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Leveraging National Diabetes Prevention Programming for Your Health Center Thursday, November 29 th 2:00pm ET – 3:30pm ET

Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

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Page 1: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

LeveragingNationalDiabetesPreventionProgrammingforYourHealthCenterThursday,November29th2:00pmET– 3:30pmET

Page 2: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Presenters

MiriamBell,MPHTeamLeadNationalDiabetesPreventionProgramCentersforDiseaseControl

GinaTrignani,MS,RD,LDNDirector,TrainingandCapacityBuildingHealthPromotionCouncil

Page 3: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Presenters(cont.)

Nena TolenoaExecutiveDirectorKosrae CommunityHealthCenter

ChairAAPCHOPacificIslanderCenterofExcellenceinPrimaryCare

NeighborhoodHealthCentersofTheLehighValley

AliciaRivera,BSHealthEducator

DonnaB.WinstonMSN,RNDirector,ClinicalOperations

Page 4: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

NationalNurse-LedCareConsortium

TheNationalNurse-LedCareConsortium(NNCC)isamembershiporganizationthatsupportsnurse-ledcareandnursesatthefrontlinesofcare.

NNCCprovidesexpertisetosupportcomprehensive,community-basedprimarycare.

– Policyresearchandadvocacy– Technicalassistanceandsupport– Direct,nurse-ledhealthcareservices

Page 5: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

QuestionsWelcomed

Toaskaquestionormakeacommentforourpanelists,typeitintotheQuestionspaneintheGoToWebinarcontrolpanel.

We’lladdressallaudiencequestionsduringQ&A!

Page 6: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

• UnderstandtheNationalDiabetesPreventionProgram

administeredbytheCDC

• Identifyopportunitiestoincorporatediabetesprevention

programminginahealthcentersetting

• Describetheavailabilityofreimbursementandtechnical

supportforpreventionprogramming

LearningObjectives

Page 7: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Whichofthefollowingbestdescribesyourorganization?

• Communityhealthcenter(FQHC,Look-Alike,orother)

• Academicinstitution

• Federalagency

• Local/statedepartmentofhealth

• Community-basednonprofit/technicalassistance

provider

PollQuestion#1

Page 8: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

DoesyourorganizationoffertheNationalDiabetesPrevention

Program?

• Yes,throughapartnershipwithanexternalprovider

• Yes,wehavestaffonsite(trainedlifestylecoaches)

• No,wecurrentlydonotoffertheprogram

• Notsure/notapplicable

PollQuestion#2

Page 9: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

CentersforDiseaseControlandPrevention

TheNationalDiabetesPreventionProgram

MiriamT.Bell,MPH

TeamLead,NationalDiabetesPreventionProgram

DivisionofDiabetesTranslation

NationalCenterforChronicDiseasePreventionandHealthPromotion

CentersforDiseaseControlandPrevention

Page 10: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

OurPublicHealthChallenge

30 million Americans have diabetes

84 million adult Americans have

prediabetes

9 out of 10 adults with prediabetes don’t know they have it

CentersforDiseaseControlandPrevention.Nationaldiabetesstatisticsreport:estimatesofdiabetesanditsburdenintheUnitedStates,2014.Atlanta,GA;USDepartmentofHealthandHumanServices,CentersforDiseaseControlandPrevention,2014.https://www.cdc.gov/diabetes/data/statistics/2014StatisticsReport.html

Page 11: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Largestnationalefforttomobilizeandbringeffectivelifestylechangeprogramstocommunitiesacrossthecountry!

NationalDiabetesPreventionProgram

Page 12: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

TYPE 2 DIABETES PREVENTION EVIDENCE SUMMARY

Randomized ClinicalControlTrials:• TheDiabetesPreventionProgramResearchGroup.Reductionintheincidenceof

type2diabeteswithlifestyleinterventionormetformin.NEnglJMed.2002;346:393–403.

