URI awarded $14 million Innovation grant to improve care and lower costs for cognitively challenged adults with chronic diseases

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KINGSTON, R.I. — July 23, 2012 — As the Americans with Disabilities Act marks its 22nd anniversary this week and lawmakers nationwide evaluate plans to implement some or all of the Affordable Care Act, the University of Rhode Island is putting to work a $14 million grant to improve the lives and lower the healthcare costs for cognitively challenged adults with chronic diseases and those with Alzheimer’s who receive Medicare and Medicaid benefits.

The three-year grant from the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) is projected to save the federal government and the state of Rhode Island just over $15 million in health-care costs by preventing illness, emergency room visits, nursing home care, and hospitalization of these adults. Over the years the program will create about 31 jobs, train 226 workers, and four Rhode Island agencies — AccessPoint RI (formerly Cranston ARC), Seven Hills Rhode Island, Cornerstone Adult Services, Inc., and Generations Adult Day Health Center — will be the project’s service provider sites.

The program will integrate the efforts of state agencies, major health systems, educational institutions, disability organizations and service providers to lower costs and provide comprehensive health care for dual-eligible Medicare and Medicaid beneficiaries who are over 20 years of age.

Entitled “Living Rite-A Disruptive Solution for Management of Chronic Care Disease,” and led by Associate Research Professor Elaina K. Goldstein of Providence, R.I., the University’s proposal was selected from among 3,000 applications nationwide and chosen for its innovative solution to the challenges managing health care today. URI, Northeastern University and Dartmouth College were the only New England universities to receive innovative awards.

People with cognitive disabilities and Alzheimer’s, the people who care for them, faculty and research experts were all involved in developing the proposal. In fact, U.S. Senator Sheldon Whitehouse brought the director of the CMS Center for Medicare and Medicaid Innovation to Rhode Island last December.

“Our goal is to create an environment where people will be able to get preventative care and chronic care management in a place where they already come on a regular basis for recreation and employment. It will be a place where their care is integrated with a team of doctors and care providers and managed using telemedicine capabilities. This way all providers can see and treat patients together — but remotely,” Goldstein said.

Goldstein further explained the development of the new care approach. She said the unique disruptive chronic care model is based on principles outlined in the book, “An Innovator’s Prescription,” by Harvard Business Professor Clayton M. Christensen and Dr. Jason Hwang. The new model will use interdisciplinary care management teams, including community health workers, combined with the Multiple Health Behavior Change technique to teach patients how to best manage their chronic diseases, to provide comprehensive and preventive care for intellectually and developmentally challenged (including individuals with dementia) dual eligible adult Medicare and Medicaid beneficiaries.

The interdisciplinary “individual team” approach they will use is based on the work of Phil Clark, professor and director of the Gerontology Center at URI in combination with the Multiple Behavior Change model developed by James O. Prochaska, professor and director of URI’s Cancer Prevention Research Center and an internationally recognized expert in behavior change.

URI President David M. Dooley said, “We are very proud of Dr. Goldstein’s work and the team she has built for this innovative project. This project truly builds on our interdisciplinary leadership, showcases the smart use of existing resources.

“We are very thankful for the support of this initiative from Rhode Island’s legislative team,” said Dooley.

“Dr. Goldstein’s intuitive approach to providing integrated, interdisciplinary and intra-institutional care for a growing number of challenging cases will benefit everyone — the patient, the caregivers and the medical teams,” said URI’s Provost and Vice President for Academic Affairs Donald DeHayes.

“This unique approach also taps into and expands the reach of some of our most groundbreaking behavior change research and pharmacy practice techniques,” said DeHayes.

“The University is a national leader in healthcare innovation and this federal funding will enable them to develop a new approach to helping patients better manage chronic disease. This is another Affordable Care Act investment that will provide real health benefits to Rhode Island and deliver long-term savings and cost-controls in the future,” said U.S. Senator Jack Reed.

“This is further acknowledgment that, when it comes to health care innovation, Rhode Island is a national leader,” said Sen. Whitehouse. “This funding will help URI and their community partners continue their important work to improve care for people with chronic illnesses, and I congratulate them for being chosen.”

“This URI effort represents exactly the type of innovative approach that is encouraged by the Affordable Care Act and is needed to get health care costs under control,” said U.S. Representative James Langevin, who co-chairs the Bipartisan Disabilities Caucus. “I applaud Professor Goldstein and the rest of the university community involved in Living Rite for developing a project to deliver care more efficiently, create Rhode Island jobs in a sector with tremendous room for growth, and lower health costs for groups of people who struggle to afford the treatment they need.”

“I congratulate URI and their partners for advancing this important work that will not only help improve health outcomes for more Rhode Islanders and drive down health care costs, but also create jobs and training opportunities in this vitally important sector of our state’s economy,” said U.S. Representative David Cicilline. “The University and this partnership will help raise the bar in providing higher quality services at a lower cost to Rhode Islanders, and I am proud to have helped advocate for this grant funding.”

The new workforce will include 14 clinical health professionals, eight peer wellness coaches, peer and family mentors, and five administrative and support staff for the new Living Rite Center team. URI will also hire two research associates, a program assistant, and a business manager to manage the grant. Additionally, this program will provide training, education and job placement for 21 persons with disabilities in healthcare-service occupations.

Faculty and students from five colleges –pharmacy, nursing, business, human science and services, and arts and sciences – will provide a wide variety of interdisciplinary expertise.

The grant will also fund the creation of an interdisciplinary Disability Health Center at URI that will incorporate academic programs and consolidate a range of educational and training programs for professionals and paraprofessionals, providing continuing education for currently practicing professionals to educate new cohorts of healthcare professionals for the future.

For more information about Living Rite, please contact Associate Professor Goldstein at 401-874-2210.

This announcement was made at a press conference on Monday, July 23 at the AccessPoint RI location on Park Avenue, Cranston. Watch the video from this event.