Work Group Meetings

Medical Home Meeting: February 13, 2013

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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

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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.

Medical Home Meeting: December 12, 2012

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December 12, 2012- During our December meeting of the Medical Home Work Group for Children with Special Needs in Western Massachusetts, we heard from two excellent children’s service agencies, the local Loving Care Agency of Springfield, Massachusetts, and the national Make-A-Wish Foundation.

Patricia Flink, area director from Loving Care Agency, began the meeting with a presentation of the pediatric nursing services that Loving Care provides special needs children. The agency, located at 205 Roosevelt Avenue, Springfield MA, provides home health and private-duty nursing care for children, including services for G-tubes, tracheostomy, and ventilator care. As well, intermittent skilled nursing visits are available, and services provided by Loving Care must be associated with a skilled nursing need.

Flink explained the importance that all nurses have high-quality pediatric training, which the agency provides. All nurses undergo pediatric preparatory courses with the goal that nurses will be equipped to teach families to care for their special needs children in areas such as diabetes, tracheostomy, G-tube care, and more.

As well, the agency provides unique transitional assistance for children moving from a facility to home. A “transitional team” coordinates with hospitals and facilities to customize the child’s services, and the Loving Care nurses assist families with adapting to new equipment, such as ventilators, in the home. Loving Care’s clinical managers, who are also pediatric nurses, help with insurance and maintaining quality of service. All insurance plans are accepted by Loving Care Agency. For more information, please visit the agency’s website.

Our second presenter, Julie Able from the Make-A-Wish Foundation, spoke about the fantastic gifts that the Foundation bestows upon many children with critical medical conditions. Although it is not necessary that the child’s condition be terminal, the condition must be progressive, degenerative, or malignant in nature. As well, a medical diagnosis and a doctor’s recommendation are required. For more information on this wonderful program, please visit the Make-A-Wish Foundation website.

In other news, uur Medical Home group sponsored a successful holiday event on December 18 at Shriner’s Hospital for Children which over 100 children and family members attended! We are grateful for our sponsors, THOM Early Intervention and Safe Kids of Western MA.