• The DiabetesPreventionProgramOutcomesStudy.Lancet.2015Subsequent TranslationStudies Various

Evidence-basedRecommendations

• USPSTFObesity IntensiveBehavioralCounseling July2012

• CommunityGuideReview July2014

• USPSTFCVD RiskReductionIntensiveBehavioralCounseling August 2014

• USPSTF Type2DiabetesandAbnormalGlucoseScreening October2015

• ICEREvidenceReportonType2DiabetesPreventionPrograms July2016

Page 13: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

OverviewoftheNationalDiabetesPreventionProgram1

2

AtthecoreoftheNationalDiabetesPreventionProgram(NationalDPP)isaCDC-recognized,year-longlifestylechangeprogramthatoffersparticipants:

Tosuccessfullyimplementtheselifestylechangeprograms,theNationalDPPreliesuponavarietyofpublic-privatepartnershipswithcommunityorganizations,privateandpublicinsurers,employers,healthcareorganizations,faith-basedorganizations,andgovernmentagencies.Together,theseorganizationsworkto:

http://www.cdc.gov/diabetes/prevention/pdf/ndpp_infographic.pdf

Page 14: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

NationalDPPStrategicGoals

Increasethesupplyofqualityprograms

Increasecoverageamong

publicandprivatepayers

$Coverage&

Reimbursement

Increasereferralsfromhealthcare

providers

IncreasedemandfortheNationalDPPamongpeopleatrisk

DemandFromParticipantsReferrals

QualityPrograms

Page 15: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

IncreasetheSupplyofQualityPrograms

Increasethesupplyofquality

programs

Increasecoverage

amongpublicandprivatepayers

$Coverage&

Reimbursement

Increasereferralsfromhealthcareproviders

IncreasedemandfortheNationalDPPamongpeopleatrisk

DemandFromParticipantsReferrals

QualityPrograms

Page 16: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Increase the Supply of Quality ProgramsThenumberofCDC-recognizedorganizationshasincreasedsubstantiallysincetheprogram’sinception.

CDCDiabetesPreventionRecognitionProgram,DPRPDataset2013-2018

CDC-RecognizedType2DiabetesPreventionProgramsAcrosstheU.S.

480 477 512 522644 720

953

1,2371,456

1,605 1,647 1,708 1,783

0

200

400

600

800

1000

1200

1400

1600

1800

2000

Jun2013 Dec2013 Jun2014 Dec2014 Jun2015 Dec2015 Jul2016 Dec2016 Jul2017 Jan2018 Feb2018 Apr2018 Oct2018

Page 17: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

TheLifestyleChangeProgram

1-6

7-12

Program Start

Program End

Weekly Sessions (16 minimum)

Monthly Sessions (6 minimum)

Mon

ths

PROGRAMGOAL:Helpparticipantsmakelastingbehaviorchangessuchaseatinghealthier,increasingphysicalactivity,andimprovingproblem-solvingskills

DeliveredbyatrainedlifestylecoachEvidenced-basedcurriculum

Examplemodulescoveredincorephase:• EatWelltoPreventT2• BurnMoreCaloriesThanYouTakeIn• ManageStress• KeepYourHeartHealthyExamplemodulescoveredinmaintenancephase:• WhenWeightLossStalls• StayActiveAwayfromHome• GetEnoughSleepPARTICIPANTGOAL:Lose5-7%ofbodyweight

Page 18: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

NationalDPP:DeliveryModes

§ InPerson

§ Online

§ DistanceLearning

§ Combination

Page 19: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

CDCRecognition

Recognitioninvolves…assuringqualitybydevelopingandmaintainingaregistryoforganizationsrecognized(byCDC’sDiabetesPreventionRecognitionProgram)fortheirabilitytodelivertheNationalDPPlifestylechangeprogrameffectively

