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What can we do for the Maltreated Child or child at- risk? Can we Try to prevent this? Who can help? How do they help?

What can we do for the Maltreated Child or child at-risk? Can we Try to prevent this? Who can help? How do they help?

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Page 1: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

What can we do for the Maltreated Child or child at-risk?

Can we Try to prevent this? Who can help? How do they help?

Page 2: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

Who are Children with Special Healthcare Needs?

Children and Youth with Special Health care Needs (CYSHCN) those who have or are at increased risk for a chronic physical, development, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally

Page 3: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

Medical Home Initiative Southwest CT

Medical home is an approach to providing health care services in a high quality, comprehensive, coordinated, continuous, compassionate and cost-effective manner.

Page 4: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

CYSHCN are about 16% of the population and account for 80% of pediatric health care expenditure

Page 5: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

How does Medical Home (MH) help?

MH has trained coordinators who understand the child and family’s needs

Coordinators are aware of the existing services in the community

They know how to procure resources

Page 6: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

Who decides what is required?

Plan of care is developed by the Physician/Advocate, Youth and the family.

It is shared by the other providers involved in the care of the patient.

Care among multiple providers is coordinated Families are linked to support services and

advocacy groups. Transition of care is planned

Page 7: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

How does a Coordinator help?

Coordinator will attempt to: Recognize such situations Try to prevent it from happening Seek professional help Seek solutions for the family Reach family support networks

Page 8: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

Potential problems I encounter?

Potential stressful scenarios:

Family with a CYSHCN Family with financial/other stress Abusive relationship

Page 9: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

How will the coordinator relieve stress?

Seek solutions for the family’s stresses

Find an after school program/mentor Find camps Work with connecting with DVCC Help mother out of a stressful situation if

possible Parenting classes Introduce to support group

Page 10: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

What else can we do?

Refer child and family to therapy

Crisis Management ServicesChild AdvocacyMental Health CounselingSocial Skills/Mentoring/RecreationParent Education ProgramParent Support Groups Camps

Page 11: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

How else can a coordinator help?

Help with insurance Connect children to specialists Help connect patients with Child Guidance,

Birth to three, School personnel Contact Social Service agencies Apply for Respite/Extended care funds Educate families about their rights Transition of youth

Page 12: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

Who is part of the Medical Home?

Medical Home Team

Primary care provider Family Child/Youth Pediatric office staff Pediatric specialists Allied health care professionals Community organizations/Schools

Page 13: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

Tools of Medical Home

Release Screener – 5 questions address the need for

additional services or treatment (Title V) Complexity Index – how much assistance does the

child need regardless of the diagnosis Portable Health Care Plan Directions Manual

Page 14: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

Case Study -Physician needs help Autism

10 year old boy demands excessive attention Dad walks out Physically hurts 8 years sister who breaks her

arm A year later child dies with viral

cardiomyopathy Mom and sister deeply distressed left alone

Page 15: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

Case Study -Physician needs help

KIDS in Crisis

Obese-raised by GM GM obese, hypertensive, diabetic with arthritis Child craves approval Mom does jail time for drug usage

Mother disgusted with obesity, inactive child- slob

Dad: Pizza/coke/movie

Page 16: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

PreventionHow?

Page 17: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

Prevention-Medical HomeChildhood Blueprint 0-8 years

Organized delivery of care to help those at-risk rather than wait for them to be diabetic or school failures

CYSHCN Childhood obesityAsthma Mental HealthReading Dental care

Page 18: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

Obesity effort in Stamford

Page 19: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

The YSCHN is growing up? What now?

Barriers and challenges abound Frustration mounts Parents worry Adults providers clueless of past and

challenges Youth need services to help cross this bridge

to adulthood

Page 20: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

What do we strive for?

Financial independence Positive peer group and relationships Independent living Transition helps youth achieve a

meaningful productive life

Page 21: What can we do for the Maltreated Child or child at-risk?  Can we Try to prevent this?  Who can help?  How do they help?

Medical Home Initiative

Southwest Region

1351 Washington Boulevard4th Floor

Stamford, CT

203-276-7552