They wrote the map. We built the vehicle.
Rippel spent fifteen years building the intellectual property of the vital-conditions movement — and gives it away. What it does not have is an always-on operating layer that reaches residents, an engagement data stream, or a way to keep score every day between workshops. Becky Payne wrote the thesis herself: “take our knowledge and build something for the masses.” This command center holds everything for Tuesday and for the 24 months after it.
Ripple Simulator MODELED
The pool is the county. Every drop is one real thing a person did — a module finished, a tracker logged, a post shared, an idea submitted, a kindness recorded. Four coefficients decide how far each drop travels: Height (how deep the portfolio investment goes), Frequency (how often the community acts — the block no public dataset holds), Reach (how much of the population is covered), and the Human coefficient — belonging and civic muscle, the multiplier at the centre of Rippel's wheel. Click the water, or send a drop below.
Method: intensity I = Height × Reach; adoption follows a logistic ramp whose midpoint moves earlier with Frequency and the Human coefficient, per Rippel's four-driver model. Outcome(t) = baseline + I × ramp(t) × the published full-plan effect.
Field benchmarks to keep in view: Communities RISE Together reported 30:1 ROI and 195,000 years of life restored on $30M · BHEC New Jersey turned $4.68M into $98M · Roseville turned $60K into $12M.
Overview — the merged read
What they have that we want
The lingua franca of funders (RWJF, CDC Foundation, state health foundations); 47 federal agencies behind People and Places Thriving; peer-reviewed models (PLOS One 2025); ILN's 12 organizations and learning regions; a non-commercial, trust-based posture with zero vendor smell. Thriving Together Theater already proves the field wants a game.
What we have that they structurally cannot build
PHIT: 200+ unified sources, 141 live APIs, county-FIPS normalized, SHIP/CHNA overlays, and a PHIT Score whose 35% F-block is engagement data no public dataset contains. Reach to residents: Learn It / Live It / Share It, coins, badges, Reality Health Games, Academy. The operating system for a region: Command Center, Chamber of Health, Ambassador → Group Leader → Community Director ladder. Money that stays put: the shared-infrastructure model.
Tuesday run sheet — 45 minutes
Steward-to-steward, then show — don't tell. Objective: Bobby's enthusiasm for one concrete build, a working session with partnerships in 2–3 weeks, and permission to send Becky a one-pager.
| Min | Beat | Lead |
|---|---|---|
| 0:00–0:05 | Open — “We've been using your map for a year.” Rob's Mr. Rogers open: Ground Zero, Katrina, the ISS experiments — one sentence each. “In Arizona we wrote a Shared Stewardship Charter on your Vital Conditions framework, with attribution. We came to learn from you first.” Ask what Bobby most wants from the hour. Reference the intermediary report and “how far, how fast, where.” | Rob |
| 0:05–0:15 | Bobby teaches. Modeling + well-being portfolio (Becky's stated intent). Take notes on the four drivers and where he thinks the model is weakest at local scale. Do not interrupt to pitch. | Bobby |
| 0:15–0:27 | PHIT live — the scoreboard they don't have. PHIT Scorecard on a county they care about (a learning region or an AZ county) → the equation bar: 65% government data, 35% engagement. “Your 25 indicators live in the left block. Nobody has the right block.” → Civic tab (Becky flagged it) → Advance the Dream county snapshot → SHIP/CHNA overlay (“how a portfolio turns into accountability”) → ROI Calculator (“Negotiating Priorities with dollars attached”) → 60 seconds of Resilience Lab (“your Theater, played against a real calendar”). | Lucy |
| 0:27–0:36 | The Academy concept. Walk the Well-Being Portfolio Academy: same wheel, four altitudes. Show the Reliable Transportation module and the printed 15-wedge card. Close: “Every wedge on your wheel becomes something a 14-year-old, a grandmother, and a county commissioner can each do this week — and PHIT counts all three.” | Rob + Lucy |
| 0:36–0:40 | Real world — My Healthy AZ and the churn burn. Six Medicaid plans, one shared set of pipes. Investment stays in the community as skills and workforce. “This is the financing conversation you've been hosting — with a model that pays the floor.” | Rob |
| 0:40–0:45 | Asks — five, in order of ease (next section). Leave with one named next step and one named person. | Lucy |
Questions to ask Bobby (pick 4)
- How does the Hub measure “thriving” today, and at what geography? Could county PHIT scores become a feed or a companion view?
- Which of the four drivers is hardest for local stewards to act on — would a gamified, coach-hosted layer help there?
- Thriving Together Theater: have you wanted a digital or asynchronous version? What would it need to preserve?
- What has kept the vital conditions from reaching everyday people — the 52% — rather than institutional stewards?
- Who owns partnerships and the Hub roadmap day to day? (Expect Maggie Cooke / Cierra Bryant; Molly Belsky for Theater.)
- What has gone wrong with vendors or platforms before?
- Which funders are actively investing in measurement and public engagement around vital conditions right now?
Bring / have ready
- PHIT Scorecard, Data Hub, ROI Calculator open in tabs (demo mode) + the AZ Resilience Lab; confirm
/phit-scorecard(no trailing slash — Becky's link) and the Civic tab render in incognito. - Advance the Dream county picker returns a snapshot for Morris County NJ or Fulton County GA.
