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Kentucky Heart Disease and Stroke Prevention Program

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Kentucky Heart Disease and Stroke Prevention Program

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    1. Kentucky Heart Disease and Stroke Prevention Program February 20, 2009 William D. Hacker, MD, FAAP, CPE Commissioner Department for Public Health

    2. Cabinet for Health and Family Services

    3. Cabinet for Health and Family Services Prevalence of Heart Disease and Stroke 6.0% (250,300) of Kentucky adults had ever been told by a doctor that they had a heart attack or myocardial infarction 5.7% (237,800) of Kentucky adults had ever been told by doctor that they had coronary heart disease 3.5% (146,000) of Kentucky adults had ever been told by a doctor that they had a stroke

    4. Cabinet for Health and Family Services

    5. Cabinet for Health and Family Services

    6. Cabinet for Health and Family Services

    7. Cabinet for Health and Family Services

    8. Cabinet for Health and Family Services

    9. Cabinet for Health and Family Services

    10. Cabinet for Health and Family Services

    11. Cabinet for Health and Family Services Cardiovascular Disease Is Costly 2006 - heart disease and stroke related health care costs are projected at $400 billion in US 2004 - in Kentucky inpatient hospitalization costs for cardiovascular-related diagnoses was over $2.1 billion 2004 - in Kentucky inpatient hospitalization costs for stroke was over $230 million

    12. Cabinet for Health and Family Services A Public Health Issue Heart Disease is common, costly, and deadly, and poses a major public health problem

    13. Cabinet for Health and Family Services CDC Funding 1998 - Congress provided funding for CDC to initiate heart disease and stroke prevention programs in eight states, including Kentucky Currently, 41 states and the District of Columbia are funded 28 - Capacity Building programs 14 - Implementation programs

    14. Cabinet for Health and Family Services Capacity Building Goals Goal of Capacity Building Funding establish infrastructure focus is on systems level of change statewide approach Address CDC’s Six Priority Areas for Heart Disease and Stroke Increase control of high blood pressure Increase control of high blood cholesterol Increase knowledge of signs and symptoms for heart attack and stroke and the importance of calling 911 Improve emergency response Improve quality of heart disease and stroke care Eliminate health disparities in terms of race, ethnicity, gender, geography, or socio-economic status

    15. Cabinet for Health and Family Services Capacity Building Goals Collaborate with public and private sector partners Define the CVD burden and assess existing population–based strategies for heart disease and stroke prevention. Develop a comprehensive state plan for heart disease and stroke prevention by developing heart–healthy policies, changing physical and social environments, and eliminating disparities (e.g., those based on geography, gender, race or ethnicity, or income) Identify culturally appropriate approaches to promote cardiovascular health with racial, ethnic, and other priority populations. Increase awareness of the signs and symptoms of heart attack and stroke

    16. Cabinet for Health and Family Services Heart Disease and Stroke Prevention Program Kentucky Department for Public Health CDC “Capacity Building” grant Five-Year Grant Cycle Funded since 1998 at ~ $415,000 per year Award 2007-2012 at $340,000 per year (due to decrease in Federal dollars)

    17. Cabinet for Health and Family Services Heart Disease and Stroke Prevention Program Staff Two Full Time Employees Program Manager Program Coordinator One Part Time Employee Epidemiologist (vacant) Responsibilities Networking/Partnership Infrastructure Education and Awareness Facilitate/technical assistance re: Task Force

    18. Cabinet for Health and Family Services Heart Disease and Stroke Prevention Program Next level of CDC funding: “Basic Implementation” provides ~$1 million/year Requires a 1:5 state match Kentucky would have to appropriate ~$200,000 to apply

    19. Cabinet for Health and Family Services Heart Disease and Stroke Prevention Program Burden document published August, 2004 and is available on program website http://chfs.ky.gov/dph/mch/cd/cardiovascular.htm Task Force Established in June 2006 develop and strengthen infrastructure

    20. Cabinet for Health and Family Services Heart Disease and Stroke Prevention Task Force University of Louisville University of Kentucky Western Kentucky University American Heart Association/American Stroke Association Kentucky Board of Emergency Medical Services Kentucky Fire Commission Health Care Excel (QIO) Kentucky Medical Association Kentucky Hospital Association Primary Care Association Kentucky Department of Education Western Baptist Hospital Pikeville Medical Center St. Elizabeth Hospital AmeriHealth Mercy Cardinal Hill Rehabilitation Hospital Healthsouth Northern Kentucky Rehabilitation Hospital

    21. Cabinet for Health and Family Services Heart Disease and Stroke Prevention Task Force Strategic map developed in June 2006 Three Guiding Principles Reduce disparities, address high risk groups Strengthen surveillance and evaluation Develop sustainable collaborations and partnerships Five Tracks of Work/Subcommittees Evidence-based prevention strategies Community and site-based interventions Integrated CVH delivery systems Policy and legislative support Funding

