The Indiana State Department of Health (ISDH) Division of Chronic Disease, Primary Care and Rural Health is applying for the Centers for Disease Control and Prevention (CDC) CDC-RFA-DP18-1815 Improving the Health of Americans Through Prevention and Management of Diabetes and Heart Disease and Stroke. This funding opportunity will support a coordinated effort across ISDH program areas to improve the health of Indiana’s residents in the communities with the highest burden for heart disease, diabetes and stroke. The funding opportunity will enable ISDH to work with targeted communities for both Category A-Diabetes Management and Type 2 Diabetes Prevention strategies and Category B-Cardiovascular Disease Prevention and Management strategies.
To achieve outcomes, ISDH will implement 6 strategies within Category A and five strategies in Category B. ISDH will be targeting communities and counties at high-risk for diabetes and heart disease and stroke to implement a comprehensive approach to diabetes services and management, while integrating the activities for hypertension management and cholesterol identification and management. Many of these communities and counties have limited community resources for DSMES and diabetes prevention, and hypertension and cholesterol management. Strategies for developing referral systems between health systems and community resources will allow a comprehensive implementation of strategies in health systems and communities for both Categories A and B. ISDH will also work directly with the health systems and communities to increase the utilization of community health workers for diabetes, pre-diabetes, hypertension and cholesterol prevention and management. Sustainability activities for the CHWs will be addressed at the state-level for policy development, Medicaid reimbursement and a process for education and certification.