Ongoing Services
- Announcing an Interactive Cross-Cultural Communications Website Designed Especially for Healthcare Professionals
- The Colorado Pediatric Postpartum Depression Screening and Referral Toolkit
- Language as a Communication Barrier in Medical Care for Hispanic Patients Plus A Spanish Course For Providers
- Child Psychiatrist Available to Provide Conferences for You In your Office
- Child Psychiatry Telephone Consultation on Medicaid Children
- Introducing The CCHAP Quick Reference Link
- Cavity-free at Three
- Practice Manager's Meeting March 11, Noon to 1PM @ TCH, RSVP carter.joyce@tchden.org
- Integrating Developmental Screening In a Pediatric Practice
- Medical Spanish Training For Your Office Staff

^{Download Newsletter Thirty-Five}

JANUARY 2010 PRACTICE MANAGER WEB CAST SUMMARY

At the CCHAP Practice Manager’s Meeting held on January 13th, Gina Robinson, Program Administrator from The Colorado Department of Health Care Policy and Financing (HCPF), made a presentation to the group on Medicaid Billing.  Practice Managers provided questions in advance that helped Mrs. Robinson focus her talk on the  particular needs and issues of practice managers.  This meeting used web cast technology to allow practices throughout the entire state to see and hear the entire presentation and to offer additional questions for discussion.  

To view the video of the presentation, the PowerPoint presentation including Q&As, and the relevant web links go to: www.cchap.org/pmmeeting

Presentation highlights included:

• Provider Bulletins – This monthly bulletin contains updated information on policy changes, billing and coding updates and Medicaid information.  You can receive this bulletin electronically or have it mailed to you.  Every provider receives this bulletin.  Note: These are mailed to your billing office address. The link to the Provider Bulletins is:
  http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1246972411343
• It was stressed that eligibility be verified at each visit and that the eligibility verification page of the portal be printed and retained. If your claim is denied for ineligibility for Medicaid on the date of services, Medicaid will pay you if you can prove with the screen print that the patient was eligible on the day that services was provided.
• Co pays are not collected for patients under 18 years of age or while the patient is pregnant.
• If a patient needs a prescription in less than 72 hours after being determined eligible for presumptive eligibility Medicaid, call the pharmacy number and they will update the system so that the patient can fill the prescription immediately. 1-800-365-4944
• Let Medicaid provider services know if you have a provider leave the practice.  They will make the changes necessary to remove the providers from the billing group number.
• Medicaid Provider Billing Manuals can be found at:
  http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1201542320888
• Rendering Provider  versus Billing Provider –  The Rendering Provider is the actual provider/practitioner who saw and treated the patient. An Individual Provider number is reimbursed through the provider’s Social Security Number (SSN).  The Billing Provider – May be either a group or an individual.  A Billing Provider (Group) number is reimbursed through a Tax Identification Number (TIN) 
• Presumptive Eligibility (PE) is temporary coverage of outpatient Colorado Medical Assistance Program services until eligibility is determined. Clients may be enrolled under either the Medicaid program or the CHP+ program as presumptively eligible. Verify Medicaid PE through the Web Portal, Faxback or CMERS, after the client has been entered into the system. Client eligibility may take up to 72 hours before it is available for PE clients in the system.  Actual enrollment can take 45 days.
• Direct Medicaid billing questions to ACS/ Provider Services 303-534-0146 or 1-800-237-0757. Can help you with: Claim problems; Claim form completion questions; Billing or payment questions; Ordering paper forms – Most forms may also be downloaded from the Provider Services Forms section; EDI enrollment; FRS report issues. If you are calling ACS regarding billing issues and feel that you are not being heard or helped, ask to speak to a Supervisor.
• Direct CHP+ billing questions to Colorado Access 1-888-214-1101
• Behavioral Health Organizations (BHOs)  are Medicaid mental health HMOs in  Colorado’s Mental Health managed care program. The state is divided into five (5) service areas.  In each area the program is managed by a BHO.  Your CCHAP manual on the CCHAP web site has the telephone numbers to call to have a children on Medicaid seen for a mental health problem.
• Medicaid patients with Commercial Insurance: The Commercial Insurance must be billed first. The Colorado Medical Assistance Program is always the payer of last resort. 
• Original Timely Filing - 120 days from the date of service. The Timely Filing period may be extended when: Commercial insurance has yet to pay or deny; Delayed notification of eligibility from client; Backdated eligibility from county. If the Commercial Insurance hasn’t processed the claim and it is nearing the 365 day cut off: File the claim with the Colorado Medical Assistance Program to receive a denial or rejection and continue filing in compliance with the 60 day rule until insurance info is available.
• Medicaid Website: http://www.colorado.gov/hcpf
• FAQs: http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1201542696399
• Medicaid Forms: http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1201542696550
• Prior Authorization Line can help you with: Information needed to obtain a PAR; PAR revisions; PAR status -  For faster results, providers should check PAR status through the Web Portal; Prior Authorization Line cannot help you with: Submitting PARs electronically; Billing Issues. Outside Denver Metro 1.800.237.0757 Within Denver Metro 303.534.0146
• CGI can help you with: Technical questions regarding the Web Portal; CGI cannot help you with: Submitting Claims/PARs electronically; Billing Issues; EDI Enrollment issues; Trading Partner IDs; FRS Issues; Statewide 1.888.538.4275 Email: helpdesk.HCG.central.us@cgi.com.