QualityStandards

§ DPRPStandardsandOperatingProcedures--updatedevery3years

RegistryofOrganizations

§ Onlineregistryandprogramlocatormap

DataSystems

§ Dataanalysisandreporting§ Feedback/technicalassistanceforCDC-recognizedorganizations

KeyActivities

Page 20: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

BenefitsofCDCRecognition§ Quality—linkedtonationalqualitystandardsandoutcomesproven

toprevent/delayonsetoftype2diabetes

§ Data—enablesustomonitorprogressindividuallybyprogramandacrossthenation

§ Sustainability/Reimbursement—privateandpublicpayersreimbursingfortheprogramarerequiringCDCrecognition

§ Support—recognizedprogramshaveaccesstotechnicalassistance,training,andresources

§ Marketing—canbeaneffectivemarketingtooltoencouragereferrals(“OurprogrammeetsCDCnationalqualitystandards.”)

Page 21: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

IncreaseDemandfortheProgramAmongPeopleatRisk

Increasethesupplyofquality

programs

Increasecoverage

amongpublicandprivatepayers

$Coverage&

Reimbursement

Increasereferralsfromhealthcareproviders

IncreasedemandfortheNationalDPPamongpeople

atrisk

DemandFromParticipants

Referrals

QualityPrograms

Page 22: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

1.CDCDiabetesPreventionRecognitionProgram

Anestimated242,476individualshaveenrolledasofOctober20181

29,66346,812

75,285

106,306

134,936

181,954

213,822

242,476

0

50,000

100,000

150,000

200,000

250,000

300,000

CumulativeNumberofIndividualsEnrolledintheNationalDPPLifestyleChangeProgram1

IncreaseDemandfortheProgramforPeopleatRiskThenumberofenrolledindividualshasincreasedsubstantiallysincetheprogram’sinception

Page 23: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

AwardWinningPrediabetesAwarenessCampaignAdCouncil,AMA,ADA,CDC

Page 24: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

IncreaseReferralsfromHealthCareProviders

Increasethesupplyofquality

programs

Increasecoverage

amongpublicandprivatepayers

$Coverage&

Reimbursement

Increasereferralsfromhealthcareproviders

IncreasedemandfortheNationalDPPamongpeople

atrisk

DemandFromParticipantsReferrals

QualityPrograms

Page 25: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

IncreaseReferralsfromHealthCareProviders

CDCworkswithnumerouspartnerstohelpidentifyandreferat-riskindividualstoCDC-recognizedorganizations

Page 26: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

IncreaseCoverageAmongPublicandPrivatePayers

Increasethesupplyofquality

programs

Increasecoverageamong

publicandprivatepayers

$Coverage&

Reimbursement

Increasereferralsfromhealthcareproviders

IncreasedemandfortheNationalDPPamongpeople

atrisk

DemandFromParticipantsReferrals

QualityPrograms

Page 27: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

IncreaseProgramCoverage&ReimbursementManypublicandprivateinsurersareofferingtheNationalDPPlifestylechangeprogramasacoveredbenefit.

CommercialInsurers StateCoverage

§ Colorado§ Delaware§ Kentucky§ Louisiana§ Maine§ Maryland(partial

payment)

§ Minnesota§ Tennessee§ Georgia

§ AmeriHealthCaritas§ Anthem§ BCBSFlorida§ BSCalifornia§ BCBSLouisiana§ DenverHealth

ManagedCare:Medicaid,Medicare,PublicEmployees

§ EmblemHealth:NY§ GEHA§ Highmark

§ Humana§ Kaiser:CO&GA§ LACare:Medicaid§ MVP’sMedicare

Advantage§ PriorityHealth:MI§ UnitedHealth

Care:National,State,Local,Private,andPublicEmployees

ManycommercialhealthplansprovidesomecoveragefortheNationalDPP.Examples

include:

Over3.4millionpublicemployees/dependentsinthefollowing19stateshavetheNational

DPPasacoveredbenefit:

