Clackamas County Public Health

In 2016 Clackamas County Public Health Division was awarded funding from the State of Oregon, Oregon Health Authority for Sustainable Relationships for Community Health (SRCH).  The goal was to work with a consortium to develop a closed-loop referral and payment and reimbursement mechanism for pre-diabetic patients into the CDC-based Diabetes Prevention Program (DPP). Research shows that people with prediabetes who take part in a structured lifestyle change program can cut their risk of developing type 2 diabetes by 58% (71% for people over 60 years old).

Oregon was one of two States to receive grant funding from the National Association of Chronic Disease Directors (NACDD) for this demonstration project. The Clackamas County Consortium consisted of Health Share of Oregon, FamilyCare Health, Oregon Community Health Care Workers (ORCHWA), YMCA of Columbia-Willamette, and Clackamas County Health Centers (FQHC). DPP is a lifestyle change program that targets diabetes prevention through supporting health changes in eating and physical activity. This demonstration project took a systems level approach to build capacity for classes, train additional lifestyle coaches, enroll eligible Medicaid beneficiaries, advise providers about patient attendance in the program as well as address billing and payment for the administrative and program delivery cost for patients to attend the yearlong life style change program.

So far, Health Share of Oregon and FamilyCare Health have enrolled over 100 patients into the demonstration project, which ends January of 2018. As an additional partner in this work, the Harold Schnitzer Diabetes Center, at Oregon Health & Science University, has trained 24 new coaches to provide more capacity for increased DPP classes.  The consortium has applied an equity approach throughout this project and is targeting DPP to those disproportionately affected by diabetes, while offering culturally specific classes in a variety of languages.
 
Medicare will begin reimbursing for the program in 2018, and consortium partners feel confident in continuing the work that has been built with payment models, workflows and the relationships that have been established. Julie Aalbers, Public Health Programs Manager at Clackamas County Public Health Division said “Developing new systems and infrastructure through a demonstration project has been challenging, but the outcome of establishing a mechanism for pre-diabetics to access the DPP program is exciting and promises to impact chronic disease in a positive way.”

For further information about the Clackamas County SRCH project contact: Apryl Herron at
.(JavaScript must be enabled to view this email address) or by phone at: (503) 742-5343