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HOME > Newsletter Articles > Newsletter 24, December 2008

 

CCHAP Newsletter Twenty-Four December 2008

Articles

80 Pediatric Practices Along The Front Range
Devote a Portion  Of Their Practice To Medicaid Children

Announcing an Interactive Cross-Cultural Communications Website
Designed Especially for Healthcare Professionals
 
Colorado’s Laws Regarding Medical Homes for Children
and
Colorado’s Medical Home Standards
 
How Well Is Your Practice Doing
As A Medical Home?

Practice Manager’s Corner

Continuous Quality Improvement and Patient Safety at the National and Local Levels

Ongoing Services
- Language as a Communication Barrier in Medical Care for Hispanic Patients
  Plus A Spanish Course For Providers
- Postpartum Depression Screening For Mothers
  And Training For Your Practice
- Child Psychiatrist Available to Provide Conferences for You In your Office
- The Cross-cultural Curriculum for the Department of Pediatrics
  The syllabus is now available for you and your practice
- Child Psychiatry Telephone Consultation on Medicaid Children
- Provider Resource Hotline for Children with Chronic Illness
- Integrating Developmental Screening In a Pediatric Practice
- Medical Spanish Training For Your Office Staff

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Thank You To 80 Pediatric Practices
Along The Front Range

CCHAP is now working with state Medicaid to support over 80 pediatric offices along the Front Range, as these practices devote a portion of their practice to providing a medical home for Medicaid and CHP+ children. Thank you to those pediatric providers and practice managers. In 2005, a study by Steve Berman found that only 20% of pediatric practices were accepting Medicaid and CHP+ children.
           Surveys of practice managers, providers and staff completed last month continue to show a high level of satisfaction with CCHAP and the new higher reimbursement from Medicaid. Over the next 6 months CCHAP is confident that the remaining pediatric practices along the front range will join in. When all Colorado pediatric private practices are devoting 10% or more of their practice to Medicaid and CHP+ children, they will have the capacity to provide a medical home to close to 80,000 Medicaid and CHP+ children.

The CCHAP Newsletter is Going Statewide

Since the majority of Colorado pediatricians are providing a medical home for Medicaid and CHP+ children, beginning in January we will be sending the CCHAP newsletter to all pediatricians and pediatric practice managers statewide. If you discover someone you know has not received this newsletter, please let us know. Thank you.

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Announcing an Interactive Cross-Cultural Communications Website
Designed Especially for Healthcare Professionals

 

dimesionsofculture.com

 
Register now! Click the link above and get full access
with your own secure login and password!

A Website to Support On-going Training for Healthcare Professionals in Colorado

Because culture can have important clinical consequences, this website is devoted to supporting the self-development of healthcare professionals in basic cross-cultural communication competencies that impact health outcomes for patients. In place of the typical "diversity training" approach, practical communication strategies are emphasized that can be put to use immediately in private practices, clinics, and hospital settings.

An Interactive Website for Building a Learning Community
 
The content of this cross-cultural communications website focuses on reinforcing key concepts presented in cross-cultural communication trainings by Marcia Carteret. Additionally, this site presents the opportunity for physicians and staffs in multiple healthcare settings to interact with one another through threaded discussions. Because nothing can replace real life experience in the learning process, a virtual learning community will make it possible to share true stories and post useful questions while culture and medical experts facilitate discussions.
Website Features
Listed here are the pages that currently make up dimensionsofculture.com. Please note that some pages require a login and password because only select groups of healthcare professionals, including all CCHAP pediatric practices, will have full access to the “community” pages.

Public Pages

• Home Page
• Greetings from the Site Editor
• Culture Calendar- Monthly religious and cultural holidays
• Culture Quest – Information about cultural happenings in our community, as well as statewide and nationally.

Healthcare Community Pages (Login/Password Protected)

• Newsletters – Monthly articles addressing key cross-cultural communication topics written by Marcia Carteret and other guest contributors.
• Interactive Forums – an interactive on-line community dialogue between healthcare professionals about communicating with patients from different cultural backgrounds. 
• Provider Profiles – An ongoing series of profiles introducing some of the dynamic and culturally diverse doctors working in the CCHAP network of pediatric practices
• Culture Ambassadors – A panel of representatives from cultures around the globe, with a strong focus on the cultures most heavily represented across out state.

