Effort Urges Seniors With Chronic Conditions To Change Habits

by George Lauer

It’s like traffic school for chronic offenders.

The “traffic” in this case is healthy habits — eating right, exercising, taking your meds. The chronic “offenders” are diabetes, arthritis and heart disease. The “school” is the pivotal part of a new statewide partnership with the goal of getting ailing, aging Californians to live healthier lives.

Partners in Care Foundation and the California Association of Physician Groups are joining forces to expand the Healthier Living program teaching self-management methods for older adults with chronic conditions.

Based on the Healthier Living Program developed by Kate Lorig and her colleagues at the Stanford Chronic Disease Self-Management Program, the heart of the effort is a series of six 2.5-hour workshops presented over six weeks by two trained leaders, one or both of whom have a chronic disease themselves.

The highly scripted program deals with issues everyone with an ongoing health condition lives with — managing medications, dealing with isolation and depression, starting an exercise program, eating and drinking wisely, meeting goals and communicating better with physicians.

The three-year initiative will launch by creating five “mini-networks” in selected parts of the state linking community college adult programs, physician groups and county public health departments. The networks will identify, refer and enroll older Californians in the workshops. The goal is to enroll 9,525 older Californians in Healthier Living by 2011.

Eventually, the program will include online support groups to augment the workshops, organizers said.

Improving Quality of Life, Reducing Costs

“Chronic conditions are so rampant in the older years, we’ve got to do what we can to help people improve their quality of life,” said June Simmons, president and CEO of Partners in Care Foundation.

“These programs can go a long way to counteract so much decline and pain in so many people’s lives. That’s our primary goal, but we’re also cognizant that these kinds of programs can help relieve pressure on the health system in general,” Simmons added.

Donald Crane, president and CEO of the California Association of Physician Groups, said doctors’ involvement makes sense on several levels.

“It starts with the realization that chronic care is such a huge issue for seniors in California, particularly obesity and diabetes,” Crane said.

“We need to find more and better methods of coping with what is only going to be a bigger and bigger issue as more people get older. This program is low hanging logical fruit for us all to pick. It’s going to help patients, doctors, clinics, hospitals — pretty much everybody along the way,” Crane said.

In addition to helping individuals cope with chronic conditions, the program is designed to help reduce costs in the health system.

“Programs like this ultimately will reduce costs across the board — for individuals, for providers, for insurers and for the government,” said Christina Clem, spokesperson for AARP.

“We had a study that came out in 2007 showing 40% of Medicaid enrollees had some kind of chronic illness. And that number is going to go up as our population ages,” Clem said.

“We’re happy to see any growth in education and counseling that will help patients handle day-to-day chronic disease management. These sound like excellent programs for everybody, starting with the patients,” Clem said.

Seeded With Grant Money, More Sought

Partners in Care Foundation, a not-for-profit based in San Fernando, is designated by the state Departments of Aging and Public Health Program Office to oversee California’s evidence-based health promotion efforts for older adults.

The Foundation’s Healthier Living program is being funded in part with $300,000 in grants from the National Council on Aging and Atlantic Philanthropies, part of a national initiative awarding grants to eight states to promote healthy habits among seniors with chronic problems.

Foundation officials are beating the bushes for $640,000 more in grant money to expand the program’s scope.

In addition to CAPG, the program includes collaboration with the state Departments of Aging and Public Health, Kaiser Permanente, community colleges and other community partners to identify and recruit physician groups to expand the reach of Healthier Living. The goal is to make the program available to 60% of older Californians.

The CAPG collaboration will serve to identify best practices for physician referrals to three non-credit community-based courses and prepare tools for future expansion including physician group readiness assessment, patient screening and referral criteria, education tools for office/clinical staff, referral forms and fax back forms for community based organizations.

CAPG plans to educate physicians about Healthier Living through statewide, regional and medical policy meetings, e-mail updates and newsletter/magazine articles. Once programs are up and running and physicians begin making referrals for their managed care patients, Healthier Living could become a general standard of practice, CAPG officials said.

Kaiser Permanente Lessons Applied

Lessons learned by Kaiser Permanente, which has had some success with physician referrals to the Healthier Living program over the past decade, will be adapted and applied by CAPG members in more open systems. At least one physician group — Healthcare Partners in Los Angeles — will adopt the Healthier Living program internally by becoming licensed by Stanford University and hosting Healthier Living on-site, mirroring the Kaiser Permanente model.

After the first five “mini-networks” are established, program officials hope to expand to the entire state.

There is a sense of urgency with many programs aimed at caring for a growing aging population. The U.S. population age 65 and older is expected to more than double to 72 million by 2030. Many health industry experts predict the system won’t be able to keep up as baby boomers age and develop chronic conditions.

“Unfortunately, many people with chronic conditions feel they lack the skills to effectively manage their illness. Healthier Living is designed to educate and support older adults to make behavior changes so they can lead more active and satisfying lives,” said Jennifer Wieckowski, Partners in Care program administrator for the state initiative.

“The goal of Healthier Living is to offer older Americans who often suffer chronic health conditions an opportunity to take control of their health through behavior changes that have proven effective in reducing the effects of disease and disability,” Wieckowski said.