The Autism Program of Illinois Webinar with Autism NOW April 26, 2011

8/6/2019 The Autism Program of Illinois Webinar with Autism NOW April 26, 2011

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Early Detection &Medical Home Webinar for:

Autism NOW: The National Autism Resource andInformation Center


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Presenters:

Georgia Winson Executive Director, The Hope Institute for Children and Families

Ola Aqel Northern Health Services Facilitator, TAP, IMPACC project

Julie Muoz-Njar Central Health Services Facilitator, TAP, IMPACC project

Sandy Tiahrt Southern Health Services Facilitator, TAP, IMPACC project


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Overview of The AutismProgram of Illinois

Overview ofProject IMPACC goals

Early Autism Detection Screening and Referral

Medical Home Implementation

Linking Early Detection to Medical Home in ASD

Webinar Objectives


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About The Autism Program of Illinois

12 centers

4 university partners

More than 30 collaborativepartners

Impacts more than 16,000families annually

Largest statewide networkin the country for Autismservices


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The Autism Program of Illinois

Diagnosis, treatment and support of children with ASDs and their

families

Training for parents, providers and educators

CommunityP

lanning Policy development

Resource support through Family and Community Resource Rooms at

centers statewide, providing items for loan and clinical support

Lifespan support through involvement in the national initiative,

Advancing Futures for Adults with Autism

Accessibility support through Community Avenues for Autism, an

initiative providing tools for using community resources like museums,

airports and libraries

For more information: 217.525.8332 or www.theautismprogram.org


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ASD System Overview in IL

Challenges

Emphasis on intervening late resulting in costly, intensive, restrictive

service

Inadequate funding and commitment to quality community-based

service

Fragmentation and poor coordination across service sectors and

across the lifespan

Inadequate and poorly trained workforce limiting access to quality

service

Opportunities

Growing consensus

Legislative commitment

Collaborative relationships with key governmental and community

stakeholders


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Illinois State Implementation

Grant - IMPACC

Funding: HRSA and MCHB funding for the CAAI State

Implementation Grants for Improving Services for Children

and Youth with Autism Spectrum Disorders

General Goal: Advance an enduring, comprehensive,

coordinated system of care for individuals with ASD

Specific Goals:1. Adequate public and private funding

2. Organized community services3. Transition to adult services

4. Family/professional partnerships

5. Early, continuous screening, evaluation, diagnosis andintervention

6. Access to comprehensive service - Medical Home (MH)


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Project IMPACC

Built on existing statewide network

Project IMPACC worked toward goals in all 6 grant

initiatives: Financial Initiatives

Accessibility to Community Services

Transitions

Family / Provider Partnerships

Early Autism Detection and Referral

Medical Home


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Financial and Accessibility

Initiatives

Financial

Billing procedures outlined

Pilot Program developed Accessibility

Cultural Competency Training

Accessibility kits for families

Spanish translation of Medical Accessibility Kit


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Transition in Illinois

AFAA (Advancing Futures for Adults with Autism)

National Town Hall at 16 sites across the country on

November 13, 2009

Congressional Briefing on July 15, 2010 www.afaa-us.org

Building Bridges to the Future

Six nonprofit agencies to serve the needs of special education

students and their families during transition to adulthood

Transition Outreach Specialists at the 6 agencies will:

Be primary liaison and attend IEP (Individual Education Plan) meetings aspart of each students interdisciplinary team

Develop and maintain linkages between families, Special Education staff,

and adult service providers by ensuring that transition is part of the IEP

Provide training and advocate for parents, guardians, and students

Assist in establishing eligibility for community services for students


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Family / Provider Partnerships

Family Advisor Program

Advocacy trainings and quarterly meetings provided to families

Information packets for families to present to their childs

physician Physician Engagement

Early Autism Detection and Referral Training created by TAP

with distribution through ICAAP

Training provided to practices around the state: 100 practices trained

800+ Medical professionals trained

Over 1.5 million Patients affected


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Early Autism Detection,

Screening, & Referral

Learning Objectives

Define autistic spectrum disorder

Recognize the earliest signs of autism

Routinely assess young children for autism

Identify common misconception

Learn how to refer to early intervention, special education,

and specialists for children who show signs of autism

Become familiar with the team approach to diagnosis and

the importance of evidence based treatment of autistic

spectrum disorder


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Practices

Getting into the practices Illinois Department of HFS (Medicaid program) provides us with

a list of physicians throughout the state of IL

Through our family advisor program

Referrals from other IL physicians

Steps to approaching the practices Going to the practice in person

Making phone calls to the practice

Talking to the front office staff or the doctor to approve the

training


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Training

Provided for the practices:

45 mins to an hour training

Lunch

Autism resource toolkit for clinicians (AAP- American

Academy ofPediatrics)

First signs screening kit

Medical Accessibility Kits (English & Spanish)

Screening tools & education for pediatric providers (Council on Children with Disabilities et al., 2006; Johnson et al., 2007)

Certification of attendance


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Challenges

Physicians that do not have time

Some Physicians lack interest in autism

Going back to the practice 2 to 3 times Unsure of practice screening behaviors and

utilization of screening tools post presentation


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Autism Basic Facts

Presents at birth with onset of symptoms before 36

months

Accurate diagnosis possible at 18-24 months or

earlier

Parents first concerns around 18 months but

diagnosis is typically not until 3 years or older

Cost of lifelong care can be reduced by 2/3 withearly diagnosis and intervention.

