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FACILITATING STATE COALITION BUILDING

New Hampshire: Falls Risk Reduction Task Force

• Need buy-in from the top – must be inclusive of the Health Department at the state level as well as those other state agencies focused on falls.
• Start small to get the plan and the buy-in before proceeding.
• Identify and disseminate education programs for older adults. Create demand.
• NH has produced a large scale “doll house” that serves as a visual for home safety presentations and they use a variety of “do-dads” as other visual aids/attention  getters.
• Consider adopting a mobile screening kit similar to the one Minnesota uses to assess falls risk in the community.
• Promote fall prevention at every opportunity, especially the name of the coalition.
• Keep abreast of what is current in the field and disseminate broadly.
• Have one person or office set up as the contact, focal point.
• Stay in contact with other states as peer support, learn from others and do not reinvent the wheel if processes are already available.

California: Falls Prevention Initiative

• California enjoys an alternate source of funds in the Archstone Foundation. Other states interested in this work need to cultivate alternate sources of funding for state wide activities.
• Collaboration has been a key to the success, especially with the Archstone funded Fall Prevention Center of Excellence. Being able to bring together the important partnership of Center’s four organizations to focus on one issue -- fall prevention.
• Appreciate the growing interest in fall prevention and how it can be marshaled to jump start the process; recognize that this can be tied to all senior mobility issues.
• Recognize a lot has been done already and there are best practices and models so that you do not have to start from scratch.

Michigan: Statewide Fall Prevention Workgroup

• Identify and align with existing priorities within the state health department.
• Take time to strategically build infrastructure across the state.
• Take time to coordinate the efforts, set realistic priorities, identify appropriate partners, and facilitate their participation. Absolutes include: physicians, physical therapists, and nurses (in the best position to identify who’s falling). A key partner has been the Michigan State Medical Society.
• Create demand among both providers and consumers.
• Identify and promote physician champions.

Wisconsin: Statewide Falls Prevention Initiative

• Compelling state falls data demonstrates a need to address this growing and costly health and quality of life issue for older adults.
• Defining Task Force role to integrate fall prevention in all aspects of injury prevention, providing education, technical assistance, and evaluation but mostly serving in a facilitation role that promotes linking local resources.
• To insert injury prevention with a defined objective of reducing falls in Wisconsin into the new State Health Plan.
• Collaboration has been a key to the success of this coalition – choose members carefully, grow core group strategically, and meet quarterly with frequent intervening communications.

CHALLENGES TO ADDRESS

A recognized barrier that can also serve as a strength of a broad-based coalition is the integration of diverse perspectives in a comprehensive collaborative approach to the issue of fall prevention (Riggs, Feinberg, & Greenberg, 2002). States also encountered the followed challenges:

New Hampshire: Falls Risk Reduction Task Force

• Lack of dedicated funding --> the Task Force provides training and suggests strategies to local teams for finding funding opportunities. Most recently they have been in discussion with the state to identify funds for sustaining this work.

California: Falls Prevention Initiative

• Although the data are compelling, it is viewed as a Medicare issue by the legislature and not one needing solving by an infusion of state funds. To that end, the state is in need of Medicaid data on health care costs associated with falls that result in long term care needs.

Michigan: Statewide Fall Prevention Workgroup

• The Center may be too focused and could broaden its perspectives to be more inclusive, but that may evolve over time.
• Finding sustainable funding sources.
• Building linkages between partners who do not usually collaborate.
• Translating research into practice? learning what does and does not work.

Wisconsin: Statewide Falls Prevention Initiative

• It has been challenging to work with 72 counties, each with a very diverse set of geographical, cultural and ethnic issues.
• A challenge now that the internal workgroup is working on is evaluating the coalition/state shorter term outcomes, since affecting change in the state falls data will be a long term venture.
• Gap to be addressed soon: assess education programs, referrals and screening/assessments as benchmarks of progress.