Links

• Medicaid Website:
  http://www.colorado.gov/hcpf 
• Medicaid Forms:
  http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1201542696550
• Medicaid Billing Manuals:
  http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1201542320888
• Medicaid Provider Bulletins:
  http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1246972411343
• Medicaid FAQs: 
• http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1201542696399

To learn more about the new “Lock-in Policy,” in which patients can be “locked” in to your practice, so that Emergency Departments will call your practice for authorization to see your patient prior to the ED visit:

• Lock-In Policy Information (word doc) - click here
• Lock-In Letter Template (word doc) - click here

PEAK is  The Program Eligibility Application Kit is a web site for families to use to determine whether they might be eligible for Medicaid or Welfare.
https://peak.state.co.us/selfservice/

- contents - newsletter archive - home -

 
Medical Home Certification

Around 50 of the 150 pediatric and family practices that CCHAP currently works with are in the process of obtaining “medical home certification.”    The Colorado Department of Health Care Policy and Financing (HCPF), which administers Medicaid in Colorado, is directed by  Senate Bills 07-130 and 07-211 to document that children on Medicaid receive care in a quality medical home.  So, HCPF is asking practices that are receiving the enhanced reimbursement (as a CCHAP – affiliated practice) to obtain Medical Home Certification to document the quality of the medical home they provide to children on Medicaid.  Practices that have affiliated with CCHAP in the past 8 months have already begun the certification process.  The remaining CCHAP-affiliated practices will be asked to begin the certification process very soon.  

Medical home certification is a three step process.  The CCHAP orientation is step one.  The following are the two steps needed for medical home certification for practices that were oriented in the past and are already receiving the enhanced reimbursement.  Each CCHAP-affiliated practice will be asked to:

• Conduct a self-assessment survey of practice staff and providers called the Medical Home Index.  This brief survey seeks to determine your perception of how well you are doing in providing a medical home.  The survey also will be given to some parents in your practice.
• After reviewing your survey results, you will be asked to select some aspect of “medical home-ness” to improve using a quality improvement process.  CCHAP staff is available to coach you through the quality improvement process if you wish and we have QI projects already prepared for you to implement easily in your practice if you wish.  You may already have QI projects going, which will likely meet this objective.

Medical Home
The American Academy of Pediatrics and the American Academy of Family Practice have promoted the concept of a medical home for many years now.  A recent combined statement by the two academies reaffirmed their support of the concept.  The Academies believe that all children should have a medical home where care is accessible, family-centered, continuous, comprehensive, coordinated, compassionate and culturally effective.  For a reminder of the American Academy of Pediatrics and the American Academy of Family Medicine description of a medical home for children, click here. 
And if you want someone to come to your office to present a more description of what a medical home is and does, please contact: Anita Rich (Rich.Anita@tchden.org) or Angie Goodger (angela@cchap.org) for more information.

Medical Home Index
Starting in April 2009, recently oriented CCHAP practices began the process of Medical Home Certification.  The Medical Home Index is completed at a group meeting of your practice with as many of the practice staff and providers as possible. During this meeting the group will complete a Medical Home Index self-assessment, discuss how each indicator rated relates to a quality Medical Home.  The facilitator will conduct informal interviews of families coming to your practice that day asking them to assess the practice’s medical “homeness.”  For a look at the medical home index, click here.

Quality Improvement Projects
Within a few weeks after the practice takes the MHI, you will be contacted by a Quality Improvement Coach with CCHAP. At that time, you will receive your Medical Home Index results, as well as guidance as to how to interpret the results. HCPF asks that you select an element of being a medical home that your practice wishes to work on.   The Quality Improvement Coach from CCHAP – at no cost to your practice – is available to help you decide what your practice would like to work on, develop strategies for making the changes you want to make, and measure the effectiveness of the resultant changes.   