- Rob's Tuesday Brief PDF on the iPhone; the Shared Stewardship Charter; the Toolkit for Intermediaries one-pager.
- One printed 15-wedge card — the tangible object of the meeting.
- One Chamber of Health / Ambassador story with a face and a number.
Asks & objections
Say these, in this order
- Permission to build. “May we draft a co-brand license so the Well-Being Portfolio Academy can carry your definitions, verbatim and attributed, free to every resident?”
- One region. “Which of your learning regions would you most want to see play a Thriving Together Season for real?”
- One data conversation. “Can we get 30 minutes with whoever owns the 25-indicator set to map it into PHIT?”
- One introduction. “Who in the ILN should see the Toolkit for Intermediaries first?”
- One review. “Would you red-line our Charter and this brief? We'd rather be corrected by you than by the field.”
Objections we should expect
| They say | We say |
|---|---|
| “Aren't you a vendor?” | “We're a toolkit for intermediaries. Configurable, community-governed, mapped to all eight hallmarks in your 2026 report. Regions own their data and their Sustainability Fund.” |
| “Where does the PHIT engagement data come from?” | “From our members' Learn It, Live It, Share It activity — consented, aggregated, county-level. It's the leading indicator for your lagging ones.” |
| “Gamification trivializes stewardship.” | “Your Theater is a game. Ours simply doesn't end when the workshop does — and it rewards the neighbor, not just the steward.” |
| “Our content can't be commercialized.” | “Agreed — that's why the Academy layer on your definitions would be free at the Explorer tier and co-branded, with a written license we draft together.” |
| “How do you know it works?” | “We don't yet at county scale — that's the study we want to co-author. Our simulation is anchored to your model's published coefficients and labeled MODELED until the pilot region gives us observed data.” |
Follow-up within 24 hours: a two-paragraph “learn from you first” email, Rob's brief PDF, the Charter, the 15-wedge card. Nothing about pricing unless they asked.
Language rules
Use
stewards · shared stewardship · vital conditions · urgent services · belonging and civic muscle · thriving / struggling / suffering · well-being portfolio · multisolving · co-benefits · “with, not to” · “no exceptions” · Co-Founder & Medical Director (Rob) · 501(c)(3) fiscal agent · standards-aligned enrichment challenges · members / neighbors · sustain / make available toNever
solution · disrupt · own the space · users · monetize · “selling to your partners” · curriculum · “Foundation” for our nonprofit · “commons” as a noun (it is the Force for Health Network supporting a community's common goals) · white-label / pricing / PMPM in the first meetingRippel profile
| Legal name | The Fannie E. Rippel Foundation — Morristown, NJ, est. 1953 — operating foundation |
|---|---|
| Flagship | ReThink Health: workshops, facilitated dialogues, coaching, dynamic modeling, tools. Rippel and ReThink Health are registered trademarks. |
| Roadmap 2023–2033 | North star: all people and places thriving together, no exceptions. Four commitments: reinforce a unifying narrative · bridge differences · invest in vital conditions (esp. belonging & civic muscle) · measure movement. |
| Bold goal | +20 points in national thriving by 2036 (Gallup Life Evaluation Index: thriving / struggling / suffering). |
| Federal validation | People and Places Thriving (formerly ELTRR): 68 recommendations, 150+ career staff, 47 agencies, transpartisan. |
| Reach 2023–25 | 345 orgs / 3,000+ people coached · 17,905 tool downloads · 882 Toolbox webinar attendees · 1,628 Unsung Stewards streams. |
| Tool shelf | Thriving Together Model (25-yr simulation; four drivers) · Thriving Together Theater · Health System Dynamics Model · Well-Being Portfolio toolkit (2018) + definitions (2023) · Explore: Thriving & Vital Conditions Data (25 indicators, with IP3 ASSESS) · Movement to Thrive Together Hub (2025) · ReThinkers Collaborative · Toolbox webinars · Stewards Rising · Unsung Stewards podcast · Pulse Check on Shared Stewardship · Building the Will to Thrive Together (with TheCaseMade) · Intermediary Learning Network. |
| Recent science | PLOS One, Apr 2025 (Milstein lead): full federal-plan implementation over 25 years → life expectancy +2.6 yrs (to 81.5), thriving +20% (to 73.5%), suffering −2.5% (to 1.5%), gains largest for those with most to gain, no new appropriations required. |
People
Bobby Milstein — Director, System Strategy
The architect. 20 yrs CDC (built its program evaluation framework). Directs the ReThink Health Dynamics Model and Theater. Lead editor, Thriving Together Springboard (2020); co-editor, Intermediary Learning Report (2026). Co-founder, WIN Network. MIT Sloan visiting scientist. Former documentary filmmaker and West Wing consultant. Respects measurement and mechanism; lights up at narrative and games; allergic to hype. His frame: “How far, how fast, and where?”
Becky Payne — President & CEO (optional)
Since 2021. 20 yrs CDC, former Deputy Chief of Staff; led the federal ELTRR plan; first Workforce Development Director, Louisiana Healthy Communities Program — a direct bridge to FFH Workforce Development. She flagged the PHIT Civic tab and Advance the Dream, and wants to share modeling + the well-being portfolio.
