From: Cassandra JenningsTo: Cassandra JenningsSubject: NCBM ACA Follow Up EmailDate: Thursday, August 22, 2013 12:49:13 PMAttachments: NCBM ACA Cover Letter 8-19-13 Final.docx

NCBM ACA Commitment Checklist 8.13.13.docxACA Health Insurance Marketplace Toolkit - FINAL.pdf

From: Kevin Johnson Date: Monday, August 19, 2013 4:57 PMTo: Kevin Johnson Subject: ncbm affordable care act outreach initiative (reply by email or fax requested)

dear members of the national conference of black mayors,

thank you to those who were able to join our conference call on the ncbm affordable care actoutreach initiative with secretary kathleen sebelius & paul dioguardi from hhs. i was inspiredand moved by your deep commitment to enroll your communities in life-saving healthcare.as secretary sebelius mentioned, mayors are on the front lines in making this law work for allamericans.

the ncbm's goal is ambitious but well within what our great organization can accomplish:enroll 100,000 americans in health insurance, or 10% of our cities & states uninsured.

here are our goals and what we want every mayor to pledge to do:

1. 100 mayors please commit to join our effort and get 3-5 mayors to do the same. ihave attached a commitment letter for you to sign. please return it to cassandrajennings by friday, august 30th (cjennings@cityofsacramento.org; fax 916.808.7456)

2. 1000 actions look at the provided toolkit for resources on how to educate & engageyour constituents. we want every mayor to take 10 actions.

we will have another call in september to check in on our progress & exchange best practices.

key resources

below are resources mentioned in todays call that i thought would be helpful to you andyour constituents:

marketplace.cms.govhealthcare.gov24/7 call center 800.318.2596 (in 150 languages)or for those who missed todays call, there will be a general call tomorrow, august 20,at 1:00 pm with secretary sebelius for local elected officials countrywide that willreview some of the same topics. click here to rsvp and receive the call-in information.

thanks for supporting our organization and the health of your constituents. and kudos tomayor goodall of forest heights, md & mayor bryant of forrest city, ar for being the first 2mayors to send in their letters!

kevin

August 13, 2013

National Conference of Black Mayors

ACA Outreach Initiative

Dear Mayors,

Health care as we know it is undergoing a dramatic transformation. From October 1 through March 31, millions of Americans will have the opportunity to sign up for low-cost and subsidized access to affordable health insurance through the Health Insurance Marketplaces created through the Affordable Care Act.

The National Conference of Black Mayors is leading the way in making the ACA successful. Many of those without insurance lack knowledge about their options under the new law; thus, the greatest challenge is to raise awareness. As trusted leaders in our communities, our efforts could help educate our constituents about the choices and opportunities they now have. The Department of Health & Human Services and the White House have provided a comprehensive Marketplace Toolkit, which you can use to begin outreach and enrollment or supplement existing efforts.

Our goal is simple: enroll at least 10% of the estimated uninsured individuals in each city and each state in their state marketplaces, a total of roughly 100,000 persons. To achieve that goal, we will collectively take 1000 actions such as hosting events, training staff, or placing information on social media websites to educate and engage our constituents about their marketplace options. I am asking 100 mayors to commit to 10 actions each. With your support, NCBM will demonstrate that it is the leading force in the country advocating for the health and well-being of every American. Attached is the NCBMs ACA Outreach and Enrollment Plan that you can complete and return to show your commitment to your own communities and to a healthier America. We will use these to keep the White House apprised of our efforts.

As President of the NCBM, I am confident we will be celebrating our accomplishments as leaders who have positively contributed to communities of color. Americas health care system is improving and our communities stand to gain tremendously. Thank you for your time and continued support.

Sincerely,

Kevin Johnson

President of the National Conference of Black Mayors

Affordable Care Act (ACA) Participation Commitment

The following are ways you can contribute to the NCBMs goal of supporting the ACA in this pivotal upcoming year. Please check the item(s) you think your office could contribute to. These are general areas; examples of specific actions as well as resources to complete these actions can be found on pages 4&5 of the Toolkit.

Educate

Sign up to stay up to date on important information on the ACA

Train your staff to assist constituents with questions about the Marketplace

Distribute ACA educational materials online, in your office, and at events

Engage

Use social media to share information & announcements with constituents

Hold conversations & establish partnerships with community stakeholders

Host a pre-enrollment information session in your community

Enroll

Host an enrollment kickoff media event

Help constituents enroll at your office, via computers or trained office staff

Host enrollment sessions for your constituents

Other: ________________________________

Other: ________________________________

I will contribute to the NCBMs efforts to help make the ACA succeed by completing the items marked.

________________________________________________________________

Print NameSignatureDate

City: ______________________________State: ______________________________

Please return this form to Cassandra Jennings at cjennings@cityofsacramento.org or fax it to 916-808-7456

Affordable Care Act Health Insurance Marketplace

Outreach and Enrollment Toolkit for Elected Officials

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Table of Contents

Overview of the Marketplace ....................................................................... 2 Sample Outreach and Enrollment Plan ...................................................... 4 Sample Materials ........................................................................................... 7 Community Resources ................................................................................ 11 Frequently Asked Questions ...................................................................... 13 HHS Regional Office Contact Information .............................................. 18

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Overview of the Health Insurance Marketplace When the Affordable Care Act was signed into law in 2010, it carried with it a promise of expanding access to quality, affordable health coverage for millions of American families and small businesses.

The law is already making health coverage stronger for the majority of Americans who already have it. More than eight out of ten Americans have already begun to experience the benefits of the Affordable Care Act with better coverage, including free wellness and prevention care like mammograms and cancer screenings. Three million kids who didnt have coverage before now can stay on their parents plans until age 26. But for the nearly two in ten Americans without health insurance, there will be a new easy way to get affordable coverage.

Beginning October 1st, a new Health Insurance Marketplace will open in every state, giving Americans a whole new way to shop for health insurance.

For the first time in the history of the private insurance market, consumers in every state will be able to go online to one place to check out their coverage options, get accurate information in easy-to-understand language, and make apples-to-apples comparisons of plans before they make their decision.

The Health Insurance Marketplace will offer Americans lower costs on their monthly premiums making more affordable coverage a new reality for many hard working Americans and their families. All plans will be required to cover a comprehensive set of benefits, including physician visits, preventive care, hospital stays, and prescriptions. Discrimination based on gender or pre-existing conditions will be banned. And many families and small businesses will qualify for a break on their monthly premiums.

The Marketplace will be available on HealthCare.gov and CuidadoDeSalud.gov starting on October 1st. Right now, families and small business owners can visit these websites to start getting ready for open enrollment. A toll-free call center is also available to help answer questions 24 hours a day, seven days a week.

Whether consumers seek out help through the call center, through the websites live chat feature, or through trained professionals who will be working in their communities, theyll have access to support that is personal, unaffiliated with the insurance industryand available to help in more than 150 languages.

The U.S. Department of Health and Human Services (HHS) and partners across the country have already taken important steps to start delivering on the promise of expanding access to quality, affordable health coverage for millions of Americans by ramping up pre-enrollment efforts and launching a new set of educational tools that will help Americans learn about their new options and get signed up for coverage.

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Early data shows that the Marketplace will give many consumers greater choice. In a majority of states today, for example, a single insurer covers more than half of all individuals enrolled in the private marketbut when the Marketplaces open up this fall, consumers will have an average of at least 15 qualified health plans to choose from. Another study found that by making health insurance more affordable and ending discrimination against pre-existing conditions, the law will enable up to 1.5 million more Americans to go into business for themselves. The promise of the Affordable Care Act is within our grasp. Over the summer, community health centers and other organizations will receive funding to help consumers navigate the new Marketplace, and leaders from across the country are stepping up to help Americans learn about their new options and get signed up for coverage. Working together, we are on our way to a healthier America with better health insurance options and better health outcomes for the American people.

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Sample Outreach and Enrollment Plan Open enrollment in the Health Insurance Marketplace begins on October 1st and will run through March 31st. The number of people and small businesses that benefit from the Marketplace will ultimately be determined by each communitys efforts to educate people and get them to sign up. As trusted leaders in your communities, you are essential to the success of Marketplace enrollment efforts. By reaching out now to build coalitions and educate stakeholders, you will lay the groundwork for enrolling people in the Marketplace starting on October 1st. Many of you are already engaged in conversations about the Affordable Care Act. Over the next few months, elected officials across the country can take these efforts to the next level. We are committed to working together and supporting your efforts, and want to hear what works best in your community. Ways You Can Get Involved EDUCATE

1. Contact your HHS Regional Office to stay up to date on important information and announcements. A listing of the HHS Regional Directors is provided as part of this toolkit and available at http://www.hhs.gov/iea/regional. Many HHS Regional Offices can provide additional materials and support for outreach efforts.

2. Get the latest news and updates by signing up online at Healthcare.gov and CuidadoDeSalud.gov and feature links to Healthcare.gov and CuidadoDeSalud.gov on your local government website.

