Frequently Asked Questions

Below please find answers to frequently asked questions about Proposition 14, the initiative to continue funding for research, treatments and cures in California.

What is Proposition 14?

Proposition 14 – also known as the California Stem Cell Research, Treatments, and Cures Initiative of 2020 – will authorize $5.5 billion in state general obligation bonds to continue funding stem cell research and the development and delivery of treatments in California. If approved by California voters on the November ballot, it will help accelerate development of treatments and achieve cures for chronic diseases and conditions including cancer, Alzheimer’s, diabetes, heart disease, lower respiratory diseases, spinal cord injuries, blindness, multiple sclerosis, HIV/AIDS, kidney disease, infectious diseases like COVID-19, and many others. To read the full text of the initiative, please click here.

What are stem cells?

Stem cells are the foundation cells for every organ and tissue in our bodies. By harnessing the power of stem cells, researchers and scientists could give rise to any other specialized cell needed by the human body – this means they can be used to repair damaged tissue, treat chronic diseases and even grow new organs for people who need them.

What is the California Institute for Regenerative Medicine (CIRM)? What does it do?

The California Institute for Regenerative Medicine (CIRM), California’s statewide stem cell research and therapy development funding agency, was established in 2004 with the passage of Proposition 71. CIRM supports cutting-edge medical research across all stages of development – from discovery science to translational studies to clinical trials – increasing the pace of medical discovery and accelerating the development and delivery of treatments and cures.

What was the first stem cell research and funding initiative?

In 2004, California voters approved Proposition 71, a landmark proposal that authorized a $3 billion investment in stem cell research to advance therapies and treatments for chronic diseases and injury. California voters’ breakthrough investment firmly established the state as the epicenter of stem cell research, attracting leading scientists from around the globe to join the state to advance treatments and cures.

What did Proposition 71 accomplish?

Proposition 71 delivered on its promise to advance groundbreaking medical discoveries and treatments that have already changed and saved lives. To date, research funded by CIRM has led to more than 2,900 published, peer-reviewed medical discoveries and has enrolled, or is expected to enroll, more than 4,000 patients in more than 90 clinical trials. This research has saved the lives of children born without a functioning immune system, and it has changed the lives of people living with chronic diseases and conditions, including diabetes, kidney disease, leukemia and blood cancers, blindness, spinal cord injuries and cancer. Just a few examples of the many lives that have been changed, include:

  • A high school student who was paralyzed, regained function in his upper body and went on to college. More than 95% of patients in this trial showed motor improvements.
  • A mother who went blind from a genetic disease continues to experience improved peripheral vision. At the optimal dose, all the patients in this trial showed an average improvement of 2 complete lines on the eye exam.
  • Two FDA-approved treatments have been developed for fatal blood cancers.
  • More than 50 babies who were born without functioning immune systems have been cured of the once-fatal “bubble baby” disease.
  • Human stem cell-generated beta cells transplanted into patients with Type 1 Diabetes secreted insulin.

With funding from Proposition 71, world-class medical and scientific facilities have been built across California – empowering medical and scientific research, offering learning opportunities for our best and brightest talent, and protecting critical stem cell research from ideological constraints. As of 2018, CIRM projects have created more than 55,000 full-time equivalent (FTE) jobs in California, generated

With funding from Proposition 71, world-class medical and scientific facilities have been built across California – empowering medical and scientific research, offering learning opportunities for our best and brightest talent, and protecting critical stem cell research from ideological constraints. According to a recent USC study, CIRM projects have created more than 55,000 full-time equivalent (FTE) jobs in California, generated more than $640 million in state and local tax revenues and increased the state’s economic activity by more than $10.7 billion.

How will Proposition 14 build on Proposition 71’s track record of success? Why is there a need for more funding?

A vote for Proposition 14 is a vote to advance groundbreaking medical discoveries into more treatments and cures that could save your life or the life of someone you love. With countless treatments and cures in the development pipeline, the future of California’s stem cell research program is even more promising than the strong foundation we have already built – Proposition 14 is needed to continue our charge forward.