This website is designed to meet the needs of the healthcare community served by Colorado Children’s Healthcare Access Program. If you are a participating CCHAP provider or staff member and have suggestions for the website, please contact Marcia Carteret at mcarteret@gmail.com or 720-777-3124. Your comments and suggestions will help make dimensionsofculture.com an effective tool for learning and community building.

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Colorado’s Laws Defining a Medical Home for Children

Senate Bill 07-130 (Concerning Medical Homes for Children)
Directs The Colorado Department of Health Care Policy and Financing (HCPF), which administers Medicaid and CHP+ and the state Department of Public Health and Environment (CDPHE) to develop systems and standards to maximize the number of Medicaid and CHP+ children who have a medical home. The systems and standards developed shall include, but need not be limited to, ways to ensure that a medical home shall offer family-centered, compassionate, culturally effective care and sensitive, respectful communication to a child and his or her family. And, the care should be continuous, accessible, comprehensive and coordinated.
This law says that medical homes should at least ensure:
(a) health maintenance and preventative care;
(b) anticipatory guidance and health education;
(c) acute and chronic illness care;
(d) coordination of medications, specialists, and therapies;
(e) provider participation in hospital care; and
(f) twenty-four-hour telephone care.

This definition was derived in large part from the AAP’s definition. Several members of the Colorado Chapter of the AAP helped craft this bill. CCHAP works closely with HCPF and CDPHE to determine what supports a practice needs in order to provide a medical home for Medicaid and CHP+ children.

Colorado Senate Bill 07-211 (Concerning Improvements To Health Care For Children)
This law does many things. Included among its objectives is for the state to increase the number of children receiving Medicaid and CHP+ coverage and to document the quality of the care they receive. The state has to report back to the legislature on a variety of improvements in the state Medicaid and CHP+ systems. An important element that state Medicaid and CHP+ must report on to the legislature is the quality of health care these children are receiving. The law directed the state to develop “standards” that represent quality health care for children and then monitor and report to the legislature how well those quality standards are being met. These standards must include medical home standards.

The Colorado Medical Home Standards

Standards of care that Medicaid and CHP+ children should receive from a medical home in Colorado were developed over the past year under the leadership of HCPF and CDPHE, with considerable input from the Colorado Chapter of The American Academy of Pediatrics, CCHAP, the Colorado Academy of Family Practice, parent groups and many, many community-based organizations. Many of you participated in a survey to help develop the standards.

The medical home standards for Medicaid and CHP+ children in Colorado are the result of the laws described above and the one year planning process. They drew heavily from the AAP’s work on medical home initiative As mentioned above, many pediatricians and practice managers contributed to their development. Thank you. Here is what Colorado would like Medicaid and CHP+ children and their parents to experience when being care for in a medical home:

1. 24 -hour 7 day access to a provider or telephone nurse triage service.
2. Family has a personal provider or team of providers.
3. Appointments are based on the child’s condition (acute, chronic, and well) and provider can accommodate same day scheduling when appropriate.
4. Information is made available about insurance, community resources, non-medical services, and transition to adult providers.
5. Information is made available about insurance, community resources, non-medical services, and transition to adult providers.
6. Provider and office staff are culturally competent.
7. The Medical Home takes the primary responsibility for care coordination.
8. Age appropriate preventive care and screening are provided through structured templates and anticipatory guidance, counseling and referrals as appropriate.
9. A Medical Home adopts and implements evidence-based diagnosis and treatment guidelines.
10. A Medical Home’s medical records are up to date and comprehensive.
11. A Medical Home has a continuous quality improvement plan that references Medical Home standards and elements.

CCHAP, CDPHE and HCPF Are Here to Help

The Colorado Department of Health Care Policy and Financing (HCPF) manages the largest health plan for children in Colorado (Medicaid and CHP+). They are leading the way in Colorado in wanting to promote these medical home standards which are closely aligned with the AAP’s work.. The commercial health plans are sure to follow.

