HW2020 Community Engagement Survey II Chronic disease by liuqingyan


									              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) .
                 forum;Member Focus
                 Area Strategic
                 Leadership Team
              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.
              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
              13 Neighborhood Leader   Public Sector (Non- To have a better health plan for all the people of Wisconsin and the United States

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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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