Others to know
Maggie Cooke, Assoc. Director, Strategic Partnerships (likely day-to-day). Cierra Bryant, Manager, Learning & Impact (ILN report co-editor). Anna Creegan, Director, Systems Change. Katherine Wright, Deputy Director, Strategic Initiatives (Delaware). Alex Middleton, SVP Strategy/Culture/Ops. Molly Belsky, Communications (Theater contact). Jane Erickson (formerly Rippel; ILN editor, now consulting).
Featured partners registry
Every organization and place named in the Impact Report 2023–2025, the 2026 Intermediary Learning Report, rippel.org, and Rob's brief — with county FIPS so each row can be scored in PHIT and simulated below. Use it as the target list for Rung 2 introductions and the candidate list for a pilot region.
| Partner / place | Type | Geography | FIPS | Vital conditions touched | Why it matters to FFH | Source |
|---|
Vital-condition tags are our reading of each partner's documented work, not Rippel's classification. FIPS = county unless noted (state = 2-digit, city = place code).
Side-by-side — where 1 + 1 = 3
| Area | Rippel / ReThink Health | Force for Health Network | Together |
|---|---|---|---|
| Framework | Vital Conditions: 7 vital conditions + 7 urgent services + belonging & civic muscle at the center (with RWJF, 2017). Adopted by funders and public health. | Learn It / Live It / Share It; Healthy Basics; five well-being pillars; PHIT Affordable Care Layers; Chamber of Health. | Adopt their taxonomy as the organizing spine of the Academy and PHIT (with attribution and license). We stop inventing vocabulary; they gain a platform that operationalizes theirs. |
| Portfolio design | Negotiating a Well-Being Portfolio toolkit (2018): a visual wheel, sticky notes, four learning regions. | PHIT Scorecard (county PHIT Score, Digital CHNA, SHIP overlay, workforce gap) + PHIT ROI Calculator. | Digitize the wheel. Each investment becomes a tagged record on a wedge, scored against the 25 indicators, re-balanced quarterly instead of at a retreat. |
| Data | Explore: 25 indicators from 200+, national/state/county, demographic breakdowns, built on IP3 ASSESS. Spotlights DE, NC, WV. | PHIT Data Hub — 200+ sources, 141 live APIs, county/state/ZIP endpoints, historical PHIT Score, webhooks; Explorer / Professional / Enterprise. | Ingest their 25 indicators as a named Vital Conditions Panel in PHIT's H-block. Their “what is” gets our F-block of “what people are doing about it.” |
| Simulation & games | Thriving Together Theater: facilitated 10-year simulation, scorecard every two simulated years. | Community Resilience Lab, Reality Health Games, Prevention Bingo, Train the Brain, Jeopardy, Ripple Lab — real people, real coins, real time. | Theater is the tabletop; FFHN is the season. Theater kickoff, then 90-day rounds with the PHIT Score as the scoreboard. |
| Stewards | Stewards Rising, Unsung Stewards, ReThinkers Collaborative, Pulse Check. | Ambassador → Group Leader → Community Director ladder; Licensed Educator; Chamber of Health Directors; CRM. | Their stories inspire; our ladder credentials. A “Certified Community Steward” pathway gives Stewards Rising a next step. |
| Learning | Toolbox webinars; Three Horizons, dynamic modeling, multisolving, casemaking; financing workbook; Building the Will playbook. | FFH Academy (80% pass, coins), standards-aligned enrichment challenges, Coach Lucy / Dr. Rob voice, Social Meme Kits. | Their webinar content becomes evergreen, gamified modules with pre/post assessment — reaching residents and students, not only professionals. |
| Intermediaries | Co-steward of the ILN; 2026 report — 3 commitments + 5 entry points; multiplier evidence (~21× and 30:1). | FFHN Toolkit for Intermediaries mapped to all eight hallmarks; configurable infrastructure, not a program. | We are the tool intermediaries were missing. Rippel introduces; ILN members pilot. |
| Financing | “Beyond the check,” financing workbook, grantmaking-to-vital-conditions webinars (June 2026). Funds via philanthropy; does not sell. | Shared-infrastructure model: PMPM base access, Ambassador tier, Sustaining Partner boosters, Sustainability Fund via the 501(c)(3) fiscal agent, Medicaid ROI Sandbox. | Their language legitimizes the model to funders; our model gives their regions a revenue floor that survives the grant cycle. |
| Audience | Regional stewards who hold purse strings. | Everyone across the lifespan — plus the stewards. | They reach the top of the region; we reach the base. Whole-region activation. |
| Business model & IP | Non-commercial. Content © Rippel, educational use only. | Commercial platform with a charitable arm (501(c)(3) fiscal agent). | Needs a written co-brand/license. Headline ask, not a footnote. |
Vital conditions × FFH assets
| Vital condition | Live or near-live FFH assets | PHIT feeds |
|---|---|---|
| Belonging + Civic Muscle | PHIT Scorecard Civic tab (civic engagement, civic power); Advance the Dream Community Score Card (8 pillars, county 0–100); Chamber of Health®; Civic Health Cadets Club; My Civics Girl; Listening Labs; Ambassadors & groups | F-block Share It score, volunteering, Ambassador activation, event attendance |
