The Alliance for Health is Cleveland County’s Healthy Carolinians Task Force. Healthy Carolinians is a North Carolina statewide initiative that allows local coalitions to be certified as the entity for community-based action planning to address health issues. The Alliance for Health began well before receiving the first certification as a Healthy Carolinians Task Force.
The concept of the Alliance for Health was born out of the Cleveland County Health Assessment Task Force, which was chaired by Dr. T.R. Harris. The Health Assessment Task Force had several subcommittees, one of which was the Ambulatory Care Committee. This subcommittee recommended that a group form to address prevention efforts in the county. With this in mind, staff from Cleveland Regional Medical Center (CRMC), Cleveland County Health Department (CCHD), and the Cleveland Center (Area Mental Health/Developmental Disabilities/Substance Abuse Program) began to meet as “Prevention Partners.” The Prevention Partners’ original focus was to identify where services were duplicated, where gaps existed and how to develop a means for collaborating in the future. In 1995, the Prevention Partners brought their idea of developing a Prevention Framework back to the Health Assessment Task Force.
After getting approval from the Health Assessment Task Force, the Prevention Partners sought out and were awarded $25,000 in grant funds to hire consultants to design a blue print for a Prevention Network. These consultants utilized focus groups and surveys to determine the specific needs of Cleveland County as well as to determine what it would take for a Prevention Network to operate successfully in the county. Several of the suggestions made by the consulting group included establishing an infrastructure that would support a community health network and developing a strategic plan that unified community-based services to improve health.
In 1996, the Alliance for Health’s Steering Committee was officially formed with representatives from all three hospitals in the county, the Cleveland Center (Area Mental Health/ Developmental Disabilities/Substance Abuse Program), Cleveland County Health Department, Cleveland Home Health Agency and CLECO (Cleveland County’s Rural Primary Care Network). This steering committee issued invitations to all of the not-for-profit agencies to get involved in the full partnership at a community wide kick off.
At this time the Steering Committee worked to establish the Alliance for Health’s mission: to collaboratively organize, operate and fund a unified system of preventive health initiatives to improve community health. Building from this mission the Alliance for Health also established its first strategic plan. This plan involved addressing major gaps in healthcare services with the “natural champion” for each initiative taking the lead in addressing the issue. The five major initiatives addressed in this first strategic plan were:
- To work with partners to establish school-based health centers in every middle and high school in the county;
- To promote and expand the FACES (Families And Communities Equal Success) mental health grant-funded program which addressed coordinating care (particularly related to mental health and developmental disabilities) and utilizing resources for children in danger of being removed from their homes;
- To increase access to preventive healthcare for children in the county by reopening the Child Health Clinic at the Health Department;
- To develop a work site wellness program, WIN (Wellness for Individuals Now), to address identifiable risk factors for chronic diseases and implement programs to reduce those risks;
- To utilize CLECO to address prevention initiatives with regular clients.
While continuing to address these initiatives, the Alliance for Health decided to become a Healthy Carolinians Task Force. In 1998, an application was submitted to the state and the Alliance for Health received its first certification as a Healthy Carolinians Task Force. As part of this process, the Alliance for Health has recruited a medical advisor, expanded the Steering Committee to include representatives from the Department of Social Services, the faith community, the Cleveland County Chamber, Carolinas Community Health Institute (CCHI), and the Partnership for Children and added more agency members to the full partnership.
Also in 1998, the Cleveland County Health Department was one of Glaxco-Wellcome’s Child Health Award Recipients for demonstrating effective community collaboration in developing the Alliance for Health to address the needs of the county. This $5000 award has allowed the Alliance for Health to provide refreshments and buy small incentives for various events. In addition, the Alliance for Health has also successfully partnered with Carolinas Community Health Institute, which provides funds to support the executive director’s position as well as almost $100,000 in implementation money for the community. In 1999, the Alliance for Health utilized some of these funds to support a full-time coordinator to maintain the daily operations of the Alliance for Health.
1999 saw the publication of a comprehensive community needs assessment Cleveland County Today to identify emerging health and human service issues in the community. Based on the results of this assessment, committees were established to address high priority needs: heart disease, violence, substance abuse and teen pregnancy. These committees worked to develop and implement community health action plans for each of these areas, a requirement for continuing certification as a Healthy Carolinians partnership. In 2000, funding from the Carolinas Community Health Institute was received to implement programs in these for areas as well as to support the operational costs for the Cleveland County Parish Nurse Ministry. Also in 2000 a newspaper insert which summarized the findings of the community assessment was published in The Shelby Star and the Kings Mountain Herald entitled Cleveland County Today: A Snapshot of Our Lives in 2000.
