External Leadership Team Meeting Minutes January 27th 2014

Healthy South Carolina Initiative
External Leadership Team (ELT) Meeting- January 27, 2014
ELT Members in attendance: Dr. Graham Adams, Dr. Christine Beyer, Dr. Marion Burton,
Mr. Stephen Creech, Dr. Rick Foster, Dr. Saundra Glover, Ms. Cheryl Johnson Benjamin,
Dr. Anna Scheyett, Dr. Myriam Torres, Mr. Ryan Wilson, Ms. Judy Verona and Dr. Vicki
Young (for Ms. Lathran Woodard)
ELT Members not in attendance: Mr. Jim Headley, Dr. Todd Thornburg
Other attendees: Ms. Virginie Daguise, Mr. Jay Daniels, Mr. Rob Davis, Dr. Brent Egan,
Mr. Louis Eubank, Ms. Beth Franco, Ms. Barbara Grice, Ms. Michelle Harris, Ms. Shauna
Hicks, Ms. Marlo Koger-Thomas, Mr. Joe Kyle, Ms. Lauren Neely, Dr. Lee Pearson, Dr. Andy
Pope, Ms. Allison Rapp, Ms. Shaena Rouse, Dr. Lillian Smith, Ms. Lavell Thornton, Dr. John
Ureda and Dr. Megan Weis
The meeting began shortly after 9:30 a.m. with a welcome and introductions led by Dr. Lee
Pearson with the South Carolina Institute of Medicine and Public Health (IMPH). Dr. Pearson
introduced Dr. Christine Beyer as the newest member of the ELT, representing the South
Carolina Department of Education. Responding to Dr. Pearson’s request for updates, Ms. Beth
Franco, the new executive director for Eat Smart, Move More South Carolina, shared that her
organization had received a grant addressing the new USDA guidelines to implement smart
snacks in schools. The “Voices for Healthy Kids” grant was awarded by the American Heart
Association and the Robert Wood Johnson Foundation.
Dr. Pearson then introduced Mr. Jay Daniels from DHEC to present community success stories.
Mr. Daniels highlighted efforts from Beaufort, Jasper, Chester, Spartanburg, Greenville,
Orangeburg, Calhoun, Goose Creek, the Trident (Charleston) area, Fairfield and Richland. Mr.
Daniels was asked about considerations of having rural groups apply for grants themselves,
rather than metropolitan organizations receiving the funds to go out and do work in the rural
communities. In addition, a number of questions arose around the composition of community
partnerships in a number of the featured communities. Ms. Cheryl Johnson Benjamin from the
United Way of the Midlands was able to address a number of these concerns as the United Way
is involved with many of the efforts. Members of the ELT expressed an interest in further
understanding the community groups that make up the partnerships. ELT members want to
ensure that funding is distributed to groups that were not necessarily funded in the past and that
funds are truly being directed to the communities, not just groups at a higher organizational level
that would work with the communities. Dr. Saundra Glover asked specifically about baseline
information regarding Chester County and (given the online aspects of the project), if disparities
are adequately addressed.
Dr. Glover expressed interest in going into the community to speak with the grantees and ensure
that their voices are being heard. Dr. Graham Adams shared the concern that communities are
feeling over studied and a need to streamline the community approaches. Dr. Lillian Smith
asked the group to think about coordination across the state at the upper level. She highlighted
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the lack of a state health improvement plan and the need to remember that we are an
implementation state and that we should focus on what we want our legacy to be. Dr. John
Ureda described the complexity of community engagement, expressing that communities don’t
often come together to plan because they have done it so much in the past. He shared a concern
that too often a top-down approach is administered in community work and there is a need to
find community leaders in order to ensure sustainability. Mr. Kyle added that as resources
change, efforts need to be aligned. He expressed that community engagement is a continuous
process and quality improvement is a part of this process. Dr. Glover reiterated the importance
of identifying and ensuring sustainability of the work regardless of the availability of funding.
Dr. Ureda added a concern around the distribution of funds to the city level and that funds may
not be reaching the areas outside of city limits and into the rural areas. Ms. Franco announced
that Eat Smart Move More South Carolina is looking to hold four regional trainings this year and
one of the goals will be to connect the local coalitions to businesses and foundations in order to
provide sustainability. Dr. Rick Foster expressed the need for defined measures and a challenge
that grass-tops often don’t stay around when the community is involved. Dr. Anna Scheyett
made a request to look at building the capacity of young leaders as a form of ensuring
sustainability. Dr. Smith explained how the Arnold School of Public Health is already working
on this through service learning projects and mentoring. Dr. Scheyett and Dr. Smith agreed to
further discuss collaborating on this specific issue.
Dr. Pearson then transitioned the conversation to feedback received via the ELT and ILT surveys
and how that information has led to adjustments in meeting frequency and format. He shared
that the survey results highlighted a need to better align initiatives and focus on sustainability.
He added a clear desire of both groups to meet less, but do more. As a result, the ELT will move
to quarterly meetings for 2014. In response to the more substantive feedback about the need for
greater focus and action, the idea of a “mid-point summit” was proposed. Given that the Healthy
SC Initiative (funded through the 5-year Community Transformation Grant) is nearing the midpoint of its funding timeline (October 2011 through September 2016), the summit would provide
an opportunity for ELT and ILT members to come together with community representatives and
others to share successes, harvest lessons learned and discuss strategic steps needed to ensure the
goals of the initiative are achieved. With the support of DHEC and the positive responses of the
group, the Mid-Point Summit will be planned for Monday, April 14th. A brief planning survey
will be sent to the group by IMPH to gather input for the summit agenda. (This event will serve
as the next meeting of the ELT.)