| Basic Needs for Health + Safety | Prepared Patient; LIVE It trackers; Health Risk Assessment; Find Help Near Me; SCD Community Scorecard; Birth-Defects County Tracker (live CDC) | CDC PLACES, BRFSS, Healthy Basics trackers |
| Lifelong Learning | 360° Health Academy — Partner Journeys (26 courses / 411 lessons: AmeriCorps, HPAC, Mayo); 11 body-system enrichment series; Train the Brain; STEAM TEAMS | Census ACS education, Academy completions (E-block) |
| Meaningful Work + Wealth | Career Ecosystem Cards, Specialty Pathways, Marstronaut, phlebotomy prep, intern program, Workforce ROI Simulator, Capital Flows Score Card | BLS wages, Workforce Pipeline |
| Thriving Natural World | Get Outside Explorer Bingo; Regional Biodiversity; Digital Infrastructure Scorecard; OneHealthFORCE; Resilience Lab (heat/flood/wildfire) | EPA AQI, heat index, USDA, FEMA NRI |
| Reliable Transportation | WBP Academy Wedge 6 module — built, see the Academy panel (Learn/Live/Share, Ride Gap Detective game, route audit, meme kit); Sports Finder; Resource Locator | ACS commute, HRSA access |
| Humane Housing | Thin today — Resource Locator; say so honestly; reason to integrate their Hub data | ACS housing cost burden, HUD |
The offering — Well-Being Portfolio Academy
Powered by the Force for Health Network, in partnership with The Rippel Foundation (working title, pending license). Their PDF defines 15 elements: seven vital conditions, seven urgent services, and belonging & civic muscle. Each becomes four things at once — same wheel, four altitudes — all counted by PHIT.
Altitude 1 · Stewards' Accelerator
8-week cohort for a region's purse-string holders. Output: a live regional portfolio in PHIT, a baseline PHIT Score, a 12-month challenge calendar, a signed Shared Stewardship Charter. Credential: Certified Community Steward (FFH Licensed Educator pathway).
Altitude 2 · Resident Academy
15 modules, one per wedge, each Learn It / Live It / Share It, pre/post at 80%, coins on completion. Sixth-grade reading level; Dr. Rob and Coach Lucy voice; OpenEvidence-checked. Free at the Explorer tier. Co-branded.
Altitude 3 · The Game
The Portfolio Wheel becomes a Prevention-Bingo-style card. “Negotiating Priorities” becomes a team board game (Jeopardy engine). Theater becomes a 90-day Thriving Together Season in Reality Health Games. Scoreboard: the PHIT Score.
Altitude 4 · Real-World Challenges
Every wedge ships with IDEAS projects a person, class, church, or business can do in a week, verified with a Share It post or drop, approved by a Community Director, funded as sponsor “fountains.” Counted in PHIT's F-block, by wedge, by region.
Accelerator arc — the digitized Negotiating Priorities exercise
| Weeks | Move |
|---|---|
| 1–2 | See the portfolio you already have. Stewards drag every current investment onto the wheel inside PHIT (sticky notes, digitized and dollarized). PHIT shows the urgent-services vs vital-conditions split. |
| 3–4 | Read the region. 25-indicator panel + PHIT Score + Digital CHNA + SHIP priorities. Resilience Lab stress test: which wedges fail first under a shock? |
| 5–6 | Negotiate. Team play of the priorities board; ROI Calculator on the top three moves; “simple rules” drafted. Belonging & civic muscle scored as a multiplier, not a wedge. |
| 7–8 | Commit and launch. Charter signed, Season 1 calendar published, Ambassadors enrolled, sponsors' fountains attached. First PHIT re-score at day 90. |
The 15-wedge card
Teal = vital conditions (all people, all the time). Red = urgent services (anyone under adversity, temporarily). Gold = belonging & civic muscle — the center of the wheel and the multiplier. Print this; it is the tangible object of the meeting.
Learn It · Live It · Share It — the Academy
The engagement layer, live on the platform today. These are the three things a member does, the loop that produces the activation block of the PHIT Score, and the part of the system Rippel has no equivalent for. Open any of them on the call.
IT
Learn It — the Academy
Standards-aligned enrichment challenges across eleven body systems, plus the Partner Journeys built with AmeriCorps, HPAC and Mayo — 26 courses, 411 lessons. Pre- and post-assessment at 80% to pass, coins on completion.
IT
Live It — trackers & tools
What a member does in their own week: activity, sleep, water, movement, streaks, the 360° Explorer, and real-world audits like the route-to-clinic walk in the Reliable Transportation module.
IT
Share It — the Studio
Where a member turns what they found into something the community sees — meme kits, posts, events, campaigns, and a fix submitted to a Community Director. This is the civic-muscle signal, and it is the one no federal file contains.
Reliable Transportation — the built sample module BUILT · NOT YET DEPLOYED
Dr. Rob's working proof that one wedge of Rippel's Well-Being Portfolio becomes a full Learn It · Live It · Share It journey. This is the one to open on a call — it is the difference between describing the Academy and showing it.
