Comprehensive Overview of the Health Care Program for Children with Special Needs

1. Synopsis of HCP Data A broad-based look at The Health Care Program for Children with Special Needs Compiled by: Arthur McFarlane II, Epidemiology, Planning, and Evaluation Branch Presented to HPAC on May 22, 2013

2. Acknowledgements • Carsten Baumann • Angela Goodger • Indira Gujral • Dale Knochenmus • Abby Laib • Kristin McDermott • Kelsey Mefford • Jennie Munthali • Ann Whitehouse • Participants in the focus groups and key informant interviews and respondents to the Family Survey and Specialty Clinic Survey • HCP Care Coordinators

3. Introduction

4. Introduction • The presentation will summarize the data gathered by five projects that the HCP Program and the Epidemiology, Planning and Evaluation Branch collaborated on between July 1, 2012 - June 30, 2013 • The five projects are: • The Annual CYSHCN Data Report • The Annual Care Coordination Family Survey • The Specialty Clinic Family Satisfaction Survey • Care Coordination Focus Groups with current HCP Partners • Key Informant Interviews with counties not implementing HCP care coordination

5. Description of Projects

6. The Annual CYSHCN Data Report • Data-driven view of the care coordination process to inform decision-making at the state and local levels • Designed to examine the first year of data since the new HCP Care Coordination model was implemented • Client-level data are aggregated to describe service delivered by care coordinators • Report reflects data from Nov. 1, 2011-Sept. 30, 2012 • 964 clients who received HCP Care Coordination with an action plan were included in this analysis • 6,647 individuals were entered into the data system during the timeframe

7. The Annual Care Coordination Family Survey • Designed to assess family satisfaction with care coordination services • Survey was predominately a mail-delivered paper instrument administered January-February 2013 • 925 families who met care coordination criteria and had complete address information were eligible to be surveyed • 828 surveys were delivered • 97 surveys were undeliverable • 178 surveys were completed • The response rate was 21.5%

8. The Specialty Clinic Family Satisfaction Survey • Designed to help understand the experience of families who receive specialty clinic services • Surveys are administered at clinics immediately following a visit and collected using a locked drop box at each location • Data were analyzed and reported for the first quarter of 2013 • Data were collected at all nine specialty clinic sites • Of the 170 responses, 131 (77.1%) were returned at neurology clinics, 31(18.2%) at rehabilitation clinics and 8 (4.7%) at orthopaedic clinics

9. Care Coordination Focus Groups with Current HCP Partners • LPHA representatives from small, medium, and large counties were asked to share their thoughts on how the HCP care coordination model is working and to provide recommendations for program improvements • Five focus groups were held over a two-month period • Each focus group was designed to address different aspects of care coordination • They were 90-120 minutes in length

10. Key Informant Interviews with Counties Not Implementing HCP Care Coordination • Designed to better understand why 23 of 56 counties opted to stop offering HCP model of care coordination services • Phone interviews were conducted with representatives from 19 of 23 counties • Participants were asked up to eight questions during a 30 minute interview

11. Results and Conclusions

12. Project 1 : The Annual CYSHCN Data Report

13. The Annual CYSHCN Data Report • Clients are 60% -Male/40%-Female • Median age of client is 4 years of age • 73% spoke English/21% spoke Spanish • 39% are Hispanic • 12% needed an interpreter • 30% are in single parent households • Intake interviews were conducted in the home 38% of the time; over the phone 34% of the time; in the office or specialty clinic 22% of the time • 86% of the intake interviews were conducted by nurses

14. The Annual CYSHCN Data Report

15. The Annual CYSHCN Data Report

16. The Annual CYSHCN Data Report

17. The Annual CYSHCN Data Report

18. The Annual CYSHCN Data Report

19. CYSHCN Report Conclusions • The CYSHCN database allows the program and the care coordinators an opportunity to look at the population being served in a consistent manner across LPHA’s throughout the state • A large percentage of the children in the system (85%) do not meet the “care coordination” criteria • It is much more difficult to measure the impact of information only versus the HCP model of care coordination with an action plan

20. CYSHCN Report Conclusions continued • The system has a large percentage of missing data in crucial demographic areas making it more difficult to ascertain if underserved communities are being served • Additional years of data will allow the program to address subgroups with greater certainty

21. Project 2: The Annual Care Coordination Family Survey

22. The Annual Family Survey

23. The Annual Family Survey

24. The Annual Family Survey

25. The Annual Family Survey

26. The Annual Family Survey

27. The Annual Family Survey

28. The Annual Family Survey

29. The Annual Family Survey

30. The Annual Family Survey

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35. The Annual Family Survey

36. Family Survey Conclusions • Responses indicate that most of the families have a doctor and health insurance for their child • Responses indicate that most of the families find doctors and health insurance without help from HCP care coordination • Satisfaction with care coordination appears to be generated by the medical coordination provided • There is room for improvement in the knowledge about, completion of and updating of action plans • Management of care was improved in 63.4% of the cases in the sample

37. Project 3: Specialty Clinic Family Satisfaction Survey

38. The Specialty Clinic Family Satisfaction Survey

39. The Specialty Clinic Family Satisfaction Survey

40. The Specialty Clinic Family Satisfaction Survey

41. The Specialty Clinic Family Satisfaction Survey

42. The Specialty Clinic Family Satisfaction Survey

43. The Specialty Clinic Family Satisfaction Survey

44. The Specialty Clinic Family Satisfaction Survey

45. The Specialty Clinic Family Satisfaction Survey

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47. The Specialty Clinic Family Satisfaction Survey

48. Specialty Clinic Conclusions • Comments and responses showed that most respondents were pleased to have a clinic in their area so they did not have to drive to Denver • Comments were overwhelmingly positive about the doctors, nurses and staff of the clinics • Although the sample is self-selected there is a good distribution of respondents from different parts of the state and across dates in the quarter, lending validity and reliability to the results

49. Project 4: Care Coordination Focus Groups with Current HCP Partners

50. Focus Groups with Current HCP Partners – FG#1 • Question: What are the best features of the current HCP care coordination model? • Provides standards, structures and consistency to the program and to the state • Reports from CYSHCN are accurate and helpful • Accommodates and supports a multi-disciplinary team approach • Action plan is good as a foundation • Assessment guides the approach we are going to take with the family • Care plan can identify specific goals in a set timeframe • 6-month timeframe keeps us focused