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© 2010. National Council on Aging A non-profit service and advocacy organization
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Improving the lives of older Americans
State Strategies for Developing a Sustainable Distribution and Delivery System
AoA Resource Center Webinar December 14 and 15, 2010
© 2010. National Council on Aging A non-profit service and advocacy organization
Agenda
Welcome
AoA vision/introduction (Lori Gerhard and Jane Tilly)
Massachusetts: Health Policy Forum – raising the visibility,
building a state coalition (Ruth Palombo and Anita Albright)
Maryland: Using Affordable Care Act funding opportunities
with the MIPPA, Options Counseling, Money Follows the
Person and Care Transitions options to recruitment
participants (Judy Simon and Donna Smith)
Wisconsin: Institute for Healthy Aging – legislation and
proposed funding support for statewide program
implementation (Gail Schwersenska and Anne Hvizdak)
Q &A
Recovery Act CDSMP
Grant Vision
$27 million to 45 states, DC and PR
• 50,000 “completers”
• Evidence- Based Prevention Program Distribution & Delivery Systems to assure easy access (like meds)
• State level partnership between aging, public health, Medicaid
• Focus on underserved
Evidence Based Prevention Program
Distribution & Delivery System
Components
Leadership
Public Education/Awareness
Infrastructure Capacity Building
Enrollment/Registration
Resource Coordination
Quality Assurance
Accounting/Financial
Project Management Data Collection & Reporting
System
Key Principles
Be Proactive and Strategic:
• Assure that programs as available as meds
• Think Global/Act Local — Build the system
and serve 50,000 people
Build with Sustainability in mind — Workforce, Organizations, Financial
Create a different future — EBPs
embedded in multiple agencies/ coordinated,
integrated person-centered systems
8
Ingredients of Healthy Aging
Healthy Aging, Seniors will ….
Be socially engaged
Be physically active
Lead meaningful lives
Be pro-active about health
Feel safe and secure
Have good diets
And….Communities
will support older adults to achieve these goals
10
Healthy Aging in the Commonwealth:
Pathways to Lifelong Wellness
December 14, 2009
300+ in attendance
Wide range of agencies and interests
Extended support for HA:
- Steering Committee
- Second Forum and Issue Brief
Resulted in establishing a Healthy Aging
Steering Committee
11
Steering Committee
Composition:
State agency staff
Health and aging services providers
Advocates
Researchers/academics
Conveners: Tufts Health Plan Foundation
and Brandeis University – Heller School of
Management and Policy
12
Steering Committee Focus
1. Generated ideas about key elements of a
HA strategy
2. Determined actions on elements
3. Decided on Core & Cross-cutting elements
4. Planned subcommittees
5. Identified 2nd forum speakers for Core and
Cross Cutting Elements
15
Massachusetts as a Model for
Healthy Aging
September 27, 2010
Presented Issue Brief on work of committee
Summarized the work and the discussions
Included all ideas put forth by committee
No decisions made on a coordinated strategy
No decisions made on the details
Introduced concept of subcommittees/core elements
16
Organizational Structure
Healthy
Aging
Steering
Committee
Public Awareness
Subcommittee
Healthy Aging
Communities
Subcommittee
Healthy Aging
Programs
Subcommittee
17
General Purposes of
Subcommittees
Develop plans for strengthening HA programming in the area
Account for the related work by state and local government, providers, advocates, & others
Interface with the other sub-committees
Address systems linkages, evaluation, older adult engagement, & leadership
Be politically & financially feasible & sustainable
18
Public Awareness Subcommittee
Improve images of older adults
Raise awareness of benefits of physical
activity and social involvement
Integrate public awareness campaigns
with programs, services and activities
being offered
Consider a broad range of traditional and
alternate media
19
Healthy Aging Programs
Subcommittee
Disseminate HA programs statewide
Increase outreach to all groups
Sustain funding
Ensure fidelity
20
HA Communities Subcommittee
Build a blueprint for a community that supports HA
Develop plans for pilot projects that build HA into the
fabric of local communities
Create a plan to select pilot cities and towns
Include a list of potential project partners
21
Future Opportunities
Health Care Reform
Long Term Services and Supports
Care Transitions
Healthy Communities
22
Massachusetts’ State Leads
Ruth Palombo Assistant Secretary for Program Planning and Management
