MID-AMERICA REGIONAL COUNCIL

Chronic Disease Self-Management Education Program Grantee

Prevention and Public Health Fund 2021, effective May 1, 2021

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Goals

The overall purposes of this 3-year grant are to:

• Goal 1: Strengthen integrated state, 

regional, or tribal networks that address 

the social and behavioral determinants of 

health of older adults and adults with 

disabilities.

• Goal 2: Significantly increase the number 

of older adults and adults with disabilities 

who participate in chronic disease selfmanagement education and selfmanagement support programs.

Strategies and Activities

The Mid-America Regional Council (MARC), the 

Network Lead Entity for the Missouri Association 

of Area Agencies on Aging (MA4) Network, will: 

• Significantly increase the number of older 

adults and adults with disabilities who 

participate in chronic disease selfmanagement education (CDSME) 

programs, targeting populations at-risk of 

institutionalization to ensure Missourians 

can stay in their homes longer.

• Create referral pathways to a full range of 

community services to address social 

determinants of health of CDSME 

program participants.

• Develop products and workflows to 

accept and process CDSME referrals from 

a wide range of sources and to track 

referrals to community services. 

• Strengthen the MA4 Network to offer an 

expanded suite of CDSME programs.

• Expand the MA4 Network’s sustainable 

revenue sources.

Proposed Interventions

• Chronic Disease Self-Management 

Program (CDSMP)

• Chronic Pain Self-Management Program 

(CPSMP)

• Diabetes Self-Management Program 

(DSMP)

• Tomando Control de su Salud

• Toolkits for Active Living

• Workplace Chronic Disease SelfManagement Program

• Walk with Ease (WWE)

Partnerships

To achieve the goals of the grant, MARC will 

collaborate with the following key partners:

• 8 Area Agencies on Aging

• University of Missouri Extension

• Community-based and non-profit 

organizations
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Prevention and Public Health Fund 2021, effective May 1, 2021

• Missouri Department of Health and 

Senior Services

• Missouri Department of Mental Health

• Missouri Department of Social Services

• Key commercial, Medicaid and Medicare 

Advantage managed care partners

Anticipated Results

MARC and its partners propose to achieve the 

following results: 

• Reach at least 1,719 participants with 

evidence-based CDSME programs, at 

least 75% (1,290) of whom will complete 

the programs.

• Design, implement and test with at least 

180 referrals a statewide system to 

accept and process referrals into CDSME 

programs through multiple pathways to 

accommodate diverse contracting 

structures with various payer and 

provider types.

• Generate 270 referrals to other 

community services offered in Missouri 

that address the social and behavioral 

determinants of health of program 

participants.

• Execute 4 agreements with health and 

community-based providers to refer 

socially and medically complex clients 

with public or private health insurance 

coverage to CDSME programs.

• Train or cross-train 90 new or existing 

leaders to offer an expanded suite of 

CDSME programs, including CDSMP, 

Toolkits for Active Living with Chronic 

Conditions, Tomando Control de su Salud, 

DSMP, CPSMP, Workplace CDSMP, and 

Walk with Ease.

• Execute two new contracts with health 

payers for reimbursement to the MA4 

Network for CDSME programming.

Contact:

James Stowe

Mid-America Regional Council

jstowe@marc.org

For more information: 

Administration for Community Living 

U.S. Department of Health and Human Services

Washington, DC 20201

http://www.acl.gov