• 2-1-1 Helpline Center (SD)
  • Benjamin Rose Institute (OH)
  • Community Health Partners (IA)
  • Mainstreaming Consultants, Inc. dba Disability Rights & Resources (NC)
  • Middle Alabama Area Agency on Aging (AL)
  • North Central Area Agency on Aging (CT)
  • Open Hand Atlanta (GA)
  • Rhode Island Parent Information Network
  • Samaritan Health Services (OR)
  • South Carolina Association of Council Aging Directors
  • Washtenaw Health Initiative (MI)


The purpose of the National Council on Aging’s (NCOA) Center for Healthy Aging Network Development Learning Collaborative (NDLC) is to provide community-based organizations (CBOs) with the knowledge and skills to create, enhance, and/or successfully manage community integrated network partnerships.


The health care industry and federal and state governments are more cognizant that addressing holistic care coordination for high-need health care consumers requires an integrated approach to achieve better quality and performance outcomes and to increase these consumers’ capacity to live independently in their communities.  These health care and CBO engagement trends require that CBOs evaluate their traditional modes of delivering services, especially as stand-alone entities.  Moreover, assessing organizational capacity and infrastructure are necessary components of a strategic business plan that supports outreach and engagement with new health care customers.  According to a published survey report from the National Association of Area Agencies on Aging (n4a), the number of CBOs delivering contracted services to health care organizations has increased significantly in the last several years.

Ongoing developments in managed long-term services and supports, Medicare Advantage, and accountable care organizations continue to transform health care delivery and quality. The 2018 CHRONIC Care Act promotes wide sweeping changes in person-centered support for Medicare Advantage enrollees.  Person-centered planning and holistic approaches to care coordination are increasingly ingrained into the traditional health care delivery systems, synchronizing the social determinants of health (SDOH) with traditional clinical care.  This shift adds a new wrinkle to health care consumer management. CBOs, who are the SDOH experts, have a significant opportunity to engage with health care partners across the industry ecosystem.

CBOs that invest in developing a deeper understanding of health care organizations’ needs, create partnerships and networks to meet those needs, and define (and deliver on) the value propositions can effectively address health care organizations’ needs. The sustainability of CBOs as community resources is dependent upon the aptitude and ability to adapt to their business philosophies and practices to access new sources of revenue.  A key factor in developing productive relationships with health care organizations is the alignment of collaborative networks among CBOs.

A community-integrated network utilizes a centralized, coordinated model for service provision by incorporating uniform logistical practices for recruitment, referral, enrollment, marketing, quality assurance, and evaluation.  This process is carried out under the direction of the community-integrated network’s central organization and is coordinated among the collective service delivery network.  It provides a unified and consistent approach to program delivery across a geographic area, either regional or statewide. The central organization is the center of this business model that connects a network of partners, including health care systems and local community organizations who offer home and community-based services and evidence-based programs, all working together toward a common goal.

Among the many benefits in the establishment of network hubs is the capacity to:

  • Deliver a broader scope of SDOH services;
  • Reach more diverse consumers and populations;
  • Build stronger administrative infrastructures;
  • Capitalize on economies of scale;
  • Provide expanded regional/statewide coverage;
  • Offer one-stop contracting for multiple services with payors;
  • Expand quality improvement initiatives and successes; and
  • Generate revenue.

Participation in the NDLC provides selected participants with training on the fundamental elements of community integrated network development such as identification of CBO partners, establishment of participation agreements, and exposure to the primary drivers for health care organizations to support building value propositions.  Over a period of 10 months, the NDLC will provide participants with an opportunity to learn from NCOA and health care industry subject matter experts. Additionally, NDLC participants will be engaged with other CBOs across the country that have successfully created integrated networks and are contracted with health care organizations.


10 months: September 2019 – June 2020


The NDLC faculty include leading experts in the development of community-integrated networks in the field of aging, including:

  • Dianne Davis, Vice President, Health Self-Management Services, Partners in Care Foundation
  • Jennifer Raymond, Chief Strategy Officer, Elderly Services of Merrimack Valley, Inc.
  • Sharon R. Williams, Founder of Williams Jaxon Consulting, LLC
  • Kathleen Zuke, Senior Program Manager, National Council on Aging

Key NDLC Learning Benchmarks

Participating organizations will work toward achieving these tactical objectives:

  • Draft a participating organization agreement;
  • Complete the n4a Readiness Assessment Tool and utilize the results to strengthen your strategic plan;
  • Complete a partnership evaluation;
  • Utilize cost calculator tools to support development of fiscal planning;
  • Detect gaps, if any, in current hub composition and identify additional partners/network participants to maximize organizational capacity; and
  • Target a local health care organization for partnership engagement

NDLC Participant Benefits

  • A no-cost, significant investment in the long-term sustainability of your community-integrated network.
  • Over 15 hours of content delivered monthly, paired with defined action steps to help you create transformation. This includes monthly webinars with lectures by experts from the field, peer-to-peer learning, and discussion of suggested readings and homework assignments.
  • Access to a private online community to connect with peers and access resources.
  • Individualized support and small group mentor calls every other month for the successful execution of NDLC expectations and discussion of lessons learned and challenges.
  • Connection to experienced organizations that have successfully created community-integrated networks and contracted with health care organizations.
  • Access to one hour of consulting through the Evidence-Based Leadership Council focused on the implementation of multiple evidence-based programs.

Participant Expectations

Up to 10 organizations will be selected to participate in this learning collaborative. Participants will be announced in August 2019.  Participants are expected to complete the entire 10-month NDLC curriculum, which includes:

  • Identifying key community-integrated network partners to participate as a team on monthly NDLC webinars and related activities;
  • Collaborating with your team to develop measurable goals and objectives to achieve the NDLC purpose;
  • Actively participating during monthly webinars, including reporting on progress and lessons learned to encourage shared growth among all participants;
  • Dedicating 4-5 hours per month to collaborating with community-integrated network partners to prepare for monthly NDLC lectures and assignments;
  • Actively and regularly participating in ongoing discussions on the online community;
  • Submitting homework assignments and progress report updates monthly through the online community;
  • Participating in mentor calls every other month; and
  • Becoming familiar with the community-integrated health care resources on NCOA’s website as well as other supplemental materials.

Click here to download this charter.

Please contact Kathleen Zuke ( with any questions regarding the learning collaborative.

The learning collaborative is funded by the Administration for Community Living, U.S. Department of Health and Human Services.