The higher reimbursement practices receive for preventive care is the reward for your practice’s commitment to providing a quality Medical Home for children on Medicaid.


AAP and AAFP Board Certification for pediatricians and family physicians
Both the AAP and the AAFP require that all physicians, when they recertify, develop a quality improvement project in their practice as part of their recertification.  So, CCHAP is helping you obtain both professional board certification and Colorado Medicaid medical home certification.

For more information
Shortly, we will be expanding the Medical Home Certification process to all CCHAP practices.  More information will follow. You may also contact Anita Rich (Rich.Anita@tchden.org) or Angie Goodger (angela@cchap.org) for more information.

Quality Improvement Coach
Your CCHAP Quality Improvement Coach is Angie Goodger. Angie holds masters degrees in Public Health and Healthcare Administration.  Angie comes to us from Minnesota where she previously worked as a home healthcare manager. Angie is very excited about working with your practice using Quality Improvement methods to work on those issues you want to address.

- contents - newsletter archive - home -

CCHAP Advisory Board

Is Looking For New Volunteer Board Members

CCHAP has always depended on the advice of practice mangers and providers over the past 3 years to guide our program development and help us with important issues and decisions.  So, CCHAP has always had an informal advisory board.  As Colorado reforms its Medicaid program and moves back into working with and through managed care-like organizations (the Accountable Care Organizations), practices will interact not only with state Medicaid, but potentially with several ACOs. With this increasing complexity, there will be even greater need for primary care practice managers and providers to guide CCHAP as it advocates for low-income children and the practices that provide a medical home for them.  Since CCHAP now works with around 160 primary care practices (500 providers, 95% of Colorado pediatricians and over 150 family physicians, caring for 90,000 children on Medicaid and CHP+), we can’t obtain everyone’s opinion, so we would like to form a formal Advisory Board to represent this large number of children and practices.

The CCHAP Advisory Board will be made up of practice managers, providers and patient / parent advocates and we are looking for volunteers, who would be willing to attend meetings in person or by phone every 2 months for 1-2 hours (the actual time would depend on whether there are pressing issues to address).  This Board would advise the CCHAP team and would advocate in behalf of Medicaid and CHP+ children and the practices that provide them a medical home.  

If you are interested in participating on this Board, please contact Steve Poole at
Poole.steven@tchden.org or 720-777-6004

- contents - newsletter archive - home -

It’s Quick. It’s On-line. It’s the “Quality & Culture Quiz”
And Your QI Project Just Got Easier!

Roughly sixty pediatric practices in the CCHAP network participated in at least one cross-cultural communications workshop during the last two years. The goal of the workshops has been to help health care professionals develop more effective communication with their patients and families who come from different cultural backgrounds. In 2010, Part Two of the workshop will be presented to many of these same practices, and as the number of providers and staff affiliated with CCHAP grows, even more health care professionals across Colorado will take advantage of these unique skill-based trainings.
          Before the second workshop, it is ideal for those who participated in the first one to be able to measure the extent to which they have used the knowledge and skills they gained. To what degree have the individuals trained been able to experience a greater sense of comfort and confidence in cross-cultural situations? Have they actually been able to implement what they learned into their day to day interactions with patients and families? Perhaps most important, have they consciously and continually renewed their commitment to demonstrating greater sensitivity and awareness when dealing with patients from different cultures? If so, do they feel this has led to greater patient satisfaction?  
          Given how busy private practices are, these important questions may not get addressed regularly; there are so many pressing concerns in medicine every day. In an effort to make it easier to give some immediate attention to the cross-cultural aspects of patient care, we encourage workshop participants to check out our Quality & Care online self-assessment at www.dimensionsofculture.com. This quick 23-question assessment tool will stimulate your thinking about interactions with culturally diverse patients based on key cross-cultural concepts. It will prompt you to think about what you learned from the first workshop and help prepare you for Part Two. The assessment isn’t a test, it’s a learning tool. The correct answers are provided with complete explanations.
Here’s a sample question:

Which of the following is good advice for a provider attempting to use and interpret non-verbal communication?
a. The provider should recognize that a smile may express unhappiness or dissatisfaction in some cultures.
b. To express sympathy, a health care provider can lightly touch a patient’s arm or pat the patient on the back.
c. If a patient will not make eye contact with a health care provider, it is likely that the patient is hiding the truth.
d. When there is a language barrier, the provider can use hand gestures to bridge the gap.

