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Statewide Health Improvement Program (SHIP)
Minnesota Department of HealthCara McNulty, MSSHIP [email protected]
Setting the Stage for SHIP
Health care costs increased 60% since 2000 in Minnesota
Minnesota’s historically strong private health insurance market has eroded, and % uninsured has risen
Quality of health care is unevenly distributed for different segments of the state and population– For many, quality is well below a level we should expect for
the money we are spending Rising rates of unhealthy behaviors (tobacco use,
poor nutrition and physical inactivity) and prevalence of chronic illness
Chronic diseases are among the most prevalent, costly, and preventable of all health problems
Initial Legislation and Plan In response to increasing rates of chronic disease and rising health
care costs, legislation passed in 2007 called for creation of plan to fund and implement comprehensive statewide health improvement
Plan developed in consultation with State Community Health Services Advisory Committee (SCHSAC) and MDH Executive Office
Addresses risk factors for preventable deaths, decreased quality of life and financial costs from chronic diseases in four settings: – Community – Worksites – Schools– Health care
Incorporates expert knowledge from the state and local level Based on federally funded Steps to a HealthierMN
Model for Statewide Health Improvement
Community input into planning, implementation and evaluation
Adherence to socio-ecological model
Health promotion in four settings: community, schools, worksites, health care
Local program advocates
Informed by evidence-based interventions
Focus on common risk factors
Extensive and comprehensive evaluation linked to program planning
Policy, systems, and environmental change that supports healthy behavior
Accountability and oversight
The Process – Summer and Fall 2007
MDH developed plan for SHIP based on Steps to a HealthierMN model in Summer 2007
MDH Executive Office and advisory committee (SCHSAC) adopted plan Fall 2007
Plan presented to Governor’s Health Care Transformation Task Force and legislative committees including Health Care Access Committee
Details of evidence, cost-effectiveness of prevention, and examples of state/local policies provided to committees
Governor’s Task Force included plan in recommendations to Governor Pawlenty for health care reform
Plan introduced by legislature as part of broader health reform bill
The Process – 2008 and 2009
2008 Minnesota State Legislative Session: Plan included in both House and Senate versions of
health reform bill Public health element in addition to other reforms in:
– Health care coverage/affordability– Chronic care management – Payment reform and price/quality transparency – Administrative efficiency– Health care cost containment
Signed into law May 2008 as part of health reform bill
2009 Minnesota State Legislative Session: Funding sustained by legislature Final budget completed by Governor Pawlenty on June
30, 2009
Description of SHIP
Signed into law as integral public health component of Health Reform Initiative
SHIP intended to reduce obesity and tobacco use in Minnesota through policy, systems, and environmental changes
$47 million appropriated for fiscal years 2010 and 2011
Competitive grants to Community Health Boards and tribal governments rolled out beginning July 1, 2009
SHIP funding will not supplant other funds
SHIP Description Continued
Community Health Boards and Tribal Governments required to:
Match 10% of fundingSubmit community action plans,
establish partnerships, and develop community leadership team
Implement policy, systems, and environmental changes in four settings
Work with MDH to evaluate programs
SHIP Description Continued
MDH will:Set outcomes to support obesity and
tobacco goalsMeasure baseline status Provide content expertise, technical
expertise, and trainingConduct comprehensive biennial
evaluationProvide biennial reports to legislature
SHIP Internal Structure
SHIP Executive
Team
Intervention Work Group
Evaluation and Data
Collection Work Group
Technical Assistance
Work Group
Communications Work Group
Request for Proposal
Development Work Group
Risk Factor and Chronic
Disease Integration
Work Group
SHIP Planning and Implementation Workgroups began meeting in Fall 2008
– Involved key stakeholders such as local public health, tribal governments, CDC, and others including SCHSAC SHIP Ad Hoc Workgroup
Utilizing/modifying existing data collection, assessment, and reporting systems
Explicit guidance provided for implementing and evaluating evidence-based policy, systems, and environmental interventions to reduce obesity and tobacco use and exposure
Technical assistance and training opportunities previously offered and more under development
Internal and external communications put in place
Opportunities
Building on existing prevention efforts to expand and not duplicate work that is already being done
Enhancing capacity of local public health and tribal governments to implement policy, systems, and environmental changes
Integrating with other Health Reform Initiative components to support overall health reform transformation
Developing a statewide system to demonstrate that reductions in risk factors decreases in chronic disease substantial health care savings!
SHIP Applications and Grant Awards
Request for Proposals (RFP) released February 2009
Applications due April 2009Applications received from all 53 CHBs
and 8/11 tribes, including up to 14 counties collaborating on policy, systems, and environmental change
39 grant awards made based on $47 million in funding
Grant agreements signed and rolled out July 2009
SHIP Next Steps
Continue planning and implementation with our partners
Provide technical assistance to grantees to ensure successful implementation
Secure future funding to achieve goals of reducing obesity and tobacco use and exposure in Minnesota
Reduce the burden of chronic disease to generate future health care-related cost savings
Lessons Learned
Contact legislators and ask them to ask YOU to prepare a plan or report
Expect to work hard and quicklyExpect to partner with and incorporate
input from stakeholders and experts at every stage (plan program implementation evaluation reporting)
Expect multiple revisions of all documents
Lessons Learned, continued
Prepare for process with legislative committees, legislative session, and planning - Do not be discouraged
Allow sufficient time to plan for program implementation
Prepare high quality communications systems and materials (which require resources) to make sure interested parties can access information easily
Prepare sound justification for program ready to share with interested parties
QUESTIONS?
Contact Information:Cara McNulty, MSStatewide Health Improvement Initiatives [email protected](651) 201-5438
SHIP Website:
http://www.health.state.mn.us/healthreform/ship.html
SHIP Email:[email protected]
Contact Information:
Cara McNulty, MSStatewide Health Improvement
Initiatives (SHIP) [email protected]
(651) 201-5438
THANK YOU!
