Building and Sustaining Partnerships


AF Mid-West Chapters’ Experience: Marketing to Managed Care Organizations
AF New York Chapter Partners with Group Health Inc.
AF So California Chapter Gains New Systems Partner with Atria Senior Living Group
Partnership with Area Agencies on Aging to Promote AF Exercise Program in Michigan
AF Exercise Program at Congregate Meal Sites /Lifecare Alliance in Ohio
Increasing Reach in Illinois Through Partnerships


AF Mid-West Chapters’ Experience: Marketing to Managed Care Organizations


  • The AF Indiana Chapter implemented a multi-pronged approach to working with managed care organizations (MCOs).
  • One strategy involved hosting luncheons that brought together a variety of different prospective partners (including MCOs, hospitals and businesses) called Building Better Partnerships.  Some invited businesses already had relationships with the AF, either through fundraising or the programs department.  The chapter was able to get key people from these businesses to attend. Organizations could see what the AF did, who they were partnering with, as well as network with each other.
  • The luncheon was an opportunity to promote the programs and gain more program leaders.  Each business received a personalized thank you packet.
  • The AF Indiana Chapter also used a personal approach using key volunteers to make the initial contact. For instance, the chapter’s board chair contacted Blue Cross/Blue Shield (BC/BS) and connected the chapter with the BC/BS medical director. After meeting with the medical director, the chapter met with a team including representatives from product marketing, medical personnel, etc.  Because BC/BS covered members in Indiana, Kentucky, and Ohio, the involved chapter presidents met with each other to discuss terms of agreements.  The Indiana Chapter served as the lead chapter and, among other responsibilities, received all funds paid by BC/BS for the AF programs. Indiana Chapter disseminated the money to the other chapters involved.
  • The AF provided the AF Self-Help Program to BC/BS older adult/ senior membership. In turn, BC/BS paid the chapters for this benefit for their members.
  • BC/BS launched the partnership program and marketed to its members via their newsletter.
  • New AF Self-Help classes were started just for BC/BS members. They were led by existing trained leaders. Payment was included for leaders out of the money that BC/BS paid the chapters.




  • The partnership was very well received and successful. There was a waiting list each time a course was offered to the membership.
  • The partnership strengthened the overall relationship between the AF and BC/BS, and there was a better understanding of why MCOs should partner with groups like the AF.


Key Learnings/ Tips


  • Figure out why you want to make contact with the MCO.
  • Understand how the insurance industry works and know how AF programs and services will be beneficial to the MCO.
  • Be able to discuss the economic impact of arthritis and make the case for partnership because of the evidence-based data. 
  • Cultivate the relationship by designating a chapter volunteer and staff member as the primary contacts. Maintain face-to-face interactions, and invite the organization to key chapter events such as galas or education seminars.
  • Clearly document the partnership parameters and responsibilities in a letter of agreement and develop a timeline.
  • Take the program to the target audience, and make programs convenient to the membership. This was important to BC/BS.


Contact – Marva Stanford/Chief Field Operations - AF National Office/317-849-9832 /


AF New York Chapter Partners with Group Health Inc. (GHI) and HIP Health Plan of NY to Implement AF Programs


  • Group Health Inc. (GHI) is a managed care organization (MCO) with approximately three million members including 55,000 members with arthritis. HIP Health Plan of NY (HIP) has more than one million members including 33,000 with arthritis. The chapter used a personal approach to establish relationships with champions at both organizations.
  • Through a chapter fund-raising event, the President of GHI was honored and later asked to join the AF NY Chapter Board. The chapter wanted to expand its relationship with GHI from a fundraising to a program relationship. GHI was already impressed with the AF Self-Help Program data.
  • The GHI President assigned the VP of GHI services to shepherd the project through negotiations and contracts and through the initial implementation. This shepherd then passed the project on to another contact person at GHI as primary contact. 
  • Following the success of the GHI initiative with the AF Self-Help Program, the chapter honored the CEO of HIP and initiated contact to discuss a partnership to deliver the AF Exercise Program. The CEO then placed the chapter in contact with the HIP President who became the shepherd to negotiate the relationship and contract. The partnership was easier to begin because of the work the chapter had accomplished with GHI.
  • In both cases, the negotiation process involved about a year of cultivating relationships with key people. The chapter began with an initial meeting with the CEO champions, and then moved on to work with the shepherds. Next, they met with medical directors, managed care policy and program departments and the marketing and product development departments. Chapter staff also involved their volunteer chair of their Patient Services Committee in this negotiation process.
  • The chapter developed clear, concise proposals that outlined the program outcome data, benefits of the AF disease management programs and the proposed chapter and MCO roles in collaboration. Responsibilities were documented in contracts and a partnership work plan.
  • MCO responsibilities included marketing to members and recruitment of class participants through direct mailings to health care providers and to members, MCO newsletter and annual report articles, advertisements in targeted newspapers and distribution of promotional kits to subscriber groups including unions and city employees.





