1. Pacific Islands Primary Care Association (PIPCA) 51 st PIHOA Meeting Tuesday, November 15, 2011 Honolulu, Hawai‘i

2. Mission To promote and support quality Pacific Islands primary health care for all member islands.

3. Role Your role: What role do you see your members and your association playing in NCD response? What do other groups need to understand about the role of your members and/or association in NCD response? Primary health care services are a key element in addressing the NCD crisis Thus PIPCA, plays a key role in helping define, and supporting the regional primary health care response in better addressing the NCD crisis Mission: To promote and support quality Pacific Islands primary health care for all member islands.

4. Contribution Your contribution: Please give a brief overview of the NCD-related actions and strategies that your association intends to undertake over the next few years. What will be your association’s contribution to the Regional NCD Road Map? How do NCDs factor into the strategic direction or plan for your association? Framework: (thanks to CCPI) -- Prevention-- Supportive Care Services -- Diagnosis-- Data Collection -- Treatment-- Research

5. Contribution Prevention Leverage resources Advocacy/ Policy development: social/health disparities –Food access –Physical activity access Develop common messaging Coordinate plans for primary prevention activities Adapt/develop/implement evidence-based programs

6. Contribution Diagnosis Screening Early detection Risk factor identification

7. Contribution Treatment Better defining and strengthening the role of primary care – via the PI CHCs and others – in providing quality treatment

8. Contribution Supportive Care Services Better defining and strengthening the role of primary care – via the PI CHCs and others – in providing supportive care

9. Contribution Data Collection Minimum regional data collection and reporting standards Common NCD indicators to be collected, tracked and reported Leverage resources supporting jurisdiction capacity to meet minimum NCD data collection needs

10. Contribution Data Collection Support CDEMS if there is broad regional agreement for this system and it is clear there will be ongoing technical assistance support for this system Support building regional/jurisdictional/clinical capacity to effectively analyze and make good use of the data collected Support regional/jurisdictional/clinical IT expertise to support data management (HIS SWAT team) Support regional assessment of current data systems

11. Contribution Research Better defining and determining the role of primary care – via the PI CHCs and others – in supporting research

12. Requirements for Success Requirements for Success. In general: What needs to happen to ensure that your members and association are prepared to play the role they have identified for themselves in NCD response? What resources (financial, technical, etc..) will you need? And more specifically: What do your members and association need from the other affiliate groups (doctors, ministers, behavioral health professionals, nurses, laboratorians, etc…) to do their job effectively? Developing much stronger working connections with the other regional health organizations

13. Brief Update – November 2011 Current US political situation and possible impact on PI CHC funding –US continuing financial downturn and strong disagreement between the Republicans and Democrats in the US Congress The CHC “expanded services” increased funding opportunity did not get funded Last New Access Point (NAP) funding cut significantly: instead of 350 new CHCs, only funding for 27 –CNMI application did not get funded –No idea yet how much funding will be available in 2012 for NAP The Affordable Care Act and future health care funding (particularly Medicaid and Medicare) may be cut significantly –“Super-committee” November 23 deadline to recommend $1.5 trillion in cuts to reduce deficit

14. Brief Update – November 2011 That said, hopefully the funding supporting the CHC program and primary health care will remain strong through this period of turmoil.

15. Thank you. Clifford Chang Pacific Islands Primary Care Association 808-537-5855