Working file: Dr Rob Input / Ready to Test for Lucy / rippel-meeting-kit / ripple-lab / rippel-meeting-kit / wbp-reliable-transportation.html · 96 KB, single file, opens straight from disk.
Ten phone screenshots: FFH-WBP-Reliable-Transportation-Screen-Tour.pdf in the same folder.
Intended live URL once shipped: theforce.health/wbp-reliable-transportation/
Deploy Ready/wbp-reliable-transportation/ folder holds only a README, and the HTML sits three levels down inside the meeting kit. Against the FFH standing rules the file still needs: (1) the 🪙 emoji replaced with the real coin assets at /brand-assets/coins/ — 29 instances, plus 15 drop glyphs; (2) one base64-inlined image swapped for a canonical /brand-assets/ path; (3) the SMART Clipboard widget added; (4) the public-page nav completed — Sign In / Sign Up / Learn More and the Dashboard pill to /demo-dashboard/; (5) the 15-dimension tag manifest (ffh: meta tags + _tags.json + registry entry). Rob's own README also marks the health content DRAFT pending OpenEvidence verification and his sign-off — that one is his to clear, not ours.
Per the deploy-ready pre-flight, anything out of Ready to Test for Lucy routes through ffh-dr-rob-activator before packaging. Say the word and I will run that pass and stage it.
Slug note: /ffh-share-it-studio/ is a legacy slug carrying the ffh- prefix. Under the current naming rule it should become /share-it-studio/ with a 301 redirect before this page is deployed publicly.
Partner map — where Rippel's stewards are, scored
Every located partner from the registry on one map, the way Rippel's own Impact Report maps “a portion of those stewards” — except each county here carries a score. Circle size = county population; circle color = PHIT-H proxy, the Community Health Baseline block of the PHIT Score, computed live in your browser from CDC PLACES (age-adjusted prevalence of fair/poor health, frequent mental distress, frequent physical distress, obesity, no health insurance, no leisure-time physical activity; proxy = 100 − their mean). The full PHIT Score needs the C/A/E/O/F blocks from the Data Hub — only Pima carries a demo PHIT Score today. Gray = not yet fetched or a national organization with no county footprint.
Data: CDC PLACES County Data 2024 release (BRFSS 2022), fetched at data.cdc.gov/resource/swc5-untb.json when the page opens — same pattern as the live PHIT Scorecard; fails silently offline. Proxy is an FFH construction for this workspace, not a published PHIT Score. Basemap: Esri World Light Gray Canvas (no key required). We moved off OpenStreetMap's public tiles on 2026-09-16 after OSM blocked them under their Tile Usage Policy.
What the partners reported — numbers extrapolated from the 2026 Intermediary Learning Report
Rippel co-stewards the ILN and Bobby co-edited this report; these are the figures its contributing organizations reported about their own initiatives. They are self-reported and initiative-level, not county outcomes — but they are the multipliers Bobby will recognize, and the benchmarks a Thriving Together Season should be designed to beat.
| Initiative · intermediary | Reported result | Where it lands on the map |
|---|---|---|
| Communities RISE Together / ARISE · WE in the World + PHI, Heluna Health, CDC Foundation | $30M through 3 intermediaries; 13 intermediary partners; 2,400+ communities; real-time data pipeline in 1,009 communities (1 in 3 counties); 11,572 jobs; 1.5M people kept well; 195,000 years of life restored; ≈$900M economic benefit; 30:1 ROI | National (Boston HQ) |
| Building Healthier, More Equitable Communities (NJ) · Reinvestment Fund | $4.68M → $98M (21×); Interfaith Neighbors +$295K then $500K RWJF; four-city network changed a state housing program | Asbury Park, Camden — Monmouth 34025, Camden 34007 |
| Invest Health · Reinvestment Fund + RWJF | 50 small/mid-size cities over 10 years; 40% implemented programs/policies from peer learning | Philadelphia 42101 |
| Cities of Opportunity · National League of Cities | 70+ cities since 2016; Roseville CA $60K → >$12M municipal | Placer 06061 |
| Portfolio Design for Healthier Regions · Rippel / ReThink Health | Palm Beach core team trust +50%; 5 Healthy Towns trust +80%; $45M over 8 yrs committed to behavioral health & prevention (MI) | Palm Beach 12099 · Washtenaw 26161 |
| Hospital Systems in Transition · Rippel | Jefferson Health channeled >$70M of philanthropy to vital-conditions work | Philadelphia 42101 |
| Accelerating Investments for Healthy Communities (MA) · Center for Community Investment | >$70M into affordable housing anchored in racial equity | Massachusetts |
| The BUILD Health Challenge | 68 projects, 27 states/territories; DC asthma MLP ≈$10K savings in 18 months → insurer cost-sharing | Washington, DC |
| Housing Solutions Collaborative · Lift to Rise | Coachella Valley pipeline 300 → 10,000 affordable units; eight cross-sector teams | Riverside 06065 |
| Wellville · North Hartford Ascend | Residents share governance of $66M combined prenatal-to-career investment | Hartford 09003 |
| Enterprise Community Partners | Green Communities criteria in 29 states' LIHTC plans; Community Innovations for Racial Equity +86% CDC capacity | National (Baltimore HQ) |
| Build Healthy Places Network | 89% of participants reported increased cross-sector capacity | National (SF HQ) |
| CACHI · South Stockton | Paid resident Trustbuilders; community-owned data | San Joaquin 06077 |
PHIT comparison — Rippel's active communities LIVE FEDERAL DATA
This is the panel to show Bobby. It computes the PHIT Community Health Baseline (Domain H) for every Rippel community from live CDC PLACES data, using the exact benchmark normalization the production PHIT Scorecard uses — S = clamp(100 × (1 − (local − best) / (worst − best)), 0, 100) across four measures (frequent mental distress, diabetes, obesity, uninsured), then averaged. Nothing here is generated, hashed, or modeled. It is one block of the PHIT equation, and it is labeled as one block.
