Improving Diabetes Prevention and Management

Project Title

Expanding the Chronic Care Model for Patients with Diabetes in Central New York

Grant Amount


Priority Area

Improving Diabetes Prevention and Management

Date Awarded

November 15, 2007


Central NY





According to the Family Health Network of Central New York (FHN), a multisite, federally qualified health center in Cortland County, more people with diabetes in Cortland County die of complications related to diabetes than in other parts of the State.

This region of the State also has the third-lowest reported daily self-monitoring of blood glucose and the fifth-lowest reported daily foot self-check among members of the New York Diabetes Coalition. In January 2008, NYHealth awarded FHN a grant to expand its existing diabetes program that was launched in 2006 to include more care teams and locations in Cortland County. NYHealth funded this project through its 2007 Setting the Standard: Advancing Best Practices in Diabetes Management request for proposals.

While the prevalence of diabetes is relatively low in the area, the mortality rate is high (28.0 compared to 20.5 statewide). Perhaps not surprisingly, the region has the third lowest reported daily self-monitoring of blood glucose and the fifth lowest reported daily foot self-checks among the New York State Diabetes Coalition Regions.

The Family Health Network, which operates a network of medical and dental centers, school-based clinics, and obstetrics and gynecology services in Cortland and Cayuga counties, received training on the Chronic Care Model in 2002 and implemented the model in two of its five medical sites. NYHealth funding will expand the model to the Family Health Network’s additional three sites and incorporate elements of the model into its occupational health program (which reaches male adults who frequently do not seek preventive or screening care). Along with this expansion, the network plans to implement the “Take the Plunge” weight-loss program in all communities it serves.