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Chronic Disease

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Chronic Disease
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Community Engagement Survey II

Survey Dates: October 8-15, 2009



CHRONIC DISEASE PREVENTION AND CONTROL

Provisional Objectives

Health Across the Lifespan: Improve the prevention and management of chronic conditions through

integrated comprehensive care by building a business case and securing reimbursement.



Health Equity: Reduce barriers and enhance opportunities for consumers to make informed decisions

about their health and quality of life.

# Group Sector What do you suggest are the best ways to move these objectives forward?

1 Registered for fall 2008 Public Sector (Non- Policies to provide financial support for case management to be provided by home

Community Engagement Government) health /public health nurses who have done this for years; but are now too

forum underfunded with the acute care; primary care medical model and fee for service

reimbursement only going to medical treatment.

2 Member Focus Area Community Sector The physician can no longer be the Captain of the Ship. The reason: 94% of

Strategic Leadership poor health is related to factors other than health care! Providers should be

Team (FAST) thought of as just one member of the orchestra of people who will be needed to

provide care. This team-concept needs to be formed very early in training; and

goes across all specialties; including neighbors; family; pharmacy; nursing;

economic support; social services; ministries; etc.

3 Member Focus Area Government (State Completely unacceptable health equity objective. Health equity is basically not

Strategic Leadership or Local) about individual decisions and individual behaviors; it is about social and

Team (FAST) economic structural factors that constrain behaviors and contribute to chronic

stress. Since much chronic disease is a result of the aggregation of years of

chronic stress (cortisol and adrenaline excess); prevention - - through a health

equity lens - - will require addressing issues far upstream; including;

fundamentally; racism and poverty. Intermediate health equity objectives to

prevent chronic disease would include improving unemployment and educational

outcomes; reducing neighborhood violence; improving childcare quality and

availability; public transportation; etc.

4 Member Focus Area Private Sector Support reimbursement policies/legislation that include prevention; care

Strategic Leadership coordination; and case management; empower individuals through

Team (FAST) education/outreach and reimbursement to self-manage their chronic conditions



5 WI Aging Government (State Addressing chronic disease cannot be accomplished by public health departments

network;Wisconsin or Local) alone; or even primarily. Expansion of evidence-based Chronic Disease Self-

Department of Health management is vital.Coordination of health care for elders and adults with

Services program or disaiblities who have multiple chronic diseases is key. Dementia should be

management staff considered a chronic disease.









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# Group Sector What do you suggest are the best ways to move these objectives forward?

6 Member Focus Area Government (State 1.) Document and market the cost savings of prevention to employers and

Strategic Leadership or Local) insurance groups; 2.) Duplicate innovative models of care that has been shown

Team (FAST) effective in improving the quality of life of participants; 3.)Develop and market

standards for promotion of quality of life; and 4.) recognize providers that

participants rate highly as implementing quality of life standards

7 Member Focus Area Public Sector (Non- *Incent local health departments to screen (blood pressure/cholesterol/glucose)

Strategic Leadership Government) dispariate populations. Too often health departments are competing with local

Team (FAST) health care organizations for screening and health promotion activities at

worksites. These are not disparate populations. Screen at older adult high-rises;

at WIC clinics; at the unemployement offices; etc.



8 Registered for fall 2008 Nonprofit Sector *Link nutritional and PA campaigns into a comprehensive campaign to fight

Community Engagement chronic illness*Create and promote a comprehensive online nutritional & PA

forum resource tool kit targeted to adults >35 years of age -- free downloads; coupons;

local produce venues; comparison charts; et.

9 expert panel Nonprofit Sector Incorporate the evidence based programming for Chronic Disease Management

member;Registered for that currently exists in the state and that has current funding attached. Chronic

fall 2008 Community Disease Self Managment Program or Living Well (with a chronic condition) .

Engagement

forum;Member Focus

Area Strategic

Leadership Team

(FAST)

10 Registered for fall 2008 Nonprofit Sector 1. Ensure that providers and clinics have a comprehensive knowledge of

Community Engagement prevention and management of chronic conditions. They are key to helping

forum patients make decisions and setting up an infrastructure that helps patients to

navigate their way through the healthcare system. Include reminder systems for

patients and providers when necessary screenings or check-ups are needed.2.