As you look over this list, you are probably thinking, we do most of that right now and we do it well. There may be a few things on the list that you would want help in developing or improving. Providing that type of assistance is why we created the non-profit organization CCHAP. Also, there is a task force sponsored by HCPF and CDPHE, co-chaired by Steve Poole MD and Barbara Deloian PhD, RN, PNP, which was created to determine what practices will need in order for HCPF and the practices to meet these objectives. CCHAP actually already has many support services to help meet these objectives.

We need your help in determining what technical assistance and additional support programs your practice will need in order to feel comfortable that you will be providing a medical home that meets these objectives. And, you may already know of other resources we should tell other practices about. We need your recommendations!

Planning meeting: Would you or someone in your practice be able to attend the next planning meeting?
          The Provider / Practice Manager Task Force Meeting
          December 10 from 8:30 AM to 10 AM
          At The Colorado Public Health Dept.
          4300 Cherry Creek Drive South, Denver
          RSVP –poole.steven@tchden.org

10 Minute Questionnaire: Would you be willing to complete a 10 minute questionnaire to help us identify what technical assistance or support services you would need to feel you were comfortably meeting the standards? If so, please email Steve Poole (poole.steven@tchden.org)

Simply want to make a suggestion? As you look at the list of “standards,” do you have a suggestion for a way that CCHAP, CDPHE or HCPF could help your practice, please send your suggestion to Steve Poole at: poole.steven@tchden.org
Thank you.

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How Well Is Your Practice Doing
As A Medical Home?

 
The Medical Home Index (MHI) is a validated self-assessment and classification tool designed to translate the broad indicators defining the medical home (accessible, family-centered, comprehensive, coordinated, etc.) into observable, tangible behaviors and processes of care within any office setting. It is a way of measuring and quantifying the "medical homeness" of a primary care practice. The MHI is based on the premise that "medical home" is an
evolutionary process rather than a fully realized status for most practice settings. The MHI is a nationally validated tool that measures a practice's progress in this process.
 
What can the MHI do for your practice?

• You can identify your practice’s strengths
• You can identify what aspects of a medical home you would like to build on or improve
• It gives you a clear starting point
• It allows you to measure your progress
• It promotes the conversation among all providers and staff about what you want the practice to be
• It is a great way for a practice to begin a quality improvement process, because it creates buy-in among all staff
• It will improve care
• It will help you improve patient- and parent-satisfaction.
• Health plans are going to be requiring something like this within a few years. Get a head start on it, now

You can learn more about the MHI by visiting the

National Center of Medical Home Initiatives website www.medicalhomeinfo.org

The National Center for Medical Home Implementation supports medical home implementation in order to ensure that all children and youth, including those with special health care needs, have the services and support necessary for full community inclusion.

 

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Practice Manager’s Corner
December, 2008

Christina Ells

Coding and Billing
Look for a spot on the website where I will be posting coding tips and tricks and excepts from Medicaid Bulletins in order to help reduce your coding errors and increase your revenue. I will send out an e-mail launching the new part of the site as soon as it is completed.

Synagis
Medicaid still is working on the Synagis reimbursement issue and will let me know soon when it has been adjusted to reflect the current manufacturer’s price. I will pass that along to you as soon as I can.

PAR’s
This is a reminder that PARs are submitted to various agencies depending on what they are. For example, DME/Supply is submitted to ACS whereas EPSDT home health is submitted to the Colorado Foundation for Medical Care. Please refer to the November, 2008 bulletin for a listing of services and PARs and their location for submission. The link for bulletins is as follows: http://www.colorado.gov/cs/Satellite?c=Page&cid=1201542321017&pagename=HCPF%2FHCPFLayout . I suggest you have someone in your billing office save this link and refer to it often for billing changes and updates.

 
Here is a Q and A session that I thought you might all find helpful. It is reprinted in december’s Medicaid bulletin and can be accessed by using the link referenced above.

