July 2019
Rural Matters
In This Issue...
jackHas CDSMP's Time Finally Arrived?
Jack Salo, Executive Director

The Chronic Disease Self-Management Program (CDSMP) is an evidence based self-management education workshop developed by researchers at Stanford University. Participants attend six, two and a half hour workshops led by two certified trainers. Individuals and/or caregivers of individuals with chronic health conditions are taught problem solving and decision making skills alongside helpful information on healthy eating, exercise, communicating effectively with health professionals and addressing both the physical and psychological effects of chronic disease.

In our region, CDSMP has had "fits and starts" over the years but has never really taken off. There are two primary reasons:

1. CDSMP and other community health education programs generally do not receive referrals directly from health care professionals. This limits participation to those who may see recruitment information in the media, or hear about a workshop being offered from family or friends. Rural Health Network has had to cancel workshops over the years due to insufficient enrollment. Many who could benefit from the program never hear about it.

2. There is not a sufficient - sustainable payment mechanism for CDSMP. There was NYS support for regional development of CDSMP capacity several years ago, and when the funding dried up, so did the effort. Care Compass Network has funded CDSMP capacity building and participation through DSRIP, but again, this is time-limited funding. Organizations that participate by having staff trained to lead workshops are required to cover all or most of the cost associated with maintaining certification and offering CDSMP. Clearly this is not an incentive to continue or expand the program. Many organizations participate for a year or two and then scale back or drop CDSMP.

There are some potential positive developments on the horizon. The interest in social determinants of health, health literacy and health education is creating greater interest on the part of health care systems to work more closely with community organizations. Powerful electronic medical record systems and data repositories now have the capacity to identify and refer individuals who can benefit from an array of non-clinical services.

On the payment side, Medicaid funded value based payment models that require participation of community organizations in clinical - non-clinical networks may create opportunities for funding CDSMP and other evidence based community health education programs. Relatively low cost health education programs like CDSMP that have demonstrated improved health outcomes and healthcare savings could also be of interest to private insurers. Finally, approving CDSMP as a reimbursable service through Medicare and/or Medicaid could help provide the funding necessary to further develop and sustain CDSMP.

Until there are regular, sufficient referrals to CDSMP from health care providers and sufficient and sustained payment for the service, CDSMP will remain a modest and underutilized opportunity to help those with chronic health conditions have a more active and effective role in managing their health condition(s).

  Jack Salo             
Executive Director

Read more about the return on investment for CDSMP: 

"CDSMP participation was associated with a $245 reduction in average inpatient unplanned costs"

The Impact of Chronic Disease Self-Management Programs: Healthcare Savings Through a Community-based Intervention
"Findings from analyses showed significant reductions in ER visits (5%) at both the 6-month and 12-month assessments as well as hospitalizations (3%) at 6 months among national CDSMP participants. This equates to potential net savings of $364 per participant and a national savings of $3.3 billion if 5% of adults with one or more chronic conditions were reached."

Healthcare Cost Savings Estimator Tool
"Given findings from previous studies, CDSMP could save a significant amount of healthcare costs by averting ER visits and hospitalizations, if even only a small portion of the population was reached." 

hireWe're Hiring
Rural Health Network is currently recruiting for the following positions:

*Program Coordinator - Getthere
*Mobility & Transportation Advocate
*Coordinator, Northern Broome NORC (Naturally Occuring Retirement Community)

Application instructions: ALL applicants must apply HERE: https://form.jotform.com/RHNSCNY/rural-health-network-application-
emmaUpdate on the Social Determinants 
Measurement Project
The SDOH project team has brought on two second-year Binghamton University MPH student interns for the summer. Both projects focus on measurement of social determinants interventions.

Bre'zhe Brooks and Emma Ospelt

Bre'zhe Brooks will conduct focus groups with participants of the 2018 Fruit and Vegetable Prescription program to discuss the program's impact on their lives. Bre'zhe has created an evaluation plan that connects the participants' satisfaction and behavior surveys to measureable changes in their health, such as improved blood pressure, blood sugar levels, or weight. This blended survey-biometric design will be piloted with FVRx participants in the Our Lady of Lourdes cohort at 303 Main St. primary care practice, with potential applications in all of Food and Health Network's FVRx sites.

Emma Ospelt has designed a laundry voucher program to support the 303 Main St. cohort. For some families, the cost of laundry and laundry supplies puts a strain on the household budget. Having clean clothes restores a sense of dignity, and cleaning linens regularly reduces the risk of bed bugs and other health concerns. Modeled on similar efforts in Ithaca and Whitney Point, this program will distribute coins and detergent for cohort members and their families, with potential expansion to other community members in the future.

To learn more about these activities and the RHN Social Determinants Measurement project, please contact  Emma Nalin , Project Coordinator. 
  Tioga Tells Progress Report

The Tioga Tells Quality of Life Assessment hosted a forum on Tuesday, July 16 to present the results from the first phase and share plans for phase two. Read the Executive Summary or the Full Report.

See coverage of the event HERE featuring an interview with AmeriCorps VISTA Member Deanna Hutchison who led the project during year one.  

Members of the Tioga Tells Steering Committee are pictured below.

Front: Susan Medina; Elaine Jardine; Ron Doherty
Back: Rose Cornelius; Catherine Rodgers; Scott MacDonald; Deanna Hutchison; Bill Ostrander; Maureen Abbott; Mary Maruscak

Missing: Andy Fagan; Dorothy Richter; Eric Yetter; Fraser Williams; Jack Salo; Jackie Bogart; Megan Kaminsky; Shawn Yetter

Tioga Opportunities, Inc. will lead Phase Two of project. We're currently recruiting for an AmeriCorps VISTA member to serve a one-year term to create action plans based on the findings from the assessment. 
Partnering to Address Oral Healthcare

Nicole Argro, Rural Health Network Community Health Worker (photo left) in her new office at Lourdes Center for Family Health on 303 Main St in Binghamton and Karyn Palmer, Community & Public Relations Manager from Wilson Dental (photo right) are excited to share with patients dental care products donated by Wilson Dental! Oral health matters and it takes partnerships to improve care.

Photo credit: Lourdes Nurse Navigator, Kelly Murtha who graciously shares her office with Nicole to meet patients where they are and offer support and community resources to improve their health status.
articleArticles of Interest
Broome County Seeks Input for next Comprehensive Plan

Broome County is updating their Comprehensive Plan which was last adopted in 2013. The plan outlines the vision of the community and is used for making decisions, preparing the County's Capital Improvement Program, and supporting grant writing efforts. The county is seeking input from those who live or work in Broome County. Take a few minutes to complete the survey

National Organization of State Offices of Rural Health Accepting Nominations for 2019 Community Stars

NOSORH is dedicated to bringing attention to the outstanding contributions of those who are working to improve health in rural America through leadership development, advocacy, education, and collaborative partnerships. If you know of an individual or organization that NOSORH should shine a light on and celebrate this National Rural Health Day (11/21), please take just a few moments to nominate them by August 9, 2019
impactOur Latest Impact Report

Our latest Impact Report has been published. Please take a moment to learn more 
about our work and the impact we're making in south central New York. 

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