CHALLENGE CHALLENGE CENTERCENTER

Filling the Gap in Filling the Gap in the Continuum of the Continuum of

CareCare

Filling the Gap in Filling the Gap in the Continuum of the Continuum of

CareCare

Background Information aboutBackground Information aboutChallenge CenterChallenge Center

Non profit Community Non profit Community Based Physical Based Physical Therapy/Fitness Therapy/Fitness CenterCenter

Founded-1987Founded-1987 Located in City Park Located in City Park Primary population Primary population

served-Physically served-Physically DisabledDisabled

Secondary-Served Secondary-Served Ambulatory Seniors Ambulatory Seniors

Emerging Role of Health Emerging Role of Health Promotion for People with Promotion for People with

DisabilitiesDisabilities Traditional managed care invests financial Traditional managed care invests financial

resources in diagnosing and treating/ resources in diagnosing and treating/ curing diseasecuring disease

Research shows investment in health Research shows investment in health promotion is cost effective, beyond the promotion is cost effective, beyond the “absence of disease” or acute recovery.“absence of disease” or acute recovery.[Rimmer JH. Health promotion for people [Rimmer JH. Health promotion for people with disabilities]with disabilities]

Healthy People 2000Healthy People 2000

A clear opportunity exists for A clear opportunity exists for health promotion and disease health promotion and disease

prevention efforts to improve the prevention efforts to improve the health prospects and functional health prospects and functional

independence of people with independence of people with disabilitiesdisabilities page 41 page 41

Continuum of Care + the GAPContinuum of Care + the GAP

ER/

Acute Care

Community Health and Wellness

Gyms

Fitness Specialist

THE GAPTHE GAP

---Not trained to meet special

needs

CHALLENGE CHALLENGE

CENTERCENTER Accessible Equipment

Trained Personnel

PHYSICAL THERAPY

The need for health promotion The need for health promotion

While medical technology has While medical technology has increased the life span of those with increased the life span of those with disabilities, little has been done to disabilities, little has been done to improve their health span.improve their health span.

Fewer than 10% of adults participate Fewer than 10% of adults participate in structured physical activity. in structured physical activity. Rimmer JH, et al Rimmer JH, et al

Greater number of trauma Greater number of trauma SurvivorsSurvivors

ER- Trauma care increasing rates of ER- Trauma care increasing rates of survivalsurvival

Acute care – advancements in Acute care – advancements in medicine increasing levels of acute medicine increasing levels of acute recoveryrecovery

In-Patient Rehabilitation – longer In-Patient Rehabilitation – longer stays replaced with limited home stays replaced with limited home health and outpatient serviceshealth and outpatient services

Continuum of CareContinuum of CareHome Health services – help bridge the Home Health services – help bridge the

gap in acute recoverygap in acute recovery

Out-patient services expanding To Out-patient services expanding To Include Cardio and Pulmonary Include Cardio and Pulmonary Education and TrainingEducation and Training

Challenge Center concept is similar Challenge Center concept is similar

approach for neurological patients approach for neurological patients

Continuum of CareContinuum of Care

Driven by consumers need for Driven by consumers need for training and self-empowerment in training and self-empowerment in recoveryrecovery

Increased perception of Increased perception of responsibility for self-health and responsibility for self-health and fitnessfitness

Continuum of CareContinuum of Care

Ideal outcome of continuum of care Ideal outcome of continuum of care is commitment to healthy lifestyle is commitment to healthy lifestyle and regular exercise by the patientand regular exercise by the patient

There is a gap in the plan …There is a gap in the plan …

Challenge Center HelpsChallenge Center HelpsFill the Gap for Persons with Fill the Gap for Persons with

Disabilities and Special NeedsDisabilities and Special Needs

Promoting Health in Persons Promoting Health in Persons with Disabilitieswith Disabilities

Perception of “healthy disabled” Perception of “healthy disabled” gradually changinggradually changing

Health is not static for all populations Health is not static for all populations

– dynamic and multi-factorial in – dynamic and multi-factorial in nature. Rimmer JH,et alnature. Rimmer JH,et al

Promoting Health in Persons Promoting Health in Persons with Disabilitieswith Disabilities

Lifetime health cycle and benefits in Lifetime health cycle and benefits in healthy lifestyle choices similar for able & healthy lifestyle choices similar for able & non disabled populationsnon disabled populations

Physical disability and functional frailty Physical disability and functional frailty creates risk for fitness centers and creates risk for fitness centers and disabled clientsdisabled clients

Lack of skilled physical therapists, trainers, Lack of skilled physical therapists, trainers, specialized equipment, eliminates many specialized equipment, eliminates many with disability from conventional fitness with disability from conventional fitness centers centers

Physical Challenges Require Physical Challenges Require Specialized ApproachesSpecialized Approaches

Skilled physical therapists, Skilled physical therapists, Trainers, specialized equipment Trainers, specialized equipment TransportationTransportation Participation of care giversParticipation of care givers Peer support Peer support

Secondary Complications,Secondary Complications, Partial ListPartial List

Decubitus Ulcers, pressure sores Decubitus Ulcers, pressure sores =$30,000 X 3=$30,000 X 3

Inactivity, isolationInactivity, isolation Obesity Obesity Diabetes/Insulin Sensitivity Diabetes/Insulin Sensitivity Chronic PainChronic Pain Depression Depression Loss of Functional AbilityLoss of Functional Ability Premature Institutionalization Premature Institutionalization

Health Promotion/ Wellness and Health Promotion/ Wellness and Fitness for persons with Disabilities Fitness for persons with Disabilities

Persons with disability Persons with disability Insurers Insurers Family and care giversFamily and care givers Buyers of insuranceBuyers of insurance Acute care resources Acute care resources The government and tax payerThe government and tax payer

Persons with disability Persons with disability Insurers Insurers Family and care giversFamily and care givers Buyers of insuranceBuyers of insurance Acute care resources Acute care resources The government and tax payerThe government and tax payer

Who Benefits?Who Benefits?

Why is post acute therapy not a Why is post acute therapy not a priority ? Reasons for the gappriority ? Reasons for the gap

Medical focus on primary diagnosisMedical focus on primary diagnosis Insufficient prevention efforts in chronic Insufficient prevention efforts in chronic

populationspopulations do health maintenance organizationsdo health maintenance organizations really “maintain health”?really “maintain health”? Acute care system not designed for chronic careAcute care system not designed for chronic care Misguided cost assumptionsMisguided cost assumptions Lack of awareness of recent advances in physical Lack of awareness of recent advances in physical

medicinemedicine Disability & health seen as an oxymoron? Disability & health seen as an oxymoron? The move from institutional to community care The move from institutional to community care

model model

CHALLENGE CENTERCHALLENGE CENTER

Supported in large part by Supported in large part by philanthropic dollarsphilanthropic dollars

Special eventsSpecial events Contractual agreements Contractual agreements Sliding scale for cash paymentSliding scale for cash payment Client-specific sponsorsClient-specific sponsors We pray a lot !We pray a lot !

How it Works on How it Works on $$$$$$$$

CHALLENGE CHALLENGE CENTERCENTER

Our GoalOur GoalIf we are to intervene with health If we are to intervene with health promotion practices which prevent promotion practices which prevent functional declines in clients with functional declines in clients with

long term disabilities, we will realize long term disabilities, we will realize significant costs saving and prevent significant costs saving and prevent

unnecessary human suffering. unnecessary human suffering.