Disease Prevention and Health PromotionThe Implementation of Evidence-Based

Standards

California Department of AgingBarbara Estrada, M.S., R.D.

In 2012, Congress Changed Appropriation Language

Title IIID funds can be used only for programs which “have been demonstrated through rigorous evaluation to be evidence-based and effective.”

ACL developed a three tiered set of criteria for defining OAA evidence-based interventions.

Consolidated Appropriations Act of 2012 (P.L. 112-74): http://www.gpo.gov/fdsys/pkg/PLAW-112publ74/html/PLAW-112publ74.htm)

Implementation of 2016 Evidence-Based Standards

ACL set October 1, 2016 as the effective date for complying with the new Title IIID evidence-based standard based on the Federal Fiscal Year

The California Implementation Date: July 1, 2016 is based on survey responses from the AAAs and aligns with the State Fiscal Year, CDA Standard Agreement Contract Period and the 2016-2020 Four Year Area Plan Cycle.

PM 15-10 issued July 29, 2015 provides information on any changes for the Area Plan, Contracts, Fiscal and Data Reporting

Older Americans Act Title IIID Requirements

OAA Section 102. Definitions includes health screenings and other services that do not meet the new ACL standard for Title IIID services

OAA Section 361. Part D – Disease Prevention and Health Promotion Services Program Authorized

Services Not Eligible for Title IIID Funding

These services do not meet the new definition of Evidence-Based programs Nutrition Education and Nutrition Counseling Health Fairs Medication Minders

Allowable Evidence Based Program

(July 1, 2016 and beyond)

Programs meeting the ACL 2016

Evidence-Based Standard

(similar to previous Tier III: Highest-level Criteria)

Program Considered

Evidence-Based by an Agency

within HHS

ACL 2016 Evidence-Based Standard

l

Title IIID Evidence-Based Standards

Evidence Based Criteria:1. Have demonstrated through evaluation to be effective for

improving the health and wellbeing or reducing disease, disability and/or injury among older adults; and

2. Have been proven effective with older adult population, using Experimental or Quasi-Experimental Design; and

3. Have research/evaluation results published in a peer-review journal; and

4. Have been implemented previously at the community level (with fidelity to the published research) and shown to be effective outside a research setting.

5. Includes developed dissemination products that are available to the public.

Health and Human Services Websites

ACL’s Aging and Disability Evidence-Based Programs and Practices,

Title IIID Evidence-Based Disease Prevention and Health Promotion Programs Cost Chart,

CDC’s Compendium of Effective Falls Prevention Interventions,

SAMHSA’s National Registry of Evidence-Based Programs and Practices,

NIH’s Cancer Control Evidence-Based Portal

SNAP-Ed Programs that Meet the 2016 Title IIID Evidence-Based Standards

Not all SNAP-Ed programs meet the 2016 Title IIID Evidence-Based standards, but these SNAP-Ed programs are Title IIID eligible: Arthritis Foundation Exercise Program Enhance Fitness Fit and Strong Staying Healthy Through Education and prevention

(STEP) Tai Chi for Arthritis Matter of Balance Tai Chi Moving for Better Balance Walk with Ease

Status of California’s Area Agency on Aging Network

Some Area Agencies do not yet provide programs that meet the new ACL Evidence-Based Standard

More than half of the Area Agencies in California currently provide programs that meet the new ACL Evidence- Based Standard

All Area Agencies must meet the new ACL Evidence-Based Standard by July 1, 2016

Establish the Health Promotion Need of the Community

Needs assessment County statistics on Chronic Disease

from the Center for Disease Control and Prevention (CDCP)

California Health Interview Survey (CHIS)

CDA Diabetes Spreadsheet CDCP Behavioral Risk Factor

Surveillance System (BRFSS) from

Evidence-Based Programs in the Community

County Public Health Agencies may provide evidence-based classes o For example: Arthritis exercise classes and otherso Healthy Hearto Falls preventiono Depression management

Local Health Care groups may offer evidence-based classeso Diabetes Management, Chronic Disease Management

