CHALLENGE CENTER

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CHALLENGE CENTER

• Filling the Gap in the Continuum of Care

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Background Information aboutChallenge Center

• Non profit Community Based Physical
  Therapy/Fitness Center
• Founded-1987
• Located in City Park
• Primary population served-Physically Disabled
• Secondary-Served Ambulatory Seniors

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Emerging Role of Health Promotion for People
with Disabilities

• Traditional managed care invests financial
  resources in diagnosing and treating/ curing
  disease
• Research shows investment in health promotion is
  cost effective, beyond the absence of disease
  or acute recovery.Rimmer JH. Health promotion
  for people with disabilities

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Healthy People 2000A clear opportunity exists
for health promotion and disease prevention
efforts to improve the health prospects and
functional independence of people with
disabilities page 41
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Continuum of Care the GAP
Fitness Specialist
---Not trained to meet special needs
Inpat Rehab
Home Health PT/OT/RN
Outpat Rehab
THE GAP
ER/ Acute Care
Community Health and
Wellness Gyms
CHALLENGE CENTER
Cardiopulmonary Rehab
Accessible Equipment Trained Personnel PHYSICAL
THERAPY
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The need for health promotion

• While medical technology has increased the life
  span of those with disabilities, little has been
  done to improve their health span.
• Fewer than 10 of adults participate in
  structured physical activity. Rimmer JH,
  et al

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Greater number of trauma Survivors

• ER- Trauma care increasing rates of survival
• Acute care advancements in medicine increasing
  levels of acute recovery
• In-Patient Rehabilitation longer stays replaced
  with limited home health and outpatient services

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Continuum of Care

• Home Health services help bridge the gap in
  acute recovery
• Out-patient services expanding To Include Cardio
  and Pulmonary Education and Training
• Challenge Center concept is similar approach for
  neurological patients

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Continuum of Care

• Driven by consumers need for training and
  self-empowerment in recovery
• Increased perception of responsibility for
  self-health and fitness

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Continuum of Care

• Ideal outcome of continuum of care is commitment
  to healthy lifestyle and regular exercise by the
  patient
• There is a gap in the plan

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Challenge Center HelpsFill the Gap for Persons
with Disabilities and Special Needs
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Promoting Health in Persons with Disabilities

• Perception of healthy disabled gradually
  changing
• Health is not static for all populations
  dynamic and multi-factorial in nature. Rimmer
  JH,et al

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Promoting Health in Persons with Disabilities

• Lifetime health cycle and benefits in healthy
  lifestyle choices similar for able non disabled
  populations
• Physical disability and functional frailty
  creates risk for fitness centers and disabled
  clients
• Lack of skilled physical therapists, trainers,
  specialized equipment, eliminates many with
  disability from conventional fitness centers

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Physical Challenges Require Specialized Approaches

• Skilled physical therapists,
• Trainers, specialized equipment
• Transportation
• Participation of care givers
• Peer support

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Secondary Complications, Partial List

• Decubitus Ulcers, pressure sores 30,000 X 3
• Inactivity, isolation
• Obesity
• Diabetes/Insulin Sensitivity
• Chronic Pain
• Depression
• Loss of Functional Ability
• Premature Institutionalization

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Health Promotion/ Wellness and Fitness for
persons with Disabilities
Who Benefits?

• Persons with disability
• Insurers
• Family and care givers
• Buyers of insurance
• Acute care resources
• The government and tax payer

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Why is post acute therapy not a priority ?
Reasons for the gap

• Medical focus on primary diagnosis
• Insufficient prevention efforts in chronic
  populations
• do health maintenance organizations
• really maintain health?
• Acute care system not designed for chronic care
• Misguided cost assumptions
• Lack of awareness of recent advances in physical
  medicine
• Disability health seen as an oxymoron?
• The move from institutional to community care
  model

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CHALLENGE CENTER

How it Works on

• Supported in large part by philanthropic dollars
• Special events
• Contractual agreements
• Sliding scale for cash payment
• Client-specific sponsors
• We pray a lot !

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CHALLENGE CENTER Our Goal

• If we are to intervene with health promotion
  practices which prevent functional declines in
  clients with long term disabilities, we will
  realize significant costs saving and prevent
  unnecessary human suffering.

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