1 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Implementing and Sustaining Chronic Disease Self-Management Education Programs Cora Plass, MSW, ACSW Senior Director National CDSME Resource Center IlluminAge Presentation June 11, 2015

2 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging  Introduce NCOA and the role of the National CDSME Resource Center  Provide an overview of the burden and impact of chronic diseases  Explain why CDSME is important for CBOs  Describe the suite of Stanford programs  Offer helpful tips and resources for planning, implementing, and sustaining your programs Objectives

3 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging National Council on Aging (NCOA) Who We Are: NCOA is the nation’s leading nonprofit service and advocacy organization representing older adults and the community organizations that serve them. Our Mission: To improve the lives of millions of older adults, especially those who are vulnerable and disadvantaged.

4 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging NCOA Social Impact Goal Touch the lives of 10 million older adults by 2020  Improved health and reduced disability through greater access to proven programs  Greater economic security through increased access to benefits, financial resources, and job opportunities  Enhanced capacity to live independently in the commu nity

5 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging  Primary Goal  Increase the quality and years of healthy life for older adults  Two National Resource Centers  Chronic Disease Self-Management Education (CDSME)  Falls Prevention  Other Key Areas of Focus  Behavioral Health  Oral Health  Physical Activity Center for Healthy Aging

6 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging National CDSME Resource Center  Funded by ACL/AoA for more than a decade  Serves as national clearinghouse for collecting and sharing information, resources, and best practices  Provides TA to support state and community partners with implementing, scaling, and sustaining CDSME programs  Provides a variety of communication channels for networking, sharing, and contributing to knowledge base  Manages and maintains national database for CDSME  More than 21,000 workshops in 46 states, DC, and Puerto  Reaching almost 240,000 people (March 2010–May 2015)  Well over half have multiple chronic conditions (MCC)

7 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging  7 out of 10 deaths are from chronic diseases  80% of older adults have at least one chronic disease  Nearly 2 of every 3 older adults have multiple chronic conditions  95% of health care costs for older Americans are for chronic diseases  Spending escalating with the increase in chronic diseases and the aging population  Primary focus has been on “sick care” rather than prevention Chronic Disease Epidemic

8 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Chronic Diseases are Highly Preventable Poor health and disability are not inevitable consequences of aging

9 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Self-Management Education – A Key Factor to Improving Health but Vastly Underutilized  Practicing simple self-management techniques on a regular basis can improve the health and quality of life of older adults.  While self-management education programs have grown, they are still not reaching enough older adults to have an impact on population health.  The unmet need presents a unique opportunity for aging organizations to step up to the forefront by making CDSME a priority.

10 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging CDSME – Stanford’s Suite of Programs  Chronic Disease Self-Management - English and Spanish  Diabetes Self-Management - English and Spanish  Arthritis Self-Management  Chronic Pain Self-Management  Cancer: Thriving and Surviving  Positive Self-Management Program for HIV

11 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Stanford University

12 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Stanford CDSME Workshop Overview  Small-group workshop developed by Kate Lorig, RN, PhD, at Stanford University  6 interactive sessions/2.5 hours each  Facilitated by trained leaders, one of whom has a chronic health condition  Participants:  Gain knowledge, confidence, and skills to better manage their health  Set goals and action plans to make positive lifestyle changes  Learn from and support one another to make changes that lead to better health  Learn problem solving to overcome barriers to achieving their goals

13 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Session Topics Action Planning Managing Pain and Fatigue Fitness/ Exercise Getting a Good Night’s Sleep Problem- solving Dealing with Difficult Emotions Healthy Eating/Weight Management Working with Health Professionals Decision Making Better Breathing CommunicationMedication Usage

14 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging CDSMP Program Benefits – National Study  Better Health  Self-assessed health  Depression  Quality of life  Unhealthy physical/mental days  Better Care  Communication w/ physician  Medication compliance  Health literacy  Lower Costs  ER visits  Hospitalizations

15 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Tips for Getting Started or Expanding Your Existing Efforts Proper planning is important…  Identify the Need –  Consider enlisting help from your state or local health department epidemiologist to help you understand the prevalence and impact of chronic diseases.  Will you start with the generic CDSMP or a disease specific program?  Is the program already available? If so, are there gaps to fill or a market niche for your program? Who are your competitors?  Where will you start? How will you expand your efforts?

16 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Tips for Getting Started or Expanding Your Existing Efforts  Determine the Capacity –  What is your organizational capacity? Consider human and financial resources.  Who will be involved? Who will be trained? What organizational processes need to be in place? How will you cover the program costs?  Assess your readiness - good timing and organizational readiness  Who are your potential partners? What roles can they fill? Are there champions that can help you?  What other resources are available? Transportation?

17 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Develop Marketing Approaches  Personal approaches and messages are the most effective  Community presentations  Word of mouth from people who are known  Referrals or recommendations from trusted individuals  Personal contacts, sign up, and follow up at health fair, church, or other event  Referral partnerships are important to fill workshops, e.g., health care systems  Messaging should reflect what is important to your target audience Feel better; do the things you want to do; put life back in your life

18 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Marketing – Language Preferences  Use language that is positive and empowering  Be clear and concise  Couch messaging around health benefits  “Workshop,” or “program” instead of “classes”  “Ongoing health condition,” rather than“chronic disease”  “Helps you learn”over “teaches”  “Strategies” over “skills” Source: Teresa Brady, CDC Arthritis Program

19 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Develop a Performance Monitoring and Evaluation Plan  What are your goals?  How do you measure success?  How will you monitor your progress?

20 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Performance Monitoring and Evaluation  Continuous Quality Improvement (CQI) process – planning, monitoring, evaluating, and making changes to improve performance  Fidelity – to what extent are you “true” to the way the program was designed?

21 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Plan for Sustainability – What Will It Take to Keep Your Program Going  What are you going to sustain?  What human resources are needed/available and who will do what?  Leadership  Staffing  Partners  What will it cost?

22 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Center for Healthy Aging Resources

23 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Resources In our Online Library - Planning  RE-AIM - how to use the RE-AIM framework to plan and evaluate your program  Reach  Effectiveness  Adoption  Implementation  Maintenance  Innovation Readiness Assessment Tool  Program Cost Calculator – Interactive tool

24 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Marketing Resources  Outreach and recruitment - strategies  Marketing and recruitment materials  State examples and best practices

25 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Quality Assurance and Evaluation Resources  Summary of national and state translational research findings  CDSME Infographic for national study – with a fillable PDF option to customize for including your data  RE-AIM  AoA QA Recommendations

26 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Sustainability Resources  Annual meeting presentations and handouts on our home page  “Creating a Business Plan” online training module  Examples of sustainability and business plans from states  Issue brief – “Key Factors and Strategies Contributing to Program Sustainability”

27 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Key Sustainability Components Strong Public Health and Aging; State/ regional management and support Effective Leadership Right-size workforce/ sites to ensure programs are consistently available Adequate Delivery Infrastructure Embedded into health systems/ reform and “turn-key” delivery system partners Partnerships Ongoing marketing, referral, registration, ADRC integration to build demand Centralized, Coordinated Logistical Processes Business plan; diversified funding (DSMT, fee for service, contracts) Business Planning and Financial Sustainability Being data driven with CQI and fidelity monitoring to ensure quality and promote value Quality Assurance

28 Improving the lives of 10 million older adults by 2020 © 2015 National Council on Aging Questions/Discussion Cora Plass