    22. Cabinet for Health and Family Services Heart Disease and Stroke Prevention Task Force State plan to be developed from strategic map (draft due by June 2010) Video-conference meetings are scheduled on a quarterly basis to facilitate communication and increase member participation January 2009: 15 sites, ~100 people

    23. Cabinet for Health and Family Services Current Program Activities - Developed a Kentucky Stroke Registry by utilizing the Get With the Guidelines program The KY Stroke Encounter Quality Improvement Project (SEQIP) formed with 16 hospitals participating A training workshop was conducted February 3, 2009 with an “Action Plan” developed to address performance measurements Completing a statewide training needs assessment for Task Force members and licensed healthcare professionals Assessment available by June 2009 Develop a training plan to increase the capacity of staff and partners

    24. Cabinet for Health and Family Services Current Program Activities Heart Disease and Stroke Prevention Task Force Subcommittees -carry forward activities from the strategic map Community and Site Based Interventions Subcommittee conducted 6 regional partnership forums 2008 to formulate state’s top 5 priority issues 9 Regional Partnerships established Task Force membership increased from 64 to 201 activities Heart Disease and Stroke Prevention presentation added to KMA website In process of developing in conjunction with KMA a provider toolkit (“Know Your Numbers”)

    25. Cabinet for Health and Family Services Current Program Activities Will publish a State plan by June 2010: that uses burden and assessment findings; addresses prevention of heart disease and stroke; proposes policy and systems changes; identifies how progress toward successful achievement will be evaluated; documents partner involvement in planning and implementation

    26. Cabinet for Health and Family Services Current Program Activities Conduct by June 2010 an evaluation of the Task Force, including partner satisfaction, commitment and involvement, infrastructure and functioning, effectiveness and outcomes, and sustainability Partnering with Northern KY Women’s Care Collaborative Project (Blood Pressure Awareness Campaign) Northern KY Women’s Care Collaborative is a federally funded project DHHS/Office on Women’s Health Stroke Systems of Care Applied for additional funding for FY2010 Telemedicine as a Health Solution

    27. Cabinet for Health and Family Services

    28. Cabinet for Health and Family Services

    29. Cabinet for Health and Family Services Heart Disease and Stroke Prevention Program Appalachian CVH Summit (May 2-4, 2007) Hosted by American Heart Association and the West Virginia Heart Disease and Stroke Prevention Program Representatives from all 13 states The Appalachian Cardiovascular Health Network   Will focus on the disproportionate burden of CVD in the region, foster capacity building to affect Appalachian-specific needs, and result in development and sharing of best practices  Appropriate funding and resources (i.e. staff and website) will be pursued to assist in the creation of during a one year time period Kentucky volunteered to serve on the leadership council WV lost their funding and this program is on hold for now

    30. Cabinet for Health and Family Services Progress Standardized training for EMS/first responders on National Stroke Association’s Stroke Rapid Response through Kentucky Fire Commission, Kentucky EMS educational systems and SEQIP Hospitals Online (TRAIN) Education module for firefighters (heart attack is number one cause of firefighter death’s in KY) Worked with the Obesity Program and the Kentucky Chamber of Commerce Worksite Wellness Resource Guide – a business toolkit

    31. Cabinet for Health and Family Services Progress 6 Regional Partnership forums were conducted in 2008 to garner buy-in from stakeholders for the Kentucky Heart Disease and Stroke Prevention Task Force 9 Regional Partnerships formed in 2008 2 additional Regional Partnerships are forming in 2009

    32. Cabinet for Health and Family Services Progress Kentucky Board of EMS endorsed development of statewide stroke protocols and standardized training for EMS professionals Kentucky Stroke Registry – Stroke Encounter Quality Improvement Project (SEQIP) Telemedicine grant pending Task force partnership/membership increased to 215 (February 2009)

    33. Cabinet for Health and Family Services

    34. Cabinet for Health and Family Services Questions & Answers Contact Info: Bonita A. Bobo, RN, IBCLC Program Manager 502-564-7996 bonitaa.bobo@ky.gov Mary Fegenbush, RN Program Coordinator 502-564-7996 mary.fegenbush@ky.gov

    35. Cabinet for Health and Family Services

    36. Cabinet for Health and Family Services HDSPP: Epidemiology Data Sources Behavioral Risk Factor Surveillance System (BRFSS) 6 modules: prevalence, hypertension, cholesterol, control of HBP, signs and symptoms of HA and stroke Risk factors: blood pressure, blood cholesterol, tobacco use, diabetes, obesity, low physical activity, poor diet Hospital Inpatient Discharge Database Vital Statistics (Mortality) HEDIS (Health Plan Employer Data Information Set) Medicaid

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