1©2014

Leadership Council Presentation

Fall 2014 Update

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Collaboration Goals

5 shared goals with a Health Equity perspective

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Health Equity Leadership Group

• Guiding principles, practices, and call to action for all ACT participants

• Embed equity in ACT tools, resources, and communications

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Goal: Identify and Invest in Promising Approaches

• In-person caregiver support intervention modeling reflected in Health Affairs and subsequent Net Savings analysis

• Initial modeling: potential savings

• Net Savings completed

Identify/Invest

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Goal: Increase Detection and Improve Care

• Develop and disseminate Provider Practice Tools and curriculum that support providers in assessing, diagnosis, treating and managing dementia

Detection/Care

Provider Practice Tools

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Tools for multiple audiences , including:• Full disease spectrum• EMR decision support• Care coordination2015 focus : • Implementation• Health leadership

summit

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Dementia Curriculum

• Interdisciplinary dementia curriculum that embeds practice tools

• Curriculum will be foundation of national uniform dementia curriculum

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Goal: Sustain Caregivers

Caregiver focus within:• After a Diagnosis resource • Provider practice tools

(assessment and support) • Dementia is Everyone’s

Business (working caregivers)Sustain Caregivers

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Goal: Equip Communities and Raise Awareness

• Develop a Community Toolkit to foster dementia-friendly communities

• Support community implementation of the Toolkit

Equip Communities

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Dementia-Friendly Community

All sectors are informed, safe and respectful and foster quality of life

Sector-Specific Support Resources

Dementia-friendly action steps for:• Businesses• Community-based

supports• Faith communities• Health care community• Legal and financial

services• Local government• Residential settings

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1. Convene key community leaders and members to form an Action Team.

2. Assess current strengths and gaps within the community.

3. Analyze findings to understand your community’s needs and develop a plan to take action.

4. ACT Together to pursue priority goals that foster community readiness for dementia.

Cross-Sector Collaboration Support

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Communities ACTing on Alzheimer’s

32 Action Communities

Technical assistance from AAAs and Alzheimer’s Association

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Action Communities Happenings

• Creating dementia-friendly businesses

• Training Dementia Friends• Training health care

providers on ACT tools• Training local emergency

responders• Creating memory cafés

• Educating to increase awareness

• Developing Rabbi training• Hosting a caregiver

conference • Training teens within the

Jewish community• Training local government

employees

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Learnings: Collaborative

• No one owner• Consistent project support, coordination and

communications• Collective impact structure• Transparency and inclusiveness• Diverse participants and funders• Reporting progress

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Learnings: Early Adopters Survey

Increase detection and improve care• Survey questions about ACT tools and resources showed:

– Significant interest and participation in developing the tools– Limited understanding of their impact

Work ahead: Tool adoption; track/communicate impact

Invest in promising approaches• Economic model for caregiver intervention noted as

important work; survey timing impacted feedback Work ahead: Policy for caregiver supports and other

modeling

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Learnings: Early Adopters Survey

Sustain caregivers• Survey responses reinforced the conscious effort to infuse

caregiver support in all aspects of the workWork ahead: Action communities share/provide

resources

Raise awareness and equip communities• Survey participants believe the fostering of Alzheimer’s

awareness and its impact on communities is seeing results and making a difference for Minnesota

Work ahead: Action communities as models

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Sharing ACT Nationally

• National Alzheimer’s Project Act Advisory Council (April 2014)

• Scottish Institutes Knowledge Exchange (June 2014)• Dementia Action Alliance (June 2014)• Administration for Community Living Webinar

(August 2014)• WA2 Conference (September 2014)• HCBS Waiver Conference (September 2014)• AARP/Global CEO Initiative/Internat’l (Oct. 2014)

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Sharing ACT Nationally

• Curriculum• Use ACT on Alzheimer’s as foundation for uniform

national portal for dementia-friendly communitieso Centralized and maintained at national levelo Technical assistance and implementation at

state and local level

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Work In and Beyond 2015

• Practice tool adoption/implementation• Dementia-friendly communities support • Dementia-related policy advocacy (e.g.,

caregiver support)• National replication that helps sustain

Minnesota’s work

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Post-2015 ACT

• Steering Team considered various scenarios

• Recommend hybrid scenario

• Reduced/shared infrastructure

• Focus on tool implementation and community work

Minimal Centralized “Glue:”

Communication, Convening, Tracking,

Website

Foster enhanced national/

international DFC portal that would

also support MN

Foster dementia friendly

communities (w/caregiver and health equity lens

embedded)

Increase provider capability

(w/caregiver and health equity lens

embedded)

Policy/ systems change

(including advocacy)

Championed by health systems, health plans and Alzheimer’s Association, via embedding and training ($40k/yr for two years in training/outreach costs)

Policy/systems change issues articulated by Glue and pursued by Steering members or ‘housed’ within one existing organization (e.g., MNLCOA/Alz Assocation) (in-kind support).

Championed and sustained by AAAS and Alzheimer’s Association through joint fundraising and shared administration (including website) $30k per community inclusive of admin

Anticipated Supporting

Infrastructure

Glue could be direct “hire” for project management/direction or a donated function that is rotated across Steering members over time ($60k per year)

Voluntary, Broad-Based Steering Team that Champions/Informs/Disseminates Work

Foster national curriculum/ standards/

tools adoption to reinforce

implementation in MN

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Leadership Council Discussion

• Does the proposal warrant an ACT 2.0 and, if so, how will we organize to support it?

• If not, should we consider supporting a limited “glue” function (e.g., staff person under an existing organization)?

• Immediate next steps if any?

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Health Equity Courageous Conversation

• History and courageous conversation of health equity leadership group

• MDH health equity and elder rights parallel tracks

• Clarity around identity and purpose

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ACT on Alzheimer’s is a critical vehicle for fostering health equity

• Racial and ethnic minorities are at greater risk for developing Alzheimer's disease

• Members of minority ethno-racial groups often receive delayed diagnosis or inadequate treatment

• Protective defenses against and risk factors for dementia flow directly from societal inequities that disproportionately impact minority ethno-racial groups

• Health inequities are exacerbated by structural racism; they are avoidable, unjust and ACTIONABLE… so let’s ACT

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Health Equity—doing differently to achieve the same

Findings of Institute of Medicine (IOM) Crossing the Quality Chasm and Unequal Treatment reports:• Cultural competence• Person-centerednessimprove quality and eliminate racial/ethnic health care disparities

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Health Equity LG Initiatives

• Establish and implement health equity guiding principles, practices and call to action for ACT and its participant organizations

• Embed health equity lens into all ACT provider practice and community tools and communications

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Health Equity Discussion

• What responses do you have to the call to action?

• What opportunities do you see to adopt/embed the Health Equity principles and practices within your own organizations?

• Next steps?

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Next Steps

• Further comments or discussion?• Glen Campbell Documentary Screening

• Thanks!