Focus on health literacy and empowering patients to take an active role in their

health care. Help them find accessible care.

11 Wisconsin Department Government (State Align payment incentives with quality objectives to have early intervention of

of Health Services or Local) chronic problems. Ensure all Wisconsin residents have health insurance that

program or management provides for early care and intervention for chronic conditions.

staff

12 Wisconsin Department Government (State Chronic Disease Self Management classes should be covered by private

of Health Services or Local) insurance and physicians should be educated to make appropriate referrals.

program or management

staff

13 Neighborhood Leader Public Sector (Non- To have a better health plan for all the people of Wisconsin and the United States

Government)









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# Group Sector What do you suggest are the best ways to move these objectives forward?

14 Representative; Nonprofit Sector Work with health systems and quality improvement organizations to develop and

Comprehensive Cancer implement QI efforts to prevent and manage chronic conditions.Develop a

Control (CDC & State business case for prevention and coordinated care and present to policy and

funded) decision makers. Develop strategies to include chronic disease prevention and

coalition;Registered for management into pay for performance reimbursement programs (health

fall 2008 Community systems; medicaid; etc.) Develop initiative to address health literacy issues for

Engagement forum priority populations for public health departments; health systems; and health care

providers; as well as community based organizations.

15 Member Focus Area Government (State This sounds like a goal; and not a specific; measurable; achievable; realistic; time-

Strategic Leadership or Local) measured objective.

Team (FAST)

16 Wisconsin Tribal Chair Tribe Reduction of barriers and enhancement of collaboration partnerships with

or Tribal Health Director enhanced reimbursement rates for collabortive partnerships.

17 Member Wisconsin Public Sector (Non- Expanding chronic disease management to all levels of clients. In some counties

Public Health Council or Government) only the elderly are being reached. Increasing prevention of chronic disease to a

a standing committee system wide population.



18 Registered for fall 2008 Government (State Promote the use of nurse educators in primary and secondary prevention of

Community Engagement or Local) chronic diseases (ex: nurse diabetes educators) with incentives for health

forum systems to utilize. Help local public health agencies move policy issues forward on

the local level. (Ex. filling in the local policy blanks to remove tobacco smoke

from the environment; until you reach a tipping point that yields statewide

consensus and policy). Make life habit changes for health a prominent feature of

all school curricula; engaging support from parents as models. Built environment

should include Dept of Transportation at state and local level--don't cut people off

from the rest of the world with 8 lane highways. Engage ALL public health

workforce staff in promoting these issues; not just public health nurses and

educators. Make sure elitist attitudes don't creep into policies; plans and activities.



19 Member Focus Area Government (State the only way these objectives can move forward are for an integrated partnership

Strategic Leadership or Local) with the practicing community through large health systems; public health data

Team (FAST) organization; and a few clear choices of community based priority areas.



20 nonprofit partner Nonprofit Sector ensuring that all Wisconsin residents have access to affordable health care

21 Member Focus Area Nonprofit Sector Work with health systems and incentivise MD's for qualityIncrease access to care

Strategic Leadership

Team (FAST)

22 Member Focus Area Government (State The State legislature needs to hear about these issues directly and receive input

Strategic Leadership or Local) from the people in communities - directly - in order for these individuals to know

Team (FAST) what a majority of the population in this State deals with on a daily basis. This

would be an important first step.

23 Registered for fall 2008 Nonprofit Sector The business case for chronic desease managment is already made in the payer

Community Engagement and provider sectors. To move this forward; we need to work with consumers to

forum engage them in managing thier own health and health care in partnership with

thier providers.



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# Group Sector What do you suggest are the best ways to move these objectives forward?

24 Member Focus Area Public Sector (Non- First implement disease management programs that target major high cost

Strategic Leadership Government) illnesses such as diabetes; COPD; asthma; etc..).Require member/insured

Team (FAST) participation in these programs as a precondition to receiving ongoing health

coverage benefits.

25 Member Focus Area Nonprofit Sector Utilizing current information to build a business case that can be presented to

Strategic Leadership payors (BadgerCare/MA; HMO; MCO; etc) on the benefits of reimbursing for

Team (FAST) integrated comprehensive care. Then offering recomendations for how this could

be accomplished.









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