3. Refer constituents with questions about the new Marketplace to the 24/7 call center available now at 1-800-318-2596 with trained customer service representatives who can answer questions about the Marketplace in 150 languages.

4. Distribute educational materials available at marketplace.cms.gov (and in the sample materials section) to your constituents:

Include Marketplace information in your emails, newsletters, bulletins, and more to ensure your constituents have the most up-to-date information on enrollment.

Hang posters in your office and make educational materials available. Bring brochures, fact sheets, and other materials to events in the community,

including speaking engagements, parades, field days, fairs, library events, new business openings, etc.

5. Train officials and staff in your office to be ready to assist residents with enrollment, starting October 1.

Sign up for Marketplace 101 webinars to learn more at: marketplace.cms.gov/NewsEvents/Webinars/Spring-Summer-2013-Health-Insurance-Marketplace-Training-Schedule.pdf.

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ENGAGE

1. Host conversations with community stakeholders to ensure uninsured people in your area are aware of the new Marketplace and know how to sign up for coverage.

Community stakeholders you can engage: other state and local elected officials, Chambers of Commerce, small and large business owners, educational institutions, community colleges, local libraries, recreational leagues, religious leaders, civic organizations, grassroots organizations, foundations, etc.

For example, Walgreens and CVS Caremark have made national commitments to provide information about Marketplace options in their stores and at health care fairs around the country.

You can find materials for these conversations at marketplace.cms.gov. 2. Use Facebook, Twitter, YouTube and other social media to share important information and

announcements. You can record and send out a public service announcement about the Marketplace and share stories about constituents that are taking advantage of the Marketplace.

3. Host pre-enrollment information sessions in your community in August and September. After participating in trainings, you can hold information sessions for your

constituents using presentation materials provided here: http://marketplace.cms.gov/training/get-training.html.

ENROLL

1. Certify members of your office as a Certified Application Counselor (CAC) organization to assist consumers with enrollment.

Learn more about becoming a Certified Application Counselor (CAC) organization at: marketplace.cms.gov/help-us/cac.html.

Applications are now available for interested organizations to complete at: marketplace.cms.gov/help-us/cac-apply.html

2. Starting in October, provide computer stations at your office that constituents can use to enroll in the new Marketplace. Ask other community leaders to provide computers and space for additional enrollment events and activities.

3. In October, host an enrollment kickoff media event. A kickoff media event allows the press to help spread the word to those who can benefit from the Marketplace.

4. Between October and March, host enrollment sessions for your constituents. There will be people in your community who are trained and certified to help people

apply and enroll Navigators, Certified Application Counselors, and In-Person Assistors. For more information on these assistance programs, please visit http://www.cms.gov/CCIIO/Resources/Files/Downloads/marketplace-ways-to-help.pdf. These individuals and organizations can participate in enrollment sessions to provide information and assist consumers with enrollment on site.

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Additional Outreach Resources

Where can I find more information? Consumer Websites: HealthCare.gov / CuidadoDeSalud.gov Call Center: 1-800-318-2596 Partner/Stakeholder Website: Marketplace.cms.gov Facebook: http://www.Facebook.com/HealthCare.gov Twitter: @HealthCareGov

Where can I get materials to distribute? Resources for talking to your community including sample talking points, customizable flyers, brochures, widgets and logos to use in materials and more are available online at http://marketplace.cms.gov/getofficialresources/get-official-resources.html and in the sample materials section of this toolkit. Where can I get information on companies and organizations doing outreach? Some national organizations that have announced plans for education efforts include:

Walgreens www.walgreens.com/topic/reform-insurance/guidelines.jsp CVS www.cvs.com/promo/promoLandingTemplate.jsp?promoLandingId=affordable-

care-act American Library Association www.ala.org/tools/affordable-care-act

How can my office/staff learn more about the Marketplace? You and your staff can find informational videos on marketplace.cms.gov or sign up for one of the upcoming webinars at: http://marketplace.cms.gov/NewsEvents/Webinars/Spring-Summer-2013-Health-Insurance-Marketplace-Training-Schedule.pdf.

Learn more about becoming a Certified Application Counselor (CAC) organization at http://marketplace.cms.gov/help-us/cac.html.

Applications are now available for interested organizations to complete at http://marketplace.cms.gov/help-us/cac-apply.html

Where can I find more information about the Affordable Care Act? For a state-by-state analysis of the immediate benefits of the Affordable Care Act please visit: http://www.hhs.gov/healthcare/facts/bystate/statebystate.html.

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Sample Materials There are a number of official resources available on marketplace.cms.gov to help you inform your community about the Marketplace. Included are resources that you can use for public speaking events, to include in newsletters and to use on social media or on local materials. Check out the online resources page for more resources including online widgets and downloadable graphics, posters and brochures. Limited free copies of materials are available to order at http://productordering.cms.hhs.gov/.

Sample Materials - Discussion Points

When the Affordable Care Act was signed into law in 2010, it carried with it a promise of expanding access to quality, affordable health coverage for millions of American families and small businesses.

We have already taken important steps in our efforts to start delivering on the promise of expanding access to quality, affordable health coverage for millions of Americans as we ramp up enrollment efforts and launch a new set of educational tools that will help Americans learn about their new options and get signed up for coverage.

Beginning October 1st, a new Marketplace will open in every state, giving Americans a whole new way to shop for health insurance.

For the first time in the history of the private insurance market, consumers will be able to go to one place to check out their coverage options, get accurate information in easy-to-understand language, and make apples-to-apples comparisons of plans before they make their decision.

All plans will be required to cover a comprehensive set of benefits, including physician visits, preventive care, hospital stays, and prescriptions. Discrimination based on gender or pre-existing conditions will be banned. And many families and small businesses will qualify for a break on their monthly premiums.

And only by shopping at the Marketplace will Americans be able to get lower costs on their monthly premiums making more affordable coverage a new reality for many hard working Americans and their families.

First, weve launched the new and improved HealthCare.gov, which will be the Marketplaces online home starting in October. For Spanish speaking consumers, CuidadoDeSalud.gov has also been updated in preparation for the Marketplace.

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Right now, families and small business owners can visit HealthCare.gov to start getting

ready for open enrollment on October 1st. And over the summer, the site will continue to add new functions that will allow consumers to shop for qualified health plans that fit their budget with less hassle.

Weve also opened a consumer call center that will be open 24 hours a day, seven days a week.

This toll-free service will help answer questions, and starting October 1st it will provide personalized assistance for callers who are filling out their application or selecting a plan

Whether consumers seek out help through the call center, through the websites live chat feature, or through trained professionals who will be working in their communities, theyll have access to support that is personal, unaffiliated with the insurance industryand available to help in more than 150 languages.

As we head into summer, well kick our enrollment efforts into high gear. Well be distributing funds to community health centers and other organizations that have signed on to help consumers navigate the new Marketplace. And well be working closely with additional partners across the country to help American families and businesses get ready for the fall.

With the Marketplace taking shape, were already seeing some early indicators of how Americans could benefit.

Weve heard promising news about rates that will be offered in a number of states, including Vermont, Rhode Island, Washington, Oregon, and California.

And early data also shows that the Marketplace will give many consumers greater choice.

In a majority of states today, for example, a single insurer covers more than half of all individuals enrolled in the private marketbut when the Marketplaces open up this fall, consumers will have an average of at least 15 qualified plans to choose from.

Another study found that by making health insurance more affordable and ending discrimination against pre-existing conditions, the law will enable up to 1.5 million more Americans to go into business for themselves.

The promise of the Affordable Care Act is within our grasp. We are way to better health

insurance options for the American people.

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Sample Materials - Drop in article for newsletters, etc.

Are You Ready? The Health Insurance Marketplace is Coming No doubt youve been starting to hear about the new Health Insurance Marketplace (Marketplace), a key part of the health care law that will be open for business on October 1. But you probably still have questions. Like what is the Marketplace, and can you really get health insurance? Well weve got answers.

The best place for the latest, most accurate, information on the Marketplace is the updated website, HealthCare.gov. At the site, you can learn what it is, who can apply for insurance, how to get insurance, how to lower your costs, and more. If you own a small business, theres information for you, too.

Starting this fall, the Marketplace will help you find health insurance that fits your budget and meets your needs, with less hassle. No matter where you live, you may buy insurance from private health plans that cover a comprehensive set of benefits, including doctor visits, hospital stays, preventive care, and prescriptions. And plans in the Marketplace must treat you fairly; they cant deny you coverage because of a pre-existing condition.

With a single application, you can also see if you qualify for Medicaid or the Childrens Health Insurance Program, or savings you can use right away to lower your health insurance premiums.

Enrollment Starts October 1, 2013 Visit HealthCare.gov to Get Ready HealthCare.gov is your best source of information about the Marketplace. You can read information that pertains to you, print checklists, and watch videos to help you get ready to apply and enroll.

You and your family can explore every qualified health plan in your area, and fill out an application when youre ready. Youll be able to take control with better information, including details about benefits and prices presented in clear language you can understand, so youll know what your premiums, deductibles, and other costs will be before you make a choice.