Massachusetts Executive Office of Elder Affairs
Anita Albright Director of the Office on Healthy Aging and Disability
Massachusetts Department of Public Health
I. Overview of the CDSMP Program in Maryland
II. Affordable Care Act Initiatives:
ADRCs & Related Programs
Senior Health Insurance Assistance Program (SHIP)
III. ACA Synergy with CDSMP
T-trainers (3)
Master Trainers (90)
Lay Leaders (225)
Participants (2500)
CDSMP
DSMP
Other EB:
PSMP
Enhance Fitness
MOB
AF
State Partners Department of Health and Mental Hygiene – Health
Promotion, Chronic Disease Prevention, Mental Health
Universities & Foundations
Hospitals & Clinics
Insurance Companies and Medicaid Office
Trainers and Participants
Local Partners AAA’s
Local Health Departments
Hospitals, Doctor’s Offices & Clinics
Religious and Community Organizations
Community Colleges
National initiative under AoA and CMS
Maryland Access Point (MAP) in Maryland
National and State goals: Develop trusted single-point-of entry or no-wrong-door
access to long term supports and services information, programs and providers
Funnel new grants and efforts for diversion from institutional care through and ADRC infrastructure-thus the connection with Living Well
Community Providers
CILs
Advocacy Groups
Institutional Providers
P & A
Medicaid
Disability-Specific
Organizations
County Government
Federal Programs
Aging & Disability
Resource Center
State partners: Maryland Departments of Disabilities
Human Resources
Veterans Affairs
Health and Mental Hygiene - Medicaid Agency
Local partners: Area Agencies on Aging
Centers for Independent Living
Local Health and Social Services Departments
Statewide web-based searchable data base www.marylandaccesspoint.info
Options Counseling Community Living
Guided Care Nurse Veterans
Person-Centered Hospital Discharge
Money Follows Person
Web-based Searchable Database
Waiver
WHO IT SERVES
Medicare beneficiaries of all ages, older adults without Medicare coverage, and their caregivers
(SHIP) MIPPA/ACA Mandate
Collaboration with Maryland’s ADRCs & ADRC website
Promotion and Enrollment in Medicare Part D "Extra Help" Program and Medicare Savings Programs (QMB/SLMB/QI)
Medicare Benefits and Preventive Services
Maryland’s Senior Prescription Assistance Program
State partners: Maryland Departments of Disabilities and Insurance
Administration
Maryland Medical Assistance Buy-In Program
Social Security Administration
National Councils on Aging
Health and Mental Hygiene - Medicaid Agency
CMS Regional Office
Maryland SPDAP
Local partners: Area Agencies on Aging
Centers for Independent Living
Local Health and Social Services Departments
Services provided through Area Agencies on Aging Understand and utilize their health insurance benefits
Access to governmental benefit programs
Resolve problems with billing and coverage
150 volunteers Statewide
Services are confidential and free of charge
Free community presentations
TRAINING & COMMUNICATION NETWORKS
What We Have In Common
Volunteers
Agency staff
Paid Staff
Partners
Outreach Demographics
Seniors
Providers & Advocates
Caregivers
Public & Private Agencies
People with Disabilities
Younger Population
Cross-training at state and local levels
Example: State staff present about CDSMP at SHIP Coordinators Meeting Local CDSMP Coordinators present about CDSMP at volunteer meetings
Joint Outreach and Marketing
Example: MDoA Statewide Marketing Effort: 3P’s (Planning, Prevention and Preparedness)
Establish cross-referral networks
Example: MAP counseling, information and assistance and short term case management will include Living Well as a service option
Options Counseling standards for MAPs and related programs
Example: Standards and manuals will include CDSMP and recommendations for making referrals Appropriate for people seeking information on long term supports and services
Action Plan for Sustainability
Judy Simon , MS, RD, LDN Nutrition and Health Promotion Programs Manager
410-767-1090 [email protected]
Stephanie Hull
Chief, Long Term Supports and Services 410-767-1107
Michelle Holzer, Program Officer Senior Health Insurance Assistance Program
410-767-1109 [email protected]
Donna Smith
Chief, Client and Community Services 410-767-1271
Maryland Department of Aging
WIHA Project Map
Issue RFP
Select Facilitator
Install
Transition
Board
By-laws
Incorporation
Advocacy
Create Task Force
Develop Model
Prepare
Implementation
Plan
Discharge Task Force
Hire Staff
Physical
Location
Develop
Board
Selection
Process
And… then came CAARN
• Dr. Mahoney receives NIH grant to create Community Academic Aging Research Network (CAARN).
