Building Medical Homes That Work

Building Medical Homes That Work

1Presentation adapted by Family Voices from materials developed by Michael D. Warren, MD MPH FAAP Director, Title V/Maternal & Child Health, Tennessee Department of Health 2Materials developed by the Tennessee Disability Coalition with funding from:

-The US Department of Human Services Health Resources and Services Administration, Maternal and Child Health Bureau (Project # H84MC00004-09-00)--The Tennessee Affordable Care Act Family-to-Family Health Information Center.

-The Tennessee Disability Coalition

In this Presentation you will learn about...

The Medical Home ApproachFamilies juggle a lot at onceAccessible CareCompassionate CareComprehensive CareCoordinated CareCulturally Effective CareFamily-Centered CareElements of Family-Centered CareEngaging Families and building leadership skills

4The Medical Home Approach

The term Medical Home was first used in the 1960sLiterally meant a central place to store records of children with special health care needsOver time, the definition has expanded to describe an approach to care5The Medical Home ApproachThe Medical Home is not:

One particular placeOne particular buildingOne particular provider6The Medical Home ApproachThe Medical Home is really an approach to caring for children and families

It is a system of care that includes:Children and familiesPrimary Care providersSubspecialty providersCommunity resource providers

7Families Juggle a lot at Once

Family/MarriageHousingChild CareMedical Care

WorkHealth InsuranceBig Picture: Child and FamilyEducation

8Families Juggling a lot at Once

Me

Health Insurance/Medical CareSpecialist

CommunityResourcesChild CarePCPFamily/MarriageEducationMedical Concerns: Child and FamilyMedical Home

9The Medical Home ApproachCare that is:

AccessibleCompassionateComprehensiveContinuousCoordinatedCulturally EffectiveFamily-Centered

Accessible includes:-- general access to health care as well as-- care that meets ADA standards for both physical and programmatic access10Accessible CareCare provided in the childs community

All insurance types accepted

Practice physically accessible and meets the Americans with Disabilities Act requirements

RE: ADA Requirements for physical access as well as effective communication (e.g., providing sign language interpreter, cued speech transliterator, Braille, large print)there are resources on our website:Access To Medical Care For Individuals With Mobility DisabilitiesQuestions and Answers for Health Care Providers (ADA-Effective Communication)11Compassionate CareProvider expresses concern for well-being of child and familyProvider tries to understand and empathize with feelings and perspectives of family

12Comprehensive CareProvider well-trained to manage childs carePreventive, primary, and tertiary care needs are addressedProvider is accessible 24 hours a day, 7 days a week, 52 weeks a yearProvider shares information about available community resources

13Coordinated CareProvider and family develop plan that is shared with others involved in care of patientCare among multiple providers is coordinatedCentral record of care is availableWhen referral is made, primary care provider communicates with specialist

14Culturally Effective CareChild and familys background, values, beliefs are recognized, valued, respected, and incorporated into care plan

Provider makes every effort to make sure that child and family understand the care plan

15Family-Centered CareProvider knows the child and family well

Family and provider share responsibility for well-being of child

Family is recognized as principal caregiver and expert in childs care

16Elements of Family-Centered CareRespecting the pivotal role of the family as caregiver, advocate, decision maker.The role of professionals is to support families in their care giving roles.Based on familys values, preferences, priorities, and needs.

17Elements of Family-Centered CareThe family is the constant in a childs life, while service systems and support personnel within those systems fluctuate.Parent/professional collaboration at all levels of hospital, home, and community care:Program development, implementation, evaluation, and evolution; andPolicy formationCare of an individual child

18Elements of Family-Centered CareEncouraging and facilitating family-to-family support and networking.

Ensuring that service and support systems are: flexible accessible comprehensive

19Elements of Family-Centered CareAppreciating families as families and children as children, recognizing that they possess a wide range of strengths, concerns, emotions, and aspirations beyond their need for specialized health and developmental services and support.

20Engaging Families and Building Leadership SkillsAsk families their opinion.Families with experience can mentor newer families.Share leadership opportunities for families:Hospital parent advisory councilsCSS (Children Special Services) advisory councilFamily Support CouncilsVolunteer Advocacy ProjectSponsor and/or share training opportunities.-Opinions thru surveys and conversations and have them give input on publications or handouts used in your office. -Families can be mentors with children with similar dx, or just a strong parent leader giving tips to a new mom about nursing and going back to work. This not only helps the newer parents but it helps build up the mentoring parent as well in their confidence to be a leader. Physicians can build their own network of parent leaders. If you are a parent and willing to be a mentor, let your physician know and sign HIPAA releases on the front end if needed.-Sharing leadership opportunities with families is important, and if you are a parent and are part of a program and feel it benefits you, share this info with your physician so they can encourage other families to take part.-Family Voices and other agencies across the state can provide training around many issues families face. From navigating service systems for children with special health care needs, to special education to child abuse prevention. Providers could advertise, and provide a free meeting space for families to meet to learn about these important issues. 21

The Medical Home ApproachMedical CarePCPSpecialistFamily/MarriageChild CareSchoolWork

22

Belinda HotchkissFamily Voices DirectorTennessee Disability Coalition615.383.9442belinda_h@tndisability.orgwww.tndisability.orgToll Free: 1.888.643.7811

Belinda:If you have questions regarding Family Voices, and helping families please feel free to contact me. I have included my contact info here, and I know it will be posted on the WIKI as well.

Now that we have touched on Family Centered Care, I want to discuss the FME (Family Mentor Experience)

The Family Mentor Experience is a completely different experience than any of your clinicals you have had or will have. This is not the time for you to put into practice your disciplines expertise, but a time to step back and allow the family to teach you, and to open your eyes to the total experience of having a child with a disability. Typically, providers only see a snapshot of a family. The FME will allow you to see how the family functions and the impact of the disability (if any) on the family unit.

Before visiting your families, you need to do a little homework..yes, even the FME has some prep work. There will be materials posted on the WIKI that you will need to access. One is a video discussing home visits. All the families that are used for the FME are vetted and we dont expect any problems, however, you should be prepared for the unknown when conducting your home visits.

Each trainee will need to contact me when they have scheduled their home visits to do a pre visit discussion, and to let me know when you plan to meet w/ the family. Then you will need to contact me once you have left the home, either text or call, so I know that youve left safely. When you visit the family for the visit time, you will need to have them sign the FME agreement. This helps explain who you are and what your role is along with your expectations.

Thank you for listening and we are now able to take a few questions!

23Resources for FamiliesMedical Home Toolkit:Tools for providers and families to promote coordinated care for children in Tennesseehttp://www.tn.gov/goccc/initiatives/medicalhome/index.html

National Center for Medical Home Implementation: This resource is for health professionals, families, and anyone interested in creating a medical home for all children and youth.http://www.medicalhomeinfo.org/

Health Reform Hit Main Street (Video on Affordable Care Act) : Confused about how the new health reform law really works? This short, animated movie explains the problems with the current health care system, the changes that are happening now, and the big changes coming in 2014.http://www.youtube.com/watch?v=vmdbllWOOzs

24Resources for FamiliesACA Homepage: Take health care into your own handshttp://www.healthcare.gov/

FamiliesUSA: The Voice for Health Care ConsumersFamilies USA is a national nonprofit, non-partisan organization dedicated to the achievement of high-quality, affordable healthcare for all Americans.http://www.familiesusa.org/health-reform-central

25