  • Since 1998, these partnerships have resulted in over 9200 participants in 292 classes and over $815,000 income to the chapter to cover the program costs. In 2006 alone, a total of 24 AF Exercise Programs, 10 AF Self-Help Programs, and eight AF Tai Chi courses were offered, reaching approximately 1200 participants.
  • Outcome data showed that compared to a wait-list control group, program participants had statistically significant improvement in knowledge, practice of self-care techniques, arthritis symptoms, depression and self-rated health.
  • These partners were a good fit because they give access to groups that they chapter was not reaching on its own. For instance, HIP interfaces with a lot of NY City workers, people in the public sector, etc. 


Key Learnings/ Tips


  • Find the right persons to serve as a champion and shepherd for the partnership. It is important to get into the companies at a high level first.
  • Develop a clear concise proposal that clarifies the chapter and MCO’s roles in collaboration.
  • You may want to start on the chapter’s fund-raising side to get foot into door at the company
  • Once the chapter is working with the MCO, make sure the MCO is targeting the right market that the AF wants to reach through various marketing campaigns and venues.
  • Evaluating the program is key to sustaining the program because the companies want to see that the programs are beneficial to their members.
  • Offering the classes free of charge also is helpful in sustaining the program.
  • The chapter’s partnership with the two MCOs has created a friendly competition. In turn, this has helped sustain the programs.
  • Designate a staff person as the go-to person at the chapter for the company to call on.  


Further detail about the program outcomes can be found in these evaluation reports: MCO presentation, GHI report and presentation, HIP report and presentation.


Contact - Helen Levine/ AF New York Chapter/ 212-984-8710/



AF Southern California Chapter Gains New Systems Partner with Atria Senior Living Group


  • Atria Senior Living Group is the third largest provider of senior living services, with more than 120 retirement and assisted living communities in 27 states, serving more than 12,000 seniors. Atria is committed to quality care and each of its communities offers an Engage Life Program including educational, fitness and other life enrichment programs.  Engage Life Directors at each community develop programming to meet the needs of their residents.
  • The AF Southern California Chapter is collaborating with Atria’s Western Division which includes 46 communities in California, Nevada, Utah, New Mexico, Arizona and Colorado. 
  • The relationship grew out of a long standing program relationship between the chapter and an individual instructor who had been involved with the AF for nearly 10 years as a certified Arthritis Foundation Exercise Program instructor and Arthritis Foundation Self-Help Program leader.  When the instructor began her new key role as the Atria, Western Division Engage Life Specialist, she saw the need to deliver comprehensive fitness and program training to her Engage Life Directors.  She felt that the AF Exercise Program instructor training was the exact certification that would elevate her Engage Life Directors to meet more of the fitness needs of their residents.  Furthermore, she believed that the AF Exercise Program was the perfect class to offer at every Atria Senior Living Community.
  • The Engage Life Specialist contacted the chapter to initiate the relationship and spearheaded the negotiations. An action plan was developed to build the partnership on a large scale level, including delivering a comprehensive training program to all Engage Life Directors in every community and to build a strong partnership model for program delivery.
  • A letter of agreement was negotiated between Atria and the AF and distributed by the Engage Life Specialist to all of the Atria Engage Life Directors in each Atria community.  Directors will sign for their individual communities. Key components of the agreement and action plan include:


    • A phased in approach for training and certifying the Western Division Engage Life Directors in the AF Exercise program (Phase 1: Southern California and San Diego sites; Phase 2: Northern California; Phase 3: Nevada and surrounding areas; and Phase 4:  complete training for surrounding states).
    • Each Engage Life Director will teach at a minimum two classes per week to meet the standards of the Evidence-Based Programs and will teach at least six class sessions within two months of program launch to meet certification requirements.             
    • Programs will be open to the outside community.
    • After training, the AF program director staff will meet with their local Atria Engage Life Directors to cultivate the relationship.  The program directors will offer assistance with program outreach and delivery; explain the Reach data collection process, conduct a site visit for quality control assessment, and collect the signed letter of agreement.
    • Program delivery will include marketing efforts made by both Atria and the AF marketing department to showcase the relationship and advertise new program classes for the community.
    • The Engage Life Specialist will be trained and certified as an AF Exercise Program trainer which will help sustain the program and allow Atria to partner with the AF in more direct training opportunities.




