1. Cara McNulty, MS Manager Office of Statewide Health Improvement Initiatives Julie Ring Director Local Public Health Association Statewide Health Improvement Program (SHIP)

2. SHIP Overview  SHIP is a key public health component of historic health reform bill signed into law May 2008  SHIP aims to reduce obesity and tobacco use and exposure through evidence-based systems change strategies  $47 million appropriated for SHIP for fiscal years 2010 and 2011  Competitive grants to Community Health Boards and tribal governments began July 1, 2009

3. Impact on Local Public Health  Grants awarded to all 53 CHBs (87 of 87 counties) and 9 of 11 tribal governments  Unprecedented collaboration  38 of 53 CHBs are working collaboratively  Seven tribal governments are working collaboratively on a unified SHIP project  Shift in public health focus from programs to systems-change approach

4. Importance of a Systems-Change Approach  Major health problems will not be solved solely by addressing individual health behaviors  Health problems are influenced by societal policies and environments that in some way either sustain behaviors or fail to foster healthier choices  By moving “upstream” to address fundamental causes or poor health, and by improving environments where we live, work, learn, play, and receive health care, we can prevent many people from becoming chronically ill

5. SHIP Interventions A comprehensive Menu of Interventions was created with input from local, state, national and tribal government experts Grantees were required to select a minimum of four interventions that included:  At least one in each of the four settings (schools, communities, worksites and health care)  At least that addresses tobacco  At least one that addresses obesity

6. Statewide Evaluation  Grantees are required to:  work with MDH to finalize an Evaluation Plan  submit interim and annual reports detailing overall progress towards SHIP goals and objectives  Should grantees fail to meet expectations, MDH will work with grantee to modify activities to meet goals of each intervention  In addition, MDH  synthesizes evaluation across state  conducts surveillance of health care costs, health behaviors, risk factors, and systems changes related to SHIP goals

7. Statewide Technical Assistance Designed to facilitate successful implementation of a comprehensive, integrated health improvement program  Assist and develop capacity of community health boards and tribal governments to implement systems change at local level A team of experts from MDH and partner organizations provide assistance, drawing on internal and external resources Technical assistance involves:  Planned trainings  Responsive technical assistance  Guidance documents  Peer-to-peer assistance  Statewide conference

8. Early Successes in SHIP Communities In first six months of grant period, SHIP grantees:  Built community capacity to leverage experience in chronic disease prevention and policy change  Coalesced community support and commitment through official teams, partnerships and coalitions  Completed community assessment of needs, supports and assets  Selected interventions based on community assessments  Developed action plans to implement strategies in schools, communities, worksites and health care settings  Submitted evaluation plans that:  Identified outcome measures  Designated key benchmarks to measure progress

9. Early Successes in Tobacco In first year of grant period:  At least 37 post-secondary campuses have begun work to become tobacco free. Six campuses, affecting over 38,000 people, have adopted policies since SHIP began  Over half of SHIP grantees are working on implementing comprehensive worksite wellness interventions, many of which address tobacco use and exposure among employees. SHIP has been an integral part of a number of early successes in this arena.  For example, Coborn’s Grocery Stores have implemented a tobacco- free grounds policy and links employees to cessation for their 26 Minnesota locations affecting 6,500 employees.

10. Early Successes in Health Care In first year of grant period:  About two-thirds of SHIP grantees are working with providers to improve the active referral process for patients in need of weight management or cessation services to resources offered by health plans or in the community.  In Hennepin County alone, the 3 grantees have partnered with 33 clinics and Park Nicollet system involving 18 additional clinics

11. Early Successes in Healthy Eating and Active Living Majority of SHIP grantees have elected to work on strategies that:  Increase affordability and access to healthy foods in communities and schools. Well over 40 communities and more than 110 schools are engaged  Increase opportunities for walking and biking for transportation and rec­reation in communities and schools. Well over 50 schools and more than 130 cities are engaged  Implement comprehensive worksite wellness initiatives that support reduced tobacco use, increased physical activity and improved nutrition. Well over 160 worksites across state, including large corporations and manufacturing businesses such as Polaris, Swift Manufacturing, Cargill, General Mills, HealthPartners, Target, Best Buy, Medtronic, and many others are engaged

12. Lessons Learned  Integrate with other Health Reform Initiative components to support overall health reform transformation  Build on existing prevention efforts to expand and not duplicate work that is already being done  Make efforts to help grantees succeed, even before funds are awarded including developing list of evidence-based strategies  Enhance capacity of local public health and tribal governments to implement policy, systems, and environmental changes  Develop a statewide system to demonstrate that reductions in risk factors  decreases in chronic disease  substantial health care savings!

13. Achieving SHIP Goals “We are building something here, that will last our lifetime and beyond.” – Mitch Jasper, Mayor, City of Jackson In many ways, SHIP grantees have only just started their work, yet results they have already accomplished show tremendous promise for future success It will take time and sustained effort throughout our communities to achieve reductions in tobacco use and exposure and obesity that can lessen burden of chronic disease in Minnesota SHIP is on path to reaching those goals by making healthy choice the easier choice for all Minnesotans

14. Questions? SHIP Website: http://www.health.state.mn.us/healthreform/ship.html http://www.health.state.mn.us/healthreform/ship.html Cara McNulty, Manager, Office of Statewide Health Improvement Initiatives Email: Cara.McNulty@state.mn.usCara.McNulty@state.mn.us Phone: 651-201-5438 Julie Ring Director, Local Public Health Association Email: Ring@mncounties.orgRing@mncounties.org Phone: 651-789-4354