Medical Home Meeting: March 13, 2013

Our March meeting started with Philip McCauley, Director of PSA Healthcare (Shrewsbury).  This agency provides home health care services for both children and adults.  Technology-dependent clients are encouraged to appy for home care services.  PSA offers 24/7 clinical and ancillary supports, and provides family-centered care.  The staff has extensive, ongoing training.  The nurses are well-versed in caring for patients on ventilators.  PSA provides on-call care, but does not offer PT and OT services.

PSA accepts all insurance, and will work with co-vendors.  A discussion arose about co-vending.  The Work Group was reminded that all families can coordinate home care with multiple vendors (PSA, Centrus, Loving Care, etc) if one vendor cannot meet the needs of the family.  This discussion moved into the availability of pediatric respite care from medically complex children.  A combination of cognitive and medical needs are necessary to qualify for respite care.  Unfortunately, we no longer have a facility in Western MA.  Families are encouraged to take advantage of services in Groton, Billerica or Plymouth, MA.

Our second presenter was Janet Simeone, Director of the Center for Human Development Early Intervention Program (CHD).  Eligibility for Early Intervention (birth to 3 years old) is as follows:

  1. Medical conditions with relatively well-known expectations of developmental delay (EI diagnosed conditions list);
  2. Development of at least 1.5 standard deviations below the mean in one or more areas of development;
  3. Biological insults to the central nervous system in prenatal, perinatal or neonatal period–and/or–environmental risk factors that limit early life experience (poverty, exposure to violence, homelessness);
  4. Questionable quality of developmental skills and functioning, based upon informed clinical opinion of a mulitdisciplinary team.

*Effective March 20, 2013:  MDPH will no longer charge a fee to families receiving Early Intervention services.  Public and private insurers and state & federal funds will support Massachusetts EI.

CHD provides bilingual staff (English/Spanish).  OT, PT and Speech Therapy is provided if the assessment includes a recommendation for services.  Transition services start at 2.5 years old, when children are referred to the school system or elsewhere.

Nancy Bazanchuck spoke about CHD’s Making Healthy Connections, a 12-week transition program for youth.  This program covers a range of topics, including by not limited to:  disability pride, independent living, transportation, relationships, sexuality, healthy cooking, and mental health.  This program is run in collaboration with Partners for Youth with Disabilities (PYD), a transition program for youth ages 14-22 years old.  The peer leaders group is for ages 16-24 years old.  This program helps parents to activate teh transition process.

The new campaign is “Don’t Dis My Disability”.  Check out this campaign from Australia!

Medical Home Meeting: February 13, 2013

In February, we welcomed Marcy Colby, Clinical Coordinator at Baroco.  Baroco offers day habilitation programs for adults and transitioning young adults in Western New England.  Baroco offers four programs in Western Massachusetts and three programs in Connecticut.  There is a 1:4 ration of staff to clients, with adjustments to best meet the present needs of the clients.  A full range of services is available:  communication therapy; physical therapy; occupational therapy; social development; behavioral management; nursing and community building.

Clients are referred through DSS or the local school system.  Families are encouraged to contact Baroco directly if they are interested.  Intake requires a 2-day visit at least.  Baroco recommends beginning the process around a client’s 20th birthday to faciliate transition from other services.  There is a van that will pick up clients; families provide lunches. Some clients eventually leave to take jobs.  Others may leave for a time because they are ill or if they are not succeeding at Baroco.  One of our Medical Home Workgroup attendees volunteered that her son attends Baroco and loves it.

Next up:  Caitlin Thomas, RN, BSN and family advocate, on the 411 for Social Security Diabilities Claims.  Caitlin reviewed the differences between social security disability insurance (SSDI) and supplemental security income (SSI).  SSDI is not need-based, but rather based upon the employment record of the person who is disabled.  A benefit of SSDI is Medicare.  SSI is funded through Title XVI, a federal entitlement.  SSI is need-based, and covers both children and adults.  SSI is based on disability, but income and assets are used in the calculations to determine eligibility.