Q: Can I bill Colorado Medical Assistance Program clients for services not covered by the Colorado
Medical Assistance Program?
A: Yes. Before providing services that will not be covered by the Colorado Medical Assistance Program,
providers shall have the client sign an acknowledgment of financial responsibility. Only if a written agreement is developed do clients have the following responsibilities:
• If the service is not a covered benefit of the Colorado Medical Assistance Program, clients may be billed for the service.
• Clients are responsible for Colorado Medical Assistance Program co-payment. By federal law, providers may not refuse services if the client cannot pay co-payment when services are rendered.
B0800255 Page 3
Improving access to cost-effective, quality health care services for Coloradans
colorado.govhcpf
Clients may be billed for unpaid co-payment. Providers may apply standard collection policies if the client fails to satisfy co-payment obligations.
• Clients in nursing facilities are responsible for patient payment when under Medicare A (skilled nursing) coverage. If the patient payment amount exceeds the Medicare A co-insurance due, the difference is refunded to the client.
• Colorado Medical Assistance Program clients enrolled in a Colorado Medical Assistance Managed Care Program must follow the rules of the Prepaid Health Plan (PHP). Clients who insist upon obtaining care outside of the PHP network may be charged for non-covered services.
• Colorado Medical Assistance Program clients enrolled in the Primary Care Physician (PCP) Program are required to follow PCP Program rules. Non-emergency care in a setting that is not authorized by the primary care physician is not a benefit of the Colorado Medical Assistance Program. Clients who insist upon obtaining non-emergency care in an emergency or urgent care setting without PCP authorization may be charged for the cost of those services.
• Colorado Medical Assistance Program clients who have commercial insurance coverage that requires them to obtain services through a provider network must obtain all available services through the network.
• Clients who insist upon obtaining non-managed-care covered services outside the network may be charged for such services.

Refer to the following sites for questions concerning charging Medical Assistance Program clients for services rendered:
• Code of Federal Regulations: Title 42 Section 447.15 - Acceptance of State payment as payment in full.
http://www.gpoaccess.gov/cfr/index.html
• Colorado Revised Statutes: 26-4-403 - Recoveries–overpayments–penalties–interest–adjustments– liens.
http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1223548942896
• Colorado Code of Regulations (State Rules Concerning the Medical Assistance Program): 10 CCR 2505-10, 8.000 et seq. 10 CCR 2505-10, section 8.012 10 CCR 2505-10, section 8.205.4.I
http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1223548942896
• Colorado Medical Assistance Program Provider Participation Agreement, Page 2 Item G.
http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1201542696393
• Colorado Medical Assistance Program General Provider Information section
http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1201542320888
• Medical Assistance Program Bulletin #B9900020, July 1999
http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1201542321017

 

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Continuous Quality Improvement and Patient Safety at the National and Local Levels

Tiffany Brown, PhD

"I expect the final rule and the creation of Patient Safety Organizations to greatly improve the quality of health care for all Americans. By making it easier for clinicians and health care organizations to report and learn from adverse events without fear of new legal liability, we will be able to improve our Nation's health care systems and minimize factors that can contribute to mistakes." - Health and Human Services Secretary Mike Leavitt

There has been a lot of movement setting up different infrastructures to help you improve patient safety and quality of care both at the national and local levels. At the national level a new rule updating the Patient Safety Act offers protections for you in your efforts to improve safety and quality in your practice. It will go into affect on January 19, 2009. This rule provides final requirements and procedures for Patient Safety Organizations. Patient Safety Organizations (PSOs) are newly developing entities where health care providers can work to collect, aggregate and analyze data, within a legally secure environment and confidentiality protections, to identify and reduce patient care risks and hazards. PSOs provide a safe environment to monitor patient safety in your practice. This approach takes the blame off providers and staff and allows for the opportunity to look at systems rather than just individuals as a way to improve patient safety and quality of care. The Patient Safety Act is a voluntary program through which health care providers can share information relating to patient safety events with PSOs in a legally protected environment. PSOs are treated as business associates where patient safety activities are treated as part of health care operations under the HIPAA Privacy Rule and therefore do not require covered providers to obtain patient authorizations to disclose patient safety work. However, participation in a PSO does not exempt providers from participating in state legislated reporting. A process of certification and listing of PSOs will be implemented and overseen by the Agency for Healthcare Research and Quality (AHRQ). Confidentiality compliance will be investigated and enforced by the Office for Civil Rights (OCR). More information can be found on the Agency for Healthcare Research and Quality’s Patient Safety Organizations website at: http://www.pso.ahrq.gov/ .

