On Common Ground for Health Expanded Plan Our Coordinated Efforts to Prevent and Manage Chronic Disease in Missouri 2014 - 2018 Developed by the multi-stakeholder Chronic Disease State Plan Workgroup, On Common Ground for Health describes recommended strategies to coordinate the prevention and management of common chronic conditions in Missouri. FY 15 Status Report Plan Summary The CHCDP program staff worked on action steps to move the section toward the goals set forth in this integrated strategic plan to prevent and manage chronic disease in Missouri. During year two, many accomplishments have occurred with efforts continuing into fiscal year (FY) 2016. This report also features statements, ideas and activities to enhance communication, integration, plan refinement and measures. Team leaders will use these statements, ideas and activities as discussion points with their teams and report decisions back to CHCDP. These discussions may result in modification of the plan action items, team makeup, and plan measures that will be noted in future reports. The coordinated and collaborative nature of the teams will continue and program integration efforts will strengthen. Both attributes will lead CHCDP to achieving the goals and objectives set forth in this plan. For this strategic plan and report, an operational plan converts the components of the strategic plan (vision, mission, goals, objectives, etc.) into short-term workable statements with measureable milestones. The plan contains a comprehensive set of integrated, carefully orchestrated actions that put objectives and strategies into operation for the fiscal year. The plan needs to also define the interrelationship between all of the necessary actions to achieve milestones, including those actions of internal and external partners. To aid in reading the report, utilize the following acronym list. ABCS Aspirin (when indicated), Blood Pressure, GODAC Governor’s Organ Donation Advisory PCHH Primary Care Health Home Cholesterol, Smoking Cessation Committee CDPP Chronic Disease Prevention Program HEAL Healthy Eating Active Living Program PCP Primary Care Provider CHC Community Health Center HRC Health Resource Center PHC Pioneering Healthier Communities CHW Community Health Worker HRSA The U.S. Department of Health and Human PHHS Public Health and Health Services Block Grant Services, Health Resources and Services Administration CLPHS Center for Local Public Health Services LPHA Local Public Health Agency PSA Public Service Announcement Public Service Announcement CLS County Level Survey LTC Long-Term Care ROI Return On Investment CSC Children Services Commission MAPCP Missouri Asthma Prevention and Control SHI School Health Index Program CSF Comprehensive Smokefree MAPP Mobilizing for Action through Planning and TGA The Guideline Advantage Partnerships Page | 2 CTF Comprehensive Tobacco-Free MARC Mid-America Regional Council WIC Women’s Infant and Children’s DRS Donor Registry System MCC Missouri Cancer Consortium DRVS Data Repository Visualization System (by MCP Missouri Convergence Partnership Azara) EMR Electronic Medical Record MoQuIN Missouri Quality Improvement Network Page | 3 STRATEGY AREA #2: Environmental Factors GOAL Environmental and social factors support individuals engaging in healthy living. Objective 1: Through 2018 increase community policies, rules, or ordinances that are proven to effectively promote healthy lifestyle environments for Missourians. YEAR ONE ACTION PLAN Status-FY15 Action Measures As of 6/30/2015 Conduct survey to Number of surveys FY15: determine baseline conducted  Legislation (SB 135) to amend 302.020 RSMO (Motorcycle Helmet Law) for operators with first-party insurance coverage and distinctive license plates was defeated during the 2014 legislative session Future Plan Discussion Points:  Rewrite action to better focus assessment efforts related to environmental and social support for healthy living within communities  Determine which measures to utilize and develop a plan to complete a baseline assessment, i.e., nursing homes, childcare centers, etc.  