  • This is the largest partnership ever undertaken by the Chapter.
  • In early 2007, the chapter conducted an AF Exercise Program instructor training for 20 NEW instructors and facilities. Atria Engage Life Directors throughout the Southern California and San Diego area have been certified in the program. 
  • After training and certifications have been conducted for every Atria Senior Living Group Engage Life Director, the AF will work with Atria on the next level of partnership opportunities. Atria has already expressed interest in expanding the programs to include the AF Self-Help Program, the AF Aquatic Program (in sites which have pool space available) and the AF Tai Chi instructor training. National expansion opportunities are also being explored.


For more information on Atria, see:


Contact – Mireya Pena/AF Southern California Chapter/ 323-954-5160/


Partnership with Area Agencies on Aging to Promote AF Exercise Program in Michigan


  • With the help of the state agency on aging, the chapter identified likely prospects and then approached health planners in Area Agencies on Aging (AAA) in four regions of the state.  Chapter staff presented the proposed collaboration and provided each agency a copy of a handout which further outlined expectations and benefits. (See the Michigan Senior Center Flyer (New Opportunity in the Aging Network”).
  • The chapter also approached two retirement community chains and an AF representative presented at regular meetings of senior center directors to further promote this opportunity.
  • The area agencies were invited to refer senior centers to the chapter that would be likely participants in the project (because of their wellness focus, their proven ability to benefit from grant opportunities, their commitment to sustainability, or other special factors). The chapter pledged to provide the area agency with $100 for every site they recruited that resulted in a successful class.
  • The area agencies were asked to publicize the project and scheduled classes. An article in their newsletter (developed by the AF) and distribution of AF marketing flyers through their information and referral service were just two examples of ways they could provide publicity. The chapter compensated the area agencies for labor and postage to an agreed-upon maximum.
  • One of the area agencies recruited sites by sending out an e-mail to senior center directors in the region promoting the project and the benefits of the program. Other area agencies made personal contacts with senior center directors to sell the program.
  • All responsibilities were confirmed in writing in a letter. Sites and leaders signed the standard AF agreements to participate in the program. A key part of the agreements were to submit both REACH and IMPACT data.




  • The chapter provided three area agencies on aging with payment in the range of $100 to $300 for site recruitment. All three provided some level of marketing support, but none of them charged for labor or postage for their publicity efforts.
  • Through the area agencies, word-of-mouth and other recruitment efforts simultaneously focused on senior centers and retirement communities, the chapter added 22 sites in a period of four months. In 2006, the Chapter’s roster of exercise program sites grew from 25 at the beginning of the year to 62 at the end.
  • The Chapter recruited and trained 38 new leaders. Classes are currently underway at senior centers, adult day care centers and retirement communities as a result of the project. Sites have also expressed an interest in the AF Self-Help Program and Tai Chi programs.


Key Learnings/ Tips


  • The state aging office was consulted prior to beginning the project and recommended AAAs that would be good targets for the initiative.
  • AAAs with new wellness initiatives were specifically selected to participate in the program
  • AAA representatives designated sites in their regions that they thought would be good candidates for this opportunity.
  • AAA representatives contacted site directors to sell the benefits of the program and give it added credibility. Then they facilitated an introduction between the sites and the AF.
  • Funds from a state grant supported two free training workshops  that were essential for members of the aging services network who perceive  themselves as having limited resources.
  • Training candidates were carefully recruited to ensure  they had the requisite skills and experience to be comfortable with their training and delivery of classes.
  • Special training workshops were held just for these candidates from the aging services network, and they had a lot in common with other participants and could generate a lot of ideas and enthusiasm.
  • The timeline for the project was very precise , creating a sense of urgency (recruit in spring, train in summer, launch classes in fall, evaluate in December).
  • Training workshops were held in July and August with classes beginning in September so that the excitement of the workshops carried over into scheduling and marketing classes, with no time lag.
  • Coincidentally, the staff person responsible for this project happens to have a gerontology background and some positive connections in and understanding of the aging services network
  • AAAs assisted in marketing classes through their newsletters, information and referral contacts, etc. Sites also used their newsletters to market classes, as well as on-site flyers and one-on-one participant recruitment.
  • Sites were required to create one-page sustainability plans to keep classes going in 2007. The AF and AAA representatives assisted with development of the plans.
  • With funds from a state grant, incentive monies were available to compensate AAAs and sites, if needed, to pay leaders, cover manpower costs of recruitment and marketing, etc. Only part of those funds will be used, principally because sites are paying the leaders.