On a local level, organizations such as the Colorado Clinical Guidelines Collaborative and Physician Health Partners provide assistance through in practice quality improvement coaching, in which your practice works on system-level changes to workflow to help improve quality of care for your patients.

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Abe Grinberg MD, FAAP MPH
   

Language as a Communication Barrier in Medical Care for Hispanic Patients
 

           Communication with patients and their families is essential in providing quality medical care. Cultural and language barriers create a void in the delivery of safe health care, customer satisfaction and quality of care. The public debate on how to bridge cultural and language barriers has a long history. The use of formal interpreters and translators is associated with the ability to eliminate these barriers; however, the ability to communicate directly with health professionals in a common language is associated with an increase level of trust in medical settings.

           There are 7 important points to have in mind when addressing cultural and language barriers with the Hispanic patients and their families:

1. The number of people speaking a language other than English at home and the number of Americans Limited in English Proficiency (LEP) in the United States is significant. It is expected that the total number of people in these two groups will continue to increase at a faster rate than the one of the general population in the USA. About two thirds of them are Spanish speaking individuals (₁) (₂).
2. Multiple studies document that quality of care can be seriously compromised when Spanish LEP patients need but do not get translation and interpretation services (₃) (₄).
3. Studies also document that the quality level of interpretation offered by bilingual providers and professional hospital interpreters is high. However, the quality of interpretations offered by hospital employees who are not professional interpreters, family members, relatives, friends, and ad-hoc translators are many times incorrect and of poor quality (₅).
4. Interpretation errors are common. About 60% of the errors have potential clinical consequences. Even professional interpreters commit significant errors about 50% of the time (₅).
5. Patients, who interact with a bilingual provider, frequently rate them as more friendly, respectful, and concerned when compared to those who interact with a translator or interpreter. Patients and families who are taken care by a provider who speaks their own language frequently have a more accurate recall of critical information about the encounter than those who interact with a provider who uses a translator or an interpreter(₆)(₇).
6. There are data that suggest that the length of hospital visits, the incidence of any testing, the cost per visit and the number of hospital admissions are decreased in those patients who interact with a provider who speaks their own language when compared to those providers who use a translator or interpreter during the course of the medical encounter (₈). 
7. There is evidence that courses in Medical Spanish can help health care professional achieve fluency in Spanish at the functional level and promote cultural awareness that strengthen communication skills. The promotion of such courses is associated with decreased interpreter use and increased patient and family satisfaction (₉).

          Bear in mind that Hispanics embrace people when they make an effort to speak their own language. They tend to be tolerant and have a tendency to develop relationships that are based on friendship and respect. You will make them fill comfortable and help them feel that you are concerned about their medical care.
 
          “Dele a un hombre un pescado y él comerá por un día. Enséñele cómo pescar y comerá por el resto de su vida” (Lao Tzu. Filósofo Chino).