Once youve decided on a plan, you dont need to go anywhere else. Starting in October, youll be able to enroll in the Marketplace directly for coverage that begins as soon as January 1, 2014.

Want help or need more information? As you explore your options on the Marketplace, you may want to get some help. You can participate in an online web chat on the website; or call a toll free number, 1-800-318-2596, to speak with a trained customer service representative; and there will be people in your local communities who can give you personal help with your choices.

Visit HealthCare.gov now to get all the information you need about the Marketplace. Come back October 1, fill out an application and enroll. Its that easy.

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Sample Materials - Marketplace Multipurpose Messages

(Short multi-purpose messages used for social media posts, receipt messages, texts, etc.) SUMMER (June Sept) The Health Insurance Marketplace will let you search your health coverage options in 1 place. Better options, better health - HealthCare.gov. In the Health Insurance Marketplace, you may be able to get lower costs on your monthly premium or out-of-pocket costs - HealthCare.gov. Need health coverage? The Health Insurance Marketplace will give you a clear picture of what youll pay and what youll get before you make a choice. HealthCare.gov to learn more. OPEN ENROLLMENT (Oct-March) Now theres an easier way to search for health coverage, with all your options in one place. Better options, better health - HealthCare.gov. Find out if youre eligible for lower costs on your monthly premium or out-of-pocket costs-The Health Insurance Marketplace @ HealthCare.gov Need health coverage? Get a clear picture of what youll pay and what youll get before you make a choice. The Health Insurance Marketplace at HealthCare.gov.

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Community Resources

Starting October 1, 2013, consumers in all states will be able to apply for new affordable health coverage options through the Health Insurance Marketplace (Marketplace) for coverage beginning as soon as January 1, 2014. Some states are setting up a State-based Marketplace, other states will work with the federal government in a State Partnership Marketplace, and the remaining states will have a Federally-facilitated Marketplace. No matter what state they live in, consumers will be able to get live in-person help as they go through the process of applying for and choosing new coverage options in the Marketplace. COMMUNITY HEALTH CENTERS In July 2013, Health and Human Services Secretary Kathleen Sebelius announced $150 million in grant awards to 1,159 health centers across the nation to enroll uninsured Americans in new health coverage options made available by the Affordable Care Act. Health centers in all 50 states received these awards. The purpose of this funding is to help consumers understand their coverage options through the new Marketplace, Medicaid and the Childrens Health Insurance Program; determine their eligibility and what financial help they can get; and enroll in new affordable health coverage options beginning October 1. For a list of health centers receiving this funding in your state please visit: www.hrsa.gov/about/news/2013tables/outreachandenrollment/. NAVIGATORS Each Marketplace must establish a grant program to fund entities or individuals called Navigators that will provide consumer assistance. Navigators will help consumers understand new health insurance options available through the Marketplace and will help consumers select a health plan. Navigators will have a vital role in helping consumers prepare electronic and paper applications to establish eligibility and enroll in coverage through the Marketplace. This includes steps to help consumers find out if they qualify for insurance affordability programs (including a premium tax credit, cost sharing reductions, Medicaid and the Childrens Health Insurance Program) and, if eligible, to get enrolled. Navigators will also provide outreach and education to consumers to raise awareness about the Marketplace, and will refer consumers to ombudsmen and other consumer assistance programs when necessary. Those who are approved to be Navigators in Federally Facilitated and State Partnership Marketplaces will be notified of their grant approval on or around August 15.

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In a Federally-facilitated or State Partnership Marketplace, you will be able to locate Navigators and other assisters by calling the National Health Insurance Marketplace Call Center or on HealthCare.gov under Find Someone Local (in October). A State-based Marketplace will have its own in-person assistance training requirements. You will have to check the states call center or website (which will be linked from HealthCare.gov). To learn more about the Marketplace in your state, please visit: https://www.healthcare.gov/what-is-the-marketplace-in-my-state/ or check out the chart below:

Federally Facilitated Marketplace

Conditionally Approved State Partnership Marketplace

Conditionally Approved State Based Marketplace

Alabama Arkansas California Alaska Delaware Colorado Arizona Illinois Connecticut Florida Iowa DC Georgia Michigan Hawaii Indiana New Hampshire Idaho Kansas West Virginia Kentucky Louisiana Maryland Maine Massachusetts Mississippi Minnesota Missouri Nevada Montana New Mexico Nebraska New York New Jersey Oregon North Carolina Rhode Island North Dakota Utah* Ohio Vermont Oklahoma Washington Pennsylvania South Carolina South Dakota Tennessee Texas Virginia Wisconsin Wyoming

*Utah is operating a Small Business Health Options Program (SHOP), while the Marketplace will operate as a Federally-facilitated Marketplace (FFM).

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Frequently Asked Questions Starting this fall, consumers will be able to visit HealthCare.gov to get all the information they need about the Health Insurance Marketplace (Marketplace). Whether youre uninsured, or just want to explore new options, the Marketplace will give you more selection and control over your health insurance choices. Health Insurance Marketplace General Information for Consumers Q: WHAT IS THE HEALTH INSURANCE MARKETPLACE?

A: The Marketplace is a competitive marketplace where people and small businesses can shop for and buy private health insurance. With one application, you can find out if you qualify for health plans in the marketplace, and other programs like Medicaid and the Childrens Health Insurance Program (CHIP), tax credits, and cost-sharing reductions. Q: WHAT IS THE DIFFERENCE BETWEEN THE MARKETPLACE AND THE TRADITIONAL INSURANCE MARKET? A: The Marketplace will improve todays broken insurance markets for consumers and small businesses. It will achieve this by:

More Choice. You will have a choice of health plans to fit your needs. More Competition. The Marketplace will make it easier for you to compare plans on

the basis of price, quality and benefits. This gives insurance companies incentives to offer better products at lower prices than their competitors.

More Clout. The Marketplace will give 25 million individuals and small businesses the same purchasing power as big businesses by bringing people and businesses together, lowering costs by spreading the cost of insurance across a larger group of people and allowing insurance companies to reduce prices.

Q: WHAT DOES THE MARKETPLACE MEAN FOR CONSUMERS? A: The Marketplace is a single place where consumers can apply for and enroll in health insurance coverage thats right for them and their families. Consumers can compare health plans with similar coverage levels and learn if they qualify for help paying for health care costs through tax credits and cost-sharing reductions. The Marketplace makes it easier for consumers to keep their coverage, even if income and employment changes make them ineligible for other programs like employer-sponsored insurance, private insurance tax credits, Medicaid, or the Childrens Health Insurance Program (CHIP). Q: WHEN WILL I KNOW MY HEALTH INSURANCE OPTIONS? A: Starting October 1st, consumers will be able to shop for plans on HealthCare.gov, enroll with in-person assisters, or call a toll-free call center.

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Q: IVE HEARD MY HEALTH INSURANCE PREMIUMS ARE GOING TO GO UP. A: Critics of the law are arguing that premiums will rise by selectively looking only at one part of the law while ignoring critical provisions that lower costs and drive premiums downward. These claims do not take into consideration, for example, the tax credits and competition that will make private health insurance even more affordable for millions of Americans. Q: WHAT IF I CANT AFFORD INSURANCE? A: When you fill out a Marketplace health insurance application, youll find out if you can get lower costs on monthly premiums or out-of-pocket costs, or get free or low-cost coverage. Most people who apply will qualify for lower costs of some kind. You can save money in the Marketplace in three ways, depending on your income and family size:

1. You may be able to lower costs on your monthly premiums when you enroll in a private health insurance plan.

2. You may qualify for lower out-of-pocket costs for copayments, coinsurance, and deductibles.

3. You or your child may get free or low-cost coverage through Medicaid or the Childrens Health Insurance Program (CHIP).

Q: WHAT IF I HAVE A PRE-EXISTING CONDITION? A: Starting in 2014, being sick wont keep you from getting health coverage. An insurance company cant turn you down or charge you more because of your condition. You can apply for Marketplace insurance when open enrollment starts on October 1st, and coverage starts as soon as January 1, 2014. Q: IM YOUNG AND HEALTHY. CAN I BUY A CATASTROPHIC PLAN? A: Yes; people under 30 and some people with limited incomes may buy a catastrophic health plan. A catastrophic plan generally requires you to pay all of your medical costs up to a certain amount, usually several thousand dollars. Costs for essential health benefits over that are generally paid by the insurance company. These policies usually have lower premiums than a comprehensive plan, but cover you only if you need a lot of care. In the Marketplace, catastrophic policies cover three primary care visits per year at no cost, and also cover free preventive benefits. If you have a catastrophic plan in the Marketplace, you cant get lower costs on your monthly premiums or on out-of-pocket costs. When you fill out a Marketplace application, youll see catastrophic plans listed as options if you qualify for them. Q: CAN I KEEP MY OWN DOCTOR? A: Depending on the plan you choose in the Marketplace, you may be able to keep your current doctor. When comparing plans in the Marketplace, you will see a link to a list of providers in each plans network. If staying with your current doctors is important to you, check to see if they are included before choosing a plan.