ThefollowingstateshaveapprovedcoverageforMedicaid beneficiaries:

§ NewHampshire§ NewYork§ RhodeIsland§ Vermont§ Washington§ Oregon(Educators)§ California§ Texas§ Indiana§ Connecticut(DoT)

§ Minnesota§ Montana§ Vermont

§ NewJersey§ California

CoverageReimbursement

Page 28: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

MedicareDiabetesPreventionProgram

25%ofAmericans65yearsandolderarelivingwithtype2diabetes,whichnegatively

impactshealthoutcomes

MedicareImplementation ImpactProblem

DecreasesMedicarecostsassociatedwithdiabetes

PromoteshealthierbehaviorsforeligibleMedicarebeneficiariesatrisk

fortype2diabetes

DPPmodeltestwithY-USA7,800beneficiaries

CareforolderAmericans(65+years)withdiabetescostsMedicare

$104billionannually,andisgrowing

Rulemaking to expand coverage to beneficiaries & establish MDPP

supplier type

Page 29: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

MedicareDiabetesPreventionProgram(MDPP)

§ EligiblesupplierscoveredasofApril1,2018viaexpandedmodel:– MustbeaCDC-recognizedorganizationthathasearnedeither

preliminaryorfullCDCrecognition;– EligibleMedicareparticipantsmustcomeintotheprogramon

thebasisofaqualifyingbloodglucosetest– CentersforMedicare&MedicaidServices(CMS)managesthe

entireMDPPbenefitprocess,includingacceptingsupplierapplications

– FormoreinformationontheMDPP,visit:https://innovation.cms.gov/initiatives/medicare-diabetes-prevention-program/index.html

Coverage&Reimbursement

Page 30: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

NationalDPPCustomerServiceCenterPurpose: Provide a hub for resources, training, and technical assistance for CDC-recognized program delivery organizations and other National DPP stakeholder groups

Find Resources and Info

• Quickly and easily find resources and events relevant to your needs (FAQs, toolkits, training videos, webinars, etc.)

• Discuss opportunities and challenges with the National DPP community

Receive Technical Assistance Provide Feedback and Input

• Engage with technical assistance coordinators and subject matter experts via the web-based platform or email

• View the status of and update existing technical assistance requests

• Submit feedback on your satisfaction with the technical assistance, resources, and web-based platform

• Share success stories and suggest additional resources

www.NationalDPPCSC.cdc.gov

Page 31: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Formoreinformation,contactCDC1-800-CDC-INFO(232-4636)TTY:1-888-232-6348www.cdc.gov

ThefindingsandconclusionsinthisreportarethoseoftheauthorsanddonotnecessarilyrepresenttheofficialpositionoftheCentersforDiseaseControlandPrevention.

Thankyou!

Questions?Email:[email protected]

Page 32: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

LeveragingResourcestoScaleandSustainDiabetesPreventionProgramminginPennsylvania

PresentedbyGinaTrignani,MS,RD,LDNHealthPromotionCouncil

anaffiliateofPublicHealthManagementCorporationCentreSquare|1500MarketStreet|Philadelphia,PA19102

www.hpcpa.org|[email protected]|215.731.6119

Page 33: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Health Promotion CouncilHPC is a non-profit whose mission is to promote health, prevent and manage chronicdiseases, especially among vulnerable populations through community-basedoutreach, education, and advocacy.

