UNITE HERE Health Center

Grant Status

Completed

Project Title

Development & Implementation of an Innovative Primary Care Model for Low Income Retired Patients with Diabetes

Award Amount

$460,042

Location

Manhattan

Website

http://www.unitehere.org/about/historyunite.php

Date Awarded

November 15, 2007

Diabetes is a significant disease among the elderly who often report a lower quality of life and greater complications as a result of co-morbidities. This project addresses the chronic care needs of elderly, retired, low-wage workers, and utilizes patient care assistants to improve diabetes management.

The center estimates that nearly 90% of its older retired patients with diabetes have also been diagnosed with heart disease or hypertension and are therefore at higher risk for worse disease outcomes. UHC will develop a new curriculum to train patient care assistants regarding the special needs of the elderly, with a focus on geriatric syndromes that affect care of elderly diabetic patients, including multiple medications, depression, and cognitive impairment. Retired members will receive primary care services and personalized attention from patient care assistants, who will help them set self-management goals and provide telephone follow-up to monitor progress. UHC will evaluate this project in two ways: 1) a process evaluation of the staff training on chronic disease management in elderly populations; and 2) an outcomes evaluation of clinical markers including control of A1C, blood pressure, and cholesterol and access to regular foot and ophthalmology exams.