The U.S. Department of Health and Human Services’ Office of Adolescent Health determined eight critical actions that influence whether a service will be sustained over time: 

• Create an action strategy;
• Assess the environment;
• Be adaptable;
• Secure community support;
• Integrate program services into community infrastructures;
• Build a leadership team;
• Create strategic partnerships; and
• Secure diverse financial opportunities.

Collaborative members believe that CDSMP will have achieved the goal of sustainability when the program is embedded into systems and infrastructure with significant support from policy makers, varied health benefit payers and physician referrals. -Colorado Chronic Disease State Plan, 2016

Potential Components of a Business Plan

• Purpose and value proposition
• Return on investment
• Target market
• Program costs and break-even analysis
• Define centralized and coordinated processes provided by a state or regional hub
• Roles and responsibilities of stakeholders
• Plan for program marketing and brand development
• Plan for maintaining infrastructure, including training for program leaders and master trainers
• Referral and payment sources
• Partnership opportunities
  • Goverment: Grants, social services partnerships, local health department partnerships, Medicaid Waiver, Medicare payment
  • Public: Philanthropic grants, community-based partnerships, in-kind support, university partnerships
  • Private: Participant payment or donation, pharmacies, employers and unions, emergency medical services, corporate sponsorships, insurance coverage (Medicaid Managed Care Organizations, commercial plans), health system partnerships

Tools

• Program Sustainability Assessment Tool (PSAT)
• Chronic Disease Self-Management Program Cost Calculator

Toolkits

• QIO Program Business Plan Guide for Diabetes Self-Management Education (DSME) Programs
• Massachusetts Formulating Strategic Business Plans for Healthy Aging Programs: A Toolkit for Community-Based Organizations
• Missouri CDSMP Sustainability Toolkit
• Oregon Living Well Sustainability Toolkit
• Michigan Sample PATH and Diabetes PATH Workshop Budget
• Healthy Living 4 ME Contractor Completer Rate Sheet

Sustainability/Business Plans

• New York Prevention Agenda 2013-2018
• Utah Strategic Plan 2015
• Washington State Business Plan Blueprint 2018

Medicaid Resources

• Report: Reimbursement for Evidence-Based Health Promotion Programs
• Connecticut Medicaid Waiver Renewal
• Michigan Choice Waiver Program
• Utah Medicaid Policy Issue Brief

Success Stories

Chronic Disease Self-Management Education Success Stories

• Health Systems, Networks, Contracts, and CDSME in California (page 9)
• Sustaining CDSME Partnerships with Title IIID Older Americans Funds in a Regional Health System in Connecticut (page 15)
• Prioritizing CDSMP Partnerships in the District of Columbia (page 17)
• Growing a Community Program Beyond a Grant in Pennsylvania (page 64)

See Key Components of Evidence-Based Programming: Sustainability webpage for additional guidance.