D. McDowell1

Living Well in Wisconsin Donna McDowell, Director Bureau of Aging & Disability Resources Department of Health Services

D. McDowell3 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

D. McDowell4 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

D. McDowell5 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

D. McDowell6 Self-Management Is Important Fatigue Depression Pain Stress Emotion Disease

D. McDowell7 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

D. McDowell8 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

D. McDowell9 Statewide CDSMP 262 Lay Leaders 16 Spanish Leaders 5 Spanish MT 41 Master Trainers 2 T-Trainer

D. McDowell10 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

D. McDowell11 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

D. McDowell12

D. McDowell13 Training/ Fidelity/Measures University and health system partnerships One statewide CDSMP license from Stanford Community Health Educators Reporting-common data across systems, locations, funding

D. McDowell14 Living Well Data Sample 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, 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

D. McDowell15 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)

D. McDowell16 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

D. McDowell17 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

D. McDowell18 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

D. McDowell19 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.

D. McDowell20 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 Ann