1. 1. Flores Glenn. 2005. The Impact of Medical Interpreter Services and the Quality of Health Care: A Systematic Review. Medical Care Research and Review 62: 255-299
2. Colorado Alliance for Immigration Reform. U.S Immigration Data, Projections and Graphs. Retrieved: October 2, 2008. http://www.cairco.org/data/data_us.html
3. Flores, Glen., Abreu, Milagros., Schwartz, Ilan., and Schwartz, MD, and Hill, Maria. (2000). The importance of language and culture in pediatric care: Case studies from the Latino community. The Journal of Pediatrics. 137 (6): 842-848
4. Flores G. Language Barriers to Health Care in the United States. NEJM 2006; 355:229-23
5. Flores G., M.B. Laws., S.J. Mayo., B. Zuckerman., M. Abreu., L. Medina and E. J. Hardt. 2003. Errors in clinical interpretation and their potential clinical consequences in pediatric encounters. Pediatrics 111: 6-14
6. Baker, David W., Hayes, Risa., and Puebla Julia. 1998. Interpreter Use and Satisfaction with Interpersonal Aspects of Care for Spanish-Speaking Patients. Medical Care. 36(10):1461-1470 
7. Seijo, R., H. Gomez and J Frienderber. 1995. Language as a communication barrier in medical care for Hispanic patients. In. Hispanic Psychology_Critical issues in theory and research, edited by A.M. Padilla, 169-181. Thousand Oaks,Ca: Sage.
8. Hampers, L. C and., McNulthy, J.E. 2002. Professional Interpreters and Bilingual Physicians in a Pediatric Emergency Department. Arch Pediatr Adolesc Med. 156:1108-1113.
9. Suzan S. Mazo., Louis C. Hampers., Vidya T. Chande. Steven E. Krug. (2002).Teaching Spanish to Pediatric Emergency Physicians: Effects on Patient Satisfaction. Arch Pediatr Adolesc Med 156: 693-695

Course in Medical Spanish customized for pediatric care providers. Once a week for 12 weeks (2 hour class), includes also 6 month internet access to “Spanish for health care course”. Flexible schedule to accommodate participants’ preferences; Classes take place at the providers’ office for groups of 8-12 students.
$ 389 dollars per student. Includes 6 month internet access to the on line training course.
          Contact: Abe Grinberg MD (720) 748-7669.
          abe@bilingualmed.com my web-site www.bilingualmed.com

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Postpartum Depression Screening For Mothers
And Training For Your Practice

Postpartum Depression is a significant public health issue affecting 1 out of 8 new mothers. In Colorado, it is underidentified and undertreated. The Rose Community Foundation has funded Dr. Brian Stafford and The Kempe Center¹s Postpartum Depression Intervention Program to provide Free Medical Education and On-Site assistance to practices in the Denver Metropolitan area in order to assist their identification, education, treatment, and referral for women with this condition. Practices will receive a free talk as well as a free tool kit and fliers and brochures to assist them. This provider education is paired with a public awareness campaign on this issue titled, 'Oh baby, this isn¹t what I expected.' Interested practices or practitioners should contact the Kempe Center at 303-864-5845 or Dr. Brian Stafford at tafford.brian@tchden.org to schedule the on-site pre-clinic or lunchtime training.

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Child Psychiatrist Available to Provide Conferences for You In your Office

Rick March, MD is a child psychiatrist at the Mental Health Center of Denver.  He is available to provide teaching on a variety of child Psychiatry topics (below) in your office.  He is also willing to discuss cases with you, as well.  Please contact him to take advantage of this wonderful opportunity.
He can be reached at Rick.March@MHCD.org

Here are some of the topics he can cover for you.

• Diagnosing Depression in Children and Adolescents
• SSRI’s and Black Box warnings
• Suicide and self-abuse
• Diagnosing Bipolar Disorder in Children and Adolescents (including differential diagnosis)
• Atypical Antipsychotics
• Mood Stabilizers and Antidepressants
• Pediatric Psychopharmacology and the FDA
• Kid with ADHD who don't get better on stimulant medication
• Psychosis in Children and Adolescents

And, remember there is a child psychiatrist on call available by phone for your Medicaid children…..

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The Cross-cultural Curriculum for the Department of Pediatrics
The syllabus is now available for you and your practice

 

There is a syllabus available on the CCHAP web site that covers a variety of topics related to cross cultural health care.   Click Here to view the entire curriculum or visit www.cchap.org/cchc-syllabus/. The following topics are covered:

Demographics of Colorado’s Children

Health Disparities among Colorado’s Children

Health Disparities
              Poverty
              Genetics 
              Environmental exposures 
              Life style behaviors 
              Provider’s ability to understand/accommodate the patient’s / parent’s culture
              Provider’s ability to communicate well with families
              Patient’s / parents limited English proficiency
              Patient’s / parent’s limited health literacy 
              Disimination

What can Providers do to improve outcomes?

