2014 Together on Diabetes Grantee Summit Atlanta, GA February 24-26, 2014

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1 2014 Together on Diabetes Grantee Summit Atlanta, GA February 24-26, 2014 PURPOSE On February 24 th -26 th, 2014, the Bristol-Myers Squibb Foundation (BMSF) and the National Network of Public Health Institutes (NNPHI) convened grantees and partners for the 2014 Together on Diabetes (ToD) Grantee Summit. This annual meeting provides an opportunity for grantees and partners to connect, share lessons learned, develop skills and build collaborative efforts. The summit was held at the Emory Conference Center in Atlanta, GA and had a special focus theme of Achieving Sustainable Solutions to America s Diabetes Challenge. The over 100 participants included ToD grantees, BMSF staff and experts in the fields of diabetes, health disparities, and public health. BACKGROUND Through its third year of grant making, ToD has committed over $57 million to 35 grantees across the United States, China and India. This philanthropic initiative was launched in November 2010 by BMSF to improve health outcomes of people living with type 2 diabetes in the United States by strengthening patient self-management education, community-based supportive services and broad based community mobilization. In line with BMSF s mission to promote health equity and improve health outcomes, the initiative targets adult populations disproportionately affected by type 2 diabetes. In 2013, the initiative expanded to include projects with a special focus on the relationship between diabetes, depression and distress. Full information on the ToD program and grantees projects, including the initiative s expansion to China and India can be found on th ToD website at and partner to ensure the success of ongoing implementation and program support projects. NNPHI is one of the twenty five grantees of the ToD-US initiative. NNPHI is the national membership network committed to helping its 35+ public health institutes sustain improved health and wellness for all. Working closely with the Bristol-Myers Squibb Foundation, NNPHI s role is to support the grantee learning collaboratives, including hosting the two-day grantee summit and supporting learning collaborative calls and webinars. NNPHI facilitates the exchange of ideas and best practices among grantees, providing leadership and professional development opportunities, and enhancing the relationship between grantees and the broader public health practice community. MEETING SUMMARY The 2014 Summit marked the third in-person gathering of the US ToD grantees and their implementing partners. Over 100 attendees came from 50 organizations serving heavily affected populations and communities in 25 states and the District of Columbia. To view the ToD 2014 summit materials, including the agenda, presentation slides and videos of the keynote speeches, go to: The following summary provides an overview and captures the key messages and insights of the summit. Grant making for the ToD ended in December BMSF will continue to work with the current grantees

2 Summit Welcome: Achieving Intervention Scale and Sustainability- The National Diabetes Prevention Program Ann Albright, PhD, RD, Division of Diabetes Translation, US Centers for Disease Control and Prevention Dr. Ann Albright, Director of the Division of Diabetes Translation at the Centers for Disease Control and Prevention (CDC) welcomed the participants with a discussion of learnings around sustainability from the CDC s National Diabetes Prevention Program (NDPP). The NDPP is an evidence-based lifestyle change program aimed at preventing type 2 diabetes by teaching participants strategies for incorporating physical activity into daily life and eating healthy. She discussed the main principles CDC considered when developing the NDPP, in order to assure scalability and sustainability, They were: the necessity of the program defining the problem; effectiveness of the program and accompanying evidence; the risk of diabetes must match the cost of the program; the program must be economically sustainable; and the program must be widely available. Dr. Albright also cited an American Journal of Public Health article 1 that stated for public health programs to be successful, there are six necessary components: 1. Innovation 2. Partnerships 3. Technical limitations 4. Effective performance management 5. Communication 6. Political commitment Key takeaways from her presentation include the importance of: All programs under the NDPP using and sharing and common set of goals and metrics. Examining risk across populations and assuring that the program is targeted to those for whom it can do the greatest good for the lowest cost, leading to cost-effectiveness. Not ignoring those with moderate risk. 1 Thomas R. Frieden. Six Components Necessary for Effective Public Health Program Implementation. American Journal of Public Health: January 2014, Vol. 104, No. 1, pp Making the healthy choice the easy choice for all risk levels. Having a strong and executable sustainability strategy from the very beginning. To view a video of Dr. Albright s remarks, go to: fault.aspx#keynote General Session: Together on Diabetes TM Platform for Dissemination & Scaling George Rust, MD & Sabrina Jackson, MMSc, Morehouse School of Medicine, National Center for Primary Care Dr. George Rust introduced the Bristol-Myers Squibb Foundation/Morehouse Partnership for Diabetes Health Equity (Partnership) and its goal of maximizing the