© 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

7

Role of Health Policy Forum

MASSACHUSETTS AS A

MODEL FOR HEALTHY AGING

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

9

Public Private Partnership

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

13

Core Elements

Evidence-based Programs

Public Awareness

Healthy Aging Communities

14

Crosscutting Elements

Older Adult Engagement

Evaluation

Leadership

System Linkages

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

Ruth.Palombo@state.ma.us

Anita Albright Director of the Office on Healthy Aging and Disability

Massachusetts Department of Public Health

Anita.Albright@state.ma.us

Maryland Department of Aging

December 14 & 15, 2010

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

16 of 19 Area

Agencies on

Aging provide the

Living Well

Program

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 jsimon@ooa.state.md.us

Stephanie Hull

Chief, Long Term Supports and Services 410-767-1107

sah@ooa.state.md.us

Michelle Holzer, Program Officer Senior Health Insurance Assistance Program

410-767-1109 mph@ooa.state.md.us

Donna Smith

Chief, Client and Community Services 410-767-1271

dms@ooa.state.md.us

Maryland Department of Aging

Developing Wisconsin’s

Evidence-based Prevention

Network

Gail Schwersenska

Anne Hvizdak

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

Gail.Schwersenska@wisconsin.gov

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

Anne.Hvizdak@wisconsin.gov

715-677-3037