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Fourteen state-level partnerships and 41 communities and tribal jurisdictions received two- to three-year grants in 1998 through the original Turning Point grant program. In 1999, seven additional statewide efforts received grant support from RWJF. States, tribes, and communities formed broad-based, innovative partnerships to identify, analyze, and address challenges facing public health system improvement. In addition to spearheading their respective public health systems' improvement processes, state partnerships and their participating tribal and community counterparts worked together on a statewide basis to align and develop recommendations for policy and systems change.

The community/tribal component of the initiative ended in 2002, and the state-level partnerships completed their work in 2006.