national impact of the ToD by demonstrating replicability, sustainability, and scalability. Dr. Rust also introduced the 3 element model in which all the lessons learned will be framed: Clinical Practice Transformation; Person/Family/Community Engagement; all driven by Rapid-Cycle Feedback Loops. Lastly, Ms. Sabrina Jackson provided a brief walk-through of the Partnership website Key takeaways from this session include: Goal of the Partnership is to maximize national impact of the ToD initiative by demonstrating replicability, sustainability, and scalability. Integrated Strategies for success: 1) build a Learn-Share-Connect web portal for the Partnership based on the three element model: Clinic, Home&Community, and Outcomes all driven by rapid-cycle feedback. Short- term impact of the partnership will be visibility for successful ToD programs; dissemination of the ToD three-element model and lessons learned; building up of online infrastructure to support community efforts at the national scale; and linking ToD threeelement model to larger strategic initiatives, priorities and incentives (ie: EHR adoption, PCMH certification, HIE connectivity, hospital community-benefit programs etc.) Together on Diabetes Grantee Summit Report

3 Sustainability will be implemented through ToDlike programs in new communities not receiving grant support, using only local community resources. Scalability will be implemented through the development of the online training and resource center to support autonomous replication at a national scale. Group Exercise on Sustainability Tactics Stephen Fawcett, PhD & Jerry Schultz, PhD, University of Kansas Workgroup on Community Health and Development The team from the University of Kansas Workgroup on Community Health and Development led participants in a discussion on sustainability strategiesand tactics, stressing the importance of implementing a multi-prong approach to all sustainability efforts to increase the chances of maintaining key services/activities and ensuring progress on outcomes. Dr. Fawcett and Dr. Schultz reviewed 12 sustainability tactics for the ToD projects and programs based on the grantee applications and the Community Toolbox Sustainability Module (todcasestudies.org/sustainability): 1. Share positions and resources 2. Become a line item in a an existing budget 3. Incorporate activies or services in organizations with a similar mission 4. Apply for grants 5. Tap into personnel resources 6. Solicit in-kind support 7. Develop and implement fundraisers 8. Pursue third-party funding 9. Develop a fee-for-service structure 10. Acquire public funding 11. Secure endowments and planned giving arrangements 12. Establish membership fees and dues for federal, local and private foundations, sharing volunteer lists, time sharing jobs, utilizing 501(c)3 partners to advocate on their behalf, and tapping into student resources (RNs, MD Residents, and Public Health students) to volunteer time. Shift your mindset by refining the question of What am I asking for from a funder? to What do I have? And can I sell it to partners? Jerry Schultz Keynote Address: Hot Spotting- Innovative Approaches to Caring for the Very Ill Jeffrey Brenner, MD, Camden Healthcare Providers Coalition In his keynote address, Dr. Jeffrey Brenner showcased two different projects that utlize innovative technology to identify major areas of diabetes burden and subsequently implement community-based interventions to improve outcomes. The Camden Coalition of Health Providers has been particularly focused on high utilizers of healthcare services in the city of Camden as a way to meaningfully reduce the city s overall healthcare costs. Dr. Brenner challenged the group to rethink how the U.S. healthcare delivery system works so that it can become more customer-focused and responsive and relevant to patient needs. He made a case for health services and public health to start thinking like an advertiser to reach the very sick populations. These very sick patients are costing the system the most money. They are also the patients that may not come to your programs. Dr. Brenner also challenged the ToD audience to use big data to segment rather than stratify patient risk and needs. He also made the case for shifting traditional public health mindsets to more of a business perspective both operations and ROI -- and encouraged thoughtful engagement with payers to shape sustainable solutions. Key takeaways from Dr. Brenner s presentations include: In small group discussions, participants shared examples of how their organizations are using these tactics, which included partnering with community engagement organizations, working with state quality improvement departmernss to be able to obtain calims data, applying Return on investment rests in tertiary prevention. This is where boundaries meet between public health and clinical care. In order to reduce the cost of the health care system, the focus first needs to be on the sickest Together on Diabetes Grantee Summit Report