Determine process for assessing elementary/secondary public schools tobacco polices  Determine baseline of community mental health and substance abuse facilities with smokefree or tobacco-free polices  Determine baseline of public housing authorities with smokefree or tobacco-free policies  Determine what other rules, policies, and ordinances to assesses within communities if funding becomes available  Establish baseline of elementary/secondary public school that have tobacco-free policies Page | 4 Work with Baselines determined FY15: communities to Number of  Section Administrator clarified measure focus and added physical activity, nutrition, unintentional injury assess their communities prevention and asthma environment conducting  Livable Streets contractor to work with 3 communities to conduct key informant interviews with community assessments (the leaders to gather insight for passing a complete streets policy focus, at a minimum, Future Plan Discussion Points: is: tobacco, walkable communities, child  Establish a work team of staff and partners, at a minimum consider the following individuals/organizations: care centers, physical o Brenda Maley, activity, nutrition, o Jeannie Ruth, unintentional injury o Tiffany Tuua, prevention, and o CLPHS Representative asthma) o Missouri Foundation for Health Representative  Consider assigning an Intern as team lead  Determine number of communities currently receiving assistance to assess their environments and what tools are being utilized as a baseline  Develop a list of community assessment tools communities can utilize to effectively assess their environment  Determine what measures will be utilized to measure progress  Determine how community assessment tools will be promoted and utilization tracked  Seek resources to support community assessment tool promotion and utilization  Seek resources to Assess usage of community assessment tools  Assess what community rules, polices or ordinances were put in place using the assessment data  Review MCH assessment required every three years to determine if components of that assessment help measure progress toward objectives  CLPHS may have data on assessment Support coalition Number of FY15: development and communities  Provided sustainability planning training for 28 community coalition contractors/LPHAs action implementing  Continue HEAL and CDPP contracts changes Number of FY16 Plan: community coalitions  Establish a work team of staff and partners, at a minimum consider the following individuals/organizations: working on policy o Brenda Maley, changes o Jeannie Ruth, o Sandy Hentges, o Melissa Hope, Page | 5 o CLPHS Representative, and o Missouri Foundation for Health Representative  Consider assigning an Intern as team lead  Determine what actions by local coalitions will be measured  Continue to fund LPHAs through HEAL and CDPP. Expand the strategies from which they can choose to address Future Plan Discussion Points:  Seek resources to support local coalition efforts  Develop a reporting mechanism for use by local coalitions to monitor progress  Determine: o What funding will support coalition work o If central office work team or others staff will get the regional staff current on issues, chronic disease needs and risk factors o The target communities/counties and/or LPHAs o If re-alignment of assigned areas is necessary Page | 6 Support schools in Number of health FY15: School Health Index promoting policies or  44 schools complete the SHI and develop an action plan to improve their health related policies and practices (SHI) assessment practices changed  Section Administrator has added Peggy Gaddy and Lesha Peterson to the work team Number of new FY16 Plan: health promoting policies  Change lead to Alma Hopkins to work with the following team: o Marjorie Cole o Jeannie Ruth o Lesha Peterson o Peggy Gaddy  The SHI to be completed by an additional 12-15 public schools Future Plan Discussion Points:  Educate the statewide Comprehensive Tobacco Control team on the SHI  Report number of schools that have completed the SHI and changes made as a result  Report number of schools that enacted policy change based upon the results of the SHI assessment  Determine how to incorporate Comprehensive Tobacco Control program efforts into the SHI and vice versa  Train the Comprehensive Tobacco Control team about SHI  Determine how to involve Comprehensive Tobacco Control youth teams at the local level  Develop at least one success story about impact of completing the SHI and how it will be shared Provide training and Number of programs FY15: technical assistance offering technical  Provided a two-day HEAL contractor training for 28 HEAL contractors on December 9-10, 2014. Training to partners (existing assistance included sessions on sustainability, evaluation, implementation of strategies and available resources and potential)  Through the HEAL contracts, LPHAs educated 465 decision makers about policy and environmental changes to support healthy weight  14 I am Moving, I am Learning trainings conducted reaching 314 providers  Train 700 childcare providers how to adopt policy and environmental changes to their physical activity and nutrition environments within their centers  Host quarterly conference calls for 10 CDPP contractors to review barriers for implementation of contract deliverables and network with other agencies FY16 Plan: Page | 7  Determine if the Coalition Self-Assessment