North Carolina Health Policy Information Project

Funded Proposal

The Council on Health Policy Information, established by the Executive Order of the Governor of North Carolina, recognizes that state policy makers face the long-term challenge of constraining escalating health care costs while expanding access to basic are. The looming decisions will require the availability of increasingly comprehensive health data, analysis, and usable information. While North Carolina invests significant resources in the creation and maintenance of major health data systems, the decentralized nature of health policy contributes significantly to lost opportunities for creative links between important health data sets. The institutionalization of a proactive, cooperative health statistics system developed with the support of the Council and focused in the State Center for Health and Environmental Statistics is seen as the best long term strategy to enhance North Carolina's capacity to meet these policy needs.

The Council's assessment of critical health policy issues in North Carolina identified two specific initiatives for Phase II of the project: a) disparities in care and outcomes among mothers and children; and b) affordable and achievable long-term care. These two program areas offer achievable objectives within the lifespan of the project and an opportunity to demonstrate the value of health information within the policy process. Child health is one of three critical issues advanced by Governor James Hunt, elevating interest among legislators, state agencies, and the public. North Carolina continues to rank near the bottom on selected child health indicators. Issues in long term care have policy relevance because of the rapid growth of the elderly population and corresponding increases in health care expenditures.

The following Objectives and Strategies describe the activities for Phase II of the project:

Objective #1:

Enhance the dissemination and marketing of health care data for use in policy formulation.

Strategy #1:

Improve marketing and communication skills of the State Center for Health and Environmental Statistics and Council for Health Policy Information by hiring a marketing consultant to provide technical assistance and training.

Strategy #2:

Improve knowledge and awareness of the public policy value of child health and long-term care information by working with the legislatively established study commissions, councils, and study groups.

Strategy #3:

Improve the use of available health information in decision making through implementation of an Executive Information System (EIS).

Strategy #4:

Demonstrate the value of existing health data to health care consumers and the media through an enhanced information dissemination initiative.

Strategy #5:

Plan and implement a policy-oriented annual telephone survey of the noninstitutionalized population of North Carolina.

Objective #2:

Expand policy-relevant information on child health and long-term care.

Strategy #1:

Computerize and analyze the Kindergarten Health Assessment Form an link it with the longitudinal child health database (birth to school age).

Strategy #2:

Link existing North Carolina data related to Medicaid-financed health care including nursing home care, state financed domiciliary care, and social services and aging agenda.

Strategy #3:

Obtain and analyze in Years 2 and 3 relevant national data sets applicable to the long- term care population and market the findings to North Carolina policy makers and program managers.

Objective #3:

Continually review new state information needs for health policy development and program management and integrate this review into the State Center's strategic plan.

Strategy #1:

Pursue and extension of the Executive Order creating the Council from March 1994 to 1997, with statutory recognition to be sought for the 1995 session.

Strategy #2:

Conduct formal assessments of the adequacy of the data sets for health policy; explore opportunities for linkage of existing and anticipated health data sets; explore new/emerging technologies to address health data needs; and develop recommendations to create new data sets useful in formulating health policy.

The Council on Health Policy Information will function actively in Phase II in order to ensure the integration of data initiatives with the activities of policy and program agencies, and the continuation of long range planning efforts.

Structure and Size of the IWG:

Executive Ordered Interagency Work Group
2 Elected; 14 Executive Agencies; 3 Providers
10 Consumer/lnterest Organizations

Issues:

Long-Term Support
Maternal Child Health

Effected Data Systems:

Household Population (New)
Birth (Linkage)
Medicaid Data (Linkage)
School Associations (Linkage)

Dissemination:

Reports
Newsletter
Briefings
User Conference
Public Use Tapes

Electronic Products:

Public Use Tapes
E-Mail
User-Friendly Software
Executive Information System
Linkage Projects

Name of Project: Health Policy Information

Name and Title of Project Director:
Delton A. M.S.P.H, M.P.IFL, Director, State Center for Health and Environmental Statistics

Description of Structure and Process:
We believe that, by having the right information at the right time in the right format, state policy makers and managers will have an enhanced capability and likelihood to make better informed decisions. The State Center for Health and Environmental Statistics (SCHES) in the Department of Environment, Health, and Natural Resources (DEHNR) will provide the leadership for this agenda in Phase II of the Robert Wood Johnson project. The Council on Health Policy Information (CHPI) established in Phase I has identified the SCHES as the appropriate point of coordination for this effort within state government. The Council, an advisory body to the State Center, represents the range of interests and activities involved in the production and use of health data in North Carolina. In response to these interests, the SCHES will provide a vehicle for the improvements in coordination and cooperative efforts envisioned by the Council. This partnership provides the catalyst for enhancing the use of health data in the public policy process.

The Director of the State Center for Health and Environmental Statistics (Delton Atkinson, M.S.P.H., M.P.H.) will be the Project Director and the State Health Director (Ronald H. Levine, M.D., M.P.H.) will serve as Chairperson of the Council. SCHES, with its close organizational and programmatic relationship to the Office of the State Health Director, and a history of collaborative efforts with public and private organizations throughout the state, offers experienced staff, legislative authority, and administrative structure in support of this project. Proposed activities of Phase II will significantly enhance the ability of SCHES to carry out its existing mission.

Project staff and support for the Council will be housed within the State Center. A project management team, representing the Council, will work closely with the project director and staff in the implementation of project activities in Phase II.

Short-term and Long-term Policy Issues to be Addressed:
The Council recognizes that state policy makers face the long-term challenge of constraining escalating health care costs while expanding access to basic care. The looming decisions will require the availability of increasingly comprehensive health data, analysis, and useable information. The institutionalization of a proactive, cooperative health statistics system developed with the support of the Council and focused in the State Center is seen as the long-term strategy to enhance North Carolina's capacity to handle these policy needs.

The Council's assessment of near-term health policy issues in North Carolina identified two specific initiatives for Phase II of the project: a) disparities in care and outcomes among mothers and children; and b) affordable achievable long-term care. These two program areas offer achievable objectives within the lifespan of the project, an opportunity to demonstrate the value of health information within the policy process.

Child health is one of three critical issues advanced by our newly-elected Governor, elevating interest and legislators, state agencies and the public. North Carolina continues to rank near the bottom on selected child health indicators. Issues in long term care have policy relevance because of the rapid growth of the elderly population and corresponding increases in health care expenditures.

Plan For implementing Improvements:
The long-range goal is to enhance the use of health data in the policy process. Using child health and long-term care as pilot content areas, the following Phase II activities are planned:

• Marketing of all policy relevant health information to legislative study commissions, state agency consumer advocacy groups throughout North Carolina.
  
• Development of an Executive Health Information System for the electronic dissemination of select health information.
  
• Expansion of health information through the development of one component of a birth-to-school longitudinal file on each child in North Carolina.
  
• Implementation of a policy-oriented statewide health interview survey.
  
• Enhancement of long term care information by: a) computerizing and linking existing data b) synthesizing data from national studies; and c) developing recommendations on a minimum policy for all providers of long term care services in North Carolina.
  
• Training of Council, data users, and selected SCHES staff on tools and techniques for the product dissemination of policy-relevant information and on focused communication.

The Council will continue to function actively in Phase II in order to ensure the integration of data in with the activities of policy and program agencies, and the continuation of long-range planning efforts.

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