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Q: WHAT DO AMERICAN INDIANS AND ALASKA NATIVES NEED TO KNOW ABOUT THE MARKETPLACE? A: Members of a federally recognized tribe have certain protections in the Marketplace starting in 2014.

You don't have to pay a fee if you dont have health coverage. You more easily qualify for lower out-of-pocket costs for

deductibles, copayments, and coinsurance. You get monthly special enrollment periods allowing you to get insurance

outside the yearly open enrollment period You have special cost and eligibility rules for Medicaid and the Childrens

Health Insurance Program (CHIP). For more information, visit healthcare.gov/tribal. Applying and Enrolling in Coverage Q: HOW DO I APPLY FOR COVERAGE AND ENROLL IN A HEALTH PLAN THROUGH THE MARKETPLACE? A: Starting October 1, 2013, you will be able to file a Marketplace application online, by phone (through a toll-free call center), by mail, or in person (with accommodations for people with disabilities). Coverage starts as soon as January 1, 2014. The Marketplace will automatically tell you if you qualify for discounts or qualify to participate in state programs based on your income. Then you can choose the health plan thats right for you through the online plan comparison tool. Q: HOW DO I USE WWW.HEALTHCARE.GOV TO APPLY FOR MARKETPLACE COVERAGE? A: You can enroll in health coverage in just four steps using www.HealthCare.gov.

1. Set up an account. Youll provide some basic information to get started, like your name, address, and e-mail address.

2. Fill out the online application. Youll provide information about you and your family, like household income, household size, current health coverage information, and more. This will help the Marketplace find options that meet your needs.

3. Compare your options. Youll be able to see all the options you qualify for, including private insurance plans and free and low-cost coverage through Medicaid and the Childrens Health Insurance Program (CHIP). The Marketplace will tell you whether you qualify for lower costs on your monthly premiums and out-of-pocket costs on deductibles, copayments, and coinsurance. Youll see details on costs and benefits before you choose a plan.

4. Enroll. After you choose a plan, you can enroll online and decide how you pay your premiums to your insurance company. If you or a member of your family qualifies for Medicaid or CHIP, a representative will contact you to enroll.

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Q: WHAT IF I DONT HAVE ACCESS TO A COMPUTER SO THAT I CAN VISIT HEALTHCARE.GOV? A: There will be people in local communities who can give you personal help with your choices. You can also call a toll-free number, 1-800-318-2596, and talk to a trained customer service representative in 150 languages about the Marketplace. Q: HOW DO I GET HELP ENROLLING IN THE MARKETPLACE? A: The Marketplace will offer several kinds of assistance to help you apply for coverage and choose the plan thats right for you, including online questions and answers, online chat, a toll-free call center, as well as people in your community who are trained and certified to help you apply and enroll (starting October 1st). Coverage for Employees, Self-Employers, and Small Businesses

Q: I HAVE INSURANCE THROUGH MY EMPLOYER. WHAT DOES THE HEALTH CARE LAW MEAN FOR ME? A: If you have health insurance through your employer, nothing will change. However, if youre uninsured, purchase insurance on your own, or want to explore new options, the Marketplace will make it easier for you to shop for plans and see if you are eligible for savings that lower your monthly premiums. Q: WHAT IF IM LOSING JOB-BASED INSURANCE? A: If you lose your job and with it your job-based health insurance coverage, you may buy an individual plan through the Marketplace. You may also have the option of keeping your health insurance for a limited time through a program called COBRA continuation coverage. COBRA is a federal law that may let you pay to keep you and your family on your employee health insurance for a limited time (usually 18 months) after your employment ends or you otherwise lose coverage. Q: WHAT IF IM SELF-EMPLOYED? A: If youre self-employed with no employees, youre not considered an employer. You can use the individual Marketplace to find coverage that meets your needs. You can compare important features of several plans side-by-side, all of them offering a full package of essential health benefits. You can see what your premium, deductibles, and out-of-pocket costs will be before you decide to enroll. If you currently have individual insurancea plan you bought yourself, not the kind you get through an employeryou may be able to change to a Marketplace plan. Q: WHAT DO HEALTH INSURANCE MARKETPLACES MEAN FOR SMALL BUSINESSES? A: Starting in 2014, a Small Business Health Options Program (SHOP) marketplace will be available in each state. SHOP will give small employers and their employees some of the advantages large employers have today, including choices among high quality health plans to

17

meet every budget. Employers who qualify for SHOP must have fewer than 100 employees (states may limit eligibility to employers with 50 or fewer employees for the first 2 years). Employers must also have an office within the service area of the SHOP, and prove that theyre offering full-time employees SHOP coverage. Q: DO I HAVE TO INSURE MY EMPLOYEES? A: No employer has to offer coverage. Some large businesses that dont offer coverage meeting certain standards may have to make a shared responsibility payment in 2015.

- If you have fewer than 50 full-time equivalent (FTE) employees, you are not subject to the Employer Shared Responsibility parts of the law. You may use SHOP to offer coverage for your employees.

- If you have 50 or more FTEs, you may have to make an Employer Shared Responsibility Payment if at least 1 of your full-time employees gets lower costs on their monthly premiums when buying insurance in the Marketplace.

Q: WILL MY BUSINESS GET TAX CREDITS? A: You may qualify for employer health care tax credits if you have fewer than 25 full-time equivalent (FTE) employees making an average of about $50,000 a year or less. To qualify for the Small Business Health Care Tax Credit, you must pay at least 50% of your full-time employees premium costs. The credit is available only if you get coverage through the SHOP Marketplace. You dont have to wait until open enrollment to find out if you qualify for the Small Business Health Care Tax Credit. You can find out now by visiting IRS.gov. For more information and resources, visit www.HealthCare.gov.

US Department of Health and Human Services Regional Directors Contact Information

http://www.hhs.gov/iea/regional/index.html

18

Region 1 - Boston

Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont Regional Director: Christie Hager R1-ORD@hhs.gov John F. Kennedy Federal Building Government Center - Room 2100 Boston, MA 02203 Office: (617) 565-1500 Fax: (617) 565-1491 Region 2 New York City New Jersey, New York, Puerto Rico, US Virgin Islands Regional Director: Jaime Torres Jaime.Torres@HHS.gov Jacob K. Javits Federal Building 26 Federal Plaza - Room 3835 New York, NY 10278 Office: (212) 264-4600 Fax: (212) 264-3620 Region 3 Philadelphia Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia Regional Director: Joanne Grossi Joanne.Grossi@HHS.gov The Public Ledger Building 150 South Independence Mall West - Suite 436 Philadelphia, PA 19106-3499 Office: (215) 861-4633 Fax: (215) 861-4625 Region 4 - Atlanta Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee Regional Director: Pamela Roshell Pamela.Roshell@HHS.gov Atlanta Federal Center 61 Forsyth Street, Room 5B95 Atlanta, GA 30303-8909 Office: (404) 562-7888 Fax: (404) 562-7899 Region 5 Chicago Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin Regional Director: Vacant Region5@hhs.gov 233 North Michigan Avenue, Suite 1300 Chicago, IL 60601 Office: (312) 353-5160 Fax: (312) 353-4144

Region 6 Dallas Arkansas, Louisiana, New Mexico, Oklahoma, Texas Regional Director: Marjorie McColl Petty Marjorie.Petty@HHS.gov 1301 Young Street, Suite 1124 Dallas, TX 75202 Office: (214) 767-3301 Fax: (214) 767-3617

Region 7 Kansas City Iowa, Kansas, Missouri, Nebraska Regional Director: Stephene Moore Stephene.Moore@HHS.gov 601 East 12th Street, Room S1801 Kansas City, MO 64106 Office: (816) 426-2821 Fax: (816) 426-2178 Region 8 - Denver Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming Regional Director: Vacant Doyle.Forrestal@hhs.gov 999 18th Street South Terrace, Suite 400 Denver, CO 80202 Office: (303) 844-3372 Fax: (303) 844-4545 Region 9 San Francisco Arizona, California, Hawaii, Nevada American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Marshall Islands, Republic of Palau Regional Director: Herb Schultz Herb.Schultz@HHS.gov 90 Seventh Street Federal Building, Suite 5-100 San Francisco, CA 94103 Phone: (415) 437-8500 Fax: (415) 437-8505

Region 10 Seattle Alaska, Idaho, Oregon, Washington Regional Director: Susan Johnson Susan.Johnson@HHS.gov 2201 6th Avenue, Suite 1036 Seattle, WA 98121 Office: (206) 615-2010 Fax: (206) 615-2087

19

U.S. Department of Health and Human Services (HHS) Regional Offices The HHS Office of Intergovernmental and External Affairs hosts ten Regional Offices that directly serve state and local organizations. Each Regional Office is led by a President-appointed Regional Director. The Secretarys Regional Directors ensure the Department maintains close contact with state, local and tribal partners and addresses the needs of communities and individuals served through HHS programs and policies.