Contact – Barbara Spreitzer-Berent/ AF Michigan Chapter/248-649-2891 x 224/


AF Exercise Program at Congregate Meal Sites /Lifecare Alliance in Ohio


  • The chapter understood the importance of creating a partnership with a big system partner in order to reach larger groups of people and those who are underserved. For example, they wanted to reach those who are considered to be on the lower socioeconomic scale, as well as participants who do not have access to places like fitness clubs, gyms and YMCAs.
  • The chapter discovered Lifecare Alliance through committee and coalition work.
  • The partner was a good fit because it provided a captive audience and already had interest in nutrition, healthy lifestyles and physical activity.
  • Lifecare Alliance provides the meals and oversees the meal sites. Most of the congregate meal sites are senior centers.
  • A survey was done among the clients to confirm that they wanted an exercise program.
  • The partner tried out the program as a pilot with one site in Columbus, and after they found out it worked, they brought the program to more sites. Programs in rural Fairfield County were started with funding from a county senior services levy.
  • The partnership is with the umbrella program of Lifecare Alliance and through the senior levy grant program and not with the individual sites.
  • AF trains program instructors, including nurses and other workers with health experience.
  • Most sites in Columbus, Ohio are racially diverse. Rural sites in Fairfield County, Ohio are mostly Caucasian. The average age of clients is 65 and above, and they are fairly independent.
  • The chapter has used a variety of means to sustain the relationship including:

    • Recognition activities
    • Thank yous
    • Keeping open slots in  trainings for Lifecare Alliance program instructors
    • Sending mailings to individual instructors to invite them to other AF programs and events
    • At the county level (rural sites), instructors are paid $2.50 /client and $10 /hour via the grant
    • Having a staff person in the community to help build and maintain the relationship




  • The partnership was successful in serving 150 hard-to-reach people through seven sites
  • The program was easy to maintain.
  • The program impressed other funding sources.
  • Grant money was awarded to roll out the program in the rural area; AF has also sub-contracted through Meals on Wheels for funding


Key Learnings/ Tips


  • Ask sites to try it on a small scale first helped open the door for wider dissemination.
  • Ask for buy in from the system partner to pave the way with the facility sites.
  • Stay in the community and continually network. For example, working on coalitions and committees is important in initiating and maintaining the partnership.
  • Have a branch manager, as in the community development model, staff person in Fairfield County helped spread the program in that area.


Contact – Linda Reynolds/AF Central Ohio Chapter/614-876-8200/


Increasing Reach in Illinois Through Partnerships


  • The AF Greater Illinois Chapter and the Greater Chicago Chapter collaborated with the Illinois Department of Public Health (IDPH) and 58 local health departments, (LHD) as well as other partners, including area agencies on aging, senior and community centers, senior housing, YMCAs and other sites to offer the AF Self-Help, AF Exercise and some AF Aquatic Program classes.
  • The target population of the AF Greater Illinois Chapter was people with arthritis in rural and underserved areas. The local health departments provided leaders to be trained and free space for classes. Programs were marketed through newsletters and public announcements.
  • The AF Greater Chicago Chapter is focusing on people with arthritis in urban, underserved communities and utilizes senior centers, senior high-rise apartment complexes, and neighborhood organizations in diverse areas to host AF classes. Classes are held for free or at reduced cost through grants from the Illinois Department of Health.
  • To establish relationships with the local health departments, the AF leveraged its relationship with the IDPH to begin communications.  In some cases, the IDPH sent introductory letters. AF staff would call and speak directly to the director/administrator of the LHD and ask about who the appropriate person would be to speak with. As a secondary point of initial contact, staff would call the education dept of the LHD. Once they understood that it would not cost them anything, the LHDs were interested in partnering.
  • To negotiate the partnerships, the AF presented a menu of program options and also offered the LHD various options about getting involved.  The LHDs helped to recruit program leaders, market the programs, and referred clients to the AF.
  • To help sustain the relationship and program activities, the AF:
  • Maintained continual contact and established a good rapport with the LHDs. For example, AF staff members brought AF-branded items left over from special events when meeting with LHDs,
  • Offered AF brochures and other materials to LHDs at reduced cost (this was not financially supported by IDH)
  • Encouraged LHDs to charge small fee for classes




  • An open and friendly relationship makes the overall partnership a success.
  • The partnership with the state health department was successful because of an open line of communication and mutual respect. The AF has a say in what they will do with their grant money. The Illinois Department of Health sees the AF as the expert on arthritis.
  • The partnerships implemented more than 100 programs in three years. Many of them still exist now in communities that originally had no programs at all.


Key Learnings/ Tips


  • Maintain continual contact, and call when you do not want anything just to check in and remind the partner that you’re there if they need you.
  • Train leaders in accurate REACH/IMPACT data collection.
  • Enter the right contact person from the partnering organizations into Team Approach to make sure they get updated mailings about ALL AF events.
  • Remember that it is a give and take relationship.
  • Foster a positive relationship and ongoing communication with the state health department. For example, the IDPH has committees and subcommittees that meet once a month, as well as host conference calls.


Contact – Heidi Koll AF Greater Illinois Chapter 309-682-6600 or Rhonda Clancy Illinois Department of Public Health 217-782-3300




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