• Based in Philadelphia, Pennsylvania• An affiliate with Public Health Management Corporation, a Public Health Institute• Local, state and national partnerships• Over 30 years of experience community based health education, promotion and

outreach• Programs and services reach over 40,000 vulnerable individuals annually

Fulfill our mission through: • Direct Service• Capacity Building• Policy & Systems Change

Page 34: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Organizational StructurePublicHealthManagementCorporation

RichardCohen,ChiefExecutiveOfficer

HealthPromotionServicesChristinaMiller,MSS,ManagingDirector

HealthPromotionCouncilChristinaMiller,MSS,ExecutiveDirector

PhiladelphiaAreaSexualHealthInitiative(PASHI)

TobaccoControl&PreventionServices

NutritionandActiveLiving FamilyServices

TrainingandCapacityBuilding

SeniorDirector,StrategicDevelopment

SeniorDirector,Operations&Training

OtherDivisions&AffiliateOrganizations

NationalNurse-LedCareConsortium

Page 35: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Origin of Many Resources

RegionalPrimaryContractors

LifestyleCoachOnline

Community

MasterTrainersLifestyleCoach

Trainings

• CentersforDiseaseControl• 1305(ended9/30/18)à 1815(started10/1/18)PADepartmentofHealth• 1705(NationalAssociationofChronicDiseaseDirectors)

• StateBlockGrant• MedicaidMCOPilot• FundingthroughotherPartnersAmericanMedicalAssociationtoPAMedicalSociety

Implement,Promoteand

MarketNationalDPPSeriesinPA

• IncreaseScreening,TestingandReferring(byPCPs)• Increaseaccesstoprograms• Increaseenrollmentandparticipation• IncreasesustainabilityofNationalDPPproviders

Page 36: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Partners in Pennsylvania

Page 37: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

LeveragingResourcesandPartnerships

Fundingresources

Planning Partners&Programs

TargetPopulation

Page 38: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Reducing the Impact of Diabetes

Page 39: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Prediabetes in Pennsylvania

Approximately3.5millioninPA

Morethan1outof3adultshasprediabetes

CentersforDiseaseControlandPrevention.NationalDiabetesStatisticsReport:EstimatesofDiabetesandItsBurdenintheUnitedStates,2014.Atlanta,GA:USDepartmentofHealthandHumanServices;2014.andU.S.CensusBureau:StateandCountyQuickFacts,PAAdultPopulation,2013Estimate.

Roughly3millioninPA

(onehalfto1millionnewcases)

Page 40: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Polling Question

• Doesyourorganizationhaveaccesstodatadescribingthepercentageofpatientswhoareatriskfordiabetes(pre-diabetes)?q Yesq Noq Notsureq Notapplicable

Page 41: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

DPP Strategies in Pennsylvania

qIncreaseavailabilityofDPP

§ Buildandsustainworkforce oflifestylecoaches

§ Deliverthelifestylechangeprograms throughanexpandednetworkofDPPProviders

qIncreasereferrals toandparticipationin DPP

qIncrease awareness– promotionandscreening

qWorktowardsustainabilitythroughcoverage,policyandsystemssupport

Page 42: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

PA State Action Plan for Scaling and Sustaining National Diabetes Prevention Program (DPP Action Plan)

Availability

More than 31 State Engagement Meetings (StEM) to Create a Diabetes

Prevention Action Plan

Awareness Referral Coverage

https://www.chronicdisease.org/page/STEMReport2018

Page 43: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Build and Maintain Workforce• MaintainandSupportMasterTrainers

• 3MasterTrainerSelect• 1Y-DPPMasterTrainer

• ConveneLifestyleCoach(LC)Trainingsthroughoutthestate

• Over200LifestyleCoachestrained• DevelopingaLCcommunitythroughPADOHLiveHealthyPA.organdconveningmeetings

Page 44: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

CDC Defined Workforce to Support DPP

• Lifestylecoach toleadthelifestylechangeprogramsessionsandsupportandencourageparticipants

• Programcoordinator tooverseedailyoperationsofthelifestylechangeprogram,supportandguidelifestylecoaches,andensurethattheprogrammeetsqualityperformanceoutcomes

• Datapreparer tocollectandsubmitdatatoCDC.

