Chronic Disease With community partners, develop community/neighborhood clinics for chronic disease prevention, education, management, such as sickle cell, diabetes, obesity, hypertension and asthma. Target populations with greatest need (e.g., African Americans for diabetes).

Chronic Disease - Scorecard Chris will mention that two of the measures are tied to the PRC survey so will not be updated until 2017. Two indicators measure activity in the EDs related to lack of disease management for asthma and diabetes. Significant increase in diabetes ED use. Asthma flat.

Chronic Disease “It’s All About You” – Chronic Disease Self-Management Program Lee Health Solutions Diabetes Education Program Weight Management Program Obesity Clinic at Lee Community Healthcare Lee Community Healthcare SKY Family YMCA Diabetes Collaboration Living With Diabetes (21st Century Collaborative) Family Health Centers of Southwest Florida

Accomplishments “It’s All About You” Lee Weight Management Program Chronic Disease Self-Management Program Active Leaders: 52 (2014) / 37 (2015) Participants Completing Program: 127 (2014) / 241 (2015) Increased variety of community partners ED Visit Decrease: 20% (2014) / 31% (2015) Hospitalization Decrease: 67% (2014) / 46% (2015) Lee Weight Management Program Total Participants: 3994 (2014) / 3224 (2015) Pounds Lost in 30 Days: 5 lbs (2014) / 6 lbs (2015) Pounds Lost in 3 Months: 11 lbs (2014) / 13 lbs (2015) Average 7% Body Weight Lost in 3 Months (Goal: 5-10%) Diabetes Education Program (Lee Health Solutions – LMHS) Participants: 926 (2014) / 810 (2015) Initial Hemoglobin A1C: 7.4% (2014) / 7.4% (2015) 3 Month A1C: 6.9% (2014) / 6.9% (2015) It’s All About You - CDSMP: Decrease in active leaders due to change in LPG case manager job responsibilities. Additional leader training in 2015 – Expect a minimum of 12 additional leaders by the end of this year. Community Partners: Assisted and Independent Living facilities (Cypress Cove, Brookdale College Parkway and Cape Coral, St John’s Villas, Shell Point), Hope Pace, Lighthouse of SWFL, Libraries (Cape Coral, Fort Myers, Estero), Cross Creek Estates, Deltura Country Club, Bonita Bay, Center for Independent Living, Wellness Center of Cape Coral, Pine Echo Community (Spanish workshop), Right At Home Office Bonita, Good Shepard, Faith Presbyterian, Chapel By the Sea faith communities. Lee Weight Management Program: 30 Day Weight Loss: 5 lbs (2014) / 6 lbs (2015) 3 Month Weight Loss: 11 lbs (2014) / 13 lbs (2015) Average of 7% weight lost in first 3 months of program (Goal: 5-10% of weight) Decrease in patient volume due to one dietitian position being vacant for 5 months. Diabetes Program: Both years remained constant. 3 Month goal was achieved (A1C 6.9%) Hemoglobin A1C Goal: < 7.0%

Accomplishments Lee Community Healthcare 1,123 patients diagnosed with hypertension had a decline in BP 65% of this group were able to decrease or cease utilization of medication 730 hypertension patients reduced or ceased taking medication Obesity Clinic: 57 new patients in last year, 283 total client visits Average pounds lost: 6 lbs. in 30 days. Diabetes Education Program (Lee Health Solutions) 113 Community Care Program participants in last year Initial Hemoglobin A1C: 8.7% / 3 month: 7.6% SKY Family YMCA Diabetes Prevention Collaboration Successfully Conducted the CDC’s Diabetes Prevention Program Received Community Transformation Grant (National REACH Coalition & CDC) to deliver program to the Latino/Hispanic Communities in Bonita Springs / Estero Works with employers such as the City of Cape Coral and the Lee County School District to deliver the program to employees Family Health Centers of Southwest Florida Several new programs added (Shape It Up, Smoking Cessation & Kids Quest for Health) educated 1073 people with Metabolic Syndrome 418 educational encounters with Gestational Diabetics Provided 3 baby showers for 105 low income expectant Mothers and their guests Partnership with YMCA - Pre-Diabetes Education Obesity Clinic – Dietitian available at all 3 LCH locations.

Opportunities for Improvement It’s All About You Improve participant attrition rates. Increase the number of participants registered for workshops Diabetes Education Program Increasing number of post-education refresher opportunities Lee Community Healthcare: Enhancing patient access to nutrition counseling and healthy foods Expanding patient access to care at existing clinics SKY Family YMCA Diabetes Collaboration Identify additional site locations to hold classes Increase participation in classes Family Health Centers of Southwest Florida Increase participation programs offered

Next Steps Diabetes Education Program It’s All About You Spanish Leader Training in September 2015 Strategic initiative to choose sites with marketing capabilities Trend participant attrition rates Diabetes Education Program Offer post-program refresher education once a quarter Lee Community Healthcare Offering patients low-cost medications under 340b program Recruiting providers through the National Health Service Corp Adding service sites in Cape Coral and other high need communities SKY Family YMCA Diabetes Collaboration Continue to add additional community partners Family Health Centers of Southwest Florida Continue to increase existing programs and add additional programs when necessary Chris will offer It’s All About You 6 week classes to any Healthy Lee Steering Committee members who have venues for the offering. We are expanding into communities and businesses as well as chambers of commerce.

Health Services of Mt. Hermon Ministries Living with Diabetes Health Forum Saturday, May 9, 2015

Health Services Ministry Goals To provide Personal Health Counseling To provide Health Education To provide Health Care Advocacy To bring wellness to the congregation based on the belief that health is growth towards well-being of the mind, body and spirit. Developed to help individuals stay well and tailors its health related activities to meet the desires and needs of the congregation and the community at large. Health Services Mission

Lee Memorial Health System “Living with Diabetes” Participating Health and Community Organizations Lee Memorial Health System Harry Chapin Food Bank Southwest FL Reserve Family Health Centers Nova Nordisk Mt. Hermon Ministries Department of Health Frantz Eye Care

Event Focus EDUCATION SCREENING HEALTHY FOOD DISTRIBUTION

Diabetes Education Special Guests Dr. Larry Antonucci, COO LMHS Nancy McGovern, Board Member LMHS Guest Speaker Lou Brock, Hall of Fame St. Louis Cardinals Topics Covered Nutrition and Diabetes Exercise and Diabetes

Screening High Blood Sugar 10% High Blood Sugar 23% Total Screened: 150: African-American, Caucasian, Hispanic FEMALE SCREENING MALE SCREENING High Blood Sugar 10% High Blood Pressure 25% High BMI(Overweight) 16% High Blood Sugar 23% High Blood Pressure 43% High BMI(Overweight) 42% Total Eye Health Screened: 40

Diabetes Health Forum Screening Data Comparison- 2012, 2014 & 2015 Diabetes Health Forum Screening

Discussion ─ Any Questions for the co-champions? ─ Any updates to add? ─ Suggestions for improvements?