Bar length = Domain H (0–100, higher is healthier). Orange = benchmark community. The navy tick is the benchmark's score, so every bar reads as a distance from it.
What drives the difference
Age-adjusted prevalence, CDC PLACES 2024 release (BRFSS 2022). Green = better than the PHIT benchmark ceiling, red = worse than its floor; these are the same best/worst bands the Scorecard normalizes against.
| Community | FIPS | Domain H | Mental distress | Diabetes | Obesity | Binge drinking (not in H) | Uninsured | Fair/poor health | Life expectancy |
|---|
PHIT benchmark bands — mental distress 12–28% · diabetes 7–16% · obesity 22–38% · uninsured 3.5–18%. Binge drinking is shown but excluded from H: the Scorecard's substance-use band (4–12%) was never calibrated for binge-drinking prevalence, which runs 14–20% nationally, so it would clamp every county to zero. That metric needs its own source and band. Life expectancy column is intentionally empty: it belongs to Domain O and is not wired to a real source yet (see below).
Outcomes intersect NEEDS WIRING
The question Bobby will ask and the one we want to co-author: do Rippel-coached places move differently from peer counties? Rippel's Impact Report gives reach (345 orgs, 17,905 downloads) but no outcome data by place. This panel is the scaffold for the modeled-vs-observed comparison: every partner county from the registry, its PHIT Score components, Gallup/PLACES-style thriving proxies, and a matched peer. Rows fill from the PHIT Data Hub API (GET /api/v1/phit/county/{fips}); until then they are labeled honestly.
| Partner county | FIPS | Rippel engagement | PHIT Score | H · Community health | C · Capacity | A · SHIP/CHNA | F · FFH activation | Thriving proxy | Peer county | Status |
|---|
Data plan
| Measure | Source | Provenance chip |
|---|---|---|
| Thriving / struggling / suffering | Gallup Life Evaluation Index (national/state); county proxy from CDC PLACES “mental health not good ≥14 days” + County Health Rankings quality-of-life; Rippel Hub explorer where available | MIXED |
| Life expectancy | IHME / County Health Rankings life expectancy by county | REAL |
| Vital conditions panel (25 indicators) | Rippel Explore data (IP3 ASSESS) — request via Ask #3; map into PHIT H-block | ASK |
| Rippel engagement by place | Impact Report narratives; ILN report; Rippel partnership team (Ask #3) | MIXED |
| FFH activation (F-block) | Supabase member/coin/drop activity, aggregated to county, consented | REAL where FFH is active |
| Peer matching | County Health Rankings peer counties or CDC urban-rural class + population band | REAL |
Wiring plan — what it actually takes
PHIT Systems/phit-scorecard/index.html, 2.2 MB, 98 uses of hashVal()) shows that for any county where FFH is not operating, most of the composite PHIT Score is deterministically generated from a hash of the county name, not measured. Specifically: lifeExp = 76.5 + (hashVal(county,120) % 10) / 2, voterTurnout = 52 + hashVal(county,99) % 25, nonprofitsPer10k = 25 + hashVal(county,88) % 40, hsGradRate = 82 + hashVal(county,110) % 14, and the whole of Domain F via if(!DEMO.ffh){ … hv(200…223) … } — with no Supabase query anywhere that populates DEMO.ffh. Domain F is 35% of the score and is synthetic for every county, Pima included. Bobby Milstein wrote CDC's program evaluation framework. If he opens the console, or asks “where does life expectancy come from,” a generated number ends the credibility conversation permanently. Show Domain H (real), name the rest as roadmap.Block-by-block status
| Block | Weight | Today, for a Rippel county | To make it real | Effort |
|---|---|---|---|---|
| H Community health | 20% | REAL CDC PLACES prevalence, normalized against published benchmark bands — the panel above proves it for all 15 partner counties | Done. Cache the PLACES pull server-side so it is not re-fetched per visitor. | Shipped |
| C System capacity | 10% | MIXED CMS Care Compare hospitals and HRSA sites are real as of the 2026-08-28 deploy; provider-per-10k ratios still partly derived | NPI Registry + HRSA HPSA API per county for PCP / mental-health / dental per 10k; CMS HCRIS for beds. All three are open APIs, all keyed by FIPS. | ~1 day |
| A SHIP/CHNA alignment | 15% | MANUAL Arizona is mapped; other states are placeholders | One-time human read of each state's SHIP and each partner health system's CHNA, coded to the seven vital conditions. This is the block Rippel should co-own — it is exactly their Well-Being Portfolio exercise, and it is the natural Ask #3. | ~2 hrs per state |
| E Engagement & literacy | 10% | SYNTHETIC library visits, nonprofits per 10k, voter turnout, HS graduation are all hashVal | IMLS Public Library Survey (real, county-level), IRS Business Master File or Candid for nonprofit density, MIT Election Lab county turnout, NCES/EDFacts ACGR. All four are downloadable national files — load once into a static JSON keyed by FIPS, not a live API. | ~2 days |
