1. Women in Government San Diego, CA Sept. 28, 2017
Kelly and Trish give introductions

2. Association Overview Strengthen state-based leadership & expertise
Lead & influence to shape health landscape
Member-based, member-driven, member-led
Thought leaders
Capacity building, professional development & advocacy
Kelly
Founded in 1988 in partnership with CDC to strengthen state-based leadership & expertise in chronic disease prevention and control
Vision: Lead and influence the ways that chronic disease prevention and health promotion shapes the health landscape.
Member-based, Member-driven, Member-led
Nationally recognized thought leaders
Capacity building, professional development and advocacy on behalf of and in collaboration with state programs

3. ABOUT US
Strategic leadership Coordinate action Expand & sustain proven strategies
Kelly
Our diabetes team works with state health departments and their partners to plan and implement evidence-based strategies to help prevent and manage diabetes.

4. Spectrum of Prevention
Kelly

5. Spectrum of Prevention
Kelly

6. Progression of Diabetes
9.5 million have their disease CONTROLLED
84 million Americans have PRE-DIABETES
30 million Americans have DIABETES
23 million of those are DIAGNOSED
19 million of those are TREATED
74 million
are
UNAWARE
7 million
are
UNDIAGNOSED
4 million
are diagnosed
but NOT TREATED
9.5 million
are treated
but NOT SUCCESSFULLY
CONTROLLED
20.5 million have Diabetes that is NOT CONTROLLED
Kelly - link to prevention, identification, management
PREVENT and IDENTIFY to Reduce Risk Factors and Avert Disease
IDENTIFY and MANAGE Disease in Its Earliest Stages
MANAGE Disease
to Avoid Complications
MANAGE Disease
to Avoid Complications
Avert Onset of Diabetes or Costs of Untreated Diabetes
Sources: NIH, CDC, American Diabetes Association

7. Framework What? Prevention Identification Management Who? Individual
Priority Focus Areas
Prevention
Ensuring those at high risk or with prediabetes are able to prevent type 2
Identification
Finding those with undiagnosed prediabetes, and type 2 diabetes
Management
Ensuring those with type 1 and type 2 diabetes avoid complications
Who?
Social Ecological Model Levels
Individual
Organizational
Community
Policy
Who to involve?
What State Action Plan Strategies?

8. National Diabetes Prevention Program State Engagement Meetings
Trish
Six state teams at WIG include: AZ, CA, FL, IL, MS, OK

9. Action Plan Priorities Examples
Increase
WHAT
WHO
Awareness
of prediabetes
By 2018, develop a statewide public awareness campaign to increase by 10% the number of X state residents who know they have prediabetes.
Public health
Community
Education/academia
Media
Legislatures
Availability of programs
By June 30, 2018, Increase the number of sustainable CDC-Recognized Diabetes Prevention Programs (DPPs) by X. At least 2 of these sites will be in counties that do not have access to a CDC-recognized DPP
Organizations Involved implementing the National Diabetes Prevention Programs
Philanthropy

10. Action Plan Priorities Examples
Increase
WHAT
WHO
Screening, testing, and referrals
By 2018, at least 3 health systems will implement a process for screening, testing and referring people at high risk for prediabetes to CDC- recognized lifestyle change programs in their communities.
Health care providers/Health systems/ACOs
Community
Coverage for programs
October 2019, two to four State X-based self-insured (large) employers will provide coverage for CDC-recognized diabetes prevention programs
Employers
Payors

11. DIABETES ADVOCACY EFFORTS IN INDIANA
Jasmine D. Gonzalvo, PharmD, BCPS, BC-ADM, CDE, LDE Clinical Associate Professor
College of Pharmacy, Purdue University
Clinical Pharmacy Specialist
Eskenazi Health

12. History of Diabetes Action Plan Legislation

13. Proposed DAP Legislation
Two DAP bills: 1 House, 1 Senate
Large fiscal note attached
Stakeholder Meeting
2015
House Health Committee Chair sponsored
Stakeholder meeting
2016
Democratic House sponsor
Interim study committee
2017

14. Made up of 18 members 7 Senators 7 Representatives 4 lay members
Interim Study Committee on Public Health, Behavioral Health, and Human Services
Made up of 18 members
7 Senators
7 Representatives
4 lay members

15. Committee assigned to study
Shortage of Healthcare providers
Goals, benchmarks, and plans to reduce the incidence of diabetes in Indiana, improving diabetes care, and controlling complications associated with diabetes
Potential improvements to the INSPECT program
Changes needed in state law and policy to respond to changes in federal law on health care

16. DIABETES IN INDIANA

17. Annual Diabetes-attributable Medical Costs in Indiana
Estimated Cost per person
Estimated Total Cost
Medicaid
$4,898
484.1 Million
Private insurers
$3,944
1.3 Billion
Employers
$9,182
2.2 Billion

18. 2012 Prevalence of Diabetes for Committee Legislators’ Districts
Prevalence for Indiana
Prevalence for United States

19. Cost per patient for Diabetes for Committee Legislators’ Districts

20. DIABETES-RELATED LEGISLATIVE PRIORITIES FOR 2018

21. COMMON SENSE SOLUTIONS
Create a Resolution in support of pilot projects with strategies to increase access to DPP/DSME in targeted counties
Make DSME a wellness benefit that does not require cost-sharing (eliminate copay and deductibles)
Increase the collection of data related to diabetes and diabetes-related complications
Support legislation to form a Statewide Diabetes Action Plan to ensure continued attention to diabetes

22. Support from State Department of Health critical
Challenges
Support from State Department of Health critical
Minority party sponsors
Hot topic priorities may overshadow diabetes
Successes
Strong representation from national and local stakeholders from diverse organizations
Stakeholders all supportive of similar ideas, no opposition
Several years of momentum to move DAP legislation
Surrounding States have all passed DAP legislation

23. NEXT STEPS

24. September – October 2017
Meeting with Governor’s office
Finding a sponsor from the majority party
Final interim study committee meeting on October 26

25. DIABETES ADVOCACY EFFORTS IN INDIANA
Jasmine D. Gonzalvo, PharmD, BCPS, BC-ADM, CDE, LDE Clinical Associate Professor
College of Pharmacy, Purdue University
Clinical Pharmacy Specialist
Eskenazi Health

26. Framework What? Prevention Identification Management Who? Individual
Priority Focus Areas
Prevention
Ensuring those at high risk or with prediabetes are able to prevent type 2
Identification
Finding those with undiagnosed prediabetes, and type 2 diabetes
Management
Ensuring those with type 1 and type 2 diabetes avoid complications
Who?
Social Ecological Model Levels
Individual
Organizational
Community
Policy
Who to involve?
What State Action Plan Strategies?

27. State Team Report Out Arizona California Florida Illinois Mississippi
Oklahoma