4 Segment health care data by patient complexity and cost of co-morbidities instead of only stratifying by disease state. Change the language of the social determinants of health to social correlations of health Decouple poverty and poor outcomes Medical-social risk phenotypes can be used to create intervention spectrum, incorporating geographic location. Patient data can be mapped geospatially to discern areas of concentrated risk in the population. In addition, community resource maps can be overlayed on this patient data map to better link patients with resources convenient for them to access. Through out the interventions, data is continually collected through the electronic health record and informs not only outcome and utilization metrics, but also a quality feedback loop so interventions can be improved. To view a video of Dr. Brenner s keynote address, go to: ges/default.aspx#keynote Business techniques need to be incorporated into public health. Generating savings by focus on return on investment is going to be relevant down the road. Jeffrey Brenner, Camden Healthcare Providers Coalition The Duke / Durham Project and the Southeastern Diabetes Initiative (SEDI): Marie Lynn Miranda, PhD, University of Michigan In her presentation, Marie Lynn Miranda shared how the ToD Duke/Durham project and the CMMI Innovation Center funded SEDI project are bringing creative patient risk stratification models together with community health interventions to improve quality of care and outcomes and reduce costs. In the Duke Durham project, data is pulled from a range of sources including electronic health records, demographic information, lab reports and health service utilization to determine a patient s medical-social risk. This approach allows healthcare providers to view their patients with greater dimensionality and offer them low, moderate, and highintensity interventions based on their risk profile. An example of a high intensity intervention would be a series of home visits by a nurse to monitor the patients progress and conduct personalized disease management coaching whereas a medium intervention would be a series of telephone calls for individualized disease management coaching and a low intensity intervention would be participation in community based diabetes education classes. Grantee Panel Sessions The summit planning committee and grantees identified sustainability as a key area from their project work that they wanted to learn about from each other while also sharing updates on the status of their projects. In addition to learning about the new projects with a focus on diabetes, depression & distress, panels provided an opportunity to hear about sustainability strategies and tactics for project focused on African American women; sustainability through reimbursement and leveraging community benefit and community health workers; and sustainability at or in partnership with federally qualifies health centers and community health centers. The following provides a summary of each of the panel session held on February 25 th and 26 th, To access the presentations from all of the panels, go to: /Pages/default.aspx#panels Panel Session I: Special Focus 2014 on Diabetes, Depression, & Distress Lawrence Fisher, PhD, Director of the Behavioral Diabetes Group at the University of California, San Francisco moderated this panel. Speakers were Doyle Cummings, PharmD (East Carolina University), Bethany Kwan, PhD, MSPH (University of Colorado), Gretchen Piatt. PhD, MPH (University of Michigan), and Shelia McCann, MEd (Health Choice Network of Florida). This grantee panel gathered the four projects concentrating on the special 2014 focus of diabetes, depression, and distress. The grantees shared an overview Together on Diabetes Grantee Summit Report

5 of their projects and then engaged in a discussion about their successes and challenges. Key takeaways from this panel session include: Many African-American women do not embrace the concept of depression but rather distress. Five A s of an integrated model: o Assess, Advise, and Agree (patients setting goals and conrtruct action plan) o Assist and Arrange (Most difficult component, and least likely done by Primary Care Provider) o Tracking and feedback from patients/clients are also crucial to the integrated model Boot camp translation: Build productive, sustainable relatrionship with community to inform design of intervention Some sustainability strategies pursued include dissemination of findings and tools, organization infrastructure, integration of health care systems, program recognition, billing potential, managed care, and networkwide implementation. Some reasons why programs could not be sustained include inability to get community groups to collaborate, inability to secure funding/resources, inability to get internal health care providers to adopt project, and implementing partners having separate agendas Panel Session II: Round Up of Grantees with Special Focus on African American Women Lucille Johnson, MA, Director of Special Initiatives at the Center for African American Health moderated this panel. Speakers were Valerie Rochester, MPA (Black Women s Health Imperative), Patrick Healy, RD, CDE, MPH (Whittier Street Health Center), Natalie May, PhD (University of Virginia), Amy Martin (United Neighborhood Health Services), and Lesley Lutes, PhD (East Carolina University). Members of the panel each presented summaries of their organization s ToD grant projects. The common thread among the programs was that each was utilizing a community driven approach for group level interventions to improve diabetes outcomes. They focused on increasing health equity among the community members, achieving wellness and empowering people. Key takeways from this panel session include: Be aware and respectful of decision-making processes within community organizations Work with women to understand they need to have autonomy on decisions impacting their body Be respectful of participants real life situations Provide opportunities