The correct answer is A, and this is a good example of the kind of cross-cultural communications concept that was/is covered in Part One of Marcia Carteret’s workshop for the CCHAP practices. In high-context collectivist cultures, where harmony in communication is always most important, people will often smile instead of showing their negative feelings. A more in-depth explanation of the answer is available when you take the quiz.
 
Finally, keep in mind that one of the Quality Improvement projects your practice can choose as a medical home focuses on cross-cultural competence. In fact, if your practice has already had the first training by Marcia Carteret, then you are half way to completing your QI project. Having all providers in your practice complete the 23-question assessment online and sign up for a login/password at www.dimensionsofculture.com will fulfill the cross-cultural QI requirements. Most people can complete all 23 questions in about 15 minutes. If you want more information about this QI project, please contact Angie at angela@cchap.org or Marcia Carteret at marcia@dimensionsofculture.com.

- contents - newsletter archive - home -

Funding Available for Rural Primary Care Providers

Through the Colorado Rural Health Care Grant Program, primary care providers of medical, oral, or mental/behavioral health services, located in rural areas, and whose practices include at least some underserved patients are eligible to apply for grants for infrastructure projects of up to $50,000.  

Unlike most grant programs, even private, for-profit providers can apply for funding, if they meet the other eligibility requirements.  

“Primary care” includes medical, oral, or mental/behavioral health services.  

“Rural” is not defined by county for this program. For this program it means “located outside one of Colorado’s nine Urbanized Areas” of Boulder, Colorado Springs, Denver, Fort Collins, Grand Junction, Greeley, Longmont, Louisville and Pueblo.  The grant guidelines show you a website where you can type in the address of your practice to find out if it is considered “rural.”  

“Underserved patients” includes people who cannot afford care, the uninsured, and those covered by Medicaid or the Children’s Health Plan Plus (CHP+) program. There is no minimum number or percentage requirement; each applicant entity will be asked to describe the types and amounts of service provided to underserved people.

“Infrastructure” includes, but is not limited to: equipment, construction, physical plant improvements, vehicles and vehicle upgrades, information technology, and staff training or education.  Grants will not be awarded for the delivery of direct health care services or to support operations or staffing.

Grant applications are due March 11, 2010.

Never written a grant?  Free grant writing workshops to guide you through this five-page application will be held in Fort Morgan on February 4; Gunnison February 10, and Denver February 24.  

Preference will be given to applicants who have not received funding in the past. After two years of funding, and seventy-seven awards, the Council overseeing this program has only been able to award eight oral health practices, twelve mental health centers or clinics, and fourteen private practice clinics.  Seventeen rural counties haven’t received any of this funding yet. Let’s change that this year.  Please look into this program to see if you might be eligible.

You can find out more at www.coruralhealth.org

The Colorado Rural Health Center is managing this program on behalf of the Governor’s Office. At their website you can read the full guidelines, sign up for a workshop, ask for help in determining whether or not your project is eligible, and even sign up to help review these grants (only if you decide not to apply.)

- contents - newsletter archive - home -

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.comor 720-777- 3124. Your comments and suggestions will help make dimensionsofculture.com an effective tool for learning and community building.

- contents - newsletter archive - home -

 
The Colorado Pediatric Postpartum Depression Screening and Referral Toolkit

Developed by Brian Stafford, MD, MPH
Medical Director, Perinatal Mental Health Program, The Children’s Hospital

Click here to download the complete toolkit to enable a primary care practice
to recognize and refer women with post-partum depression.    

Why should every pediatric and family practice implement this toolkit?

•  Postpartum depression is a serious medical and psychiatric illness and a significant health concern.
• Approximately 12% of all new mothers develop symptoms consistent with a major depression in the post-partum period
• If left untreated, half of these mothers, about half will continue to have symptoms that last greater than1 year.
• These symptoms include sadness, lack of energy and pleasure, irritability, guilt, anxiety, as well as thoughts of wanting to harm the infant.
• Several lines of research have shown that post-partum depression has significant risk for the child’s cognitive, social, and emotional development and may impact school readiness.
• In addition, the depressive symptoms lead to difficulties in the mother-infant and parental relationship.
• The depressive symptoms are also associated with excessive urgent care and emergency room visits as well as missed scheduled routine pediatric visits.
• Providing pediatric anticipatory guidance to a depressed caregiver does not change any parental behaviors in regard to safety, sleep, nutrition, reading, and interaction.
• Pediatric care providers of infants are in a strategic position to screen and refer depressed mothers for behavioral health evaluation and support.
• Pediatric provider inquiries about maternal health have been viewed as appropriate by mothers.
• Pediatricians, historically, like other primary care providers, have low rates of detecting maternal depression and few pediatricians have a systematic approach to screening for maternal depression.