• CAARN is the “research arm” of WIHA
• UW School of Medicine & PH Grant academic side located there – community side located at WIHA
• Partnership with university researchers and aging network
• Develop & test new prevention strategies and bring research to practice
Partnerships - current
Researchers Geriatrics and gerontology
Injury Prevention
Policy makers Office on Aging, Division
Of Public Health, AAA
Community providers Local aging services providers:
Public health, Senior Centers,
ADRCs, nutrition sites, local health
care providers, retirement centers,
fitness centers
Next Steps for WIHA
• Deputy Director starts January 3
• Strategic Plan Retreat with Board and Key
Staff Early 2011
• Advocacy for Statutory Language
• Outreach to Aging Network for CAARN
Projects
• Expand Partnerships
What will the Future Bring?
Serve as Locus
For
EB-Prevention
Programs
Monitor &
Maintain
Quality & Fidelity
Engage
Private
Partners
Expand
University
Partnerships
Participate
in research
Manage
EB grants
Support
Aging &
Public Health
Networks
WIHA
Some of the roles for WIHA
• Coordinate evidence-based prevention programs
• Maintain multi-site license for both Living Well and Stepping On
• Maintain leader list
• Serve as the licensee agency for Stepping On – North America
• Serve as Community link for CAARN
• Serve as clearing house for information regarding other evidence-based prevention programs
Proposed Statutory Language
for 2011-13 Budget
Add language to s. 46.85 that defines the Wisconsin Institute for Healthy Aging, including the following components:
• Give the Department the authority to contract with WIHA for the administration of evidence-based prevention programs;
• Give WIHA the authority to administer state prevention funds for Area Agencies on Aging, public health agencies, and Aging and Disability Resource Centers (ADRCs);
• Give the University of Wisconsin the authority to contract and partner with WIHA on grants and research efforts;
• Recognize WIHA as the licensee agency for Stepping On North America, the evidence-based falls prevention program available in a significant number of Wisconsin counties;
• Recognize WIHA as the organization that coordinates Wisconsin Stepping On falls prevention program;
• Recognize WIHA as the organization that coordinates the Wisconsin Chronic Disease Self-Management Program;
• Recognize WIHA as clearing house for evidence-based health promotion information for healthy aging;
• Authorize the WIHA to provide training and technical assistance to staff in county/tribal agencies, Area Agencies on Aging, and other aging and public health service providers.