for participants to become knowledgeable health advocates Offer supportive structures that allow for exploration of personal issues/experiences Link interventions with enhancements in selfconcept Promote linkages between the individual and larger social forces impacting their lives Keep in mind the importance of spirituality/faith in God when talking about health and chronic disease among this patient population Panel Session III: Sustainability through Reimbursement & Leveraging Community Benefit and Community Health Workers Vincent Lafronza, EdD, President & CEO of the National Network of Public Health Institutes moderated this panel. The speakers were Kathy English, and Sarah Lovegreen, MPH (National Council on Aging), Jennifer Richards, MPH & Anne Kenney, MPH (Johns Hopkins Center for American Indian Health), Erin Harvey (Mississippi Public Health Institute), Fredda Vladeck, MSW & David Gould, PhD (United Hospital Fund), and Richard Crespo, PhD (Marshall University). Each of the ToD grantees in this panel session presented overviews of their projects and reviewed anticipated outcomes. The key theme among this group of grantees is that they are each trying to leverage components of the Affordable Care Act in their projects, aiming to make a compelling case for increased investment in and reimbursement for Diabetes Self-Management Programs (DSMP) by demonstrativing cost savings and return on investment Together on Diabetes Grantee Summit Report

6 Key takeaways from this panel session include: Integrating alliances between health plans, medical providers, and community based organizations into sustainability plans from the beginning are key to NCOA s project sustainability. The goal with this type of partnership is to demonstrate cost savings or return on investment, so that DSMP may be evaluated as a future benefit under healthcare plans. The goal of JHCAIH s Family Health Coach model is to build the local workforce and capacity of resource-stressed communities while matching existing healthcare infrastructure. The model calls for working in partnership communities to improve health status, self-sufficiency and health leadership among the community to tap into community resources as a cost effectiveness study to assist with advocacy efforts. The Mississippi Public Health Institute (MSPHI) team highlighted how their approach would produce outcomes to demonstrate cost effectiveness of a diabetes focused patient centered medical home model (PCMH) within a physician owned practice. MSPHI is also aiming to achieve payment reform by working with the State Health Officer and medical community leaders to educate policymakers about the potential cost savings and health outcomes improvements associated with PCMHs when coupled with active community engagement. Both the United Health Fund and the Marshall University Center for Rural Health teams discussed how their projects are targeting presenting data that shows health care cost savings as a result of reduced inpatient and ED utilization to payers (i.e. CMS, Medicare Advantage, Medicaid managed care, PCMHs, Independent Practice Associations, and Acountable Care Organizations). It s important to approach payers with the idea that the right thing to do is to improve the lives of members and look at the big picture. Payers know that the person in the public could be your member tomorrow. Kathy English, Wellpoint Panel Session IV: Improving & Sustaining Diabetes Management and Self-Management Services at or in Partnership with Federally Qualified Health Centers and Community Health Centers Ronald Yee, MD, MBA, Chief Medical Officer at the National Association of Community Health Centers moderated this panel session. Speakers included Holly Nannis, RN (Sixteenth Street Community Health Center), Benjamin Bluml, RPh (American Pharmacists Associatoin), Edwin Fisher, PhD (American Academy of Family Physicians Foundation), Ruth Lipman, PhD & Sandra Leal, PharmD,MPH, CDE (American Assicoation of Diabetes Educators), and Kim Prendergast, MPP (Feeding America). More than 15 Federally Qualified Health Centers are implementation sites and/or partners for ToD grant projects. This panel provided an opportunity to share learnings specific to that setting of healthcare service delivery and support for people living with diabetes. Key takeaways from this panel session include: 16 th Street Community Health Center is taking a refined view of barriers to care that also includes patient perceived barriers. This approach revealed that some barriers could removed. For example, some patients were lost to follow up because they assumed that because they have financial constraints they would not be elidgible to receive care. APAF sites demonstrated that clinical pharmacy services at FQHCs can positively impact patient diabetes outcomes and care quality and reduce costs. Incentives now need to be aligned with Medicare/Medicaid for these cost effective services to be sustained. In the Peers for Progress/Alivio Health Center partnership, the leader of the Promotoras en Salud reports to the CEO of Alivio just like the medical director rather than reporting to the medical director. This ensures peer support is reliably accessible to providers and patients. AADE created a 24/7 call center to more efficiently serve patients of 4 FQHCs and dovetail with DSME to review content presented and follow-up on goals set. Calls can be scheduled to meet participant needs rather than pre defined clinic hours Together on Diabetes Grantee Summit Report