From: Cassandra JenningsTo: ejackson@savannahga.govSubject: Participation RequestedDate: Wednesday, August 14, 2013 11:42:28 AM

Hi Mayor Jackson, I hope that you can join in on the following 2 conference calls:

1. Thursday, Aug 15, 12 PM ET Update with Mayor Kevin Johnson and 7 other mayors onlatest with NCBM. Some factual and disturbing info.

2. Monday, Aug 19, 1:30 ET Call with White House and Secretary Sebelius regardingAffordable Care Act and resources for NCBM

Please let me know if you can participate. Cassandra H. B. JenningsSenior AdvisorOffice of Mayor Kevin Johnsoncjennings@cityofsacramento.org916-808-1018916-919-7766 cell

From: Gloria.Gardner@bpunltd.comTo: Mayor@kevinjohnson.com; Mayor JohnsonCc: Winfred LewisSubject: [FWD: RE: [FWD: BroadcastPUBLISHING, Inc. "Smart City" Initiative]]Date: Thursday, May 30, 2013 4:21:37 AMImportance: High

Ms. West,

I hope you are having a great day!

The correspondence below was sent to Mayor Johnson in January and I receiveda response from you in February. Since this date, Mr. Willie Picket of Sacramenthas had various conversations with Mayor Johnson about me and my company. My staff and I are attending the NCBM in Atlanta for the rest of this week. Doyou think that Mayor Johnson will find about 30 minutes to sit and speak withme about what we have to offer the City of Sacramento?

I had the occasion to see him last evening. However, I didn't want to impose orto push my way into speaking with him. I do understand that he has to prepareto speak to the entire body this week.

Please call me, at your convenience with a response when you have an answer at843-597-2211. In the meantime, this is the link to our restricted companywebsite: bstreetsigns.com for your review, as well as his, if necessary.

Best Regards,

Gloria E. GardnerBusiness Developer Director of Administration and ResourceBroadcastPUBLISHING Unlimited, Inc.Phone: 843-597-2211email: gloria.gardner@bpunltd.com"We Bring Your City to Life"

CONFIDENTIALITY NOTICE: This e-mail and the transmitted documents Contain private,privileged and confidential information belonging to the sender. The information therein is solelyfor the use of the addressee. If your receipt of this transmission has occurred as the result of anerror, please immediately notify us so we can arrange for the return of the documents. In suchcircumstances, you are advised that you may not disclose, copy, distribute or take any otheraction in reliance on the information transmitted.

-------- Original Message --------Subject: RE: [FWD: BroadcastPUBLISHING, Inc. "Smart City" Initiative]From: Kevin Johnson Date: Tue, February 12, 2013 4:52 pmTo: "Gloria.Gardner@bpunltd.com"

Hello Ms. Gardner,

On behalf of Mayor Johnson, thank you for the information.

Sincerely,

Nicole WestOffice of Mayor Kevin Johnson

From: Gloria.Gardner@bpunltd.com [Gloria.Gardner@bpunltd.com]Sent: Tuesday, February 05, 2013 10:34 AMTo: Kevin JohnsonCc: Winfred LewisSubject: [FWD: BroadcastPUBLISHING, Inc. "Smart City" Initiative]

Mayor,

I am forwarding you my previous email sent to the city email address(mayor@cityofsacramento.org). However, a friend, Willie Pickett and mycousin Charles Kidd (Kid's Sports Gym) thought this would be the bestemail to use in an attempt to contact you directly.

-------- Original Message --------

Subject: BroadcastPUBLISHING, Inc. "Smart City" InitiativeFrom: Date: Mon, January 28, 2013 4:06 pmTo: mayor@cityofsacramento.orgCc: "Winfred Lewis"

January 28, 2013 The Honorable Kevin M. Johnson915 I Street, 5th Floor Mail Code 09100Sacramento, California 95814 Dear Mayor Johnson: Mayors across the United States are challenged with bringing theirmunicipality into compliance with a federal mandate to enhance itsinfrastructure for the purpose of improving safety and sign visibility withintheir communities. BroadcastPUBLISHING Unlimited, Inc. (BPU, Inc.) is pleased to presentthe City of Sacramento, CA with the opportunity to implement a SmartCity initiative (utilizing your street name signs) and help you enhancebusinesses and residents by providing a platform to create new economicopportunities, improve education and ultimately retain residents andretrain others in your community. We are leading cities all the waythrough the federal mandate compliance with our initiative to guide themthrough the federally mandated street sign transformation that addressesmultiple issues. Our solution will creatively advance your citys infrastructure to beMUTCD (Manual on Uniform Traffic Control Device) compliant, eco-friendly, state-of-the art ready, engaging to local residents and tourists,and an attraction for local and corporate funding, annually. This advancement will integrate various "state-of-the-art" media that willallow any content to be controlled and updated on-demand 24/7 by the

municipality directly through its street name signs. In an effort todiscourage sign theft, we offer geo-location and tracking to deter signtheft. The same framework will assist cities with Inventory Managementof its street signs which is also a requirement of the MUTCD. Please go to the link, which will explain more of how we can assist youand your city, as well as, explore this opportunity that is now afforded toevery city in the United States further: www.bstreetsigns.com We know that your position does not afford you an excessive amount offree time during any given day, but it is my hope that you will take sometime to review the site and contact us so that we can discuss this subjectfurther. Your city can be one of the first cities nationwide to implementthis product. I hope you will take advantage of this opportunity by callingus at 843-608-9743 or take advantage of this opportunity to affordablymeet federal compliance and place your city on the map as the newestSmart City in America by requesting a face to face presentation viathe website. Call us today! We would not want you to miss out on this opportunity! Gloria E. GardnerBusiness Developer Director of Administration and ResourceBroadcastPUBLISHING Unlimited, Inc.Cell: 843-597-2211Phone: 843-608-9743mail: gloria.gardner@bpunltd.com cc: Winfred Lewis, CEO

CONFIDENTIALITY NOTICE: This e-mail and the transmitted documentsContain private, privileged and confidential information belonging to thesender. The information therein is solely for the use of the addressee. Ifyour receipt of this transmission has occurred as the result of an error,please immediately notify us so we can arrange for the return of thedocuments. In such circumstances, you are advised that you may notdisclose, copy, distribute or take any other action in reliance on theinformation transmitted.

From: mariah.omkj@gmail.comTo: tracydstigler@gmail.com; k_patterson4@u.pacific.edu; afoster@studentsfirst.org; alex.omkj@gmail.com;

chanee.anderson@gmail.com; aaron.omkj@gmail.com; Cassandra Jennings; meera.krishnan3109@gmail.com;asha.canady@gmail.com; draishalowe@gmail.com; mariah.omkj@gmail.com

Cc: aaron.omkj@gmail.com; draishalowe@gmail.com; tracydstigler@gmail.com; asha.canady@gmail.com;chanee.anderson@gmail.com; k_patterson4@u.pacific.edu; alex.omkj@gmail.com; Cassandra Jennings;meera.krishnan3109@gmail.com; afoster@studentsfirst.org

Subject: [Update] NCBM Morning Check-InDate: Monday, July 08, 2013 8:32:59 AM

Team - we will meet at 9am when most people arrive. We are primarily meeting tosync up on the week ahead for those that are not traveling.

Dial in is 805-360-1000 (code: 168362)

Thanks,Mariah

NCBM Morning Check-InWhen Mon Jul 8, 2013 8:30am ? 9:30am Pacific Time

Where Phoenix Room; Dial in (805-360-1000) Code (168362) (map)

Who ? Mariah Sheriff - organizer? Alex Brakebill? Meera Krishnan? Asha Canady? Aisha Lowe? aaron.omkj@gmail.com? Chanee Anderson? Tracy Stigler? Kellan Patterson? afoster@studentsfirst.org? cjennings@cityofsacramento.org

From: Josh RosaTo: Daniel Conway; Patti Bisharat; Mariah SheriffSubject: "Extra Credit"?Date: Monday, October 28, 2013 5:54:37 PMAttachments: Sacramento Tomorrow Game Plan.pdf

Hi Daniel, Patti, and Mariah,

I felt compelled to update my "game plan" for Sacramento Tomorrow when I had anadditional, pivotal thought.

I was thinking about what the Mayor had said about searching for that main "it"issue that unifies all of USCM's mayors-- And the answer that occurred to me, Ithink, intersects nicely with SMI. I suggest a central theme of the Mayor's presidencyof USCM might be "Thinking about city-government differently," insofar as thecountry's big-city mayors are increasingly emerging as a source of leadership onnational issues.

Voters are universally disappointed with the federal government these days. Thedesire for an alternative source of leadership is something that unites progressives,conservatives, and everyone in between. The USCM can highlight the major, recentaccomplishments of big-city mayors like Rahm Emanuel, Michael Bloomberg, andCory Booker-- Then, Sacramento Tomorrow underscores the contrast between thesecities' strong-mayor system and Sacramento's weak-mayor system.