(Jarbrink & Knapp, 2001)


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IMPACC Medical Home Project

Definitions

Benefits for disabilities Specifically autism

Design of IMPACC Projects MH


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Medical Home Definitions

Broad A patient-centered medical home integrates patients as active participants in their

own health and well-being. Patients are cared for by a physician who leads the

medical team that coordinates all aspects of preventive, acute and chronic needs of

patients using the best available evidence and appropriate technology. Theserelationships offer patients comfort, convenience, and optimal health throughout

their lifetimes. -American Academy of Family Physicians, Board 2008

More Specific A 2002 AAP policy statement, includes operational characteristics: accessible,

continuous, comprehensive, family-centered, coordinated, compassionate, andculturally sensitive care. A medical home is a community-based primary care

setting that integrates quality and evidence-based standards in providing and

coordinating family-centered health promotion in wellness, acute and chronic

condition management.

Some models possess aspects designed to help practices manage the higher level of

care needed for children with special needs


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Medical Home Logic Model

(Homer et al., 2008)


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How MH benefits ASD

The critical need for early identification and treatmentrequires early, appropriate engagement of families,pediatricians and family practitioners

(Council on Children with Disabilities, 2007)

Parents of children with autism, compared to parents ofchildren with other special healthcare needs, were lesslikely to report care consistent with the medical homemodel

(Brachlow et al., 2007)

Emphasis on family and person centered care enhances selfadvocacy, continuity and quality


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Design of IMPACC Medical Home

Indices

Center for Medical Home Improvement

Pediatric Medical Home Family Index

Pediatric Medical Home Index

Evaluation

Report & review

Quality Improvement Team (QIT)

Team members

Goal setting

Frequent meetings


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Design of IMPACC Medical Home

Chronic Care Management

Care Coordination

Care Plans

Specialists and non-medical providers

Resources

AAPs National Center for Medical Home Implementation

IL Chapter of AAP website (ICAAP)

CMHI Center for Medical Home Improvement

Utahs Medical Home Portal

IL Title V program: Div. of Specialized Care for Children,

MH page


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Again, why a Medical Home???

Build partnerships between parents and physicians

Enhance pediatric comprehensive care for children with

special needs (American Academy ofPediatrics, 2002; Cooley, 2004)

Establish a Quality Improvement Process in a medical

practice


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Take Away Thoughts

Better adherence to best practices (Council on Children with Disabilities et al.,2006)

Medical home practices demonstrated more efficiently managed healthcarethrough better care coordination and improved continuity of care.

Reduction in stress levels for families; increased satisfaction with provider and care

received. Better adherence to medication and therapy recommendations.

Increase in development of chronic condition care plans.

Better adherence to health supervision visits and more emphasis on preventativecare.

Reduction in sick visits (over time) and fewer days missed from school and work.

Reduction in ER visits and hospitalizations (over time). Reduction in overall healthcare costs (over time).

Better and enhanced use of community resources.

Beginning to see some private payers reimburse individual practices for carecoordination services, eg. Blue Cross/Blue Shield, United Healthcare.


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The Essential Element for families and

professionals


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References

American Academy ofPediatrics, Medical Home Initiatives for Children with

Special Needs Project Advisory Committee (2002). The medical home:Policy

statement: Organizational principles to guide and define the child health care

system and/or improve the health of all children.Pediatrics, 1, 110, 184-186.

Brachlow, A.E., Ness, K. K., McPheeters, M. L., Gurney, J. G. (2007). Comparisonof indicators for a primary care medical home between children with autism

or asthma and other special health care needs, National Survey of Childrens

Health,Archives ofPediatrics and Adolescent Medicine, 161, 399-405.

Cooley, C. W. (2004). Redefining primary pediatric care for children with

special health care needs: the primary care medical home. GeneralPediatrics,

16, 689-692.

Council on Children with Disabilities (2007). Role of the medical home in

family-centered early intervention services. Pediatrics,120, 1153-1158.


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References (continued)

Council on Children with Disabilities, Section on Developmental Behavioral

Pediatrics, Bright Futures Steering Committee, Medical Home Initiatives for

Children with Special Needs Project Advisory Committee (2006). Identifying

infants and young children with developmental disorders in the medical home:

An algorithm for developmental surveillance and screening.Pediatrics, 18, 1,

405-420.

Homer , C. J., Klatka, K., Romm, D., Kuhlthau, K., Bloom, S., Newacheck, P., Van

Cleave, J., and Perrin, J. M. (2008). A review of the evidence for the medical

home for children with special health care needs. Pediatrics, 122, e922-e937.

Jarbrink, K., Knapp, M., (2001). The economic impact on autism in Britain.

London School of Economics study, 5, 7-22.

Johnson, C. P., Myers, S. M., and the Council on Children with Disabilities

(2007). Identification and evaluation of children with autism spectrum

disorders. Pediatrics, 120, 1183-1215.


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TAPAdministrative Offices

Noll Medical Pavilion

5220 S. Sixth Street Rd.

Suite 1700

Springfield, IL 62703

217.525.8332

www theautismprogram orgwww theautismprogram org

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The Autism Program of Illinois Webinar with Autism NOW April 26, 2011