Page 45: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Increasing Availability§ Deliverthelifestylechangeprograms throughorganizations

statewide– technicalassistancetobecomeCDCRecognizedNationalDPPproviders

§ YMCA§ PACommunityHealthCenters§ PHMCHealthNetwork§ RegionalPrimaryContractors(PADOH)

§ PAPharmacistsAssociation§ AmericanLungAssociation§ ErieCountyDepartmentofHealth§ HealthPromotionCouncil

§ Employergroups– BusinessCoalitions§ Healthsystems§ Community-basedOrganizations

Page 46: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Increasing Availability / Technical Assistance in PA(1305 to 1815 CDC Funding)

Since2014• PennsylvaniaDeptofHealthFundingfromCDC

• Increasefrom9toover91CDCRegisteredNationalDPPsites

• ContractingandprovidingtechnicalassistancetositestoobtainCDCPending,Preliminary,FullRecognition

• PennsylvaniaPharmacistsAssociationaddedtoincreaseDPPprovidedbypharmacies/pharmacists

AdagioSouthwest

AmericanLungAssociation

Northeast,North&SouthCentral

RegionalPrimaryContractor

HealthPromotionCouncil

SoutheasternPAStatewideLifestyleCoach

Training

StatewideSupportforMarketingandPromotion

PADOHOnlineLifestyleCoachCommunityof

SupportLIveHealthyPA

CalendarofNationalDPPinPennsylvania

ErieCountyDeptofHealthNorthwest

PennsylvaniaPharmacistsAssociation

Page 47: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Poll Question

• IsyourorganizationreceivingtechnicalassistanceorfundingfromastateorlocaldepartmentofhealthfortheNationalDPP?q Noq Statefundingand/ortechnicalassistanceq Cityorcountyfundingand/ortechnical

assistanceq Technicalassistancefromanationalpartner

Page 48: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle
Page 49: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Increase Referral and Participation

• CBSHealthNetwork• PADOHCommunity

HealthNurses• MCOWorkgroup• PADOHWebsite

Page 50: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

DPP Toolkits

• PreventDiabetesSTAT• NationalDPPCoverageToolkit• PADepartmentofHealthDiabetesWebpage• LiveHealthyPA

Page 51: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Increase Referral and Participation

http://www.health.state.pa.us/diabetesmap/dpp-map.aspx

Page 52: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Awareness Media Campaign

Page 53: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Awareness Campaign

Page 54: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Expanding Coverage

Page 55: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Expanding National DPP to Underserved PopulationsCDC-DP17-1705

§ NACCDisoneof10CooperativeAgreementsAwardedthroughoutthecountry

§ Pennsylvania,Alaska,NewYorkandFlorida§ RuralPopulationsandthoselivingwithdisabilities§ Aninclusivecurriculumadaptationforpeoplelivingwith

disabilities§ VirtualDPPproviderHOPE80/20§ Wellpassfortext-basedengagementandretention§ HPCpartneringwithConemaughHealthSysteminYear1

Page 56: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Medicaid Managed Care Organization Pilot• MedicaidMCODPPOutreachandEnrollmentPilot

• January1,2018– April30,2019• 40counties(outsideofPhiladelphia)• 20,000membersidentified• Activeoutreachandenrollment– geo-mappingandcallcampaign(toover6,500memberstodate)

• Capacity-buildingtoexpandtocountieswithoutDPP• Year-longDPPcalendardevelopment• YMCAengaged• HealthSystems

Page 57: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Medicaid Managed Care Organization PilotMCO

Identifies20,000membersmeetingcriteriaforrisk

ContractswithHPCtoenrollmembersintoNationalDPPinPA

HPC furtherbuildscapacityinPA

StatewideAllianceYMCAPartnership;PACHC

HPC contractswithDPPProvidersinMCOCountiesserved

(upto40)

ContactCenterforHighVolume- EngagingandEnrollingupto19,000

MembersEnrolledinlocalDPP

LocalDPPProviderDeliversLifestyleChange

Program

PCPNetworkAwareness

HPC ReimbursesDPPproviderforservices

Page 58: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Pennsylvania Reach to Date