| O Outcomes & impact | 10% | SYNTHETIC life expectancy and preventable hospitalization are hashVal | County Health Rankings annual CSV carries county life expectancy and preventable hospital stays directly; CDC WONDER for infant mortality. One CSV, one join on FIPS. | ~half a day |
| F FFH activation | 35% | SYNTHETIC the entire block, in every county — DEMO.ffh has no data source | Supabase aggregation view: members / ambassadors / group leaders / directors, Learn·Live·Share coins, drops, streaks, events, pre-post deltas — grouped to county, consented, aggregate-only. Where FFH is not operating, F should be null and the composite should refuse to render, not fill with noise. | ~3 days + a policy decision |
The decision this forces
A PHIT Score for a county where FFH has no members is a score with 35% of its weight invented. There are three honest ways out, and one of them has to be chosen before any Rippel county is shown a composite:
- Two-number display. Show a Community Baseline Score (H+C+A+E+O renormalized to 100) for any county, and the full PHIT Score only where F is real. This is the cleanest, and it makes activation visibly the thing that unlocks the real number — which is the sales argument anyway.
- F = 0 until activated. Honest, but it makes every non-FFH county look catastrophic and is easy to misread.
- Composite suppressed. Blocks only, no headline number, until all six are real. Safest, least useful.
Build order
| When | Do | Unlocks |
|---|---|---|
| This week | Ship the Baseline Score split (option 1). Wire Domain O from the County Health Rankings CSV — one file, biggest credibility gain per hour, and it kills the fake life-expectancy number. | An honest composite for all 15 Rippel counties |
| Weeks 2–3 | Domain E from IMLS + MIT Election Lab + NCES + Candid, as a static FIPS-keyed JSON. Domain C from NPI + HRSA HPSA. | 65% government block fully real nationwide |
| Weeks 3–4 | Domain A: code the SHIPs for DE, NJ, PA, FL, CA, MI, NC, WV, CO, AK to the seven vital conditions — with Rippel, as the data conversation (Ask #3). Their 25-indicator set maps into H at the same time. | The co-authored artifact; Rippel's name on the method |
| Weeks 4–6 | Domain F from Supabase for Pima and the pilot region only. Everywhere else, F stays null and the Baseline Score shows. | One county with a true, complete PHIT Score — the proof |
| Then | Matched-peer comparison (County Health Rankings peer counties) and the modeled-vs-observed study design in Outcomes Intersect. | The joint funding proposal |
What to say tomorrow if he asks “can you score our communities?”
That answer is true, it demos something real, it names the gap before he finds it, and it ends on Ask #2.
Partnership ladder — five deal shapes, smallest first
Present as a ladder Rippel climbs one rung at a time. Their own words: “start with a short-term introductory engagement that can be followed by longer, deeper experiences.” Mirror that. Lucy's three-tier frame maps onto Rob's shapes: cross-promotion = 1–2; Official Partner Program / Thriving Together Channel = 3–4; white-label academy = the mature form of 2 + 5, never before the license.
Framework alignment & cross-promotion (0–90 days)
Rippel (or a named steward) signs the Shared Stewardship Charter as an ally; FFHN publicly adopts Vital Conditions as its organizing spine with attribution. Plus: Vital Conditions lens on PHIT; link exchange with the Movement to Thrive Together Hub; a Toolbox webinar on the Civic tab + Advance the Dream; a Stewards Rising story on a Chamber of Health Director; a light digital companion for Thriving Together Theater. Value: legitimacy on day one.
Permission to build the Academy on their definitions
Written permission for the 15-module Academy and the wedge card; co-branded; free at the Explorer tier; edits reviewed by Rippel. Solves the copyright constraint cleanly and unlocks everything below.
Their 25 indicators in, our civic-muscle signal out
Their indicators become the Vital Conditions Panel in PHIT (with IP3 as needed); PHIT's engagement block flows back as a county-level civic-muscle signal for the Pulse Check and the Hub. Governed by a data-sharing MOU — aggregate only, no member-level data leaves FFH.
One learning region plays a Thriving Together Season for real
A Rippel learning region or Arizona via My Healthy AZ runs the Accelerator + Season 1: Theater kickoff, 90-day rounds, PHIT re-score, joint case study. Rippel introduces; FFHN operates. Revenue: sponsored county activation (a health system in Rippel's orbit funds it; FFH bills the sponsor), PHIT Data Hub partner-rate subscriptions to Rippel's 345 orgs and the ReThinkers Collaborative with a share back to Rippel's coaching, Partner Program membership for organizations Rippel coaches.
