wellness education: promoting health literacy and positive ...€¦ · falls risk hypertension...

#AgeAction2019 | #WeAgeWell

Wellness Education: Promoting Health Literacy and Positive Health Behavior for Clients Receiving

Long-term Services and Supports

Debbie Blackner, Beth Adams and Greg Padovani

Introductions

Debbie BlacknerALTSA, Ancillary Services Program Manager

[email protected]

Beth AdamsALTSA, Outcome Improvement Specialist

[email protected]

Greg PadovaniWellness Education System Expert

[email protected]

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• What is special about Wellness Education?

• How it is different?

• What makes it successful?

• What has the impact been for participants?

Learning Objectives:

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• Aging and Long-term Services Administration

(ALTSA): To Transform Lives by promoting choice,

independence and safety through innovative services

DSHS Mission: To Transform Lives

• Developmental Disabilities Administration (DDA): To

Transform Lives by providing support and fostering

partnerships that empower people to live the lives they

want.

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State Plan Programs:

• Community First Choice [1915(k)]: launched in 2015. Services

include: personal care, nurse delegation, PERS, assistive

technology, skills acquisition training, community transition

services, caregiver management training

• Medicaid Personal Care (MPC): non-institutional level of care;

must be functionally and financially eligible. Services: personal

care and nurse delegation

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HCBS Waivers in WA State

ALTSA: • COPES

• New Freedom

• Residential Support Waiver

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DDA:• Basic Plus Waiver• Children's In-home Intensive

Behavioral Support Waiver• Core Waiver• Community Protection Waiver• Individual and Family Services

Both administrations have multiple other LTSS available to support community living.

Common Challenges for Individuals on DSHS LTSS:• Living with complex health issues

• Low health literacy

• Disconnect between daily habits and health

• Isolation, gaps in social support

Administrative Challenges:• Provide a cost-effective, individualized, monthly service

• Limited to available approved waiver services

• Broad enough to benefit the diverse complexity of our waiver population.

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The Solution:

• Client Support Training: Wellness Education (WE)

• Goals: - Self-management of health and well-being through

actionable education materials- Increase health literacy and empowerment

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Rising to the Challenge: Wellness Education

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Goals

• Health literacy

• Empowerment

• Independence

• Self-management

Wellness Education

• Monthly newsletter

• Printed and mailed to 38,000+ participants

• Translated in multiple languages

• Duplicates sent to personal representatives

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Wellness Education: Access

Available as a waiver service:

• Aging and Long-Term Support Administration:

COPES or Residential Support waivers

• Developmental Disabilities Administration:

Basic Plus, Core, or IFS waivers

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How the Magic Happens

Vendor

• Graphic Design

• Article Translation- English + 17 languages

• WE System

• Operations

• Production reports

• QA reports

• Survey tracking

WE Program Manager

• CARE client

assessment

• Data reports

• Contract management

• Quality assurance

• Articles

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Wellness Education: Four Major Components

1. Data

2. Articles

3. Targeting

4. System

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Wellness Education: Data

*Comprehensive Assessment and Reporting Evaluation (CARE)15

CARE*• Standardized client assessment• Determines functional eligibility• Evaluates the client’s support

needs for:- Service determination- Individualized support planning

The CARE Assessment:

• Occurs at least once a year

• Covers many life areas

• Results stored in database

• CARE information used to create health and

well-being indicators


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Data transfer process is:

✓ Secure

✓ HIPAA Compliant (including mailing)


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Examples of Targeting Indicators from CARE Assessment

Anxiety disorder Asthma Cardiovascular disease Employment

Depression Diabetes Military Service (Veterans) Emphysema

Falls Risk Hypertension Traumatic Brain Injury Smoking

ADA Diet Sleep Issues Post-traumatic Stress Disorder Substance abuse

Caregiver stress Pain Conflict management Suicide risk

High Cholesterol Osteoarthritis Recent Loss/Grieving Social skills

IBS Gout Tribal Affiliation BMI = or >25

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There are 110 total indicators.

Article Standards

✓ Brief

✓ Simplified language

✓ Solution Focused

✓ Action oriented

Wellness Education: Articles

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Articles Engage with Simple Messaging

Breaks LARGE subjects into many small topicsEasy to read ~170 words

Easy to understand

Actionable tips and suggestions

WENS cycles reader through series - automatically

18 LanguagesSome examples

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Library built over time• Started with just 20 English

articles

• Added 8 – 10 each month

Now• ~450 English articles x 17

additional languages = over 7600 articles


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Wellness Education System:

• Remembers every article sent to every client

• Always sends new articles


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• CARE Assessment provides indicators for targeting

• Each article targets specific indicators

Targeting Rules

Diabetes Group = Y

CV Disease Group = Y

COPD Group = Y

Age = Over 65

Wellness Education: Targeting

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Wellness Education: Targeting

Wellness Education: The Process

WE Newsletters~40,000 mailed per month

Articles

Wellness Education System

Printing &

Mailing

Client Profiles(using HIPAA compliant data transfer process)

Ultra-high Performance Decisioning System

Uses data analytics & article targeting rules to draw from ~8000 article selections

(~450 articles in 18 languages) to create each individualized issue.

Assigns the best articles to each client but never sends the same article twice!27

Value For Participants

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96%

76%

44%

Are the articles easy to understand?

Do the newsletters help you?

Have you made any changes in your life because of what you read in the newsletter?

Wellness Education SurveyDec 2018

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Survey Responses

Most Common Reported Categories of Change

Dietary improvement

Exercise Education about chronic condition

Chronic disease management

Weight control Health screening

Caregiver improvement

Emotional, psychological, and social well-being

Engagement with health care

provider

Fall prevention Tobacco use Sleep habits30

“It helped me keep

from falling.”

Survey Responses

“I have placed my

rugs differently so I

won’t trip and fall.”

31

“I certainly have started eating healthier,

and my number one thing of everything

is I quit smoking.”

Survey Responses

32

“I've become more of an

advocate for my own

health.”

“I'm being more careful

with what I eat and

seeing that I get out and

stay social.”

Survey Responses

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“I have made changes

to my diet, exercise,

and brought my A1C

down.”

Survey Responses

“I have reduced my

sugar intake, and I

quit drinking a pop a

day."

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Survey Responses

“The information

that you sent has

helped me control

my diabetes better.”

“I actually save the

newsletter because it

reminded me of an

appointment I needed

to make for a certain

test.” 35

“I've adjusted my

eating pattern.

My health worker

has used the

pattern for the

cooking in her

own life, and

when she is at

my house.”

Survey Responses

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Value For Washington State

• Continuous conversation on specific health and well-being issues

• Reaching people that are socially isolated

• Low cost / low staffing needs of the service

• Quick delivery of information

• Improved mailing address accuracy

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✓ Promoting choice, independence, and safety

through innovative services.

✓ Fostering partnerships that empower people

to live the lives they want.

Value For Washington State

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Questions?

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Tweet using #AgeAction2019 or #WeAgeWell

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Vote in the conference poll

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wellness education: promoting health literacy and positive ...€¦ · falls risk hypertension...

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