeting Steering Committee in Central Falls and has been involved in participatory budgeting processes in Central Falls ever since. "Participatory budgeting grants underrepresented individuals the right to have their voices heard and allows them to be at the forefront of change in their communities," said Figueroa.

"Six years ago, Rhode Island took the transformational step toward a groundbreaking approach to address community health by creating the Health Equity Zone initiative as a mechanism to listen to residents who deeply understood the needs of their community. This place-based, community-led approach has led to important changes in service delivery and improvements in social determinants of health," said Jeanne Cola, Executive Director of Local Initiatives Support Corporation (LISC) of Rhode Island. LISC is the backbone agency for the Pawtucket Central Falls HEZ. "This participatory budgeting process -- where the community comes together to decide how funds are invested-- is the next logical step in the process of cultivating agency, transferring power, and promoting residents as agents of change."

"Community members will help shape the decision-making process, allocate resources, and build connections with each other. We believe the process of participatory budgeting is equally important as the financial investment," ONE Neighborhood Builders' Executive Director Jennifer Hawkins said. "We invite residents of 02908 and 02909 ZIP codes to contact us to learn more about how they can share the issues that impact them and work together to help fund equitable solutions." The initial investment of $900,000 is in Health System Transformation Project (HSTP) funds. The Health System Transformation Project is Rhode Island Medicaid's signature value-based payment initiative which aims to reduce healthcare costs, improve quality of care and improve population health outcomes.

Originating in Brazil in 1989, participatory budgeting has since been implemented by governments and organizations in more than 7,000 cities worldwide and demonstrated impacts in increasing civic engagement resulting in more equitable and effective public spending.

For more information about how to get involved in the participatory processes in your city, contact:

Providence: pb@onenb.org

Pawtucket, Central Falls: Becki Marcus Assistant Program Officer Local Initiatives Support Corporation rbmarcus2@lisc.org