Indiana Chronic Disease Plan Chronic Disease Advisory Group April 19, 2016

Welcome & Introductions Name Organizational Affiliation

Agenda for Today Today’s Objectives: Review & add to SWO analysis of 4 Domains Identify & prioritize initial objectives for each domain Welcome & Review Small Group Discussions by Domain Review Initial SWO analysis Identify Chronic Disease Plan Objectives Report Back & Identify Priorities

Broad Components of CDAG Role Adopt Foundational Framework 4 Domains of Chronic Disease Prevention Culture of Health   Advice & Input Challenges that cut across disease areas Strengths, weaknesses, opportunities for synergy Objectives that emerge from SWO Over time review content, support & monitor use of Plan 

Chronic Disease Prevention System

Chronic Disease Planning Process Review feedback from CDAG meeting and organize within domains in a table that identifies strengths, weaknesses & opportunities Begin to develop action plans. Identify “low hanging fruit” Consider “gaps” and CDAG feedback to identify 3-5 strategic opportunities Develop strategic plans for these opportunities Chronic Disease Planning Process

Domain 1: Epidemiology and Surveillance Strengths Practitioners have access to data (surveillance) that can be shared 211 has great data Weaknesses Lack of a centralized database Expensive to have data analyzed Real time data is hard to come by Local data is largely missing State mandates on what’s reported throughout state – very “light” on incidence Standardized/uniform reporting is not adequately regulated Acute care and primary care lack communication. Claims data is more available than true data. Data is needed on growing disease populations. (e.g. dementia) Opportunities Look at policy and systems changes under epidemiology. Make sure we know about everything going on in Indiana by improving communications so we don’t have to reinvent the wheel. Improve data collection through communication and policy Look into creating a resource database

Domain 2: Environmental Approaches Strengths There are some policies in place to try to encourage healthier lifestyle choices IDEM has tools for recording air quality Weaknesses Lack of a centralized database There are too many barriers for Hoosiers when it comes to transportation, education, finances, primary care and other resources Schools policies on exercise and recess are not adequate Poor quality of housing Access to recreational facilities is lacking Lack of funding Opportunities Influence political will – Organizational will and collaboration can make a difference Shift from individual interventions to environmental interventions (e.g. Smoke-free air in multi-family housing) Find a way to have SNAP accepted at farmers markets Opportunities with zoning to improve access Improve quality of housing available and location Opportunities with Park/Land expenditures (built environment) Create attractive recreational facilities to encourage health A holistic approach is needed. Work on breaking down silos and improving communication Increase breastfeeding – Breastfeeding initiation with African American moms Improve safe routs to school/complete streets Push for baby-friendly hospitals

Domain 3: Healthcare Systems Interventions Strengths Grant funds are available TeleHealth Weaknesses Social determinants are not prioritized in healthcare system (e.g. conditions in the places where people live, learn, work, and play) Lack of communication between agencies Need funding Access is not equal for all No current legislation that addresses chronic disease specifically Opportunities Push for reimbursement for all members of the team and community based resources Improve the effectiveness of interventions Well-funded tobacco program to increase awareness and tobacco tax Encourage a patient care team approach Keep the “whole” health team. ISDH as support? – Technical support. Medicare reimbursement for services and prevention programs. Accreditation. Reach more people in the state – social marketing campaign Turn data into economic gain – show how certain programs will actually help the economy

Domain 4: Community Programs Linked to Clinical Services Strengths YMCA diabetes preventive program now paid by Medicare Healthcare professional – now includes case managers (nurse practitioners, RNs PT, RRT asthma educator, CICOA, EMS, paramedicine program) Weaknesses Unable to find partners who have evidence based data to report – as it is too difficult to connect to EMR Lack of engagement from people in the community Lack of funding Indiana has far fewer sliding fee scale clinics than other states (e.g. health professional shortages) Opportunities Try to provide data on return on investment Go to people vs planning events waiting on them to attend event IUPUI was just awarded a grant to work on this domain It is important that we all use the same language. (social marketing campaign) Make 211 more health oriented