• Over210lifestylecoachestrained• Over110DPPproviders(andgrowing)• Community,healthsystem,payerandprivateproviderpartners

• Reachedover2,000participants(738completed1year)

• Over225DPPcohortsdelivered/inprogresstodate

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Funding – Partners – Programs

Collaboration

Page 60: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Finding Diabetes Prevention Programs in Your State

https://nccd.cdc.gov/DDT_DPRP/Programs.aspx

https://www.cdc.gov/diabetes/prevention/index.htm

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Summary• Assess your population needs (clients, patients, staff)• Assess your ability to meet these needs

– Staff, programs, leadership support, payers/funding• Explore existing resources and partners to leverage to start

new programs and/or strengthen programs within your organization

• Partner to attract the interest of payers• Learn from other states – share and explore promising and

innovative practices

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Page 63: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Leveraging Diabetes Prevention Programming for Your Health Center:The Pacific Islander National Diabetes Prevention Program

Nena TolenoaExecutive Director, Kosrae Community Health CenterChair, AAPCHO Pacific Islander Center of Excellence in Primary Care

Page 64: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Association of Asian Pacific Community Health Organizations (AAPCHO)

´ National association representing the needs of 34 community health centers

´ Supporting health centers serving Asian American, Native Hawaiian, and Pacific Islander patient in the Continental US, Hawaii, and the Pacific since 1987

´ 500,000+ patients´ BPHC National Training and Technical Assistance

Cooperative Agreement holder´ CDC National Diabetes Prevention Program

(NDPP)Cooperative Agreement holder

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Increasing Access to the National Diabetes Prevention Program for Pacific Islanders

Our Reach: ´ Continental US, Hawaii, and the Pacific

region Affiliated StatusAbout the USAPI: US Territories

´ American Samoa´ Guam

Commonwealth´Commonwealth of the Northern

Mariana Islands (CNMI)Freely Associated States

´ Republic of Palau´ Republic of the Marshall Islands (RMI) ´ Federated States of Micronesia

(FSM)

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Pacific Islander National Diabetes Prevention Program

´ Our Partners

´ Kosrae Community Health Center´Kosrae State, Federated States of

Micronesia

´ Chuuk Women’s Council´Chuuk State, Federated States of

Micronesia

´ Kwajalein Diak Coalition´Ebeye, Republic of the Marshall Islands

´ Malama I Ke Ola Health Center,´Maui County, Hawaii

´ Arkansas Coalition of Marshallese´Springdale, Arkansas

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Diabetes Prevalence for Pacific Islander PopulationsLocation Year Prevalence

Guam 2002-2003 11%

FSM 2002 24%

RMI 2002 30%

Palau 2006 39%

American Samoa 2004 47%

Hawaii 2015 13.9%

United States 2007 8%

Sources: 1. Hosey G, Aitaoto N, Satterfield D, Kelly J, Apaisam CJ, Belyeu-Camacho T,deBrum I, Luces PS, Rengiil A, Turituri P. The culture, community, and science of type 2 diabetes prevention in the US Associated Pacific Islands. PrevChronicDis. 2009 Jul;6(3):A104. Epub 2009 Jun 15. 2. MMWR Morb Mortal Wkly Rep. 2015;64:1261-1266

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Increasing Access for Pacific Islanders to the National Diabetes Prevention Program

Our Investments:

´ Established community AND Health Systems Partnerships´ Churches´ Government partnerships

´ Workforce Development: Community Health Workers

´ Increase Access to Physical Activity Resources

´ Data Support and Training

´ Curriculum Access: Translation into 3 Pacific Islander languages

Page 69: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Increasing Access for Pacific Islanders to the National Diabetes Prevention Program

Our Results: ´ Cycle I – 2018:

