Family Partnerships: Improving Quality of Care for Children with Special Health Care Needs in Managed Care Plans July 17, 2003 Sponsored by the Division of Services for Children with Special Health Care NeedsSlide 2
Lynda Honberg Division of Services for Children with Special Health Care Needs, Maternal and Child Health BureauSlide 3
Shared Responsibilities Building Partnerships between Health Plans and Families Caring for Children with Special Health Care Needs Susan G. Epstein New England SERVE July 17, 2003 MCHB WebcastSlide 4
Why Build Partnerships? Obligation regarding evaluating and enhancing the nature of consideration is shared by all partners. Wellbeing arranges Purchasers Providers State organizations/open approach creators Researchers and... Shoppers/familiesSlide 5
In a perplexing human services framework... The nature of watch over people is reliant on their insight into how to explore the framework, and The nature of the arrangement of consideration is subject to its learning of the necessities and experience of its clients.Slide 6
CSHCN low predominance utilize various frameworks open/private chronicity reliant on changing innovation Families high significance both suppliers & customers of consideration need redesigned data substantial clients of social insurance framework Why Families are specialistsSlide 7
Why Do It? Wellbeing arrangement point of view Belief in genuine advantages of buyer ability Leadership - Champion Purchaser necessities Environmental motivations Consistent with mission Importance of particular populace Limitations of customer fulfillment instrumentsSlide 8
Why Do It? Shopper Perspective Improve nature of consideration Share mastery - come clean Eliminate foe attitude Help different families "You can\'t enhance frameworks without our assistance."Slide 9
Process To be heard Respect & discourse Avoid marks Allow challenges Family-fixated Focus on family qualities *Family Participation Statement - Advisory Council NHP, May 1999 Outcomes Commitment to execute changes Build frameworks that regard families as accomplices Increase family underpins inside wellbeing arrangement Expectations of Family Advisors*Slide 10
Challenges Discomforts Identifying purchasers Intensity of backings required Language & social differences Variability of planning Preparation of staff MentoringSlide 11
Ladder of Consumer Participation* Minimalist… … .. non-investment Informing/Consulting… true blue cooperation Partnership… . shared basic leadership; transaction Delegated Power… . straightforwardly connected to strategy making, control, administration * adjusted from Arnstein, SR, A Ladder of Citizen Participation, Journal of the American Planning Association, vol 35, no.4,July 1969, pp. 216-224Slide 12
Supports for Family Partnerships Training… on both sides Orientation - part definition, reason for association Preparation for particular assignments Collaboration Mentoring Reimbursement stipend travel, childcareSlide 13
Shared Responsibilities: Toolkit for Health PlansSlide 14
Purpose of Toolkit Get consideration of wellbeing arrangements Identify CSHCN as a populace Make a business case for putting resources into quality change Provide scope of apparatuses/assets to enhance frameworks of watch over CSHCNSlide 15
Introductory Brochure WHO are CSHCN? WHY distinguish CSHCN? WHY put resources into coordinated effort? By what method can wellbeing arranges enhance nature of consideration? WHAT is ROI?Slide 16
Identify CSHCN Screener QuICCC-R Clinical Risk Groups Administrative information calculation Improve Health Plan Checklist Organizational Readiness Measures Best Practices Collaborate Family Survey Provider Survey Family Participation Statement Family Advisor set of working responsibilities List of state Title V contacts Reporting design for data to PCPs ToolsSlide 17
How Can Health Plans Improve Quality of Care? Data for families Simplify access to care Enhance coordination Match assets to necessities Help families explore framework Promote best practicesSlide 18
Consumer Surveys Identifying obstructions inside the framework Advisory Roles Advisory Committees Focus bunches Standing Committees Grievance Quality Ethics Staff/Consultant Roles Review of composed materials Design outreach procedures Training for wellbeing arrangement staff Quality Improvement Teams How can Families Assist Health Plans to Improve Quality?Slide 19
For more data on Shared Responsibilities Toolkit... http://www.neserve.org/distributions/srt_overview.htmlSlide 20
Family Partnerships: Putting it into Practice Children\'s Choice of Michigan Managed care program in Michigan for the Children\'s Special Health Care Services populace. Serves any youngster who meets the state prerequisites controlled by their qualifying conclusion, and who choose to partake. Contract with Title V requires family organizations.Slide 21
Children\'s Choice Promise to individuals: Family Centered Services Community Based Care CoordinationSlide 22