In October 2000, the Alliance for Health was awarded its first recertification as a Healthy Carolinians Task Force. This certification was valid through 2005. Also in 2000, the task force received $2000 from the state to participate in a marketing project. The funds gathered through this grant were used to develop a logo for the Alliance for Health that was launched in November 2000.
The Alliance for Health also secured an additional $10,000 from the state budget appropriation to purchase some computer equipment, hold a leadership seminar, and purchase marketing materials. Finally, the Alliance for Health nominated the Cleveland County Health Department Child Health Clinic, an Alliance initiative, for the Glaxco-Wellcome Child Health Award for Outstanding Health Department. The clinic won a $5000 award and used some of which to hold the first annual Paul Sarazen Child Health Forum on emerging issues in child health.
In 2001, the Alliance collaborated with the Cleveland County Health Department and the Cleveland County Partnership for Children to establish and implement a comprehensive preschool health initiative to identify the specific health needs of preschool children and establish programs to meet these needs. Support for the Dental Clinic, Child Care Health Consultant, immunization and Health Check staff, and educational materials for children, parents and child care providers was provided through this initiative. The GlaxoSmithKline Child Health Award was presented to the Cleveland County Health Department in 2001 for the development and implementation of this comprehensive program; the $5000 award was used to purchase additional medications for uninsured preschool children who were treated at the Health Department’s Child Health Clinic. The Alliance also received a $7,500 award from the Office of Healthy Carolinians to address health disparities in Cleveland County and used this award to host the first Minority Health Conference in summer 2001 as well as to host the Health Odyssey 2001 conference for at-risk middle school participants in the Communities in Schools program. The Alliance also participated in the initial planning to establish the Cleveland County Asthma Coalition in 2001.
A Teen Pregnancy Forum was held in October 2001 to highlight this issue in Cleveland County with more than 100 community members attending the event. The Youth Resource Council was designated as the lead coalition for this issue and met on a regular basis to focus on teen pregnancy prevention.
A new comprehensive community assessment was published in 2002. Entitled Cleveland County 2002: Implications for Promoting Health, Growth and Development, this document presented both primary and secondary data relating to demographics, economic status, health status, mental health, social issues, criminal justice, child care, education and quality of life. Of great interest in this document were the comments from participants in the key informant survey on Cleveland County strengths, challenges and issues. Comments were published exactly as submitted by 79 of the 184 respondents to the survey. Health priority issues identified through this assessment included asthma, heart disease, overweight and obesity, substance abuse and teen pregnancy. Community action plans were developed by committees to address these issues. A major accomplishment was the agreement with all schools districts to allow public use of school walking tracks for exercise. Funding from the Physical Activity and Nutrition Branch, Division of Public Health, NC Department of Health and Human Resources, provided signs for community walking tracks and maps to free walking facilities.
The Carolinas Community Health Institute awarded $110,000 to the Alliance to support health service programming in the county. Support was provided for health promotion teams, substance abuse prevention activities including the Student Use Survey, parish nursing, Alzheimer’s support group development, and a study on car seat safety using the Buckle Bear safety program. The Alliance also administered two grant programs offered through the state office of Healthy Carolinians. Four mini-grants totaling $4,200 were awarded to ACCES (Accessing Cleveland County Elder Services) for long-term planning, the purchase of a life skills curriculum for the Cleveland County Detention Center, support for placement of automatic defibrillators for Cleveland County EMS, and the purchase of convertible safety seats for the Safe Kids Coalition. Micro-grants of $2,010 each were awarded to Boiling Springs Baptist Church, the Broad River Greenway, the Cleveland County Arts Council, the Children’s Homes of Cleveland County, the Greater Shelby Community Theater, Graham Elementary School and Shoal Creek Baptist Church for projects specifically tied to one or more of the Healthy People 2010 objectives. Also in 2002 the Alliance hosted the Philip Newbold presentation of Community Plunges designed to illustrate the development of leadership commitment to the resolution of health and human service issues.
2003 brought additional work in the five community health action areas as well as the development of the Minority Health Council to address health disparities. The Alliance received support again from the Office of Healthy Carolinians to assist the Cleveland County Asthma Coalition, the Obesity Task Force and the Minority Health Council to identify and implement evidence-based programs in specific areas of interest. A change in Alliance leadership occurred as the first Executive Director, Sally Wills, resigned and Anne Short was named to replace her.
