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Improving Nutritional Care for Children with Special Health Care Needs: The Work of the CSHCN Program PowerPoint PPT Presentation

Improving Nutritional Care for Children with Special Health Care Needs: The Work of the CSHCN Program Yuchi Yang, MS, RD, CD Nutrition Consultant CSHCN Program Washington State Department of Health May 9, 2005 MCH Core Public Health Services Direct Medical Services Enabling Services

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Improving Nutritional Care for Children with Special Health Care Needs: The Work of the CSHCN Program

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Improving Nutritional Care for Children with Special Health Care Needs: The Work of the CSHCN Program

Yuchi Yang, MS, RD, CD

Nutrition Consultant

CSHCN Program

Washington State Department of Health

May 9, 2005


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MCH Core Public Health Services

Direct Medical Services

Enabling Services

Population Based Services

Infrastructure Building Services


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Children with Special Health Care Needs ProgramFebruary 2005

Program Manager

Maria Nardella

(360) 236-3573

Secretary Administrative -- WISE

Jane Berube

(360) 236-3546

Secretary Administrative

Christy Davis

(360) 236-3571

Public Health

Nurse Consultant

Linda Barnhart

(360) 236-3491

WISE Grant

Coordinator

Karla Dudley

(360) 236-3585

Nutrition

Consultant

Yuchi Yang

(360) 236-3561

Assessment

Consultant

Stacey De Fries

(360) 236-3559

Family

Consultant

Leslie Carroll

(360) 236-3504

Program Integration

Consultant

Civillia Winslow Hill

(360) 236-3518

Budget & Contracts

Coordinator

Patsy Shumway

(360) 236-3539


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Children with Special Health Care Needs (CSHCN) Program

  • Ensuring all children and youth with special health care needs achieve the healthiest life possible”


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Prevalence of Children with Special Health Care Needs: Persons

95%CI: ± 0.11%

95%CI: ± 0.52%

Source: National (n=372,174) & WA (n=6629) Screener files.

7


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Children with Special Health Care Needs

“Children with special health care needs are those who have or are at increased risk for chronic physical, developmental, behavioral, or emotional conditions and who require health and related services of a type or amount beyond that required by children generally.”

…Maternal & Child Health Bureau


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Who Do We Serve?

  • Children up to 18 years of age who have or at risk of having a special health care needs.

  • Resident of Washington

  • Income Eligibility for certain services: 200%FPL


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What is Care Coordination?

  • …defined as “a process that links children with special health care needs and their families to services and resources in a coordinated effort to maximize the potential of children and provide them with optimal health care.”

    American Academy of Pediatrics Committee on Children with Disabilities. Care coordination: Integrating health and related systems of care for children with special health care needs. Pediatrics 1999;104(4): 978-981.


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Time Spent Providing, Arranging, or

Coordinating Care for CSHCN, per week

National

Washington

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CSHCN Coordinator is the Gatekeeper.

Call your local health department or the ASK Line (Answers for Special Kids Resource Line) through Healthy Mothers, Healthy Babies 1-800-322-2588 to help families access needed services for their child, such as medical care and other interventions.


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Care Coordination for WA CSHCN

13


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with special health care needs


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Multidisciplinary Team

  • Physician

  • Nutritionist

  • Nurse

  • Social worker

  • OT/PT

  • Speech pathologist

  • Behavioral psychologist


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Medicaid

  • Medical Nutrition Therapy

  • Enteral Nutrition Program 

      MAA home page http://maa.dshs.wa.gov


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Medicaid and CSHCN: A Comparison


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MAA Medical Nutrition Therapy

  • Certified Dietitian

  • PCP Referral/EPSDT

  • Medical Provider Number

  • Specific Fee Schedule


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Medicaid Nutrition Rates

  • $10.88 per unit

  • Unit = 15 minutes of a face-to-face interaction

  • Initial assessment up to 2 hours

  • Reassessments up to 1 hour per day

  • No annual limit on reassessments

  • $4.53 per unit for Group Therapy


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Implications for Dietitians

  • Certified Dietitians

  • MAA Provider Numbers


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Certified Dietitian

  • Go to: https://fortress.wa.gov/doh/hpqa1/hps3/Diet_Nutritionist/forms.htmfor an application form.


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Medical Provider Number

  • Go to http://fortress.wa.gov/dshs/maa/provrel/ and click on “sign up to be a WA State Medical Assistance Provider”.

  • Call MAA Provider Enrollment Unit at 1-866-545-0544 for questions.


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WIC

  • Supplemental Nutrition Program for Women, Infants and Children


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WIC Services

  • Supplemental Foods

  • Nutrition Assessments

  • Nutrition Education

  • Breastfeeding Promotion

  • Community Referrals

  • Access to Health Services


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Formula Coverage

  • WIC First

  • Medicaid

  • CSHCN Special Formula Fund through CSHCN Coordinators


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MAA Enteral Nutrition Program

  • Current rules:

    Clients receive formula from pharmacies with Dr’s prescription without prior authorization.


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New MAA Enteral Nutrition Program

  • New rules will take effect July 1, 2005

  • Key points:

    • Prior authorization.

    • Medical/nutrition criteria for oral nutrition supplements.

    • Not meeting new criteria, will be evaluated on a case-by-case base.


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CSHCN Special Formula Fund

  • Medically necessary

  • Not covered by any other program or insurance


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CHDD Nutrition Contract

  • Purpose: to promote the availability of quality, community-based nutrition and feeding team services and improve nutrition outcomes for children with special health care needs


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CSHCN Training Opportunities

  • CSHCN Nutrition Network

  • Feeding Teams

  • Distance Learning Grant (Training Modules)


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Nutrition Focus for Children with Special Health Care Needs

  • A newsletter for health professionals

  • University of Washington based

  • http://depts.washington.edu/chdd/ucedd/CO/co_NutriFocus.html

  • 6 issues per year


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Publication

  • Medicaid Reimbursement for Medical Nutrition Products and Nutrition Services for Children with Special Health Care Needs: A Washington State Case Studies Report.

  • For a copy, visit http://www.doh.wa.gov/Publicat/publications.htm


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Guidelines for the Development and Training of Community-Based Feeding Teams in Washington State.

  • Determine the Need

  • Identify Key Agencies and Professionals.

    (Revised edition will be on-line soon. Please visit CSHCN home web page)


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Nutrition Interventions for Children with Special Health Care Needs

  • To provide a resource for those involved in the monitoring or delivery of nutrition care for children with special health care needs.

  • For order information, please visit http://www.doh.wa.gov/Publicat/publications.htm


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Children With Special Health Care Needs: Nutrition Care Handbook

  • This newly published resource provides a quick and practical reference.

  • Can be purchased through ADA at

    www.eatright.org/Public/ProductCatalog


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Materials

  • Children with Special Health Care Needs Program Brochures.

  • The National Survey of Children with Special Health Care Needs. Chart book 2001

    www.cdc.gov/nchs/slaits.htm


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CSHCN Program

  • Home Page: http://www.doh.wa.gov/cfh/mch/CSHCNhome2.htm


  • Login