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Living Well in Wisconsin. Donna McDowell, Director Bureau of Aging & Disability Resources Department of Health Services. Burden of Falls. Madison – State health officials report…
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Living Well in Wisconsin Donna McDowell, Director Bureau of Aging & Disability Resources Department of Health Services
Burden of Falls Madison – State health officials report… Deaths from falls have surpassed motor vehicle crashes and suicide as the most common cause of injury-related deaths. (87% elders) Hospitalizations and emergency visits due to falls cost $800 million per year (70% elders) 70% of costs are Medicaid and Medicare
Chronic Disease • Long-term Care costs drive Medicaid • Chronic disease leads to disability • Chronic disease and disability are the reason for long-term care for most elders and adults with disabilities • Reforming long-term care requires addressing chronic disease
Intersection • Chronic disease is at the intersection of health care and long-term care • Health care prevents disease • Medical care treats disease • Long-term care supports the person’s independence and normal lifestyle • Self-management is a key to prevention, treatment and long-term living
Evidence • Focus limited resources of Older Americans Act, public health and general revenue. • Integrated evidence-based prevention into aging, public health, home and community care, primary health care • Document results • Bring to scale
State Strategy • Bureau of Aging & Disability Resources • Bureau of Community Health /Family Health Programs • Chronic disease program coordinators for arthritis and diabetes • Injury and violence prevention coordinator • AAAging Health Promotion Team • 41 CDSMP Master Trainers
Statewide CDSMP 262 Lay Leaders 16 Spanish Leaders 5 Spanish MT 41 Master Trainers 2 T-Trainer
Stepping on Falls Prevention • Building Confidence, Reducing Falls • Empower older adults to carry out healthy behaviors that reduce risks of falls and improve self management • Community workshop 1x 7 weeks • Improves balance, strength, home and environmental safety, vision and medication management
From Oz to Wisconsin • Dr.Jane Mahoney MD -UW School of Medicine and Public Health • Dr. Lindy Clemson – Australia • American version of Stepping On • Research in two urban counties led to statewide adoption. • Sure Step – in home
Training/ Fidelity/Measures • University and health system partnerships • One statewide CDSMP license from Stanford • Community Health Educators • Reporting-common data across systems, locations, funding
1,717 participants 44% (748) responded 293 ED visits in previous 6 months Follow-up showed 231 ED visits post Decrease of 62 visits Net savings $60,202 151 hospital stays in prior 6 months Follow up showed 129 visits 6 month post Decrease of 22 stays Net savings $457,336 TOTAL savings if most had same outcomes $1,177,282 Living Well Data Sample
Sustainability, Validity, Efficacy GRANT FUNDING • AARA • CDC: Arthritis, Injury Prevention, Stepping On Dissemination • AoA Sustainable Systems x 2 • NCOA • Blues/HMOs • State GPR for ADRCs • Contracts for training in other states (CA, NY, MT)
Sustainability, Validity, Efficacy INFRASTRUCTURE • Aging network – 600 meal sites in WI • 35 ADRC prevention culture • Programs address person-specific issues; not drop in support • Trained peer leaders empower • Public health can provide T-Trainers • University partnerships for data collection, research and grants
WIHA Wisconsin Institute for Health Aging • Non-profit institute affiliated with UW School of Medicine & Public Health • Board includes university, state, aging network, health care system and consumer reps • Funding from current and future grants • Dr. Mahoney 50% “in-kind” from UW
WIHA Wisconsin Institute for Health Aging LEGISLATION • Authorizes DHS to contract with WIHA to administer EBPP • Gives WIHA authority to administer state prevention funds for AAA, public health and ADRCs • Gives UW authority to contract and partner with WIHA on grants and research • Recognize WIHA as the organization that coordinates Wisconsin Stepping On
LEGISLATION (cont.) Recognizes WIHA coordinator of WI Chronic Disease Self-Management Program (CDSMP) WIHA is clearing house for evidence-based (EB) health promotion for healthy aging; Recognizes WIHA as licensing agency for Stepping On North America. WIHA to train and assist staff in county/tribal agencies, Area Agencies on Aging, and other aging and public health service providers.
Testimonials and Resources • “I was tired. My pain was my boss. It was telling me what I could and couldn’t do. Living Well put me back in charge.” • “If you’re afraid to fall you won’t go out and you’ve lost your independence. • http://www.dhs.wisconsin.gov/health/InjuryPrevention/FallPreventionhttp://www.dhs.wisconsin.gov/aging • Email:Gail.Schwersenska@wi.gov • Email: Ann Hzvidak@wi.gov