Family Centered Care at Children\'s Choice Respects basic part of family in looking after youngsters with unique needs. Family endorsement of IHCP required. Instruction and Information sharing Consumer staff prerequisites Members as AdvisorsSlide 23
Challenges of Member Involvement Unnatural Alliance Requires a movement in the force base Unfamiliar Territory, better approach for working together Requires staff and money related assets It\'s diligent workSlide 24
Benefits of Member Involvement Adds aptitude – families are specialists in getting administrations Provides in advance assessment Shared Responsibility Economic and operational efficiencies Powerful showcasing device Creative critical thinkingSlide 25
The Good News! We have great good examples for association: Title V programs for HIV and AIDS projects Children\'s Hospitals Maternity Care Early InterventionSlide 26
Multiple Roles For Member Participation Administrative staff Member Services staff Liaison to Community Groups Board individuals Quality AdvisorsSlide 27
Manager of Family Centered Services A representative of DMC who was selected in CSHCS or has a tyke who is/was enlisted in CSHCS Monitors nature of consideration and simplicity of conveyance Monitors strategy and techniques Assist family in part as backers Member instruction Monitors part requests and grievances Provider training on Family Centered CareSlide 28
Internal Policy and Practices Review all approaches and systems Participate in Senior Mgmt Team Participate in Clinical Improvement Team Monitor part offers and grievances Participate in Quality Advisory Committee Staff backing to individuals on Board Conduct yearly part fulfillment overviewSlide 29
Member Education Editor of Member Newsletter Monitor Member listserv Monitor and redesign site Develop, audit and keep up part handbook, and different reports for individuals Conduct instructive courses for part families on points identified with CSHCN Assure that part ed strategies and apparatuses advance and bolster family focused, socially equipped practiceSlide 30
Member Outreach Community Forums Family Groups with Title V Parent Participation Program Member showcasing materials advancement and support Link with existing family gatherings and associations; Family Voices, Arc Michigan, CAUSESlide 31
Provider Education Review All Provider Ed materials Contribute to supplier instruction materials in regards to Family-Centered, Community Based, Culturally Competent Coordinated Care, and Medical Home.Slide 32
Non-therapeutic assets and backings Monitor and scatter group asset guide Develop direction material on ventures to get to group based backings, for example, relief, waivers, specialized curriculum administrations, and so on Research and disperse data to neighborhood care organizers on non-medicinal backings for CSHCN Assist families in getting restoratively important administrations that are not secured advantagesSlide 33
National, State and Community Relationships Participate in nearby activities for CSHCN i.e.; CHM Parent Professional Advisory Committee Participate in state level activities for CSHCN, i.e.; CSHCS Advisory Committee, Michigan Family Voices, Michigan Hospice and Palliative Care Participate in national activities for CSHCN, i.e.; Family Voices, American Academy of Pediatrics Committee on Children with Disabilities, National Center on Financing for CSHCN, and so onSlide 34
Special Projects Identify zones of requirement for extraordinary undertakings Medical Home Transition Identify subsidizing hotspots for unique tasks Develop and submit stipend propositionSlide 35
For more data Go to: www.childrenschoicemi.com or Call: 1-800-566-1110Slide 36
Family Partnerships: The Maryland Family Access Project Grace Pushparany WilliamsSlide 38
Partners Office of Genetics and CSHCN – Title V Office of Health Services – Medicaid Maryland Physicians Care –MCO AG\'s Health Education & Advocacy Unit American Academy of Pediatrics – MD ChapterSlide 39
Trainees Nine guardians of youngsters with SHCN Geographically appropriated crosswise over state Three put with accomplice one day for each week All work in group Ongoing preparingSlide 40
Parent Training available preparing once every month Monthly telephone calls Weekly homework Active listserv Shared encounters Partners train Parents get to be coachesSlide 41
Initial Placements Medicaid Health Education and Advocacy Unit Maryland Physicians CareSlide 42
Medicaid Orientation to all divisions/exercises Special Needs Advisory Committee Communication/EPSDT subcommittees MCO enlistment cards Review material from guardian point of view Policy arrangement Develop own ventureSlide 43
Health Education & Advocacy Orientation Private protection Consumer Hotline Over 2000 protestations yearly Mediation/interventionSlide 44
Maryland Physicians Care Resource for MPC guardians Family Outreach for individuals with SHCN Participate in CSHCN group gatherings Attend Consumer Advis
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