United States Disease Prevention Program
Flexible Funding for Wisconsin's Public Health Programs
The federal Preventive Health and Health Services (PHHS) Block Grant provides funding to address health problems, prevent diseases and promote health in Wisconsin. In 2014, Wisconsin received approximately $3 million through this grant to fund health programs statewide.
PHHS Block Grant funds enable Wisconsin to provide flexible funding to address the highest priority health issues in communities. Funds are provided to the State's 87 local health departments and 11 tribal health agencies.
The PHHS Block Grant supports capacity building and core service development in various areas. Prevention funds can augment limited categorical program funds at the state or local level.
Agencies in Wisconsin collaborate with hospitals, private providers, school, universities, and local and state government agencies in identifying and implementing evidenced based interventions in their communities. Evaluation of efforts are measured and reported to their communities. Coalitions are developed and strategies to sustain efforts are identified.
The Division of Public Health (DPH) focuses its infrastructure development activities in the following dimensions:
- Modeling collaborative leadership and policy development.
- Assuring fiscal and administrative integrity through monitoring of state and local public health programs and services.
- Providing data, information, and epidemiological support to guide policy development.
- Developing and enhancing state and local partnerships.
- Providing programmatic expertise through consultation, training, and technical assistance to local programs and services.
- Ensuring evidence-based or promising practice.
- Educating state, regional, and local partners concerning public health system development.
- With local health departments (lhds), developing measurable community-level objectives to demonstrate health improvement progress.
- Providing on-site technical assistance to assure local community health improvement plans which link to the state plan.
To support effective and efficient operation of the public health system in Wisconsin and success of local and tribal agencies in meeting state and national standards four core functions of DPH, and specifically the teams working in the five regions of the state, have been defined. They are:
- Assure consistent and accountable public health services in local government.
- Provide leadership in the development of public health system capacity.
- Link the work of the Department of Health Services and local, tribal and state public health system partners.
- Monitor, analyze, plan, and facilitate a response to regional issues, conditions, events, and emergencies.
In 2013, Wisconsin agencies used Preventive Health and Health Services (PHHS) Block Grant Funds to address Healthiest Wisconsin Focus Areas, including Access to High Quality Health Care, Alcohol and Other Drug Use, Environmental Health, Injury Prevention, Mental Health, Nutrition and Physical Activity, Oral Health, and Tobacco Control. Additional PHHS Block Grant Funds were used to conduct community health improvement (assessments and plans), and Public Health Accreditation (assessment, quality improvement, strategic planning, and performance management).
Four Wisconsin agencies implemented evidenced based interventions to improve access for reproductive health services, medical homes, oral health services, and tuberculosis.
Why is this Important?
To ensure the health and economic security of Wisconsin’s families, everyone needs access to affordable and high-quality health services, regardless of health, employment, financial or family status. Improving the access, safety, and effectiveness of care is a national priority. A medical home, clinic, or practice coordinating care could improve health for many, given the complexity of health care.
Assuring access to affordable health services and a medical home with an adequate supply of well-prepared practitioners in all health care settings is a vital step in reducing disparities and keeping all residents healthy, independent, and productive.
Ten Wisconsin agencies implemented evidenced based interventions to educate, children and adults including Drug Abuse Resistance Education (DARE), alcohol compliance checks, Parent who Host, Lose the Most campaigns, alcohol density ordinances, and reduce under age access to alcohol at community festivals and organizers.
Why is this Important?
Alcohol-related deaths are the fourth leading cause of death in Wisconsin. While most people in Wisconsin drink responsibly, safely and legally, Wisconsin ranks at or near the top among states in heavy alcohol drinking. Consequences of alcohol or drug abuse include motor vehicle and other injuries; fetal alcohol spectrum disorder and other childhood disorders; alcohol- and drug-dependence; liver, brain, heart and other diseases; infections; family problems; and both nonviolent and violent crimes.
Sixteen Wisconsin agencies implemented evidenced based interventions to prioritize health issues and develop a community health plan. Health focus areas identified include access to care, alcohol and other drug abuse, chronic disease prevention, health growth and development, healthy living, nutrition and physical activity, injury and violence prevention, and mental health and suicide prevention,
Since 1993, Wisconsin State Statutes have required communities throughout Wisconsin to develop and implement local health plans to address health conditions impacting their residents. This process has been referred to as the “Community Health Improvement Process”; named in part, due to the resulting health status changes in a community and the people who live there.
Twelve Wisconsin agencies implemented evidenced based interventions to assure their communities are environmentally safe. These include human health hazard abatement, asbestos abatement, animal bites/scratches, issues from flooding, assuring safe water in private water supplies, sand mining for hydraulic fracturing, asbestos abatement, lead hazard abatement, swimming beach surveillance, indoor air and outdoor air issues, and West Nile Virus surveillance.
Why is this Important?
Human health is affected in countless ways by the physical environments where we live and work, and by the quality of air, water, and food. Foodborne illness remains a major cause of health problems and economic disruption. Major disparities in health conditions such as childhood lead poisoning and asthma result from inequities in the quality of home and neighborhood environments. Hazards are reduced through engineering, regulation, safe work practices and other methods. Increasingly, issues related to pollution, lack of physical activity, climate and injury are being addressed through comprehensive improvements to community design.