“Operationalizing the Well-Being Portfolio”
Co-apply to RWJF / CDC Foundation / Reinvestment Fund / BUILD Health Challenge / a state health foundation: Rippel as framework steward and evaluator, FFHN as platform. Named authorship in the study — the Outcomes Intersect panel is the study design. This is the realistic near-term money; the 2026 ILN report was funded exactly this way. Mature form (12–24 mo): a co-branded Stewards Academy on the Partner Journeys pattern, licensed annually, with steward scholarships receivable through the 501(c)(3) fiscal agent.
Rippel brings
Framework, license, evaluation lens, ILN and regional introductions, funder credibility.
FFHN brings
Platform, PHIT, content build, games, operations, the durable financing floor, physician-verified content.
IP, data & risks
Risks on our side
- Copyright. Academy on their definitions inside a paid platform needs written permission. Lead with it.
- Vendor smell. One slide of pricing in the wrong minute ends the relationship. Tiers, PMPM, equity stay in the appendix.
- Data claims. The F-block is proprietary and maturing; Resilience Lab coefficients and the Ripple sim are illustrative. Say “planning defaults, calibration underway” before they ask.
- Terminology. The language rules above, without exception.
- Brand tone. Rippel's culture is humility, “with not to.” Co-branded pages need a review gate on their side and a design pass on ours.
Risks on their side (say them out loud — it builds trust)
- Workshops don't compound. A sticky-note portfolio decays the week after the retreat.
- Stewards-only reach. Their tools touch the people with budgets, not the residents whose behavior moves the indicators.
- No engagement data. The 25 indicators describe conditions; they cannot see who is learning, acting, or sharing.
- Grant dependence. Regions lose momentum when RWJF cycles end; the shared-infrastructure floor is the antidote.
- Pace. Consensus-driven and slow. Design every rung so FFH gets value even if the next rung never happens.
30 / 60 / 90 after the call
| By | Milestones |
|---|---|
| 24 hrs | “Learn from you first” email; Rob's brief PDF; Charter; 15-wedge card. No pricing. |
| Day 30 | Vital Conditions lens live on the PHIT Scorecard (gated preview) · co-brand/license letter drafted and sent · working session with Maggie Cooke / partnerships · one-page concept to Becky · registry rows enriched with Rippel's own partner list |
| Day 60 | Three more WBP Academy wedges built (Basic Needs, Belonging, Acute Care) · Thriving Together Channel landing page · first co-webinar scheduled in the Toolbox series · 25-indicator mapping into PHIT H-block scoped · joint funder target list agreed |
| Day 90 | Pilot region named and Season 1 calendar drafted · data-sharing MOU drafted · Outcomes Intersect panel wired for pilot + peer counties (REAL chips) · Partner Program terms (Data Hub partner rate, referral share) · decision point on the joint funding proposal |
Kit index & sources
Rob's meeting kit (Dr Rob Input → Ready to Test for Lucy → rippel-meeting-kit)
- Rippel-x-FFHN-Tuesday-Brief.html / .pdf — side-by-side, gaps & risks, run sheet, Academy concept, 15-wedge map, deal shapes, asks (merged here)
- wbp-reliable-transportation.html — Wedge 6 sample module; deploy copy in
wbp-reliable-transportation/(the only file in the kit meant to go live) - FFH-WBP-Reliable-Transportation-Screen-Tour.pdf — 10 phone screenshots
- phit-data-hub.html — PHIT Data Hub product page for the PHIT demo segment
- PHIT-Systems-Data-Hub-Strategy-v2-canonical-weights.docx — PHIT = 0.20H + 0.10C + 0.15A + 0.10E + 0.10O + 0.35F
- index.html — The Ripple Lab — wave visualization where FFH actions drop waves (Imagination / Inspiration / Innovation / Intelligence / Kindness; Height · Frequency · Reach · Human coefficient); SIM/LIVE feed;
FFHRipple.onDrop()hook. Source of the simulation controls above and the natural “Ripple × Rippel” visual for a co-branded landing.
Lucy's brief (Opportunity Items → Ripel Foundation)
- Rippel-Partnership-Brief-and-Call-Prep-2026-09-08.docx / .md and Rippel-Partnership-Brief-2026-09-08.html — Rippel profile, people, alignment map, partnership ladder, call plan (merged here); also in the Ripel Foundation project
- Source PDFs: Rippel Impact Report 2023–2025 · Building a Thriving Future, Together (ILN, Summer 2026) · Definitions of the Well-Being Portfolio (2023) · Modeling a Path to Multiracial Well-Being
Rippel sources
rippel.org — Vital Conditions; Our Work; Dynamic Modeling; Movement to Thrive Together; team bios; “Thriving Together: A Bold Goal for the Next Decade” (Mar 30, 2026); “Beyond Programs: Grantmaking to Advance Vital Conditions” (Jun 30, 2026); PLOS One announcement (Apr 16, 2025) · Grantmakers In Health profile · Email thread Payne → Milstein → Gillio, Sep 3–4, 2026.