´ Nearly 800 participants enrolled and retained in the program

´ More than 30 community partnerships with local area churches

´ A new workforce of nearly 40 trained Lifestyle Coaches

´ Participant success in reducing 5-7% body weight and increased consumption of healthy fruits and vegetables

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Resources for Health Centers

´ Provider education and referral supports for prediabetes patients

• Translated curriculum: Chuukese, Marshallese, Kosraean

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Thank You

Nena [email protected]

www.aapcho.org

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LEVERAGINGDPPFORYOURHEALTHCENTERNEIGHBORHOODHEALTHCENTERSOFTHE

LEHIGHVALLEY

Alicia Rivera, BS Health EducatorDonna B Winston MSN, RN Director, Clinical Operations

Page 73: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

PICTURE HERE

NeighborhoodHealthCentersoftheLehighValley(NHCLV)MISSION

ThemissionofneighborhoodhealthcentersoftheLehighvalley(NHCLV)istoprovide

primaryandpreventativehealthandwellnessservicesintheLehighValley,regardlessofaperson’sabilitytopay.Westrive

todothisdirectlyandinpartnershipwithother

organizations,withagoalofcreatingaprimaryhealthcarehomeforanunderserved

community.

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HealthCenter&PatientProfile• LocatedinLehighValley,PA,andservingthecommunitysince2010

• Wehave3siteswith12providers,including3NPs,1CertifiedNurseMidwife,3residentsand5physicians

• Ourclinicsprovide:• Primarycare• MedicallyAssistedTreatmentforSubstanceUse

• IntegratedBehavioralHealth• Prenatalcare• Dentalservices• DPPandDMPrograms

• Weprovidecareforapprox.5,400patientsannually

• 90%ofourpanelconsistsofun- andunder-insuredindividuals

• MajorityHispanicwithSpanishasprimarylanguage.Wealsoservearefugeepopulation

• Approx.60% livingat100%andbelowthepovertylevel

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OurIntegratedCareTeam• NHCLVbelievesthat

healingoccursinrelationshipsandwestrivetoprioritizerelationshipswithpatientsandourcommunity

HowwebecameinvolvedwiththeNDPP• Wholeperson,relationship-

basedapproachtocare

DPPpatientsidentified• Pre-diabetes

• FBS: 100-125 mg/dL • A1C: 5.7-6.4%

Patient Family

Community

Primary Care Team

Complex Care

Manager

Diabetes Prevention Program

Medically Assisted

Treatment for Substance

Use

Outreach Enrollment Community Exchange

Integrated Behavioral

Health Team

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DiabetesPreventionProgram

• Recruitment

• Logistics

• Participation rate

• Challenges

Page 77: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

DPPProgramOutcomes

Cohort 1

10 participants completed program

Cohort 2

11 participants completed 1st

6 months of program

Average Starting Weight

175.7 167.5

Average Ending Weight 161.5 155.6Total Pounds Lost 142.0 130.0

Average Weight Lost 14.2 11.8Most Weight Lost 42.0 39.0

Page 78: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Questions?

Alicia Rivera [email protected] Bryant Winston [email protected]

Page 79: Leveraging Diabetes Prevention Program Webinar · Jun 2013 Dec 2013 Jun 2014 Dec 2014 Jun 2015 Dec 2015 Jul 2016 Dec 2016 Jul 2017 Jan 2018 Feb 2018 Apr 2018 Oct 2018. The Lifestyle

Questions?

• Slidesavailableinhandoutspane(rightsideofyourscreen)

• CME/CNEcreditlinkwillbesenttoallattendeesbyFriday,November30th*

* Thisactivity(LeveragingDiabetesPreventionProgrammingforYourHealthCenter)isapprovedforupto1.5prescribedcredithoursbytheAmericanAcademyofFamilyPhysicians.TheAmericanNursesCredentialingCenter(ANCC)acceptsAAFPCMEtowarditsmembercontinuingeducationrequirements.