Race, Ethnicity and Culture (Definitions)

Cross-cultural Communication 
              Generalization versus stereotyping 
              What providers need to know about culture? (Dimensions of culture) 
              Basics of cross-cultural communication

How to communicate with and help families with Limited English Proficiency

How to communicate with and help families with Limited Health Literacy

The Cross-cultural Health Care toolkit 
              Keys to success in cross-cultural communication 
              LEARN mnemonic 
              Cross-cultural health care Review of Systems

Case Studies

Examining our Own Personal Biases

8 Steps You Can Take to Enhance Your Skills in Cross-cultural Health Care

The Institute of Medicine’s Guidelines

The CLAS Standards (Guidelines for organizational change)
  
References

 

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Child Psychiatry Telephone Consultation on Medicaid Children

The Behavioral Health Organizations and the Mental Health Centers in the greater metro area have very generously made available telephone consultation by child psychiatrists to help providers in CCHAP – affiliated practices manage their  Medicaid children with complicated mental health issues or complicated medication regimens.   These child psychiatrists are also willing to come visit your practice to get to know you and even to discuss cases.   We are very grateful for this very generous support for your Medicaid children.

Denver County – Rick March, MD – 303-504-1520
Jefferson County – Don Bechtold, MD – 303-432-5172
Adams, Arapaho and Douglas Counties - Joe Pastor, MD – 303-853-3888
 

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PROVIDER RESOURCE HOTLINE

(Clarification of previous information)

To Help You Find All Appropriate Services and Resources
           for Your Chronically Ill or Special Needs Patients

Including Case Management or Care Coordination for the Child

And Education Resources and Support Services for Their Parents

                       Call  1-877-731-6017

                       Fax: 303-691-0846

                       Email: providerhotline@familyvoicesco.org

The PROVIDER RESOURCE HOTLINE assists  providers to identify all appropriate services and resources for children with chronic illness or special needs and for their parents:

• Case management
• Care coordination
• Specialized services, resources, medical equipment, therapies
• Parent/patient education about chronic illness / special needs
• Parent/patient support services
• Help in finding funding for uncovered services

Examples:

• You are seeing a new patient (new to Colorado) who is an infant with 22q Deletion Syndrome,  congenital heart disease, cleft palate and an oxygen requirement of undetermined etiology.  Parents want to link up with all of the support services and a parent group like they had where they used to live.
• A child with multiple developmental delays also has behavioral problems.  The parents are not sure they are getting all the help their child is entitled to and they want a parent  support group and they are asking for counseling.
• A parent with a disabled child wants your help in applying for some sort of waiver that you aren’t familiar with.

Monday thru Friday from 8AM to 4PM
Voicemail available 24/7

Provides follow-up with the provider office and with the family

CLARIFICATION 
Contact Erlinda or Lorena with CCHAP at PHONE 720-744-5522; FAX 303-751-9048
  –   When you are only wondering about socio-economic issues like food stamps, housing, Medicaid 
        eligibility, legal aid, abuse, etc.
 
If the hotline can answer your questions immediately, you can pass the information to the family while they are in the office or we can contact the family and give the information to them.

If the information is not immediately available, we will research the question or case and provide the information to you and the family later in whatever manner you and the family wish (via phone, fax, or email).

If you feel the family needs more assistance or follow- up, just let us know and share the family’s contact information with us or provide the family with our number for them to contact us directly.

