Commonwealth council on aging best practice awards 2006-2016_dars

Taking Charge of Our Health and Wellbeing:

Chronic Disease Self-Management Education

(CDSME)

Virginia Governor’s Conference on Aging May 3. 2016

Taking Charge of Our Health and Wellbeing: CDSME VGCoA 5/3/16

Presenters

April Holmes Savannah Butler

Joyce Nussbaum

http://www.seniorconnections-va.org/Home/tabid/36/Default.aspx


Why Self-Management?People spend 99 percent of their time outside the health

care system — and what they do outside largely determines their quality of life.

This prepares them for the 99 percent.

Kate Lorig Stanford University Patient Education Research Center


Chronic Disease Self-Management Education✶ Evidence-based disease self-management programs ✶ Developed and researched by Stanford University ✶ 6 week workshop, 2.5 hour sessions ✶ Tools and skills to:

⬧ Deal with symptoms

⬧ Manage common problems

⬧ Participate more fully in life


“Train-the-Trainer” Model

Master Trainers

Lay Leaders

Program Participants Completers: Attend at least 4 of 6 sessions

Chronic Disease Self-Management Program


Sample Activity: Action Planning


Long-Term Research FindingsImproved/Enhanced Reduced

♦ Energy ♦ Fatigue

♦ Physical activity ♦ Limitations on social role activities

♦ Psychological well-being ♦ Pain symptoms

♦ Partnerships with physicians ♦ Emergency room visits

♦ Health status ♦ Hospital admissions

♦ Self-efficacy ♦ Hospital length of stay


National Study Findings: Lower Health Care Use

Baseline 6-Month 12-MonthPercentage with any emergency room visits in the past 6 months

18% 13% 13%

Percentage with any hospitalization in the past 6 months

14% 11% 14 %


National Study Findings: Lower Health Cost

• $714 per person saving in emergency room visits and hospital utilization.

• $364 per person net savings after considering program costs at $350 per participant.

• Potential saving of $6.6 billion by reaching 10% of Americans with one or more chronic conditions.


CDSME in Virginia• 2005: Introduced by Virginia Department of Health.

• March 2010: Two-year grants to states from US Administration on Aging to disseminate CDSM to older adults.

Virginia receives $1,040,000 – one of the highest awards.

• September 2012: Virginia one of 22 states awarded a 3 year grant under the Prevention and Public Health Funds, Affordable Care Act.

• Area Agencies on Aging local lead agencies under the grants.

2

1 34

5

6

7 8A8B

8C9

10

1213

1415

1617/18

1920

21

22

11

8D

1 Mountain Empire Older Citizens 2 Appalachian Agency for Senior Citizens 3 District Three Senior Services 4 New River Valley Agency on Aging 5 LOA Area Agency on Aging 6 Valley Program for Aging Services 7 Shenandoah AAA 8A Alexandria Division of Aging and Adult Services 8B Arlington Agency on Aging 8C Fairfax AAA 8D Loudoun County AAA 8E Prince William AAA 9 Rappahannock-Rapidan Community Services 10 Jefferson Area Board for Aging 11 Central Virginia AAA 12 Southern AAA 13 Lake Country AAA 14 Piedmont Senior Resources AAA

15 Senior Connections, The Capital AAA 16 Rappahannock AAA 17/18 Bay Aging 19 Crater District AAA 20 Senior Services of Southeastern Virginia 21 Peninsula Agency on Aging 22 Eastern Shore AAA - Community Action Agency

8E

Virginia’s CDSME Programs 5-2-16


Participation in CDSME Workshops April 1, 2010 through April 7, 2016


Accomplishments

Reached diverse populations: • Workshops in Spanish, Chinese, Vietnamese, Korean and

sign language • Persons with disabilities

• Embedded at Wilson Workforce and Rehabilitation Center

• Centers for Independent Living • Behavioral health and recovery programs • Clubhouse programs

• Six state prisons • Low income and homeless populations

• Formed lasting partnerships-locally and statewide


Senior Connections, The Capital Area Agency on Aging

• Savannah Butler, Local coordinator for CDSMP at Senior Connections, The Capital Area Agency on Aging.

• Our Mission: "Empowering seniors to live with dignity and choice.“

• Areas that we serve: counties of Charles City, Chesterfield, Goochland, Hanover, Henrico, New Kent and Powhatan, and the City of Richmond.

• Been offering this program since 2010.


