Military Care Supports and Services

October 2019 CYSHCN Meeting

LTC Daniel Tolson MDChief Developmental Behavioral Pediatrics

Madigan Army Medical Center10 October 2019

DISCLOSURE STATEMENT

The views expressed in this presentation are those of the author(s) and do not reflect the official policy of

the Department of the Army, Air Force, the Department of Defense or the U.S. Government.”

Foundational Standards for Systems of Care for CYSHCN• 1. Identification, Screening, Assessment, and Referral• 2. Eligibility and Enrollment in Health Coverage• 3. Access to Care• 4. Medical Home• 5. Community-Based Services and Supports• 6. Transition to Adulthood• 7. Health Information Technology• 8. Quality Assurance and Improvement

1. Identification, Screening, Assessment, and Referral

• Yes• Yes• Yes• Yes

2. Eligibility and Enrollment in Health Coverage

• Yes

3. Access to Care

• Yes• Theoretically

• Definitely Yes when military and community network is accessed

4. Medical Home

• Yes • Maybe not so many home visits though• 24 hour availability sometimes includes the ER on nights and weekends

https://www.healthysteps.org/article/what-is-healthysteps-11https://www.healthysteps.org/article/what-is-healthysteps-11

• https://www.mamc.health.mil/clinical/pediatrics/school-based-health-clinics/default.aspx

• 6 High Schools• 4 Middle Schools

https://www.mamc.health.mil/clinical/pediatrics/school-based-health-clinics/default.aspx

School Based Behavioral Health Providers

• Behavior Health Providers in the school • 6 Elementary Schools

5. Community-Based Services and Supports

• Yes- Includes Home Based Services, Palliative and Hospice Care, Respite Care

We support military families impacted by Autism through timely access to resources, education and services to improve soldier readiness and family resiliency.

Services Offered• Speech Therapy

• Occupational Therapy

• ABA Therapy

• System Navigation

• Social skills classes

• Life skills training

• Parent impact/support groups

• Educational resources

CARES VISION

Family with new diagnosis or PCS

to JBLM

40% remain in CARES for

long term therapy

60% Case load turnover every 3-9

months to community partners or PCS/ETS

• Physician and Therapist oversight of CARES center

• Oversight of community Autism care for military beneficiaries

• Training and research

• Direct therapy for 100-150 children

• Eliminate referral wait time• Recapture some cost• Reduce EFMP denials• Increase readiness

• Medical Director

• Administrative Officer

• MSA/Front Desk Support

• 3 Speech and Language Pathologists

• 2 Occupational Therapists

• 2 Board Certified Behavior Analysts

• 3 EFMP System Navigators

Personnel

EFMP: Community Resources

• EFMP in partnership with MWR and MAMC CARES has monthly family activities, next up is Costume Karaoke. September was pontoon ice cream socials on American Lake.

• CYS has special Olympics programs on base year-round.

• The Children’s Museum opens their JBLM branch spring 2020 and will have scheduled monthly special EFMP opening.

Find out more about EFMP at JBLM

• https://jblm.armymwr.com/programs/EFMP

https://jblm.armymwr.com/programs/EFMP

EFMP areas of Support

• Social Security, Medicaid/waivers• IEP• Specialized recreation• Help developing a Family Service Plan

And many other services. . .• Zero to Three

• New Parent

• Military Family Life Counselors

• Daddy Doll Website

• Chaplain Family Life Center

• Parent Central

• Lactation Group

• Raindrops and Rainbows

• Family Advocacy Program

• Employment Readiness

• Military Spouse Career Advancement Tuition Assistance

• Childcare Aware

• Financial Readiness Program

• Early Head Start

• Stone Education Center

• WIC

• CYS/Parent Central

• CPR

• Red Cross

• Lactation Specialist

• Medical Care

• Behavioral Health

• Breathe2Relax

• Emergency Food Network

• Library

• Family Readiness Group

• MWR

• FOCUS. . .

6. Transition to Adulthood

• Transition Policy• Transition Readiness

Faith Clinic

• Adult Primary Care Clinic• Transition services• Employment program- Partnership with Goodwill

7. Health Information Technology

• Genesis• Patient Portal• Worldwide accessible record

Telehealth

• Authorized for:

• Fort Wainwright, Alaska• Fort Hood, Texas• Fort Carson, Colorado• Fort Huachuca, Arizona• Fort Irwin, California• Camp Zama, Japan

• Virtual Medical Center*• Everywhere (Soon)

8. Quality Assurance and Improvement

• These items are definitely monitored at the macro level• Representation on QI and QA teams• Outcomes are monitored locally

Defining the future• Ongoing data collection:

• Time to care from referral

• Family stress• Adaptive behavior • Parent empowerment• Telehealth vs in person

visit effectiveness

Average number of days to services

Family Readiness

SoldierReadiness

Chart1

Appt to EvalAppt to Eval

Eval to TherapyEval to Therapy

JBLM CARES

Community

17

29

15

78

Sheet1

JBLM CARESCommunity

Appt to Eval1729

Eval to Therapy1578

To resize chart data range, drag lower right corner of range.

Thank you. . .

For your service.

A great child and youth advocate is like a candle.A candle consumes itself to light the way for others.

Military Care Supports and Services�October 2019 CYSHCN MeetingDISCLOSURE STATEMENTFoundational Standards for Systems of Care for CYSHCN1. Identification, Screening, Assessment, and Referral�2. Eligibility and Enrollment in Health Coverage�3. Access to Care4. Medical HomeSlide Number 8School Based Behavioral Health Providers5. Community-Based Services and SupportsSlide Number 11Services OfferedSlide Number 13PersonnelEFMP: Community ResourcesSlide Number 16Find out more about EFMP at JBLMEFMP areas of SupportAnd many other services. . .6. Transition to AdulthoodFaith Clinic7. Health Information TechnologyTelehealth8. Quality Assurance and ImprovementDefining the futureThank you. . . ��For your service.