1. Indiana Chronic Disease Plan
Chronic Disease Advisory Group April 19, 2016

2. Welcome & Introductions
Name
Organizational Affiliation

3. Agenda for Today Today’s Objectives:
Review & add to SWO analysis of 4 Domains
Identify & prioritize initial objectives for each domain
Welcome & Review
Small Group Discussions by Domain
Review Initial SWO analysis
Identify Chronic Disease Plan Objectives
Report Back & Identify Priorities

4. Broad Components of CDAG Role
Adopt Foundational Framework
4 Domains of Chronic Disease Prevention
Culture of Health
Advice & Input
Challenges that cut across disease areas
Strengths, weaknesses, opportunities for synergy
Objectives that emerge from SWO
Over time review content, support & monitor use of Plan 

5. Chronic Disease Prevention System

6. Chronic Disease Planning Process
Review feedback from CDAG meeting and organize within domains in a table that identifies strengths, weaknesses & opportunities
Begin to develop action plans.
Identify “low hanging fruit”
Consider “gaps” and CDAG feedback to identify 3-5 strategic opportunities
Develop strategic plans for these opportunities
Chronic Disease Planning Process

7. Domain 1: Epidemiology and Surveillance
Strengths
Practitioners have access to data (surveillance) that can be shared
211 has great data
Weaknesses
Lack of a centralized database
Expensive to have data analyzed
Real time data is hard to come by
Local data is largely missing
State mandates on what’s reported throughout state – very “light” on incidence
Standardized/uniform reporting is not adequately regulated
Acute care and primary care lack communication.
Claims data is more available than true data.
Data is needed on growing disease populations. (e.g. dementia)
Opportunities
Look at policy and systems changes under epidemiology. Make sure we know about everything going on in Indiana by improving communications so we don’t have to reinvent the wheel.
Improve data collection through communication and policy
Look into creating a resource database

8. Domain 2: Environmental Approaches
Strengths
There are some policies in place to try to encourage healthier lifestyle choices
IDEM has tools for recording air quality
Weaknesses
Lack of a centralized database
There are too many barriers for Hoosiers when it comes to transportation, education, finances, primary care and other resources
Schools policies on exercise and recess are not adequate
Poor quality of housing
Access to recreational facilities is lacking
Lack of funding
Opportunities
Influence political will – Organizational will and collaboration can make a difference
Shift from individual interventions to environmental interventions (e.g. Smoke-free air in multi-family housing)
Find a way to have SNAP accepted at farmers markets
Opportunities with zoning to improve access
Improve quality of housing available and location
Opportunities with Park/Land expenditures (built environment)
Create attractive recreational facilities to encourage health
A holistic approach is needed. Work on breaking down silos and improving communication
Increase breastfeeding – Breastfeeding initiation with African American moms
Improve safe routs to school/complete streets
Push for baby-friendly hospitals

9. Domain 3: Healthcare Systems Interventions
Strengths
Grant funds are available
TeleHealth
Weaknesses
Social determinants are not prioritized in healthcare system (e.g. conditions in the places where people live, learn, work, and play)
Lack of communication between agencies
Need funding
Access is not equal for all
No current legislation that addresses chronic disease specifically
Opportunities
Push for reimbursement for all members of the team and community based resources
Improve the effectiveness of interventions
Well-funded tobacco program to increase awareness and tobacco tax
Encourage a patient care team approach
Keep the “whole” health team. ISDH as support? – Technical support. Medicare reimbursement for services and prevention programs. Accreditation.
Reach more people in the state – social marketing campaign
Turn data into economic gain – show how certain programs will actually help the economy

10. Domain 4: Community Programs Linked to Clinical Services
Strengths
YMCA diabetes preventive program now paid by Medicare
Healthcare professional – now includes case managers (nurse practitioners, RNs PT, RRT asthma educator, CICOA, EMS, paramedicine program)
Weaknesses
Unable to find partners who have evidence based data to report – as it is too difficult to connect to EMR
Lack of engagement from people in the community
Lack of funding
Indiana has far fewer sliding fee scale clinics than other states (e.g. health professional shortages)
Opportunities
Try to provide data on return on investment
Go to people vs planning events waiting on them to attend event
IUPUI was just awarded a grant to work on this domain
It is important that we all use the same language. (social marketing campaign)
Make 211 more health oriented