Engaging Extension in Health Reform: Connecting the Dots

at the Community Level

Presented by:

David Young

Bonnie Braun

Michelle Rodgers

Cindy Reeves

April 16, 2013

What Will This Seminar Cover?

• Overview of Extension’s Involvement in Healthy Communities

• Determining Strategic Initiatives in Health for Extension

• NIFA Perspective on Nutrition, Health & Wellness

• Health Insurance Literacy Initiative• Connecting the Dots & Use of Social Media

Extension & Healthy Communities

• Healthy People, Healthy Communities National Initiative

• 4-H Healthy Living• Healthy Community Coalitions• eXtension ‘Creating Healthy

Communities’ CoP

eXtension Creating Healthy Communities CoP

• Improve health of vulnerable populations• Develop community engagement and

leadership skills• Foster improved health policy decisions• Advance healthy community

environments

Extension Health Stories canChange the World!

What would position Extension to be a

major player in Health?

What would it take to get that done?

ECOP Health Task Force• Charge to Task Force• Goals -- The ECOP National Task Force on Health will

seek to: • Identify priorities for Cooperative Extension health

programs for the next 3-5 years. • Identify outcome indicators for each priority. • Identify potential partners, public and private,

including non-traditional partners, to be engaged in resource development, program implementation, and outcomes reporting.

ECOP Health Task Force Committee Members

Co-Chairs: Cynthia Reeves and Michelle Rodgers

1890 region Southern Region

Javiette Samuel Carol Rice Tamara Warren Ann Vail

North Central Region Western Region

Karen Bruns Roger Rennekamp Linda Cronk Sonja Koukel 

Northeast Region Other

Lily Monroe Lord Suzanne Le Menestrel Bonnie Braun Linda Kirk Fox

A new and unique opportunity to address the health and health literacy of youths and adults through

research and theory-based programming.

Braun. B. (October, 2012). Responding to Health Care Reform: Mobilizing Extension. Journal of Extension. http://www.joe.org/joe/2012october/comm1.php

Create New Stories –Together we will narrate the future

Nutrition, Health and Wellness

• Cindy Reeves• creeves@nifa.usda.gov

– Encompasses a broad array of human science issues including health & safety, nutrition & health education, health literacy, health in the environment, access to health care and preventive services, and community health planning.

NIFA Health Priority Areas

National Prevention Strategy, America’s Plan for Better Health & Wellness, June 2011

NIFA works acrossall (4) Strategic Directions

NIFA’s work on Health Reform Outreach & Education

National Prevention Strategy, America’s Plan for Better Health & Wellness, June 2011

A systems framework: Food, Nutrition & Health Security

Healthy People 2020 Leading Health Indicators-Health Access

Access to Health Services Leading Health Indicator

• Persons with Medical Insurance– Goal: Increase the proportion of people

with medical insurance from 83.2% in 2008 to 100% in 2020.

Healthy People 2020-Leading Health Indicators-Clinical Prev Svcs

Clinical Preventive Services Leading Health Indicators

• Adults receiving colorectal cancer screening

• Adult w/hypertension have BP under control

• Adult diabetics with A1c value >9%• Children 19-35 mos who receive DTaP,

polio, MMR, Hep B, Varicella & PCV vaccines

Rural Health & Safety Education RFA

• Broad program focus areas across many areas of nutrition, health & farm safety in rural communities

• creeves@nifa.usda.gov• abalsano@nifa.usda.gov

CMS-Affordable Care Act• Anticipated funding in FY13 – $875,000• Objective

– To provide tools and training for Extension professionals to educate underserved populations, in select states with high numbers of uninsured, about the Marketplace Exchanges to provide greater access to health insurance coverage as a result of the Affordable Care Act.

• creeves@nifa.usda.gov

CMS Prioritizes Program States Based on Poverty Prevalence

HealthCare.gov

Consumer Confusion Has Grave Consequences

• Consumers find themselves underinsured, too often leading to medical bankruptcy

• Under-insured consumers act like uninsured consumers – they delay getting care

• Inability to effectively compare plans• Undermines the health plan marketplace

The degree to which individuals have the knowledge, ability, and confidence to find and evaluate informationabout health plans, select the best plan for his or her family’s financial and health circumstances, anduse the plan once enrolled.

Measuring health insurance literacy: A call to action and report from the health insurance literacy expert roundtable. (2011), Washington, D.C.: Consumers Union. Available at: http://www.consumersunion.org/pub/Health_Insurance_Literacy_Roundtable_rpt.pdf

Health Insurance Literacy

ExtensionMulti-state Health Insurance Literacy Initiative (HILI)

Launched April 2012

So what question: Given their stage of change, to what extent do consumers increase their confidence, competence and control after using an Extension health insurance guide?

Maryland HILI team awarded Extension funding Theoretical framework created Review of literature and curriculum completed Webinars conducted (5) eXtension Ask an Expert begun Multi-state task forces established Assessment instruments created Draft materials created and tested Evaluation plan created Pilot testing underway Website created and launched

Accomplishments

Navigator Fact Sheet

http://extension.umd.edu/insure

Key Questions I Need to Answer

Spring-Summer• Pilot finding used to modify materials• Marketing Plan developed• Funding sought

Late Summer-Fall• Revisions available to Extension• Training for Extension teachers & others• Delivery of curriculum and data collection• Creation of additional curriculum materials• Add interactivity to website

Winter• Report impact results• Release Smart Use of Health Insurance

Tasks Ahead

Connecting the Dots at the Community Level

Connecting the Dots (con’t)

• Health Insurance Marketplaces• Navigators, In-Person Assisters,

Community Health Workers• Medicaid Expansion• Essential Health Benefits • Healthy People 2020

– Leading Health Indicators– Social Determinants of Health

• Web-Based Information Sites

Ten Essential Health Benefits• Ambulatory patient services• Emergency services• Hospitalization• Maternity and newborn care• Mental health and substance use disorder services• Prescription drugs• Rehabilitative and habilitative services and devices• Laboratory services• Preventive and wellness services and chronic

disease management• Pediatric services, including oral and vision care

Use of Social Media• Know your audience• Select the most appropriate social media

application– You Tube– Facebook– Twitter– Blogs– Linkedin

http://pewinternet.org/Reports/2013/Social-media-users.aspx

INFOGRAPHIC: Survey Reveals Which Demographics Use What Social Media

By Docstoc Articleshttp://premium.docstoc.com/article/151946864/INFOGRAPHIC-Survey-Reveals-Which-Demographics-

Use-What-Social-Media

INFOGRAPHIC: Survey Reveals Which Demographics Use What Social Media

By Docstoc Articles (con’t)

http://premium.docstoc.com/article/151946864/INFOGRAPHIC-Survey-Reveals-Which-Demographics-Use-What-Social-Media

INFOGRAPHIC: Survey Reveals Which Demographics Use What Social Media

By Docstoc Articles (con’t)

http://premium.docstoc.com/article/151946864/INFOGRAPHIC-Survey-Reveals-Which-Demographics-Use-What-Social-Media

Summary• The ACA is complex & changing• The ACA mandates outreach to

underserved, vulnerable, hard-to-reach populations

• 2 out of 3 uninsured do not understand how the ACA will impact them (March 2013)

• Extension is strategically placed to help connect the dots at the community level

Summary (con’t)

Questions