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

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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  1. 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

  2. MCH Core Public Health Services Direct Medical Services Enabling Services Population Based Services Infrastructure Building Services

  3. 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

  4. Children with Special Health Care Needs (CSHCN) Program • Ensuring all children and youth with special health care needs achieve the healthiest life possible”

  5. 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

  6. 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

  7. 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

  8. 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.

  9. Time Spent Providing, Arranging, or Coordinating Care for CSHCN, per week National Washington 11

  10. 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.

  11. Care Coordination for WA CSHCN 13

  12. with special health care needs

  13. Multidisciplinary Team • Physician • Nutritionist • Nurse • Social worker • OT/PT • Speech pathologist • Behavioral psychologist

  14. Medicaid • Medical Nutrition Therapy • Enteral Nutrition Program    MAA home page http://maa.dshs.wa.gov

  15. Medicaid and CSHCN: A Comparison

  16. MAA Medical Nutrition Therapy • Certified Dietitian • PCP Referral/EPSDT • Medical Provider Number • Specific Fee Schedule

  17. 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

  18. Implications for Dietitians • Certified Dietitians • MAA Provider Numbers

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

  20. 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.

  21. WIC • Supplemental Nutrition Program for Women, Infants and Children

  22. WIC Services • Supplemental Foods • Nutrition Assessments • Nutrition Education • Breastfeeding Promotion • Community Referrals • Access to Health Services

  23. Formula Coverage • WIC First • Medicaid • CSHCN Special Formula Fund through CSHCN Coordinators

  24. MAA Enteral Nutrition Program • Current rules: Clients receive formula from pharmacies with Dr’s prescription without prior authorization.

  25. 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.

  26. CSHCN Special Formula Fund • Medically necessary • Not covered by any other program or insurance

  27. 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

  28. CSHCN Training Opportunities • CSHCN Nutrition Network • Feeding Teams • Distance Learning Grant (Training Modules)

  29. 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

  30. 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

  31. 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)

  32. 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

  33. 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

  34. 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

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

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