Without Proposition 14, the lifesaving and life-changing treatments and cures that are at our fingertips would be delayed for years. Vital research would discontinue. Groundbreaking medical discoveries won’t be able to progress to clinical trials. Ongoing CIRM-funded studies and clinical trials will be canceled, valuable medical resources developed for these studies and clinical trials will be thrown away, and years of progress will be lost. Californians deserve better.

Why does Proposition 14 dedicate $1.5 billion for diseases and conditions of the brain?

Diseases and conditions of the brain are some of the most costly, complicated and time intensive to treat. Because of this, other sources of research funding often shy away from these areas. Therefore, Proposition 14 dedicates at least $1.5 billion to diseases and conditions of the brain and central nervous system, such as Alzheimer’s, Parkinson’s, stroke, dementia, epilepsy, depression and brain cancer.

How will Proposition 14 help make cutting-edge stem cell treatments more accessible and affordable?

Making health care accessible and affordable is one of the most pressing issues facing California and the nation. Proposition 14 will help more Californians be able to access and afford life-changing medical treatments by providing financial support for patients without the resources to cover healthcare deductibles or the full treatment, and by offering clinical trials in more parts of the state.

Proposition 14 helps increase accessibility and affordability for California patients by establishing Community Care Centers of Excellence to provide clinical trials and FDA-approved treatments in geographically diverse areas of California, and authorizing reimbursement for disadvantaged patients, families and caregivers for travel and lodging assistance. Proposition 14 also establishes a Treatments and Cures Accessibility and Affordability Working Group, which is tasked with developing and promoting policies to increase access to clinical trials and the availability and affordability of treatments developed through CIRM-funded research, including working to achieve early insurance coverage for these innovative therapies.

How will Proposition 14 help ensure California has the workforce and facilities needed to conduct this groundbreaking research?

Proposition 14 establishes training and fellowship programs to ensure that California has the workforce necessary to move new discoveries from the research stage to the clinic, to accelerate the availability of treatments and cures, and to make treatments and cures arising from CIRM-funded research available to California patients, including preparing California students for careers in the development and delivery of treatments and cures.

Proposition 14 also provides funding for the development and equipping of shared labs in which scientists working on different projects and potentially different subfields share research space. This has historically led to large amounts of synergistic collaboration where both sides learn from the other’s experience and techniques – often accelerating research and deepening the understanding of critical areas.

Is Proposition 14 a tax increase? How is it funded?

Proposition 14 is not a tax – it is a general obligation bond repaid from the state’s General Fund. General Fund payments on the bonds will be postponed for the first five years, with interest paid from bond proceeds during that period. The bonds can be repaid over roughly a 30-year period, amortizing the cost of the state’s stem cell infrastructure across the future generations who will benefit from it.

Why should California invest in stem cell research when the state is facing so many other challenges?

Investing in the future health of our families and loved ones is one of the most important investments we can make today. Stem cell research has the potential to provide new treatments and cures for diseases that touch millions of California families. When you consider that chronic disease is the leading cause of death and the leading driver of annual health care spending, this initiative is a small price to pay to potentially save millions of lives and billions of dollars in health care costs in the coming decades – less than $5 per person per year. Most importantly, Proposition 14 could save your life or the life of someone you love – how can we afford not to make this investment?

What are Community Care Centers of Excellence?

California has some of the best clinical trial centers in the world, especially since CIRM led the way in funding five stem cell therapy-focused Alpha Clinics, to better perfect and accelerate the delivery of clinical trial therapies to California patients.

Many of the more than 60 clinical trials funded directly by CIRM have been conducted at these Alpha Clinics, which are operated by esteemed medical schools and research institutions across California. However, some patients live too far away to be able to conveniently participate in these clinical trials. Community Care Centers of Excellence, in coordination with Alpha Clinics, will help bring access these clinical trials, and eventually FDA-approved treatments, to more geographically diverse areas throughout the state, making accessibility real to more California communities.

What are matching funds? Where do matching funds come from?

