February 2020 Resources of the Month
Dear UCCCN members,

Here are your February 2020 resources and meeting summary.

Medical Home Portal Updates
Annual UCCCN Learning Session
Please plan on attending the UCCCN Learning Session on Wednesday, March 18 th from 8:00 – 11:30 am on "Social Determinants of Health and their Impact on CYSHCN" at the Doty Education Center at Intermountain in Murray. Registration information forthcoming, or contact Mindy. 

Jan Bowker, Intermountain Memorial Clinic, is Retiring
Hats off to Jan for all her hard work and care for kids. Best wishes for a wonderful retirement!


Case #1: Ileana, South West Children's Clinic. Update on transitioning 26 yo young man - now on the wait list (one year) for the HOME program (would have been able to transition more directly if done before age 22). Biggest hurdle now is that the family doesn’t feel ready to let go of SWCC.

Med-Peds Physicians Services Category

Case #2 : Pat Rowe - patient getting discharged back to home in Vernal; having trouble getting access to formula, oxygen, other needs because of the rural area. Eric suggested that they tag team with the ISP team there.

Case #3:   Mindy Buttars, UVP-Provo - Do another MI training! UVP Provo staff recently used the skills they learned in our UCCCN Motivational Interviewing training after 2 kids coded back to back – stressful and traumatic to the staff. The kids are okay and the staff are doing alright in part due to MI.

Reminder about a Resource: ( Adolescent Mental Health Care Service Category)

Dora Requena, Shriners Salt Lake City - The " Gait Lab" Motion Analysis Center – patients w/issues regarding ankles, hips (muscle, bone and joint), etc., can take advantage of this service. Floor is matted, gaming/motion picture technology allows for other ways to do treatment, less invasive. Can be an alternative to surgery. Do they have to be a patient at Shriners? Not necessarily. Also, the UCCCN May meeting will be at Shriners and you can see the Gait Lab up close.

Pediatric Orthopedics Service Category

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 : February 2020 UCCCN Resources of the Month
Presenter: Avery Pince-Hyder, Utah Developmental Disabilities Council

UDDC is a federal agency that works at the state level, and works with people from age 0 to the end of life. Avery got connected with UCCCN and Eric’s Integrated Services program through Noel Taxin. Libby Osaguera, ED of UDDC, was also present in the meeting. 

UDDC works with the ACO provider groups (Medicaid). Disconnect between the boots on the ground, leadership. Wants to get rid of the miscommunication.

Focus groups subsequent to this meeting - to hear more of the individual stories.   Please let Mindy know if you want to participate in a focus group, or know a family who would want to

SDoH - Intermountain’s Alliance. Info sent to the outside provider to get resources, follow up. Now including a question in their screening about access to disability services. 2-1-1 United Way - working with this group, as well. (Invite Avery to the Learning Session!).  Also planning to work with Huntsman’s Hope Center - they are also doing a SDoH effort. The Utah Brain Injury Council (UBIC) - recipients withTBIs get waivers. UBIC members work directly with families who receive waivers.

UDDC has taken their findings to Paiute and Duchesne County commissioners – who largely send them back to people on the front lines. 

UDDC public comment meetings being held across the state through April 16 to guide their state plan. For more information and to take the survey, see this flier.     

Legislative work - happening now. Want to improve the system. 3 bills …
A. Delegation - individuals with complex medical condition, may need using nursing care (G-tube, track, etc.). This bill would allow delegation of duties to a trained person instead of a nurse. HB-274
B. Limited supports waiver. Long wait list for waiver services; about 3000 people currently waiting (based on critical needs). SB-44 is to help people get respite, community-based support, anything that isn’t residential (still trying to identify what all these services will be) while still on the DSPD waiting list. Would provide automatic access to Medicaid. 
C. One other … just got numbered Tuesday. SB 140

Research -on the UDD Council website. Four counties have the most need:
⁃               Rich - Beaver - Piute - Emery
⁃               USU’s Center for Persons with Disabilities (CPD) did a research project ... Avery went over the community health assessments. Mental health, a big concern for all counties. Education to help people access care, self-care, a problem, too.

Next – the UDDC wants input from you about what steps to take.

Eric: not enough behavioral health providers.  Is Telehealth a consideration? Avery: a state pilot for Telehealth is exciting. DSAMH is working directly with rural areas. Infrastructure is a problem. Piute county is trying to improve infrastructure. UDDC is asking about using existing structures (the high school has great internet access). Other rural counties are doing their own Telehealth pilot. Eric’s group is looking into Telehealth for some limited diagnostic services. Stigma still surrounds counseling and MH therapy. 

UDDC is helping with trainings for local providers in Price, St George on how to spot co-occurring mental illness with other diagnoses, refer according. Dual diagnosis. Natalie (GTM) says that many of the providers don’t get enough patients to become expert at seeing the issues and referring for treatment; need to better support the providers. An example would be for medication management for kiddos with ADHD – providers are not confident enough to prescribe and manage controlled substances because don’t see enough of these patients. Natalie Allen would be happy to talk more with Avery and the Utah DD Council. 

There is also a bill in the Legislature to support training for medical providers who will go back to the rural area to practices, a portion of their schooling costs would be forgiven/repaid. This won’t be useful for several years, however.

Telehealth reimbursement - Avery says she thinks Medicaid will still reimburse at the same rate as a live visit. Eric says there is an effort by UMA on the Hill right now to do a Telehealth parity bill. Because both sides of the connection incur costs, it isn’t a completely reimbursed thing yet. 

Chuck mentioned the UNI GATE program; says UNI is planning a robust approach to supporting providers with mental health situations. He and Gabi will check and get back to Avery with what UNI is trying to do. 

April mentioned that for individuals on a reservation, after discharge, even if the orders are all in place, if there isn’t DME available for use (a wheelchair, for example), or not enough providers who come to the area (Home Health), it doesn’t work. Gina mentioned Utah Family Voices & ISP work with the PCH Connector Services and many other organizations and foundations to help get what the families need before they go home. Remember to reach out to them. Dora - Shriners can also help with wheelchairs, and with travel assistance. 

Eric: Travel costs - Medicaid reimbursements are not useful enough, not timely enough.   Avery: 2-1-1 service for medical travel, it’s a free Lyft transit (one way). Utah pilot with the Via rideshare program (last mile - to get you to a fixed-stop).  Employment related. UTA on Demand by Via . Only in the south part of Salt Lake right now, would like it to reach the rural areas. MHP 36233

Our next meeting is our annual L earning Session. Please plan on attending on Wednesday, March 18 th from 8:00 – 11:30 am at the Doty Education Center at Intermountain in Murray. Registration information forthcoming, or contact Mindy to RSVP. The topic is "Social Determinants of Health and their Impact on CYSHCN."

Here is our YouTube UCCCN 2020 Playlist for archived meeting recordings. Have a wonderful weekend!

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

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