Partnerships - projected
Researchers Geriatrics and gerontology
Injury Prevention
Policy makers ADRC, Public Health,
nutrition services,
Substance abuse programs
Community providers Area Agencies on Aging, Public health,
Senior Centers, ADRCs, nutrition sites,
retirement centers, fitness centers
Family care
Medicaid managed care
Insurance, HMO’s
Medicare
Dissemination research
Univ, federal funding
Other
Local health care
organizations
Ed Psych
Population Health
Business
Living Well
(Chronic Disease Self Management Program)
November 2010
Counties with Trained Trainers/Leaders
'
$
Washburn
Burnett
Douglas
Bayfield
Sawyer
AshlandIron
Vilas
Oneida
1 MT 2 LL
Price
Polk Barron Rusk
Chippewa
1 MT
1 LL
St. Croix Dunn
Taylor
LincolnLanglade
1 LL
Forest Florence
Marinette
OcontoClarkMarathon
Shawano
WoodPortage Waupaca
Menominee
Door
Kewaunee
1 MT
6 LL
Brown
Pierce
Pepin
Buffalo Tremp-
ealeau
Eau Claire
2 MT 5 LL
La Crosse
MonroeJuneau
Adams
Waushara
Outagamie
Manitowoc
Sheboygan
1 LL
Sauk
Vernon
Crawford
Richland
Grant
Iowa
LafayetteGreen Rock Walworth
Kenosha
Racine 11 LL
Washington
5 LL
OzaukeeColumbia
Dane
Jefferson
Dodge
Milwaukee
Fond du Lac
5 LL
Marquette
Winnebago
Jackson
T-Trainer (TT), Master Trainer, Lay Leader
Master Trainer (MT)
Lay Leader (LL)
Master Trainer & Lay Leader
1 MT
2 LL
2 MT
16 LL
3 SLL1 LL
2 LL
1 MT
1 TT
10 LL
12 SLL
1 LL
1 TT
1 MT
17 LL
2 LL
1 MT
2 LL
1 MT
3 LL
8 MT 58 LL
5 SLL MT 13 SLL
2 LL
1 MT
1 MT
2 LL
3 LL
1 LL
2 LL
2 LL
12LL
1 MT
4 LL
4 LL
2 MT
4 LL
1 MT 6 LLStatewide
278 Lay Leaders
30 Spanish Leaders
5 Spanish MT
41 Master Trainers
2 T-Trainer
Waukesha
2 MT 4 LL
1 LL
Calumet
1 LL
2 LL
1MT
1 MT
1MT
2 LL
3 MT
3 LL
1 MT
7 LL
2 MT
25 LL
2SLL
2 LL
2 LL
9 LL
8 LL
2 L
1 LL
2 LL
1LL
5 LL
Oneida
Nation
2 MT
5 LL
Green
Lake
1 MT 4 LL
Living Well with Chronic
Conditions • 360 leaders
– Core El Centro partnering to ensure Tomando Control
de su Salud workshops and Leader trainings
– Oneida Nation partnering to ensure 5/11 tribes by
March 2012 participate in Living Well
• 341 workshops- 2515 participants
– ADRC’s; Senior Center; Churches; Health Care and
Insurance Agencies; Worksite; Hospitals; Clinics;
Senior Housing; Community centers; Recreation
Centers; YMCA’s
How grant funds support
leaders • WIHA
• Statewide Infrastructure
• Statewide License
• Stipends for volunteer leaders
• Leader Training
• ARRA Mini-grant for Living Well volunteers-
marketing and recruitment activities
• Supplies for workshops
Quality Monitoring and Fidelity
• Self-Evaluation tool created based on other states’ tools
and work done at Stanford University
• Bi-monthly conference calls with program leaders
• Program leader listserve
– post announcements and documents
• Fidelity checks conducted during 3rd class by master
trainers for all new leaders
• Annual Prevention Summits
• Refresher training focuses on key elements of program
– Delivered with skits, brainstorming, true/false questions and
workgroup activities
– Program currently being evaluated and critiqued by curriculum
developer
Resources and Workshops
• WI DHS Evidence Based Prevention Program Website, Living Well with Chronic Conditions
http://dhs.wisconsin.gov/aging/CDSMP
• GWAAR website marketing materials are available at
http://www.gwaar.org Tool kit prepared for leaders – marketing materials, DVD’s, Books, CD’s audio books
• Wisconsin Arthritis Program 1-800-242-9945. – I and A volunteers provide information on class schedules
YouTube video that provides testimonials and ground zero program ideas http://www.wisconsinarthritisprogram.org/videos/19-video.html
Click on “check out our videos on YouTube!”
Gail Schwersenska
Director, Office on Aging
Bureau of Aging and Disability Resources
Wisconsin Department of Health Services
608-266-7803
Anne Hvizdak
Statewide Coordinator
Evidence Based Prevention Programs
Office on Aging
Bureau of Aging and Disability Resources
Wisconsin Department of Health Services
715-677-3037