While this suggestion doesn't yet answer the Mayor's search for a specific policyissue for USCM, I think it is something cities will get behind, and it might re-framethe conversation in Sacramento about city charter reform.

I've attached an updated Game Plan and would be delighted if you gave it a look.

I would be very interested to hear your thoughts.

Thank you again for the great conversations we have had over the last two months.I hope for the privilege of having many more.

Josh Rosa916-531-5723

Sacramento Tomorrows Game Plan for Success

Contact: Josh Rosa / 916-531-5723 / josh.rosa@gmail.com

This briefing proposes a Game Plan for Sacramento Tomorrow to prepare and execute a campaign to successfully pass city charter reform, popularly known as the Strong Mayor Initiative (SMI). The context will be the November 2014 election in the City of Sacramento.

The Game Plan proposes:

o a SWOT analysis (Strengths, Weaknesses, Opportunities, Threats) to define the landscape,

o a Strategy to prescribe actions that form a path to success, and

o an Action Plan to explain and organize the actions sequentially from now to Election Day.

This Game Plans main idea is to leverage a media narrative about the growing capacity of big-city mayors to solve the countrys problems, into a conversation about how the City of Sacramento can also step up with a modernized city charter.

SWOT Analysis

Strengths

o Previous iterations of SMI have helped develop and distill a coalition of supporters. These supporters will comprise the campaigns core team identified in the Action Plan.

o Mayor Kevin Johnson, although not associated with SMIs current iteration, is gaining greater influence with national organizations this year and next (such as the US Conference of Mayors and National Conference of Black Mayors), which can help channel an emerging media narrative about the growing economic and political relevance of cities, and the emergence of big-city mayors as a source of leadership on national issues.

Weaknesses

o The previous failures to enact SMI empower opponents to characterize the new charter reform debate as a tired old matter the voters already decided.

Contact: Josh Rosa / 916-531-5723 / josh.rosa@gmail.com

o Mayor Johnsons association with previous iterations of SMI empowers opponents to allege the initiative is more an instrument of Mayor Johnsons ambitions than a proposal about the Citys future.

Opportunities

o The federal political system has been performing poorly in recent years and voters are disillusioned with gridlock in the US Congress. Political dynamics generally suggest this gridlock will persist through 2014, causing more shutdowns or near-shutdowns of the federal government. This continued gridlock will further frustrate and disappoint voters.

o There is some media narrative about the emergence of cities as a source of leadership on national issues. Big-city mayors like Rahm Emanuel, Michael Bloomberg, and Cory Booker are tackling some of the countrys most difficult problems with bold initiatives Mayor Kevin Johnson has the gravitas to match these mayors, but not the governance system.

o The contrast between city-government leadership and federal-government dysfunction is an opportunity to highlight the promise of what a more effective and accountable City of Sacramento can accomplish.

Threats

o The City of Sacramentos political system has been fairly successful in recent years (i.e., retaining the Kings, approving a downtown arena, etc.); also, recent elections have made the City Council slightly more amenable to progress than the 2008-2010 Council, so this success is likely to continue to some degree.

o The State of Californias political system has been relatively successful in recent years (i.e., on-time budgets, paying down debt, reducing the deficit, etc.); also, the top-two primary, redistricting, and a popular Governor suggest this success may continue to some degree.

o These conditions are threats because voters may be less likely to approve political reform such as city charter reform when they feel the government is working well.

Contact: Josh Rosa / 916-531-5723 / josh.rosa@gmail.com

Strategy

This Game Plan will leverage a network of coalitions and other election dynamics to:

o Reverse the perception that the initiative is about Mayor Johnson, and

o Characterize the initiative as a kind of civic innovation necessary to harness local government effectiveness and fill the void in leadership left by Congress.

This Game Plan will accomplish these goals through the following actions:

1. Build a Broad and Diverse Network of Coalitions

The network of coalitions will include business, labor, and neighborhood associations, as well as good-government organizations. It will also reach far beyond city boundaries to transcend the echo chamber of previous SMI battles. Recruiting regional and statewide organizations, under a unified banner of civic innovation, taps into greater funding and creates access to reform champions who have not been previously embroiled and tarnished by Sacramento City politics.

2. Leverage a National Narrative

The Game Plan will leverage voters dissatisfaction with the federal government into support for city charter reform by creating a brand of civic innovation that emphasizes the accomplishments of mayors. Voters are universally frustrated with the federal government, and this frustration will likely grow as the 2014 election cycle ratchets up divisive rhetoric and brinkmanship in Congress. The desire for an alternative source of leadership is something that unites progressives, conservatives, and everyone in between. Increasingly, media are looking to big-city mayors as an emerging source of leadership on national issues.

Sacramento Tomorrow can capitalize on that narrative by co-creating a brand of civic innovation, called The Future is Cities. The campaign will engage city leaders throughout California and the country who wish to join a coalition that emphasizes proactive and creative bottom-up solutions to the nations political and governmental challenges.

Mayor Johnsons upcoming presidency of the US Conference of Mayors (USCM) can be used to engage a pool of effective and charismatic mayors to form such a coalition. High-profile mayors will help the coalition attract media attention and drive the

Contact: Josh Rosa / 916-531-5723 / josh.rosa@gmail.com

message that it is time to look at city government differently While the federal government dithers, cities are creating solutions to our countrys most persistent problems.

USCM can highlight the major, recent accomplishments of big-city mayors like Rahm Emanuel, Michael Bloomberg, and Cory Booker. Then, Sacramento Tomorrow underscores the contrast between the strong-mayor systems of Chicago, New York, and Newark, and the weak-mayor system of Sacramento, which threatens to weigh down our Citys progress. By underscoring this contrast, Sacramento Tomorrow re-frames the conversation about city charter reform.

The Future is Cities brand will deliver different benefits to different mayors who participate; for Sacramento Tomorrow, it will deliver the endorsement of a national group of popular mayors, media coverage, and the message that, again, this initiative is not about any one person Mayor Johnson or anyone else but about empowering local communities to define their own future.

3. Utilize the 2014 Election Cycle

This Game Plan will capitalize on voter turnout trends and the individual ambitions of local politicians in the context of the 2014 election.

2014 will be a relatively lackluster election, statewide and nationally, due to:

o the absence of a presidential race,

o few controversial or provocative ballot initiatives, and,

o Governor Browns shoo-in status for reelection, which will dampen the gubernatorial race.

The elections mellow backdrop will help the charter reform initiative stand out. Also, because low-turnout elections tend to benefit Republicans, this backdrop will provide a modest bump to the messaging power of business and taxpayer-advocate organizations; the constituencies of these organizations are likely to vote in slightly higher rates compared to others. However, while associating the initiative with business and taxpayer-advocate organizations will be of some benefit, the primary imperative is emphasizing a diverse network of coalitions, incorporating business, labor, neighborhood, good-government, and other stakeholders.

Although 2014 will be a mellow election nationally and statewide, it will generate significant action in the City of Sacramento. Three members of the City Council are running for higher office (Cohn, Fong, McCarty). This requires Cohn and Fong to leave

Contact: Josh Rosa / 916-531-5723 / josh.rosa@gmail.com

their City Council seats, so there will be two competitive City Council races on the 2014 ballot (McCarty isnt up for reelection until 2016 so he is able to retain his seat while running for another).

This Game Plan proposes surveying the two competitive City Council races and, based on analysis of the field, persuading each races frontrunner to join a national and citywide platform of civic innovation i.e., endorse city charter reform.

Meanwhile, Cohn and McCarty are both competing for Assembly District 7. This Game Plan predicts McCarty is inclined to oppose city charter reform, based on positions on previous SMI iterations. Cohn is more amenable. Cohn is also considered the underdog in the Assembly race. This Game Plan proposes inviting Cohn to join the platform of civic innovation, which may advantage his campaign. Cohn, considered right of McCarty, benefits as an Assembly candidate by subscribing to a platform endorsed by business and taxpayer-advocate groups who might otherwise stay on the sidelines in this Assembly contest.

As a champion for city charter reform, Cohn has the benefit of both:

o a long history on the City Council, allowing him to speak with authority on the Councils systemic weaknesses, and

o nothing to lose with regard to his influence vis--vis the City Council, because he is leaving it.

In the Dickinson v. Pan race for the State Senate, this Game Plan tentatively proposes a similar calculus. Dickinson is considered the frontrunner and left of Pan. Assemblymember Pan may be amenable to endorsing city charter reform. However, this Game Plan would first propose a careful assessment of the candidates and engaging both on the issue, since it is not yet totally clear how Dickinson might assess city charter reform. Securing Dickinsons endorsement would be of significant benefit, since Dickinson is especially connected to organizations rooted within city boundaries and adept at turning out voters.