When contacting us, please provide us with the following information:
Your provider office and PCP name
Name of Child
Date of Birth
Medical Condition / Primary Disability
Type of insurance
Resource or service requested
Who should we contact with information?
Family Contact Information
How is it best to provide information back to you: phone, fax, email or voicemail

DOWNLOAD A REFERRAL FORM CLICK HERE

DOWNLOAD AN 8.5 x 11 FLIER TO KEEP ON HAND AS A REMINDER  CLICK HERE

Next time you see a special needs child, call us to see how we can help

Questions about the hotline?  Call 1-877-731-6017

The Provider Hotline Is Sponsored By
Family Voices and CCHAP

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Integrating Developmental Screening
Into a Pediatric Practice

 

• The Colorado Assuring Better Child Health & Development (ABCD) project has received a three year grant to provide training and technical assistance to providers to implement a “validated” developmental screening tool at well child visits for infants/toddlers birth to five.
• The ABCD project is partnering with CCHAP to provide training and support to pediatric practices to implement developmental screening.
• Medicaid will reimburse $34.00 to providers if you use a standardized, validated developmental screening test at an EPSDT visit.
• The Colorado Chapter of the AAP supports the ABCD project.
• Early detection and intervention improves outcomes.  Many delays in children’s development are missed in the first 4-5 years of life without a standardized, validated screening test. 
• The most time-efficient tool is one in which the parent completes a questionnaire.
• To comply with 2010 recertification guidelines by the American Board of Pediatrics, documentation will be required to show levels of involvement in practice improvement initiatives. By implementing the use of a “validated” developmental screening with a sensitivity and specificity rating of 70% or greater like the ASQ or PEDS, practices are taking steps to integrate quality improvement into their practices.
• What providers are saying about implementing either the ASQ or the PEDS parent questionnaire developmental screening tools:
  •  
    • It takes 1-2 minutes for an MA, LPN or RN to score.
    • It takes less than a minute of the provider’s time if the MA, LPN or RN scores the questionnaire.
    • In many instances, it reduces the length of the visit.
    • It helps providers concentrate on the concerns/priorities of the parents.
    • It reduces the number of concerns that come up as you are walking out the door at a well care visit.
    • It improves patient satisfaction.
    • It promotes positive parenting practices.
    • It increases provider confidence in decision-making for when to refer a child for further developmental evaluation.
• Eileen Auer Bennett, the Colorado State ABCD Coordinator and her team are available to assist providers in getting started. Training and technical assistance will be provided to practices to implement a standardized tool such as the ASQ or PEDS. Support will also be given to office staff on how to incorporate a standardized developmental screening tool into the current office work flow.

For more information, please contact:
            Eileen Auer Bennett
            720-333-1351
            ileanben@yahoo.com

The Ages & Stages Questionnaire (ASQ) is a well respected screening tool.  It has the best sensitivity and specificity.  It is standardized across various common minorities.   Health care providers have identified the following advantages:

• Parent completed—Parents are partners in their child’s
  assessment and intervention activities.
• Serves as a talking guide with parents identifying a
  child’s strengths as well as things the child is not
  doing yet.
• Practical—Scoring takes 1-2 minutes and can be done
  by paraprofessionals.
• Cost-efficient—May be photocopied repeatedly.
• Scoring is simple—Only three responses:
  1. Sometimes, occasional or emerging response from
     child = 5 points
  2. Yes, child performs specified behavior = 10 points
  3. Not Yet = 0 points
• If the child’s total score falls in a shaded area of the bar
  graph for any developmental area, further diagnostic
  assessment is recommended.

 

• Developed out of four cross-validation studies on a
  nationally representative sample of families.
• Uses parent concerns or judgments about the child’s
  development and behavioral status.
• Easy to score—two minutes to elicit and interpret.
• Enables health care providers to determine the need to
  refer and where.

Visit www.pedstest.com to view and order the PEDS tool online.

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Spanish Interpretation Training for Pediatric Practices

An assessment of each individual’s skill level will be done during a 5-10 minute phone call prior to first telephone conference/class.  Maria will contact you to schedule this initial individual telephone call upon receipt of your registration email.  A certificate of completion will be given after completion of all 6 sessions. The faculty is Maria Soto, a certified Spanish interpreter and trainer with International Language Services.

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Copyright 2008 Colorado Children's Healthcare Access Program and other entities as noted.

 

 CCHAP Home > Newsletter Articles > Newsletter Twenty-Four, December 2008