7 Feeding America s successful pilot to create bidirectional food bank-clinic partnerhips (including FQHCs) Improved blood sugar control (HbA1c) had the following results: improved blood sugar control, reduced diabetes distress, improved medication adherence, improved diabetes selfefficacy, decreased depressive symptions, increased fruit and vegetable intake. Sustaining programs is one thing; sustaining patient outcomes is another. Holly Nannis, 16 th Street Community Health Center Networking Reception and Poster Session The end of the Day 1 of the ToD 2014 Summit was concluded by a networking reception and attended poster session. The poster provided an additional mechanism for the grantees to learn about each others projects. To access the full set of grantee posters, go to: fault.aspx#posters In addition to the poster session, John Hoffman of the Public Goods Project & Rose Marie Martinez of the Institute of Medicine previewed the A Healthy America Campaign. For more information about the Healthy America Campaign, visit SKILLS BUILDING WORKSHOPS Seven skill-building workshops were held at the summit on February 25 th and 26 th, A short description of each workshop is provided below. Communications Workshop Sarah Russe and Elise Procaccio of Discovery USA led the workshop entitled, Right Words, Right Place, Right Time: Tips and Strategies for Leveraging Media to Communicate Your Strongest Message. Newspapers, television, blasts, social media and other communication platforms provide numerous channels for getting messages from grantee projects and partners out to the public. At the same time, innumerable groups are fighting for valuable attention. With so much going on, it can be hard to know where to start! This workshop explored the role of message management to ensure consistency and a sustainable impact and allowed participants to learn: I. How the news media work II. Dos and don ts of media interactions III. Best practices for engaging with different media outlets and audiences IV. Keys to crafting winning communications across different media V. How to create your own off-the-shelf media kits VI. Ways of strengthening your message using social media The participants in this workshop practiced applying the communication lessons and skills listed above to their real-world, real-project efforts to both 1) support specific aspects of their interventions like community outreach and recruitment and 2) share learnings from their projects with community, policymaking and health practitioner audiences. Policy & Advocacy Workshop Robert Greenwald, JD, Amy Katzen, JD, and Maggie Morgan, JD of the Harvard Law School Center for Health Law and Policy Innovation led the workshop entitled, Translational Policy and Advocacy Training. The Harvard team walked the group through problem statement definition and how to frame a problem. They reviewed the seven steps involved in analyzing a problem and led the group discussion of each step in a diabetes-related example. Key takeaways from this workshop include: The seven steps of policy analysis include: 1) define the problem, 2) collect evidence on the problem, 3) identify policy options to address the problem, 4) develop criteria to assess the impact you want the policy solution to have (the outcome), 5) project the outcomes you would get from each different policy option, 6) compare how the outcomes from each option meet your criteria and 7) select the option with outcomes that best meet your criteria. Advocacy involves identifying the policy window, building awareness of your problem and creating a political opportunity. Ways to Together on Diabetes Grantee Summit Report

8 achieve your goal include building a coalition, identifying the policymaker(s) who will be able to change your policy or create legislation, communicating with the policymaker(s) who connect to your problem and the media (i.e. letters to the editor, op-eds, feature stories, social media). Pick the right time- Be right there with your solution right as the problem is most present in policymakers minds. Amy Katzen, Harvard Law School Evaluation Workshop I Jerry Schultz, PhD and Chuck Sepers from the Work Group for Community Health and Development at the University of Kansas led a Monitoring Evaluation Training session for the Grantees with a special focus for Diabetes, Depression, and Distress grantees. This workshop providing an introductory training for the grantees on the Online Documentation and Support System (ODSS) used to gather and make sens of information about accomplishments. Evaluation Workshop II Steve Fawcett, PhD, Ithar Hassaballa, Jerry Schultz, PhD and Chuck Sepers of the Work Group for Community Health and Development at the University of Kansas led two workshop sessions entitled, Communicating Evaluation Information in Together in Diabetes TM Reports and Case Studies. The goal of the working session was to educate grantees on how to best communicate their project evaluation information in the biannual reports to BMSF and the final case studies for Together on Diabetes. During the session, grantees were able to begin drafting their case studies focusing on key areas that have historically been lacking clarity in reports to BMSF. Key takeaways from this workshop include: Communicating stories of transformation can be leveraged by organizations to disseminate information through conferences, articles, etc. In order to replicate and scale these interventions, we need to be able to disseminate information. Communication is important because