- contents - newsletter archive - home -

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

- contents - newsletter archive - home -

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
• Kids 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…..

- contents - newsletter archive - home -

 
All CCHAP-affiliated Practices Now Can Receive
TELEPHONE CONSULTATION ON MENTAL HEALTH ISSUES
FOR CHILDREN ON MEDICAID

Rick March is a child psychiatrist who has received grant monies to provide phone consultation regarding children and adolescents with mental health problems throughout Colorado.  He has over twenty years experience in child psychiatry and is available weekdays during regular business hours.  If you do not reach him directly, he would be able to speak with you, at the outside, by the next business day.  Dr. March is at the Mental Health Center of Denver which provides services for children who live in Denver County.  However, he may be able to arrange to see other patients outside this catchment area, possibly in your practice in very difficult cases.  He is also available to provide educational presentation for your providers on a wide variety of mental health topics.

His direct line is 303-504-1500

So, telephone consultation from a child psychiatrist for Medicaid children cared for in a CCHAP-affiliated practice is now available in all counties in Colorado.  

For Boulder and Jefferson Counties – Don Bechtold, MD – 303-432-5172
For Adams, Arapahoe and Douglas Counties – Joe Pastor, MD – 303-853- 3888
For all other counties (including Denver) – Rick March, MD – 303-504-1500

- contents - newsletter archive - home -

 
INTRODUCING THE CCHAP QUICK REFERENCE LINK!

Do you need to know the one telephone number to call for a Medicaid mental health referral?  Want to reach the CCHAP social worker?  Need help in finding resources for a special needs child?  Having trouble remembering all of the 14 support services CCHAP provides for your practice?   We have a quick reference link for your desk top!  For these things and many more…

Recently, our advisory group of physicians and practice administrators suggested an idea for a quick and easy way to access CCHAP affiliated resources for frequently used contacts and services.  We liked the idea and have developed a web link that will quickly access a single page that contains contact information as well as additional links to documents and web pages.  The goal is to have a computer desktop shortcut that, with just a click or two, will provide CCHAP affiliated providers and staff with the information you need, when you need it.  

Because this new tool is for you, we want it to be pertinent and efficient.  So please, if you have ideas as to how to improve on this, contact Kevin Heckman heckman.kevin@tchden.org or 720.777.6309, our Program Administrator, with your feedback and suggestions.  Thanks!

INSTRUCTIONS:

1. Click on this link http://www.cchap.org/qr/ to open the Quick Reference Link web page (Note: you can also type this address into a web browser manually).
2. In your browser window menu (upper left corner) click File>Send>Shortcut to Desktop. 
3. The Quick Reference Link is available from any computer with internet access.

Kevin C. Heckman
Program Administrator
CCHAP
720.777.6309

- contents - newsletter archive - home -

 
Cavity-Free at Three

Cavity Free at Three is a statewide effort aimed at improving oral health in children and pregnant women.  We are working with CCHAP to offer our program model to interested participants.  Recent Medicaid guidelines allow primary caregivers to provide oral health counseling along with fluoride varnish application and receive reimbursement for these services.  In order to participate, the medical provider as well as staff members involved in this provision of care should complete online training through the Smiles for Life Curriculum.  

Simply visit  http://www.smilesforlife2.org, and complete Module 2:Child Oral Health and Module 6: Fluoride Varnish.   After the online process is completed, we plan a coordinated effort for site visit based training opportunities offering hands on demonstrations as well as follow up and support of our program.

We are in the process of coordinating training opportunities throughout the state of Colorado beginning early 2010.  This will allow for representatives from your group to attend trainings in your area.  If you are interested in hosting a training, or learning more about Cavity Free at Three opportunities, please contact Anita Rich at rich.anita@tchden.org.  If you have questions specific to our program, please contact karen.savoie@ucdenver.edu or visit  http://cavityfreeatthree.org. Thank you.

- contents - newsletter archive - home -

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.comto view and order the PEDS tool online.

- contents - newsletter archive - home -

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.

- contents - newsletter archive - home -

Copyright 2010 Colorado Children's Healthcare Access Program and other entities as noted.

 CCHAP Home > Newsletter Articles > Newsletter 35, February 2010