Jail and prison inmates have a disproportionate burden of many chronic medical conditions compared to the general population, including hypertension, asthma,

arthritis, cervical cancer and hepatitis.

Chronic Medical Diseases Among Jail and Prison Inmates By Ingrid A. Bingswanger, MD, MPH , 10/25/2010

Chronic Disease in Prison Populations


Leading conditions: 34 to 49 year old men and women in US prisons:

1. Overweight (47%) 2. Hypertension (24.7%) 3. Obesity (24.7%) 4. Arthritis (23.1%) 5. Asthma (13.9%) 6. Hepatitis (12.9%)

Chronic Disease in Prison Populations

Taking Charge of Our Health and Wellbeing: CDSME

Chronic Disease in Virginia’s Prison Populations

♦ About 1/3 have a chronic care condition ♦ (asthma, diabetes, hypertension, HIV)

♦ Some have multiple chronic diseases

♦ Genes account for approximately 30% of wellness

♦ Inmate self-responsibility and discipline ♦ (diet, exercise, rest, and medication) are keys to health

VGCoA 5/3/16


Senior Connections’ Partnership with Local Prison

• Partnered with Powhatan Correctional Center in December 2012

• Orientation is a 3.5 hour process- go over dress code, prison life, do's and don'ts, background check, and wait about 90 days to receive volunteer badge

• First workshop at Powhatan started about a month later

• Lessons learned in the first prison system: • A class full of only male offenders, with two female leaders, was well

received and a success. The men were very respectful

• By the fourth workshop, a male leader was co-facilitating. Coordinator noted that the men really “emulate him and hung on his every word”.


Senior Connections’ Partnership with Local Prison, continued…

• Powhatan Correctional Center closed at the end of 2014 and we developed a new relationship with Deep Meadows.

• Deep Meadows is located in the same county. • 4 trained leaders that have gone through orientation and able to teach • Classes best in the afternoon • Teach every four months

• Local Numbers • 6 workshops – 80 participants- 68 completers- 85% completer rate at Powhatan

Correctional Center • 3 workshops- 38 participants- 30 completers- 80% completers rate at Deep

Meadows Correctional Center.


Senior Connections’ Partnership with local Prison, continued…

• Action planning, problem solving, and decision making are three skills that most of them lack and are valuable for success in the facility and after release.

• Workshop benefits: • Offenders learn to trust one another. • Are able to help each other with their action plans and following through with their

actions during the week.

• Leader describes her experience with action planning saying “ I will never forget one session in closing where a rather young inmate said he just wanted to go outside, that it had been years since he had been outside and his confidence level was low on being able to accomplish this. One other older gentleman-said ‘I will help you- we will do this together.’ It touched my heart”

• Here are several letters as to why we do this…


A Regional Approach to Maximizing Resources

VPAS CDSME plan for program sustainability

• Local organizations provide workshop sites, snack, marketing and

sometimes books and Leaders

• All Leaders are volunteers to VPAS

• Exploring billing Medicare for CDSME Workshops

• VPAS Regional Plan o Purpose: Establish a mutually beneficial partnership with other

Area Agencies on Aging (AAAs) to increase sustainability and

provide an opportunity for efficient and cost effective expansion

of CDSME programs through regional collaboration.



•Sustainability o revenue for existing program o reduce start up time for new programs o avoid duplication and loss of certification for Master Trainers

•Support o start strong o share best practices o minimize early mistakes

Why a Regional Approach?



VPAS provides

• Leader training

• Fidelity

• Data entry

• Program and technical support

• Marketing messages

JABA and SAAA provide

• Local coordinator

• Leader recruitment

• Workshop scheduling

• Local marketing

•Local budget

How it works



JABA

• Local Coordinator

• Ten CDSMP Leaders

• Five workshops completed

• Second Leader Training Scheduled

• Scheduling additional workshops

SAAA

• Local Coordinator

• 3 CDSMP Leaders, 2 cross trained in

DSMP and CTSP

• 3 CDSMP and 1 DSPM workshop

• Additional leaders registered for upcoming

Leader Training

Progress to Date


Questions?


ContactsApril Holmes Department for Aging and Rehabilitative Services [email protected] 804-662-7631

Savannah Butler Senior Connections [email protected] (804) 343-3004

Joyce Nussbaum Valley Program for Aging Services [email protected] (540) 896-8567

mailto:[email protected]



Commonwealth council on aging best practice awards 2006-2016_dars

Healthcare

Transcript of Commonwealth council on aging best practice awards 2006-2016_dars