it enables you to tell a story about your project s activities & outcomes, while advancing the science and practice and meeting grant requirements. Key channels of communication include: Reports to foundation/grantmakers, websites, journals, conferences, newspapers, networks and face-to-face interactions. Grantmakers, partners, consumers/advisory boards, practitioners (e.g., clinic managers, CHWs), community/advocacy groups, the general public, and policy or decision-makers all need to hear your message and share in your knowledge. Dissemination Workshop I George Rust, MD and Sabrina Jackson, MMSc of the National Center for Primary Care at the Morehouse School of Medicine led the workshop entitled, Tying it all Together: Integrating Improvements in Clinical, Community, and Outcomes to Achieve Diabetes Health Equity. This workshop took the form of a group brainstorm around the innovations and interventions that can be used to improve diabetes outcomes. The brainstorm began by listing innovations and interventions that can be implemented in the clinic, followed by innovations and interventions that can be implemented in the community. Then, the question what would it take to make these innovations and interventions a reality? was asked, and answered separately for both clinic and the community interventions. Lastly, a brainstorm was had around how to bridge the gap between the clinic and community, and what is needed in terms of leadership to make it happen. A Key takeaway from this workshop is: There are a myriad of interventions that can be implemented in the community or the clinic, but the difficulty comes in interventions that link the two locations, and in finding the kind of leadership that is needed to successfully bridge the gap Together on Diabetes Grantee Summit Report

9 Dissemination Workshop II Sabrina Jackson, MMSc and Richard Gooden of the National Center for Primary Care at the Morehouse School of Medicine led the workshop entitled, Showcasing Success via Storyboarding. The workshop presented the Diabetes Health Equity website in live format and provided participants the opportunity to build their story by compliling photos with captions allowing other communities to review and download replicable resources. Food skills that are taught in the interactive tour include: o Compare unit prices o Identify whole grains o Read food labels (fresh vs. frozen vs. canned) o Identify ways to buy produce on a budget A critical demographic to include as tour participants are mothers of children under 6 years old. Key takewayas from this workshop include: Six elements of storytelling: o Concept development what story or stories from your project do you want to tell and to whom? o Outlining o Storyboarding o Content capturing what medium/media do you want to use to tell your story? TV, internet, print, inperson, etc. o Editing o Sharing Cooking Matters Workshop Marie Gravely, RD, CDE of Marshall University led the Cooking Matters Training workshop. Cooking Matters is curriculum based on research showing that careful shopping practices are associated with measures of better dietary quality. Participants of this workshop are trained as leader of the interactive instore Shopping/Cooking Matters tours. Key takeaways from this training workshop include: Low income families say their biggest barrier to eating healthy is the high cost of health grocieries 1 in 5 children are at risk of hunger and at the same time, 1 in 3 kids are overweight. SNAP benefit cuts effective November 2013 resulted in $1.40 allocated per person per meal. This means that a household of 4 would lose $36. CROSS-CUTTING THEMES FROM THE SUMMIT Throughout the two-day Grantee Summit, ToD grantees had an opportunity to connect with one another and grasp a deeper understanding of each other projects and the potential impact of the entire Together on Diabetes initiative. The 2014 ToD Summit focused on providing grantees with strategies and tactics to sustain their projects and programs. Key themes that cut across presentations and dialogue: Sustainability is a dedicated objective for the grantees. A number of grantees are exploring sustainability strategies beyond grant seeking. Applying business and marketing concepts to population health, grantees see segmentation of data versus stratification of data as new approach to data analysis. Through the Morehouse School of Medicine/Bristol-Myers Squibb Foundation Partnership for Health Equity in Diabetes, lessons learned, stories and tools emerging from grantee projects are being made accessible to the broader diabetes, primary care, health policy and health equity communities of practice. For the progress of the Together on Diabetes TM initiative, please visit Together on Diabetes Grantee Summit Report

10 ACKNOWLEDGEMENTS This report was made possible by the support of the Bristol-Myers Squibb Foundation (BMSF). The views expressed within do not necessarily reflect those of BMSF. NNPHI is grateful for this support from the BMSF. FOR MORE INFORMATION Christopher Kinabrew, Chief Strategy Officer An Nguyen, NNPHI Program Manager (888) Created in 2001 as a forum for public health institutes (PHIs), today NNPHI convenes its members and partners at the local, state, and national levels in efforts to address critical health issues. NNPHI s mission is to support national public health system initiatives and strengthen PHIs to promote multi-sector activities resulting in measurable improvements of public health structures, systems, and outcomes. Learn more at