Keep records!!!  Record all interactions with the Social Security office, including dates and the person you spoke with.  If possible, get your documents stamped at the local SS field offices and keep copies of everything.  Keep a record of your protective filing date (PFD).  This is the date you initially contacted SS, and payments will be retroactive to this date.  Keep your contact information updated, including information on homelessness.  These are just a few of Caitlin’s recommendations.  For more information about Caitlin’s advocacy services, you can contact her at caitlinthomas (at) comcast.net or call 1-413-446-6633.

Contact Social Security at http://ssa.gov or call 1-800-772-1213

Local Social Security field offices:

  • 200 High Street, 2nd floor  Holyoke, MA  01040, 1-877-480-4989
  • 70 Bond Street, Springfield, MA 01104, 1-866-964-5061
  • 78 Center Street, Pittsfield, MA  01201, 1-866-446-7111

We had a third presentation from Elizabeth Vega of the New England Farmworkers Council.  She shared information about the Council’s Child Care Resource and Referral.  Their database lists all licensed day care providers for children, newborn to 13 years old.  There are enhanced referral services for families with special needs children, such as contacting the providers to evaluate their qualifications/experience in working with special needs kids.  The Council provides families with checklist of what to look for in day care.  For more information, call 1-866-573-4684.

Useful websites mentioned at the February meeting:

Medical Home Meeting: January 9, 2013

The January meeting opened with a presentation from Kerri Ikenberry, Lois Aldrich and Joanna Jalbert on Community Case Management (CCM), an administrative activity of MassHealth.  CCM authorizes and coordinates MassHealth Community Long Term Care (CLTC) services to a defined population of medically complex individuals.  CCM collaborates with multiple agencies and payers.  Their goal is to keep folks in the community and out of institutions.

Eligibility for in-home nursing services:  individuals must be under 22 years old at the time of referral, require greater than 2hrs/day of skilled nursing care in the home and be a MassHealth recipient.  CCM may be extended beyond the age of 22 years old.  The top 5 diagnoses for CCM are: cerebral palsy; congenital malformations; neuromuscular disease; neurological disorders; and genetic disorders.  Referrals come from everywhere (hospitals, nursing agencies, palliative care, physicians, etc)  The individual/family is an integral part of the referral process.

A skilled nurse will call the individual/family to do a CLTC assessment.  A home visit is scheduled, as well as a determination of medical necessity for services.  Contact is made with other agencies.  A service record is created and a copy is given to the family.  Once services are authorized, a clinical manager becomes the contact for the family for any issues that arise.  CCM Liaison Nurses will check on hospitalized CCM members, faciliate hospital discharge and assist discharge planners at rehabilitation facilities.  They will work with the family to authorized equipment and therapy services.

For Home Health Services, individuals must be under the care of a physician, have a care plan and have a need for skilled nursing care.  The physician and the home health care agency must determine if the individual can be maintained safely in the home.  Coverage limitations include 112hrs/week for continual nursing services.

The Personal Care Attendant Program serves MassHealth members who require physical assistance with activities of daily living.  The individuals/families are the employers of their PCAs and are responsible for recruiting, screening, hiring, training, and supervising.  To get coverage, the individual must have MassHealth Standard or Commonhealth and have a chronic, permanent disability that impairs the individual’s ability to perform activities of daily living without physical assistance.

For more information, please consult www.mass.gov/masshealth.  For information on rates for MassHealth programs and services, including home health care and personal care attendants, check out http://www.mass.gov/chia/gov/hcf/regulations.html

Our next presentation was from Sheila Rucki, Phd, PCNC, BC on Early Care & Education (ECE) and Out of School Time (OST) Programs.  This new program works with early education and child care providers to support them in learning how to administer medication in the event of an emergency.  Educators and administrators are trained in the Medical Administration in Child Care (MACC) program.  This training includes administering medication for:  anaphylaxis; seizures; skin integrity; severe asthma; and diabetes (excluding insulin injections).  The goal is to educate child care providers to recognize problems and teach them how to manage situations within their abilities to provide care.  A big part of this is teaching child care providers to learn about the emergency systems in their communities so that they can access skilled assistance ASAP for the children enrolled in their programs.

For more information, contact Thom Child & Family Services, located at 1506A Allen Street, Springfield, MA  01118, tele. 413.783.5500.