California Healthier Living Website: http://www.cahealthierliving.org/

Other organizations in your community

Toolkit on Evidence-Based Programming for Seniors

Toolkit on Evidence Based Programming for Seniorso http://www.evidencetoprograms.com/

The Toolkit provides information on how to Select a program Evaluate a program Ensure Fidelity to the program Provide Program Monitoring Working with lay leaders and quality assurance

NCOA Cost Chart (43 programs listed)

CDA Matrix

PROGRAMGOALS &

TARGET POP

PROGRAM DESCRIPTIO

N

PROGRAM DELIVERY METHOD

TRAINING REQUIREMENT

S

DELIVERY OVERSIGHT STRUCTURE PROGRAM COSTS KEY WORDS

A Matter of Balance(MOB)

 http://www.mainehealth.org/mob

 

 

▪ Reduce fall risk and fear of falling

▪ Improve falls self- management▪ Improve falls self-efficacy and promote physical activity

 ▪ Target Audience: Adults 60+ who are ambulatory, able to problem solve, concerned about falling, interested in improving flexibility, balance and strength and have restricted their activities because of concerns about falling

▪ 8 weekly or twice weekly sessions▪ 2 hours per session▪ 8-12 group participants▪ Emphasizes practical coping strategies to reduce fear of falling and teach fall prevention strategies

▪ Structured group intervention activities include group discussion, problem-solving, skill building, assertiveness training, videos, sharing practical solutions and exercise training

▪ 2 coaches (volunteer lay leaders) teach the class to participants

▪ Guest therapist visit (1 session for 1 hour)

▪ Master Trainers: 2-day

training and on-going updates▪ Coach/Lay leader training:8 hours and attend annual 2.5 hour training update

See *Delivery Oversight and Infrastructure reference. Pg. 22

Other: (Not required but recommended).

Data Collection & Entry: Staff to enter participant level data into the MOB Salesforce database, available online. The cost is around $200 per user per year and will be billed annually on the anniversary of your registration and payment the year prior.

▪ Licensing Cost: None.

Everything is included in the training fee▪ Training Cost:

- Master Trainer session open to anyone (includes all materials): $1,500 per Master Trainer plus travel- Group training available at anagency’s location upon request:a) 11-15 attendees: $16,000* plus $220/person for materials b) 16-20 attendees: $18,500* plus $220/person for materials

* plus travel, meals and lodging for 2 Lead Trainers▪ Post-training MaterialsCost:- Coach Handbook: $20- Participant Workbook: $13-

▪ fall prevention▪ group setting▪ self-management▪ health promotion

RFP Evaluation and Selection Process

Review the headings on the CDA Matrix for guidance on elements to evaluate bids and proposals. Goals and Target population Program description Program delivery method Training requirements Delivery oversight structure Program costs

Data Reporting No change in Data Reporting!

Title IIID is a non-registered service an estimated unduplicated client count is included in the “total persons served” count .

AAAs report service units to CDA o The Data Dictionary defines Title IIID

service units as contacts

2016-2020 Area Plan

Area Plan 2016-2020 should include only Title IIID programs that meet the 2016 ACL Evidence-Based Standards

Include a description of the Evidence-Based Title IIID program provided in the Area Plan Section 3: Description of Area Agency on Aging, as part of the spectrum of services

Area Plan: Section 10 Service Unit Plan

Fiscal Year

Proposed Units of Service

Goal Number Objective Number

2016-2017 1,000,000 1 1.18 and 1.19

2017-2018

2018-2019

2019-2020

2016-2020 Area Plan – Section 9

Section 9 Area Plan Goals and Objectives All Title IIID activities require an Area

Plan narrative objective. The objective should clearly describe the service activity being performed and explain how the service activity meets ACL criteria for evidence-based programs.

Recap All Title IIID programs and services must

meet the highest level of evidence-based criteria by July 1, 2016

Area Agencies on Aging are responsible to ensure programs provided with Title IIID funds meet the new 2016 ACL standards for Evidence-Based programs

Data reporting will not change Include information on the Title IIID

program in your Area Plan