Matching funds are funds that come from outside sources such as philanthropies, universities, individual donors and private entities. By the end of 2019, CIRM had generated more than $4 billion in private, public and non-profit matching funds – more than doubling the value of California’s investment in accelerating medical research and the development and delivery of treatments and cures.

Why can’t California rely on the federal government or the private sector to fund stem cell research?

The federal government remains inconsistent when it comes to funding breakthrough stem cell research – the National Institutes of Health is funding limited clinical trials that will not result in the cures Californians need with any sense of urgency. Medical research takes time and curative therapies for chronic disease take years or decades to develop, severely limiting the private sector’s financial ability and willingness to take the lead. Only by investing in the next big ideas ourselves will we get the biggest payoff for patients. Patient advocates and scientists from around the world support Proposition 14 because they agree that California’s stem cell program is the most viable path to real treatments and cures.

What is the accountability and oversight structure at CIRM?

Proposition 14 will continue strict accountability and transparency requirements to ensure that funds are invested effectively – at least 95.5 cents of every dollar must be spent directly on research, therapy development, research facilities and research oversight.

CIRM is also the only state agency that has an independent financial accountability oversight committee responsible for reviewing and auditing its financial practices annually, as well as reviewing progress in public meetings. The Controller serves as the Committee Chair, and the remaining committee members are appointed by the Treasurer, Senate President pro Tempore, Assembly Speaker and Chair of CIRM’s Governing Board.

CIRM is required to undergo an annual financial audit from a public accounting firm, and to provide an annual public report detailing how it has allocated its resources. It is also required to undergo a performance audit every three years to ensure operational accountability.

How will Proposition 14 help protect against conflicts of interest?

Proposition 14 requires CIRM’s Board to update its conflict of interest standards for the consideration of funding awards at least every four years in consultation with the National Academies of Sciences to ensure that the standards remain consistent with best practices. Some of the additional measures taken to ensure no conflicts of interest occur include:

  • CIRM Governing Board members are precluded from participating in any decision in which the member has a financial interest.
  • CIRM Governing Board members representing research institutions are prohibited from voting on any applications for funding.
  • To avoid in-state bias, an expert peer review group – composed solely of patient advocates and scientists from outside California – review and makes recommendations on applications for funding. Then, a board subcommittee – composed solely of patient advocates and life science representatives drawn from companies that are not engaged in stem cell research – based on recommendations makes all final decisions on applications for funding.
  • Grant applicants’ names and institutions are kept confidential and not shared with those voting on those grants until after the vote, ensuring an unbiased process based solely on merit.
  • CIRM adheres to the Bagley-Keene Open Meeting Act, the California Open Records Act and the Political Reform Act.

Who supports Proposition 14?

More than 70 leading patient advocacy organizations have endorsed YES on Proposition 14, including the American Association for Cancer Research, American Diabetes Association, Christopher & Dana Reeve Foundation (paralysis), the Michael J. Fox Foundation for Parkinson’s Research, OneLegacy (organ transplants), the Juvenile Diabetes Research Foundation (JDRF), and multiple foundations advocating for patients with cancer, ALS, Sickle Cell Disease, mental health conditions, arthritis, Alzheimer’s, and more. Over 100 leaders in medical research, biological scientists, revered medical practitioners and Nobel Prize winners from around the world have endorsed this initiative because they agree that California’s program is the most viable path to real treatments and cures.

To view the full list of individuals and organizations who support YES on Proposition 14, please click here

Why should I support Proposition 14?

Stem cell research has the power to help the tens of millions of Californians suffering from an incurable disease, condition or injury. Today, more than 60% of adults suffer from at least one chronic disease – the leading cause of death and leading driver of California and the nation’s annual health care costs. Stem cell research has the potential to provide new treatments and cures for the chronic diseases and conditions that touch the families of nearly all Californians – from cancer and diabetes to Alzheimer’s and Parkinson’s.

How can I help the campaign?

Thank you for your support! Here are some ways you can help our campaign:

If you’re interested in helping the campaign in other ways, please contact us.

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