The Kate B. Reynolds Charitable Trust, Health Care Division, awarded the Alliance a three year grant totaling $45,000 in 2004 for funding support for infrastructure. Highlights of 2004 included the decision by the Steering Committee to seek independent, non-profit status, to develop a new logo, and to continue the focus on health disparities through revitalizing the Minority Health Council in Cleveland County. Collaboration with the Cleveland County Health Department to develop a proposal addressing childhood overweight and obesity resulted in a grant award of $150,000 per year for three years from the North Carolina Health and Wellness Trust Fund Commission. The Alliance took on the specific responsibility for the child care component of this proposal and worked to establish the Be Active! and Color Me Healthy curricula in seven child care centers and homes annually. 2004 also brought the implementation of the Wise Guys program for athletes at Shelby High School. This evidence-based curriculum focused on making positive choices and goal setting with the goal to reduce/delay/prevent teen pregnancy. The program was implemented with athletes in fall sports and has been recognized by the North Carolina High School Athletic Association as well as the Adolescent Pregnancy Prevention Coalition of North Carolina for this unique implementation.
A focus of activity in 2005 was the re-certification of the Alliance as a Healthy Carolinians Partnership, successfully awarded on October of that year. Once again, community members volunteered their time to establish health priorities and identify potential solutions for emerging health issues. The continuing focus on heart disease, asthma, childhood overweight and obesity, teen pregnancy and substance abuse prevention allowed existing coalitions and committees to continue their work. The Alliance was privileged to implement grant funding from the NC Asthma Program to develop asthma coalitions in a sixteen-county region of North Carolina as well as to continue its work in the Fit Together Initiative funded by the NC Health and Wellness Trust Fund Commission. The Wise Guys program was expanded to include athletes from Kings Mountain High School as well as Shelby High School during this year; first year participants from Shelby High were also trained as peer leaders and presented information to students at Shelby Middle School as a part of their activities. With a grant award from the Carolinas HealthCare System, the Alliance established a physical activity/nutrition program focusing on middle school youth called S.E.N.S.E. (Sensible Eating, Nutrition and Self-Esteem). This program offered five ten-week sessions to 6th, 7th and 8th graders from middle schools in the county. Participants met twice a week for two hours, one hour of specific physical activity and one hour of nutrition education or psychosocial counseling. Three family activities were included in each ten-week session. Program results proved that family involvement is key to a student’s successful weight maintenance/weight loss goals.
The county-wide walking contest, Take the StepOne Challenge, was a major activity in 2006. Co-sponsored by the Alliance with the Fit Together Initiative of the Cleveland County Health Department and the Cleveland County HealthCare System, this contest brought 1,737 residents to their feet over a nine-week period to encourage increased physical activity. Each participant received a pedometer and a walking log with over 62,000,000 steps recorded by the end of the contest. The Search Your Heart program, a cardiovascular disease curriculum developed by the American Heart/American Stroke Association, was implemented in fifteen African-American faith communities in the county to counter the high incidence of heart disease and diabetes in this minority population. The Alliance also provided collaborative assistance in preparing grant applications for the Teen Tobacco Prevention Initiative and the Health Disparities Initiative, both of which were funded by the NC Health and Wellness Trust Fund Commission.
Activities in 2007 include publication of a comprehensive community assessment with collaborating partners and preparation for re-certification as a Healthy Carolinians partnership scheduled for May, 2008. Already in 2007 the StepOne Challenge involved 1,178 individuals reporting 420,214,351 steps in the six-week long contest. Thirteen new churches were trained in the Search Your Heart curriculum and the Coach’s Clipboard program was instituted by the Cleveland County Asthma Coalition to educate coaches about successful asthma management.
The Alliance for Health represents a successful collaborative partnership in Cleveland County for several key reasons. First, all efforts are agency and community-driven. Second, actions are based on data and identified, measurable community needs. Third, the Alliance focuses on using natural champions. It is not the Alliance’s purpose to develop duplicative committees or coalitions to address issues. Rather, the Alliance asks two key questions prior to decision-making: “What’s the issue?’ Who is the boss, or natural champion?” If a champion can be identified as being the best home for a program or service to address a community health issue, the Alliance approach is to make the contact, offer technical assistance, and promote the program or service. Only if there is no natural champion will the Alliance create a new task force, committee or coalition to address a problem, thus reducing the potential for duplication of services. Finally, the Alliance has been successful due to the broad base of community partners who count themselves as members. Agency partners participate in five partner meetings annually; each meeting highlights the work of a partner and offers opportunities for agency sharing. The Alliance website now offers a calendar where agency partners can post their special events or programs in order to keep the whole community informed about the resources available in Cleveland County. The Alliance also offers training in board development and strategic planning to its partners as well as access to the on-line grant search capacity provided by the Foundation Center’s On-Line Directory.