Nine Wisconsin agencies implemented evidenced based interventions to address animal bites/scratches, wheeled safety, child passenger seats safety, CPR, falls prevention workshops for seniors (increasing physical activity and vitamin D supplementation), and seat belt use.
Why is this important?
Injuries are the leading cause of death in Wisconsin residents 1-44 years of age, and are a significant cause of morbidity and mortality at all ages. The majority of these deaths are preventable. Each year, injury accounts for about 50,268 Hospitalizations and 448,213 Emergency Room Visits. The average yearly expenditure for injury related medical costs is $618,804,452.
Six Wisconsin agencies implemented evidenced based interventions including Child Death Review, community mental health issues, mental health assessment, mental health community guides, and suicide prevention training.
Why is this important?
Approximately 20 percent of the population experiences a mental health problem during a one-year period (Robins and Regier, 1991). Mental health issues are also associated with physical health problems and risk factors such as smoking, physical inactivity, obesity and substance abuse; factors that can lead to chronic disease, injury and disability.
Thirteen Wisconsin agencies implemented evidenced based interventions including fluoride sealants, dental hygienist services for exams, dental cleanings, and fluoride varnishes, referrals to Federally Qualified Healthcare Centers, and targeting children with no dental insurance or no dental provider.
Oral health means being free of mouth pain, tooth decay, tooth loss, oral and throat cancer, birth defects and other diseases that affect the mouth. Many diseases can start with oral symptoms, and many diseases beginning in the mouth can affect health in other parts of the body. Wisconsin experiences shortages of access for dental and other oral health services, particularly for people receiving BadgerCare or lacking insurance coverage for oral health services.
Twenty-six Wisconsin agencies implemented evidenced based interventions. For healthy foods and nutrition these include diabetes education and prevention, increasing access to fresh fruits and vegetables, promoting and supporting local food pantries, community gardens, and farmers markets, weight management support, decreasing childhood obesity in 2-4 year old and weight management for pregnant women and promoting and implementing strategies from The Wisconsin Nutrition, Physical Activity and Obesity Program. For physical activity these include promoting walking and biking by expanding existing and creating new walking and bike paths, developing and promoting bike/run/walk events, expanding after school physical activity options and after school programming, implementing summer youth camp activities
Physical activity is a preventive factor for many adverse health conditions, such as heart disease, stroke, high blood cholesterol, depression, and bone and joint disease. Changes in community design can encourage increased physical activity. Adequate, appropriate, and safe nutrition is a cornerstone for preventing chronic disease and promoting vibrant health.
Diet in childhood, including breastfeeding, is especially important to maintaining appropriate weight. One key issue for this focus area is food security, or assured access to enough food to lead an active and healthy life. Ten percent of Wisconsin households are food insecure (Nord, Andrews, and Carlson, 2009).
Three Wisconsin agencies implemented evidenced based interventions to address the use of tobacco including retailer education, coordinating training with law enforcement and a community representatives, tobacco restrictions in city beaches and parks, and assuring residents have access to smoking cessation.
Nearly 7,000 people die annually from illnesses directly related to smoking and approximately 751 die from illnesses and fires indirectly related to smoking, for a total of 7,717 annual deaths in Wisconsin. Tobacco use also costs Wisconsin approximately $4.5 billion annually in health care expenses and lost productivity.
Twenty Wisconsin agencies identified strategies to improve their capacity in becoming accreditation ready or to become accredited. These included conducting self-assessment for accreditation readiness, identify/improve tools for accreditation evidence, develop quality improvement programs, develop strategic plans and performance management plans, and revise and develop public health policies and procedures.
Public health department accreditation standards address the array of public health functions set forth in the ten Essential Public Health Services. They also address a range of core public health programs and activities including, environmental health, health education, health promotion, community health, chronic disease prevention and control, communicable infectious disease, injury prevention, maternal and child health, public health emergency preparedness, access to clinical services, public health laboratory services, management /administration, and governance.
Thus, public health department accreditation gives reasonable assurance of the range of public health services that a health department should provide. The standards refer to this broad range of work as health department processes, programs, and interventions. (Source: Public Health Accreditation Board Standards and Measures Version 1.0)
Prevention Block Grant Funds for Sexual Assault Prevention are sub-contracted to the Wisconsin Coalition Against Sexual Assault (WCASA), a statewide organization created and incorporated in 1985 to support and complement the work of Wisconsin’s community-based sexual assault service provider programs and other organizations working to end sexual violence. WCASA is the state’s central clearinghouse on the issue of sexual violence and related topics. WCASA staff work statewide to address all facets of sexual violence, from public attitudes and awareness, to effective intervention and to public policy. WCASA’s mission is to create the social change necessary to end sexual violence.
This project is focused on outreach, prevention, education and services to communities identified in Wisconsin who are traditionally under-served and often over-represented. In addition, this project will support efforts to increase knowledge and skills with teens and adults related to teen dating and sexual violence through a Teen Summit.
For more information, visit Wisconsin's local health departments and tribal health agencies.
For more information about funding to local and tribal health departments, visit the Centers for Disease Control and Prevention.
For more information about the PHHS Block Grant in Wisconsin, contact:
Angela Nimsgern, Northern Regional Office
Wisconsin Division of Public Health
2187 N. Stevens Street, Suite C
Rhinelander, WI 54501