Work Group Meetings

Medical Home Meeting: November 14, 2012

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November 14, 2012- The November meeting of the Medical Home Work Group for Children with Special Needs in Western Massachusetts provided us with an opportunity to discuss two vital local resources for children with special healthcare needs. Presentations by therapists from Weldon Rehabilitation of Mercy Medical Center and Greg Klein-Hertzel from Centrus Premier Home Care stimulated more lively discussion around the healthcare issues that children with special needs are facing.

First, several therapists from Weldon Rehabilitation, of Mercy Medical Center, and offered through the Sisters of Providence Health System, spoke about their agency, which offers many therapies and services to individuals coping with complex medical conditions. The therapists spoke about the initial processes for beginning care at Weldon, which consist of a one to two hour evaluation for speech therapies and a one hour evaluation for physical therapies. Weldon Rehabilitation works with children from birth through adolescence, and with patients struggling with many issues ranging from integration disorders to traumatic brain injuries.

Weldon Rehabilitation offers some important conveniences, such as allowing patients to maintain their own weekly time slots for visits, and coordinating therapies to reduce the amount of trips a family needs to make for therapy visits. The therapists explained that all insurances are accepted at Weldon Rehabilitation. A topic of interest to our group, however, revolved around the issue that in order to be covered by insurance, families need to associate the services they are receiving with a medical diagnosis, and not a developmental delay.

The therapists also described some of the fun and unusual therapeutic activities they offer patients, such as social communication groups and animal-assisted therapies. Weldon Rehabilitation makes annual trips to the zoo at Forest Park in Springfield and offers hip therapy activities with horses. These compelling rehabilitation services are clearly very valuable to young people coping with complex healthcare needs in the Springfield area!

Our second presenter, Greg Klein-Hertzel from Centrus Premier Home Care, spoke about the services that this home care company offers individuals of all ages with special health care needs. Centrus offers private duty nursing, along with assistance in activities of daily living. Greg explained that the process begins with a free home care assessment of needs, and that should Centrus be unable to provide the appropriate services, they will refer individuals to other organizations who can help. Centrus works with all insurers as well.

A conversation was spurred within our group around the issue of services that home health aides are unable to provide, such as administering medications to patients. Home health aides cannot provide medication to clients, but they can contact their managers or 24/7 nursing support by telephone. Unfortunately, this issue causes a predicament for some families of children whose medical needs are not complex enough to require full-time nursing care, but sometimes need more services that home health aides can offer, such as children who suffer seizures.

Greg’s presentation inspired an important conversation about the benefits and barriers of home health care. Family members and providers who are interested in continuing this conversation are encouraged to attend our January Medical Home meeting, during which we hope to further this conversation!

Medical Home Meeting: October 10, 2012

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October 10, 2012- During our most recent Medical Home meeting, two representatives from Baystate Health Rehabilitation Care– Clinical Supervisor Erin Jarosz and Physical Therapist Tien Pham- presented some of the pediatric services offered by Baystate Health Rehabilitation Care, among them being:

  • Speech Physical Therapy
  • Occupational Therapy
  • Coordination with Pediatric Developmental Services
  • Equipment Evaluations with vendors
  • Coordination with patients’ schools
  • Collaboration with Visiting Nurse and other home health agencies to develop plans of care
  • Coordination with local vendors to create adaptive designs for home assessments and to monitor progress and integrity of interventions
  • Training of home therapists from other agencies

Our group had a lively meeting with Jarosz and Pham, discussing issues such as the agency’s inability to provide home visits, as it is solely an outpatient-based organization. Nevertheless, Baystate Health Rehabilitation Care is clearly a valuable resource for families of children with special needs. Dr. Matthew Sadof of High Street Health Center Pediatrics, also present at the meeting, discussed his intention to develop a plan for collaborative work between his agency and Baystate Rehab. Ultimately, Dr. Sadof hopes to develop a guidebook of successful strategies for regional families and their healthcare providers.

To learn more about the services offered by Baystate Health Rehabilitation Care, visit the agency’s web page at http://www.baystatehealth.org/Baystate/rehab.

September 2012: Medical Interpreting: Laws, Obligations & Culture

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Our Medical Home meeting season kicked off in September with a highly informative presentation by Timothy J. Moriarty, manager of Baystate Health Interpreter & Translation Services. Because many families are unaware of the importance of translation services, we’d like to share some of the information presented on these essential resources.

The Springfield area is rich in many languages, English, Spanish, Vietnamese, and Russian being most prominent. In medical situations, where communication is crucial, significant problems can arise when proper translation services are not utilized. Although many healthcare providers rely on English-speaking family and friends of patients to relay medical information, it’s important to use an interpreter in medical settings to insure proficiency in both languages and in medical terminology used. As well, interpreters are privy to cultural issues and will avert cultural misunderstandings. Because an interpreter is obligated to interpret everything exactly as it’s said, they cannot provide opinion which could influence the patient or provider.

Although it may be convenient to use family and friends for translation assistance, it is a problematic practice that may lead to embarrassing situations, incorrect or incomplete translations, or transfer of opinions that may discourage the patient from treatment. As well, family and friends generally lack training in medical terminology, and the presence of family and friends may violate HIPAA policies.

We’d like to share some of the basic interpretation guidelines that Tim presented for patients and providers:

  • Providers should take “Medical Spanish” classes to build relationships with patients, but not to substitute for a medical interpreter.
  • Providers should ignore the interpreter and speak directly to the patient in first person.
  • Both parties should allow for breaks as necessary for the interpreter.
  • The interpreter will not stop the patient from providing extraneous information- the provider must.
  • The interpreter will not provide clarification to the patient- the provider must.

All patients have the right to medical interpretation services to ensure that their health concerns are respected and to avoid patient discrimination, as Title IV of the Civil Rights Acts of 1964 addresses. Medical staff, nonprofit organizations, and government workers should offer interpreting services because they are required to by federal and state law. For more information about patients’ rights to translation services, please review the National Standards for Culturally and Linguistically Appropriate Services in Health Care and the National Certification for Medical and Healthcare Interpreters. Also, please be aware that emergency rooms and locked psychiatric units offer interpreter services, as stated in the MA Emergency Room Interpreter Law. For further information on the Baystate Health Interpreter & Translation Services, contact Timothy J. Moriarty, MPA, CMI, Manager at tim.moriarty@baystatehealth.org.