(Action Plan on following page)

Contact: Josh Rosa / 916-531-5723 / josh.rosa@gmail.com

Action Plan

ACTIONS

CONSTITUENTS

Outreach Nov 2013-Jan 2014

Arrange 1-on-1 meetings to gauge stakeholders positions, interests, concerns, and capabilities

Identify allies, opponents, and those on the sidelines

Coalition Building Jan-Mar 2014

Organize coalitions around shared interests in charter reform

Messaging Mar-May 2014

Develop and execute messaging finely tuned to:

1. tie the initiative to a national movement for civic innovation, and

2. contrast the promise of a modernized city charter with the federal governments constant dysfunction

Reflect & Repeat May-Nov 2014

Evaluate the status of the initiative, its coalition, and progress achieved so far. Fine-tune the approach based on this evaluation, and repeat Outreach, Coalition Building, and Messaging, up to Election Day

Local Orgs Neighborhood and business associations, local labor (examples: Tahoe Park Neighborhood Association, Midtown Business Association, etc)

Target orgs that have an adverse relationship with:

1. its City Councilmember, or

2. the city bureaucracy

Regional Orgs examples: Sacramento Metro Chamber, Sacramento Region Builders

Engage regional orgs that have a stake in major development approvals or regulatory actions that are delayed by the City Council, or state or federal government

Engage civic leaders to develop coalitions of:

1. business,

2. labor,

3. neighborhood, and

4. good-government orgs

Equip friendly orgs with material that can be inserted into each orgs questionnaire for a candidate endorsements, based upon

Consult orgs about messaging, starting with these proposals:

1. for business SMI streamlines regulatory approvals,

2. for labor SMI places collective bargaining on the desk of an elected official,

3. for neighborhoods and good-govt orgs SMI increases accountability by clearly defining the roles of City Council v. Mayor

Solicit constant feedback to inform the Core Team

Re-engage immediately after the primary election to assess orgs preferred candidates to look for synergies

Contact: Josh Rosa / 916-531-5723 / josh.rosa@gmail.com

Friends of SMI Sacramento Tomorrow proponents and supporters of previous SMIs

Invite supporters to join the campaigns Core Team where each member keeps communications with a different coalition and drives central strategy through appropriate channels

Identify each supporters strengths in terms of relationships and communicative power; as well as drawbacks, such as dirty hands or perceived conflict of interest

1. Direct Core Team members to collectively compile their contacts in major local and regional orgs,

2. identify the best champions based in or associated with each org, and then

3. deploy Core Team members to start developing coalitions

Push approved messaging through the various coalitions

Any feedback on messaging should run back to the Core Team for rapid deliberation and decision in the context of the race

Convene a roundtable of SMI proponents immediately following the June primary to reassess the field

Elected Officials Federal, state, and local

Approach elected officials based on their position in the 2014 election cycle

As coalitions develop, market the growing power of each coalition to each officeholder or candidate, making them want the coalitions endorsement by keeping them apprised of the coalitions progress

Once an officeholder or candidate has endorsed the initiative, the Core Team will equip him/her with talking points, information about rallies or public forums, and press coverage so that he/she can talk positively about the initiative

Following the June primary, engage primary winners to ensure they drive the SMI message in the General Election

The Future is Cities A national brand for the loosely structured platform of civic innovation, championed by popular city leaders

Engage USCM vis--vis Mayor Johnsons presidency, as well as the National and CA Leagues of Cities, and National Conference of Black Mayors

Engage big-city mayors

Give each of the orgs a stake in the coalitions success by making them partners in the Future is Cities brand

Consult big-city mayors in the shaping and positioning of the coalition relative to national issues

Group together city leaders for national press coverage and leverage big-city mayors and USCM for media coverage

At home, elevate the contrast between big cities strong-mayor system and Sacramentos system

Use USCM and other convening events to touch base with brand partners and compare results

Maintain open lines of communication with big-city mayors

From: Josh RosaTo: Daniel Conway; Patti Bisharat; Mariah SheriffSubject: "Extra Credit"?Date: Monday, October 28, 2013 5:54:37 PMAttachments: Sacramento Tomorrow Game Plan.pdf

Hi Daniel, Patti, and Mariah,

I felt compelled to update my "game plan" for Sacramento Tomorrow when I had anadditional, pivotal thought.

I was thinking about what the Mayor had said about searching for that main "it"issue that unifies all of USCM's mayors-- And the answer that occurred to me, Ithink, intersects nicely with SMI. I suggest a central theme of the Mayor's presidencyof USCM might be "Thinking about city-government differently," insofar as thecountry's big-city mayors are increasingly emerging as a source of leadership onnational issues.

Voters are universally disappointed with the federal government these days. Thedesire for an alternative source of leadership is something that unites progressives,conservatives, and everyone in between. The USCM can highlight the major, recentaccomplishments of big-city mayors like Rahm Emanuel, Michael Bloomberg, andCory Booker-- Then, Sacramento Tomorrow underscores the contrast between thesecities' strong-mayor system and Sacramento's weak-mayor system.

While this suggestion doesn't yet answer the Mayor's search for a specific policyissue for USCM, I think it is something cities will get behind, and it might re-framethe conversation in Sacramento about city charter reform.

I've attached an updated Game Plan and would be delighted if you gave it a look.

I would be very interested to hear your thoughts.

Thank you again for the great conversations we have had over the last two months.I hope for the privilege of having many more.

Josh Rosa916-531-5723

Sacramento Tomorrows Game Plan for Success

Contact: Josh Rosa / 916-531-5723 / josh.rosa@gmail.com

This briefing proposes a Game Plan for Sacramento Tomorrow to prepare and execute a campaign to successfully pass city charter reform, popularly known as the Strong Mayor Initiative (SMI). The context will be the November 2014 election in the City of Sacramento.

The Game Plan proposes:

o a SWOT analysis (Strengths, Weaknesses, Opportunities, Threats) to define the landscape,

o a Strategy to prescribe actions that form a path to success, and

o an Action Plan to explain and organize the actions sequentially from now to Election Day.

This Game Plans main idea is to leverage a media narrative about the growing capacity of big-city mayors to solve the countrys problems, into a conversation about how the City of Sacramento can also step up with a modernized city charter.

SWOT Analysis

Strengths

o Previous iterations of SMI have helped develop and distill a coalition of supporters. These supporters will comprise the campaigns core team identified in the Action Plan.

o Mayor Kevin Johnson, although not associated with SMIs current iteration, is gaining greater influence with national organizations this year and next (such as the US Conference of Mayors and National Conference of Black Mayors), which can help channel an emerging media narrative about the growing economic and political relevance of cities, and the emergence of big-city mayors as a source of leadership on national issues.

Weaknesses

o The previous failures to enact SMI empower opponents to characterize the new charter reform debate as a tired old matter the voters already decided.

Contact: Josh Rosa / 916-531-5723 / josh.rosa@gmail.com

o Mayor Johnsons association with previous iterations of SMI empowers opponents to allege the initiative is more an instrument of Mayor Johnsons ambitions than a proposal about the Citys future.

Opportunities

o The federal political system has been performing poorly in recent years and voters are disillusioned with gridlock in the US Congress. Political dynamics generally suggest this gridlock will persist through 2014, causing more shutdowns or near-shutdowns of the federal government. This continued gridlock will further frustrate and disappoint voters.

o There is some media narrative about the emergence of cities as a source of leadership on national issues. Big-city mayors like Rahm Emanuel, Michael Bloomberg, and Cory Booker are tackling some of the countrys most difficult problems with bold initiatives Mayor Kevin Johnson has the gravitas to match these mayors, but not the governance system.

o The contrast between city-government leadership and federal-government dysfunction is an opportunity to highlight the promise of what a more effective and accountable City of Sacramento can accomplish.

Threats

o The City of Sacramentos political system has been fairly successful in recent years (i.e., retaining the Kings, approving a downtown arena, etc.); also, recent elections have made the City Council slightly more amenable to progress than the 2008-2010 Council, so this success is likely to continue to some degree.

o The State of Californias political system has been relatively successful in recent years (i.e., on-time budgets, paying down debt, reducing the deficit, etc.); also, the top-two primary, redistricting, and a popular Governor suggest this success may continue to some degree.

o These conditions are threats because voters may be less likely to approve political reform such as city charter reform when they feel the government is working well.

Contact: Josh Rosa / 916-531-5723 / josh.rosa@gmail.com

Strategy

This Game Plan will leverage a network of coalitions and other election dynamics to:

o Reverse the perception that the initiative is about Mayor Johnson, and

o Characterize the initiative as a kind of civic innovation necessary to harness local government effectiveness and fill the void in leadership left by Congress.

This Game Plan will accomplish these goals through the following actions:

1. Build a Broad and Diverse Network of Coalitions

The network of coalitions will include business, labor, and neighborhood associations, as well as good-government organizations. It will also reach far beyond city boundaries to transcend the echo chamber of previous SMI battles. Recruiting regional and statewide organizations, under a unified banner of civic innovation, taps into greater funding and creates access to reform champions who have not been previously embroiled and tarnished by Sacramento City politics.

