August 2020 Resources of the Month
Dear UCCCN members,

Here are your August 2020 resources and meeting summary.
Announcements

Medical Home Portal Updates - Clinical Content

Toxic Stress Screening - updated
Announcement #1
  • Hoping to form an ongoing UCCCN Advisory Group. It would include periodic requests for feedback, compensation provided. More details forthcoming.

Announcement #2 - Stephanie Sund, Intermountain Children's Health, GRAD Program
  • 2nd Annual AYA Transition Summit is October 8th in the morning
  • Looking for participants for the teen and parents panel, to share their story (5 minutes). Please contact Stephanie if you may know a willing parent or teen (or both): stephanie.sund@imail.org
  • Intermountain GRAD Program : MHP 35991

Brainstorming

Case #1:Jade Porter - eAsthma Tracker (it's an app) Project, University Health has been communicating with clinics about it. Katrina Jensen, Intermountain - same project; said that tier 1, 2 & 3 levels present some barriers. The dashboard is easy to manage, should decrease a lot of the management for both care coordinators and parents. UPIQ is also setting up an asthma learning collaborative next month and it will include the eAsthma tracker. Heidi Bates is the main contact. There will be MOC Part 4.  Jade: With Covid-19, people not going out as much and asthma has been better.  However, that means the symptoms aren’t as urgent and people aren’t as motivated to make good habits.

Health Related Education Service Category



Case #2: Gabi- asked about mental health in kids during Covid. Heather (Wasatch Draper) has noticed an increase in suicidal ideation triage situations, depression and anxiety. Gabi … very good recent webinar on COVID and Mental Health - Dr. Giles and Dr. Kleinschmidt.  



Disclaimer: These resources come from our members as part of the meeting brainstorming session; please check with your providers to make sure they are appropriate for your patient/families.

You can find a custom list of these service providers that can be printed, emailed, and more, here: August 2020 UCCCN Resources of the Month
Presenter: Leah Colburn, Program Manager, DHS Div of Substance Abuse and Mental Health - Children's Services

DSAMH oversees 13 MH authorities across the state. They provide services over the entire lifespan. The Children’s Services continuum includes:
  • Outpatient
  • Day/IOP 
  • School based behavioral health
  • Peer support (Family Resource Facilitators) 
  • Medication management
  • MCOT mobile crisis response 
  • SMR 

DSAMH contracts with other local agencies/authorities for residential care, and work with hospitals for acute services. Primarily work with those on Medicaid or unfunded. However, most of the local authorities also work with private insurance. 

All local authorities do school-based, but it varies.
  • Clinicians (360 schools have therapists on site, 39 of 42 districts have this in place). Grants to help un- and under-funded youth. 
  • Group 
  • Not service in a silo: BH in conjunction with school counselor, others. All were able to provide telehealth services when Covid hit. Alpine and Bear River (Cache, BE and Rich counties) … pilot program doing telehealth (pre-covid). 

Also working early childhood/infant mental health (family systems work). Also the 16-20 yo range, transitioning into adult behavioral health. Have a team dedicated to that.

A number of families have lost their jobs and insurance, so they are eligible for and need to apply for Medicaid. 

How should families access help from the state? 
  • If the school has services, that’s a good avenue
  • Schools must have more than one option for families/students, too 
  • Contact the local authority directly. Leah will send the contacts for the children’s services - warm handoffs are good

Gina: has heard that many kids who were getting face to face services refused to do telehealth after Covid because there wasn’t privacy. Alternatives? Leah: all DSAMH therapists are currently seeing patients face to face as necessary, including day treatment. 

Heather, Wasatch - their therapists are doing both telehealth and in person; having to create a contract with families and patients for productive telehealth visits - problems have included patients not dressed, not really awake (in bed). 

App that the state has licensed for those 13 yo and older - provides support. MyStrength. Emotional Relief line from Intermountain. Questions - reach out to Leah and Eric at the Division. They want to get children and youth the right services at the right time.

Presenter: Tammer Attallah, Primary Children’s Hospital Behavioral Health Services

Some recent changes at PCH/Intermountain; they are now thinking about mental health over the tri-state area: Idaho, Utah, Nevada. They know:
  1. Behavioral Health from the persecutive of the PCH is a black hole.  
  2. Access is really challenging.

Goal - how to mitigate some of the access complexities. Partnered with colleagues in their medical group and with a project Mental Health Access Initiative to improve navigation and collectively improve access. 
See a lot of failures in care because of the wrong focus of care
  • Need to know who the providers are
  • Need to know that they are reputable
  • Feedback loop

PCH Service: ARCS (Assessment, Referral and Consultation Services). Gathers a lot of info on the patient to help filter the criteria for insurance, etc.  Over the course of a decade, collecting information about providers in the community. Information on levels of care, services provided, insurance taken, location, notes. A care manager at PCH is in charge; it’s dynamic and now being shared with PCPs. It’s the interface between the ARCS team and the PCPs across the state. Getting feedback form the PCPs; they just got access to it about a month ago. It’s a rough document, designed for internal use. There is a disclaimer. Trying to develop best practices for hand offs between PCPs and Behavioral health providers. Feedback loop.  

Gabi - mainly used by care coordinators in PCP offices (not pediatricians). Mindy: how does the feedback come in? Gabi and her team is gathering the feedback. Insurance info can change rapidly. Monthly meeting- tutorial on how the document is used internally. Plan to capture info, iterate over time to make it more and more useful over time. Gabi: some say it’s too overwhelming. Others say its very helpful. It is an indicator of how robust the practice is, what their level of medical home readiness is. Janelle from Intermountain Holladay is using it, learning how to use it, very helpful and has found resources she wouldn’t have otherwise. Internal to PCH/Intermountain only for now.

Other
Our next meeting date: September 16th.

Here is our YouTube UCCCN 2020 Playlist for archived meeting recordings.

Best,
Mindy
Mindy Tueller, MS, MCHES
Manager, Medical Home Portal
Facilitator, Utah Children’s Care Coordination Network
Department of Pediatrics
University of Utah
801-213-3920

Medical Home Portal | UCCCN | 801-213-3920 | mindy.tueller@utah.edu | Medical Home Portal