ANCOR Applies for CMS Innovation Grant

“Our lives begin to end the day we become silent about things that matter.”
—Martin Luther King, Jr.

By Wendy Sokol
ANCOR President

The Centers for Disease Control and Prevention’s website states, “About one-third of U.S. adults (33.8%) are obese. Approximately 17% (or 12.5 million) of children and adolescents aged 2–9 years are obese.”

The CDC goes on to show that obesity rates for children and adults with disabilities are 38% and 57% higher than rates for children and adults without disabilities. There is as a growing body of evidence that links children and adults at greatest risk for obesity with mobility limitations, intellectual/learning disabilities, or both.

Furthermore, the U.S. Department of Health and Human Services ranked obesity among the top-10 leading health indicators for 2010. The estimated medical care costs of obesity in the United States are staggering. In 2008 dollars, these costs totaled about $147 billion, according to the 2009 article in Health Affairs, “Annual Medical Spending Attributable To Obesity: Payer-And Service-Specific Estimates.”  

Why are we in the midst of an “obesity epidemic,” and why are the rates for obesity so much higher in the I/DD population?

According to the CDC, in 1990 only 10 states had a prevalence of obesity less than 10%, and no state had prevalence equal to or greater than 15%. By 2010, no state had a prevalence of obesity less than 20%. In fact, 36 states had a prevalence equal to or greater than 25%—twelve of which (Alabama, Arkansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Oklahoma, South Carolina, Tennessee, Texas and West Virginia) had a prevalence equal to or greater than 30%.

If obesity is the simple result of body fat that accumulates overtime as a result of a chronic energy imbalance (calories consumed exceeds calories expended), then why is it so prevalent and so difficult to resolve? Why are so many of the people we support and their support staff plagued with obesity?

If you are looking at a group home or ICF/MR from the outside, it might appear that its menus and access to food is controlled by trained professionals. There is also medical and nutritional oversight. We would not tolerate a lack of intervention to manage epilepsy, COPD or any other disease, but we—as the leaders of our organizations—seem at a loss to manage this new epidemic: obesity.

So your leaders within ANCOR realized we could no longer be silent! Our people with I/DD matter—and providers need help. We must champion the solution to the obesity epidemic.

The National Center on Birth Defects and Developmental Disabilities’ strategic plan for 2011–2015 includes a challenge that will impact people with I/DD. “We need research to build evidence for interventions; effective communication to inform stakeholders; and implementation of public health programs, policies, and practices to reduce the disparity in obesity and other health indicators such as health care access,” the organization stated.

ANCOR accepted the challenge, and on January 27, 2012, submitted a three-year “Health Care Innovation Challenge” grant proposal to the Center for Medicare and Medicaid Innovation.

ANCOR—in conjunction with the American Institute for Research (AIR), the American Academy of Developmental Medicine and Dentistry (AADMD), Deyta, Mainstay, and representatives from Feinberg School of Health at Northwestern University and the University of Illinois’ Institute on Disability and Human Development—submitted a grant for a compelling new model of service delivery that holds the promise of delivering better health, better health care and lower costs through improved quality for people with I/DD who currently reside in group homes. Our intervention will reduce obesity!

According to the proposal, Mainstay’s preventative health program will provide nutritional education, assessment and oversight through a series of proven, easy-to-use supports already tested and known to reduce weight and medication usage. The healthcare intervention will result in diminished obesity, pre-diabetic conditions and high blood pressure, as well as teach staff how to increase nutritional value, menu variety and choice while simultaneously reducing food costs. The research team also predicts a reduction in participants’ usage and cost of medication, as well as a reduction in emergency room usage and acute care costs.

Data on specific healthcare measures and satisfaction would be tracked through ANCOR’s Performance Excellence portal, and Deyta would continue to manage the database and summarize data for all current and new variables.

AIR would provide project management and scientific analysis of the data that would clearly demonstrate to CMS which combination of interventions results in the greatest weight loss and improved overall health, and AADMD would provide medical oversight.

ANCOR would be the convener of the grant and would interface with funders, submit quarterly reports and provide fiscal oversight and management for the initiative. ANCOR staff would recruit and educate providers on the systems and processes required during participation and will provide effective problem resolution for participant’s issues.

Once the grant was awarded, ANCOR would provide an extensive PR campaign on the progress and success of the initiative in order to ensure its continued expansion across the United States. The anticipated award date is March 30, 2012.

ANCOR’s staff and members of the Performance Excellence committee are resolute that irrespective of whether we are successful with this specific grant or not, we have identified the parameters necessary for a successful health programs that will reduce the disparity in obesity for people with I/DD, as well as increase other positive health outcomes and we will not stop until we have found the funding to implement this solution.

Author LINK: Wendy Sokol is CEO and co-owner of SOREO In-Home Support Services. She can be reached at wendy@soreo.com.