After rejecting state health dollars in 2013, Anoka County reconsiders

Two years after two Anoka County commissioners spearheaded the county's rejection of more than $1 million in state public health aid, arguing that it paid for feel-good, do-little programs, the county is back to pursuing those dollars.

This time, commissioners say they've figured out a better way to spend Statewide Health Improvement Program (SHIP) money.

In 2013-14, Anoka was the only Minnesota county to reject SHIP money earmarked to fight obesity and smoking, after having received it since 2009. The county's Human Services Committee declined to reapply for it, an effort led by commissioners Rhonda Sivarajah and Julie Braastad.

"It seemed like a lot of window dressing — the fancy brochures, the trinkets and pedometers. I don't think that is what changes behaviors," said Sivarajah.

Anoka County now will limit the amount spent on new county health staff and brochures extolling healthy eating, exercise and the dangers of smoking, and instead funnel dollars into existing nonprofits, homeless shelters, foster homes, schools and senior center lunch programs.

These programs already serve meals and can incorporate healthy eating messages and education into their missions, the county said. The new approach calls for one new staff position; the old plan called for as many as five.

"These community programs have credibility and established clientele and established reputations," said county spokeswoman Martha Weaver.

In 2013-14, commissioners had questioned spending to pay for public health staff to observe children on playgrounds and determine what barriers they faced. It also was to have sent county staff into schools to help school nurses revamp wellness programs, which commissioners viewed as unnecessary.

The new strategy is more action-oriented, Sivarajah said.

"We took a lot of time to really identify what some of the community wants and needs were," she said. "How can we target those resources in the best way possible to leverage some of the expertise already out in the community?"

A state public health official had bristled at past criticism, pointing out that Anoka County has the highest rate of smoking in the metro area. Anoka County Commissioner Jim Kordiak also expressed displeasure with his colleagues' decision to leave SHIP in 2013, especially since they could have tailored how that money was spent.

"We did have the ability to make changes in the old grant," said Kordiak, pointing out that his colleagues could have removed the offending pedometer distribution and kept the rest of the program. "There was a political undertone to that discussion. I tend to be more liberal on social issues, and some people tend to be more conservative."

Columbia Heights schools had used SHIP money to build and staff Blooming Heights, a garden educators called an edible classroom where more than 800 students studied biology, nutrition and cooking, history and even math. The children run a weekly roadside produce stand.

The sudden loss of SHIP dollars sent the district scrambling to save the program.

"It was really hard," said Nicole Halabi, student services director for Columbia Heights schools.

Halabi said the garden does have a direct impact on community health. "Our kids are certainly eating healthier. They are consuming the produce," she said.

"There is a ripple effect. We donate a lot of produce to the Southern Anoka County Assistance food shelf."

"We decided to concentrate on specific schools that have the highest need," Braastad said.

Legislators created the SHIP program in 2008 with the aim of improving health and containing health care costs. Local health boards tailor their approach by selecting from a "menu of strategies." From 2009 to 2015, Minnesota has spent $97 million on SHIP statewide.

According to state health data, nearly 26 percent of adult Minnesotans are obese and 14.4 percent smoke. State health officials say SHIP efforts are responsible in part for a 2 percent decline in smoking since 2010 and a leveling-off of obesity rates.

Sivarajah said she's satisfied with the new Anoka County plan, which tentatively partners with University of Minnesota Extension, the nonprofit Lee Carlson Center for Mental Health and Well-Being, Stepping Stone Emergency Housing, the Hope 4 Youth homeless shelter and the North Anoka County Emergency Food Shelf.

Sivarajah, who was running for the Sixth District congressional seated vacated by Michele Bachmann in 2013, said politics played no role her 2013 decision.