Checklist tool will be used by all programs within the section. If not, determine what tool or tools will be utilized  Continue to offer training and technical assistance to child care providers through Team Nutrition and MAP  Offer a one-day LPHA contractor training for HEAL  Continue quarterly calls for CDPP contractors Future Plan Discussion Points:  Train all Section staff on the use of the (tool names) assessment tool(s)  Programs design a plan on how they will incorporate the identified tool(s) at the local level  Determine how to fund the collection and compilation of results  Determine how results will be submitted and compiled  Determine who or what agency will be responsible for collecting and compiling results  Develop a proposal to identify gaps in physical activity and nutrition licensing rules within Childcare facilities  Seek funding opportunities to identify gaps in physical activity and nutrition licensing rules  Secure funding to identify physical activity and nutrition licensing rule gaps FUTURE ACTION ITEMS Status-FY15 Action Measures As of 6/30/2015 Identify gaps FY15: in policy  Assigned Coordinating Council the responsibility to: o Identify focus areas (chronic disease, risk factor(s) and programs) o Make recommendations for policy development  Report physical activity and nutrition licensing rule gaps within childcare facilities  Report gaps for CTF policies in school districts and CTF or smokefree in other facilities (community mental health and substance abuse, local public housing) Future Plan Discussion Points:  Determine focus areas in which to identify gaps in policy  Identify other health related policies in which to focus Page | 8 Develop FY15: model  Report results of Pioneering Healthy Communities survey on shared use agreements policies as  Adopt (policy name) existing model policy for comprehensive smokefree community ordinances determined  Adopt (policy name) for comprehensive tobacco control policies within public schools by gaps  Work with Missouri School Boards Association to strengthen model shared use agreement policy for school districts  Develop a community toolkit that includes model policies Disseminate FY15: model  Distribute to communities the following model policies for Smoke free/Tobacco-free Policies/Ordinances policies to o Fundamentals of Smokefree Workplace Laws (http://www.no-smoke.org/pdf/CIA_Fundamentals.pdf) assist o Model Policy for a Tobacco-Free College/University (http://no- communities smoke.org/pdf/modeluniversitytobaccofreepolicy.pdf) with policy o School Tobacco Policy Index change (http://cphss.wustl.edu/Products/ProductsDocuments/CPPW_SchoolTobaccoPolicyIndex.pdf#SchoolTobaccoPolicy Index,2005)  Model policies for complete/livable streets are available on the Missouri Livable Streets website (http://livablestreets.missouri.edu/)  Developed the Missouri Breastfeeding Friendly Child Care Toolkit, which includes a model policy on supporting breastfeeding for childcare providers  Completed draft of the Missouri Food Service Guidelines for public service venues  Continue to promote Eat Smart in Parks for state and local parks Page | 9 Objective 2: Through 2018 maintain existing and increase state laws and regulations that are proven to effectively promote healthy lifestyle environments for Missourians. YEAR ONE ACTION PLAN Status-FY15 Action Measures As of 6/30/2015 Inform DHSS Number of grand FY15: legislative liaison on rounds to which  Released policy recommendations for childhood obesity prevention and treatment in December 2014 state laws and Department o Developed by the Children’s Services Commission’s Subcommittee on Childhood Obesity regulations that management is promote healthy invited FY16 Plan: lifestyle Number of subject  Assign team lead replacement, Belinda Heimericks retiring environments matter briefs  Secure funding for research/evaluation of existing Missouri laws, regulations or policies that can impact a provided at grand healthy lifestyle rounds  Assign a person, employee/partner team, or an intern to research/evaluate all existing Missouri laws and regulations that can impact a healthy lifestyle, by topic o Develop topic list o Prioritize topic list o Implement research/evaluation  Report findings from state law and regulation evaluation process to o Community Health and Chronic Disease Prevention program managers o Section administrators within the Division of Community and Public Health o Department Legislative Liaison Future Plan Discussion Points:  Determine which programs within the Department will collaborate and focus on this objective o Recruit individuals from those programs to be on the collaborative team  Incorporate healthy lifestyles law, regulation and policy review into Department grand rounds Page | 10