2. Leverage a National Narrative

The Game Plan will leverage voters dissatisfaction with the federal government into support for city charter reform by creating a brand of civic innovation that emphasizes the accomplishments of mayors. Voters are universally frustrated with the federal government, and this frustration will likely grow as the 2014 election cycle ratchets up divisive rhetoric and brinkmanship in Congress. The desire for an alternative source of leadership is something that unites progressives, conservatives, and everyone in between. Increasingly, media are looking to big-city mayors as an emerging source of leadership on national issues.

Sacramento Tomorrow can capitalize on that narrative by co-creating a brand of civic innovation, called The Future is Cities. The campaign will engage city leaders throughout California and the country who wish to join a coalition that emphasizes proactive and creative bottom-up solutions to the nations political and governmental challenges.

Mayor Johnsons upcoming presidency of the US Conference of Mayors (USCM) can be used to engage a pool of effective and charismatic mayors to form such a coalition. High-profile mayors will help the coalition attract media attention and drive the

Contact: Josh Rosa / 916-531-5723 / josh.rosa@gmail.com

message that it is time to look at city government differently While the federal government dithers, cities are creating solutions to our countrys most persistent problems.

USCM can highlight the major, recent accomplishments of big-city mayors like Rahm Emanuel, Michael Bloomberg, and Cory Booker. Then, Sacramento Tomorrow underscores the contrast between the strong-mayor systems of Chicago, New York, and Newark, and the weak-mayor system of Sacramento, which threatens to weigh down our Citys progress. By underscoring this contrast, Sacramento Tomorrow re-frames the conversation about city charter reform.

The Future is Cities brand will deliver different benefits to different mayors who participate; for Sacramento Tomorrow, it will deliver the endorsement of a national group of popular mayors, media coverage, and the message that, again, this initiative is not about any one person Mayor Johnson or anyone else but about empowering local communities to define their own future.

3. Utilize the 2014 Election Cycle

This Game Plan will capitalize on voter turnout trends and the individual ambitions of local politicians in the context of the 2014 election.

2014 will be a relatively lackluster election, statewide and nationally, due to:

o the absence of a presidential race,

o few controversial or provocative ballot initiatives, and,

o Governor Browns shoo-in status for reelection, which will dampen the gubernatorial race.

The elections mellow backdrop will help the charter reform initiative stand out. Also, because low-turnout elections tend to benefit Republicans, this backdrop will provide a modest bump to the messaging power of business and taxpayer-advocate organizations; the constituencies of these organizations are likely to vote in slightly higher rates compared to others. However, while associating the initiative with business and taxpayer-advocate organizations will be of some benefit, the primary imperative is emphasizing a diverse network of coalitions, incorporating business, labor, neighborhood, good-government, and other stakeholders.

Although 2014 will be a mellow election nationally and statewide, it will generate significant action in the City of Sacramento. Three members of the City Council are running for higher office (Cohn, Fong, McCarty). This requires Cohn and Fong to leave

Contact: Josh Rosa / 916-531-5723 / josh.rosa@gmail.com

their City Council seats, so there will be two competitive City Council races on the 2014 ballot (McCarty isnt up for reelection until 2016 so he is able to retain his seat while running for another).

This Game Plan proposes surveying the two competitive City Council races and, based on analysis of the field, persuading each races frontrunner to join a national and citywide platform of civic innovation i.e., endorse city charter reform.

Meanwhile, Cohn and McCarty are both competing for Assembly District 7. This Game Plan predicts McCarty is inclined to oppose city charter reform, based on positions on previous SMI iterations. Cohn is more amenable. Cohn is also considered the underdog in the Assembly race. This Game Plan proposes inviting Cohn to join the platform of civic innovation, which may advantage his campaign. Cohn, considered right of McCarty, benefits as an Assembly candidate by subscribing to a platform endorsed by business and taxpayer-advocate groups who might otherwise stay on the sidelines in this Assembly contest.

As a champion for city charter reform, Cohn has the benefit of both:

o a long history on the City Council, allowing him to speak with authority on the Councils systemic weaknesses, and

o nothing to lose with regard to his influence vis--vis the City Council, because he is leaving it.

In the Dickinson v. Pan race for the State Senate, this Game Plan tentatively proposes a similar calculus. Dickinson is considered the frontrunner and left of Pan. Assemblymember Pan may be amenable to endorsing city charter reform. However, this Game Plan would first propose a careful assessment of the candidates and engaging both on the issue, since it is not yet totally clear how Dickinson might assess city charter reform. Securing Dickinsons endorsement would be of significant benefit, since Dickinson is especially connected to organizations rooted within city boundaries and adept at turning out voters.

(Action Plan on following page)

Contact: Josh Rosa / 916-531-5723 / josh.rosa@gmail.com

Action Plan

ACTIONS

CONSTITUENTS

Outreach Nov 2013-Jan 2014

Arrange 1-on-1 meetings to gauge stakeholders positions, interests, concerns, and capabilities

Identify allies, opponents, and those on the sidelines

Coalition Building Jan-Mar 2014

Organize coalitions around shared interests in charter reform

Messaging Mar-May 2014

Develop and execute messaging finely tuned to:

1. tie the initiative to a national movement for civic innovation, and

2. contrast the promise of a modernized city charter with the federal governments constant dysfunction

Reflect & Repeat May-Nov 2014

Evaluate the status of the initiative, its coalition, and progress achieved so far. Fine-tune the approach based on this evaluation, and repeat Outreach, Coalition Building, and Messaging, up to Election Day

Local Orgs Neighborhood and business associations, local labor (examples: Tahoe Park Neighborhood Association, Midtown Business Association, etc)

Target orgs that have an adverse relationship with:

1. its City Councilmember, or

2. the city bureaucracy

Regional Orgs examples: Sacramento Metro Chamber, Sacramento Region Builders

Engage regional orgs that have a stake in major development approvals or regulatory actions that are delayed by the City Council, or state or federal government

Engage civic leaders to develop coalitions of:

1. business,

2. labor,

3. neighborhood, and

4. good-government orgs

Equip friendly orgs with material that can be inserted into each orgs questionnaire for a candidate endorsements, based upon

Consult orgs about messaging, starting with these proposals:

1. for business SMI streamlines regulatory approvals,

2. for labor SMI places collective bargaining on the desk of an elected official,

3. for neighborhoods and good-govt orgs SMI increases accountability by clearly defining the roles of City Council v. Mayor

Solicit constant feedback to inform the Core Team

Re-engage immediately after the primary election to assess orgs preferred candidates to look for synergies

Contact: Josh Rosa / 916-531-5723 / josh.rosa@gmail.com

Friends of SMI Sacramento Tomorrow proponents and supporters of previous SMIs

Invite supporters to join the campaigns Core Team where each member keeps communications with a different coalition and drives central strategy through appropriate channels

Identify each supporters strengths in terms of relationships and communicative power; as well as drawbacks, such as dirty hands or perceived conflict of interest

1. Direct Core Team members to collectively compile their contacts in major local and regional orgs,

2. identify the best champions based in or associated with each org, and then

3. deploy Core Team members to start developing coalitions

Push approved messaging through the various coalitions

Any feedback on messaging should run back to the Core Team for rapid deliberation and decision in the context of the race

Convene a roundtable of SMI proponents immediately following the June primary to reassess the field

Elected Officials Federal, state, and local

Approach elected officials based on their position in the 2014 election cycle

As coalitions develop, market the growing power of each coalition to each officeholder or candidate, making them want the coalitions endorsement by keeping them apprised of the coalitions progress

Once an officeholder or candidate has endorsed the initiative, the Core Team will equip him/her with talking points, information about rallies or public forums, and press coverage so that he/she can talk positively about the initiative

Following the June primary, engage primary winners to ensure they drive the SMI message in the General Election

The Future is Cities A national brand for the loosely structured platform of civic innovation, championed by popular city leaders

Engage USCM vis--vis Mayor Johnsons presidency, as well as the National and CA Leagues of Cities, and National Conference of Black Mayors

Engage big-city mayors

Give each of the orgs a stake in the coalitions success by making them partners in the Future is Cities brand

Consult big-city mayors in the shaping and positioning of the coalition relative to national issues

Group together city leaders for national press coverage and leverage big-city mayors and USCM for media coverage

At home, elevate the contrast between big cities strong-mayor system and Sacramentos system

Use USCM and other convening events to touch base with brand partners and compare results

Maintain open lines of communication with big-city mayors

From: Josh RosaTo: Daniel Conway; Patti Bisharat; Mariah SheriffSubject: "Extra Credit"?Date: Monday, October 28, 2013 5:54:37 PMAttachments: Sacramento Tomorrow Game Plan.pdf

Hi Daniel, Patti, and Mariah,

I felt compelled to update my "game plan" for Sacramento Tomorrow when I had anadditional, pivotal thought.

I was thinking about what the Mayor had said about searching for that main "it"issue that unifies all of USCM's mayors-- And the answer that occurred to me, Ithink, intersects nicely with SMI. I suggest a central theme of the Mayor's presid