The discussion then transitioned to the topic of the one-time funding opportunity introduced at
the previous ELT meeting. As a lead in to that discussion, Mr. Kyle informed the group that the
current federal budget does not include a specific line-item for the Community Transformation
Grants. Mr. Kyle explained that additional funds were, however, allocated for chronic disease
prevention consistent with the goals of HSCI and that those funds may allow for continued
support of the work of HSCI in the absence of a Community Transformation Grant line-item.
While the exact implications of the budgetary change are currently unknown, Mr. Kyle agreed to
keep the group informed as he learns new information.
As the meeting moved to the one-time funding discussion, Ms. Barbara Grice indicated that all
groups that submitted a proposal for the funding would have an opportunity to share the details
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of their proposal during the strategic discussion period. Dr. Myriam Torres with the Consortium
for Latino Immigration Studies led the presenters and shared her proposal that included
developing a community health worker curriculum in partnership with the Office of Public
Health Practice and developing a cultural competency training in partnership with the Office of
Minority Health, both focusing on the Latino community. Ms. Benjamin asked about the design
of the classes, and Dr. Torres explained that core competencies and a defined infrastructure
would be established. Dr. Ureda asked if funding would support the salaries of the promotores
(Latino community health workers). Dr. Torres explained that the promotores are volunteers
who occasionally receive incentives when they are available. Dr. Marion Burton added that
community health workers are now being paid through Medicaid. One particular challenge is
that these workers are so busy in the practices that they are not able to get into the communities.
Dr. Torres expressed that the programs she is proposing would comply with the community
health worker curriculum currently under development within the Department of Health and
Human Services. The difference is that Dr. Torres’s work would be tailored for the Latino
community.
Mr. Louis Eubank then provided a brief summary of the South Carolina Tobacco-Free
Collaborative’s (SCTFC) funding proposal to pursue the next phase of the LGBT intervention
shared with the ELT at earlier meetings. Previously, SCTFC conducted a health assessment
survey with LGBT individuals. The next phase would include outreach and follow-up from the
survey in partnership with Rescue Social Change. Mr. Ryan Wilson with SC Equality then
offered a synopsis of their proposal to provide cultural competency training to currently funded
communities, with a focus on LGBT issues. Dr. Graham Adams asked Mr. Wilson how training
around LGBT would be addressed with faith groups that were funded and that may be hesitant to
discuss the topic. Mr. Wilson stated that the training would be optional but highly encouraged.
The group agreed that with both Mr. Wilson and Dr. Torres’s interests in developing trainings
for cultural competency, further discussion and possible integration of these ideas is needed. Ms.
Shaena Rouse shared that a cultural competency tool exists within DHEC and should be
considered as a part of such a discussion.
On behalf of the Care Coordination Institute (CCI), Dr. Brent Egan shared details from their
proposal to implement a Bluetooth blood pressure monitoring system in addition to providing
affordable access to prescriptions by partnering with BI-LO supermarkets. The funding request
is to support the infrastructure of this pilot endeavor. Dr. Egan explained that about 200-400
patients would be served through this investment which would also evaluate the feasibility of
expanding the reach in the future. Mr. Kyle raised the question of the ability to fund this
initiative as an environmental change strategy or if it is considered a stand-alone intervention.
Dr. Egan responded that by creating a successful model for blood pressure management, insurers
and the government may ultimately step in to fund broader implementation in the future. Mr.
Rob Davis explained that the intervention would target the most expensive patients. He added
that CCI was charged with reducing cardiovascular events in South Carolina and this is the
method they are confident will work. Dr. Ureda asked how this proposal addresses the
community. Dr. Egan responded that ultimately this would be available in every community in
the state and that the approach complements public health strategies.
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Ms. Lauren Neely then summarized Eat Smart, Move More South Carolina’s proposal to provide
funding for HYPE teams to engage in a summer institute. She explained that youth groups are
finding difficulty in allocating adequate time during the school year and would benefit from a
concentrated summer program. HYPE groups are made up of existing youth groups that are
provided education and mentoring so they can advocate for policy, systems and environmental
change concerning obesity prevention. Groups are chosen from rural areas of the state with high
minority rates.
At this point Dr. Pearson asked the group how they would like to proceed with the funding
recommendations. Ms. Benjamin expressed confusion over discussions around the proposals
concerning cultural competency trainings and elements of the HYPE proposal. Dr. Foster
commented on the programmatic approach of the CCI proposal and questioned the sustainability.
He praised the work of all the partners and asked if there was enough money to fund all the
proposals. Mr. Kyle stated that funding is potentially available for all proposals based on the
modified funding requests (note: the total of the available one-time funding is $350,000).
Several ELT members expressed concerns about how the funding decisions will ultimately be
made, and Ms. Grice suggested getting a group together to finalize the decisions. Mr. Kyle
stated the desire to remain transparent in the process and agreed to have summaries of the
proposals sent to the ELT members. Mr. Kyle and Ms. Grice noted that additional proposals
from the Working Well initiative and the Healthy Columbia campaign would be discussed in a
follow-up meeting with Dr. Foster (which had been previously scheduled). Mr. Kyle noted that
those proposals were also included in the available funding estimates.
As Dr. Pearson concluded the meeting, Ms. Michelle Harris provided copies of the inaugural
HSCI Newsletter, which she developed. Participants were thanked for their time and support of
the Healthy South Carolina Initiative.
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