In 2012-13, the West Virginia Department of Health and Human Resources will take about $330,000 of the state's $1 million in federal and state diabetes money for salaries and services. The state plans to distribute about $700,000 to 14 projects that meet CDC guidelines.
There is no process for local groups to apply for any of those funds. Critics complain that the state funds the same projects year after year. "The state should help local people collaborate and pool their resources," said Pat White, who directs West Virginia Health Right, which serves 8,500 diabetics. "They could bring people together and give them examples of best practices and ideas about what they could do."
"The bottom line is, we need broad coordination of effort at the local level, with support and involvement from the state," said Krista Farley, director of health promotion for the Kanawha-Charleston Health Department. "We need to agree on a vision of where we're going so we can put the pieces in place and make every program play together."
"The school system's regional-wellness people could help," said Jorea Marple, state superintendent of schools. "I'd like to see them involved. We have a lot of children at risk of diabetes."
What are the local coalitions doing?
Of the 13 counties with diabetes coalitions, all but Hancock County have per capita incomes below state average. They all have too few diabetic services. They all express a sense of urgency.
With limited funds, each county is taking a different tack.
The Calhoun/Gilmer coalition has held "Help Yourself" classes in fire halls, senior centers, hospitals and clinics. "That's our big push now," said Barb McKown, outreach coordinator at Minnie Hamilton Health Center.
The Nicholas County group emphasizes Dining with Diabetes cooking classes, led by the WVU Extension Service. "We've taken cooking classes to remote areas and reached a lot of people who never had a chance for a class like that," said Jane Sherwood, of Friends R Fun health organization.
In Lincoln County, members run a summer FIT (Families in Touch) camp for children and parents and offer a free gym and aerobics class each weekday at Lincoln Primary Care. They want to create biking trails. "Maybe we can figure out how to do that at the July meeting," said Janet Sebert, coalition chairwoman.
Hundreds of Mingo County residents racked up thousands of miles in the coalition's walking program last year. They co-sponsored health fairs and a diabetes clinic and, with grant funding, will start a school physical activity program and rural outreach in the fall.
People in all counties say they need help. "We struggle to keep our coalition together. Our members have such full plates," said Nicholas County's Sherwood. "If we had somebody whose job was to facilitate coalitions, we could do a lot more."
Two coalitions are inactive. "The person who was spearheading ours moved," said Angel Green of Webster Memorial Hospital. "We could start up again if somebody else would do it."
If they were in Kentucky, they would have some resources. The statewide nonprofit Kentucky Diabetes Network has more than 200 member groups, including county coalitions. They hold annual meetings, produce a 16-page newsletter and mobilize hundreds to lobby the state Legislature when necessary.
"We're envious," said Richard Crespo, a Marshall University professor who helps organize coalitions.
Kentucky pays every local health department to offer diabetes self-management classes. Last year, Kentucky legislators put $3.4 million (77 cents a person) into diabetes care and prevention, compared to West Virginia's $108,000 (6 cents a person).
There's talk in West Virginia of a statewide coalition that could go after grants. Logan County plans to apply for private grants. "Funding possibilities go up when you've got a coalition," said Mingo County's Hatfield.
The new Hancock County coalition got a startup grant through the National Association of City and County Health Officials. Three months later, they're offering "Help Yourself" classes in two churches and one senior center.
"We're on a roll," said Jackie Huff, health department administrator. They're considering school programs, walking clubs and races, and a public-awareness campaign.
In Boone County, the health department, hospital and several agencies are working to create a business plan for a diabetes prevention/control program. "If we want a program that won't disappear when the grant money ends, we need a way to pay for it," said Julie Miller, health department administrator.
In 2010, about 29 percent of Boone fifth-graders had high blood pressure. About 45 percent were obese. "We've got to change that," Miller said. With federal funding being cut, she said, "joining forces just makes sense."
Reach Kate Long at 304-348-1798 or katel...@wvgazette.com. "The Shape We're In" was written with the help of the Dennis A. Hunt Fund for Health Journalism, administered by the California Endowment Health Journalism Fellowships at the University of Southern California's Annenberg School for Communication and Journalism.