PENNSYLVANIA MEDICAL HOME INFO
Announcements

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Projects and Grant Initiatives

AAP: Community Pediatrics Grant Database
The Community Pediatrics Grant Database archives previously funded Community Pediatrics grant projects, including those funded through the CATCH Program, the Healthy Tomorrows Partnership for Children Program, the Community Pediatrics Training Initiative and the Healthy People 2010 Chapter Grants. The database is searchable by seven major categories: target population, health topic, state/territory, project activity, AAP program, AAP district, and project year. Members of the AAP can obtain grantee contact information by searching through the Member Center. If you are not an AAP member, but have questions please contact docbi@aap.org.

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Developmental Surveillance and Screening Policy Implementation Project (D-PIP)
Children's Hospital of Pittsburgh Primary Care Center from Pittsburgh, PA participated in the D-PIP. The D-PIP selected 17 practices from across the United States to implement the AAP policy statement Identifying Infants and Young Children with Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening to:

  1. Determine if the algorithm is efficiently and effectively implemented into pediatric practice,
  2. Recognize strategies for implementing the algorithm, and
  3. Examine outcomes of implementation.

Following the project, information and outcomes will be shared with pediatric clinicians and other health care professionals who are seeking to improve the delivery of developmental surveillance and screening.

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Healthy Tomorrows Partnership for Children Grant (2010-2015)
Promoting Health Through Community Collaboration (PHCC) Initiative
To our Children's Future With Health, Inc, Philadelphia, PA
Primary Contact: Robin Foster-Drain, MD, MPH, President | E-mail: rfd@tocfwh.org
The federal Maternal and Child Health Bureau awarded this five-year grant to provide approximately $50,000 per year to improve child health through community-based initiatives on prevention and access to health service for vulnerable populations. Health and poverty intersect within the West and North Philadelphia regions in ways that require creative approaches to pediatric healthcare. The economic, educational and environmental conditions within these urban communities have an impact in both access and utilization of healthcare services. The project will develop and expand pediatric primary care services for children who are uninsured, underinsured, or unable to utilize their healthcare coverage at optimal levels. The overall goal of this project is to reduce the identified health disparities rooted in both access and utilization, and bridge the gaps between providers and patients. Comprehensive and coordinated healthcare services will include physicals, immunizations, sick and continuum care, HIV counseling, testing and referral, and health education.

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State Implementation Grant (D70) for Improving Systems of Services for Children and Youth with Special Health Care Needs (CYSHCN)
Grant Period: 2008-2011 (or 2009-2012, depending on which class they are)
PENNSYLVANIA DEPARTMENT OF HEALTH - Abstract Word doc download
Health & Welfare Bldg. &
Harrisburg, PA 17120-0001
Program Director: Michelle Connors
Phone: 717/772-2763 | E-mail: mconnors@state.pa.us

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Pennsylvania Medical Home Initiative
Educating Practices in Community Integrated Care (EPIC IC) is a medical home development project funded by the Pennsylvania Department of Health and the federal Maternal Child Health Bureau. The EPIC IC Medical Home Program is funded by the Pennsylvania Department of Health, Bureau of Family Health (state Title V agency). The grant administration and oversight is housed within the Division of Community. Systems Development and Outreach. The EPIC IC medical home project is based on the Educating Physicians In their Communities (EPIC) model. EPIC IC is a statewide provider of education/quality improvement programs using office-based change as the key to improving the care provided to children and youth with special health care needs (CYSHCN). The EPIC IC project facilitates the provision of medical homes to CYSCHN throughout the Commonwealth of Pennsylvania. Similar to other quality improvement projects, EPIC IC uses many tools to measure and monitor strengths, weaknesses, and outcomes of the project. This includes but is not limited to: patient registries, tracking of care coordination, Medical Home Index, family survey, quality improvement cycles, and assessment of transition efforts.

Participating in the Program
Practices work with EPIC IC to meet many care coordination criteria.  The criteria include: identification of practice team members, recruitment of Parent Partners to work with the practice team, development of a process for creating a comprehensive and continuously-updated patient registry of CYSHCN, submission of a brief monthly report, collaboration with local, community-based organizations, participation in EPIC IC monthly conference calls, and attendance at EPIC IC conferences. After meeting the above criteria, EPIC IC works with practices to refine their model of care delivery so that successive quality measures are incorporated.  62 practices have been trained by EPIC IC, over 30% of which are currently participating in intensive quality improvement activities with the EPIC IC program.  EPIC IC practices represent all 6 regions of PA, 29 counties, urban, rural, suburban areas, multiple ethnic and racial groups, federally qualified health centers, three major children’s hospital systems, and all sizes of practice…with populations varying from as little as 1500 to as many as 30,000 patients.

For more information contact Renee Turchi, MD, MPH at Renee.Turchi@drexelmed.edu or Molly Gatto atmgatto@paaap.org.

Presentations:

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Dyson Community Pediatrics Training Grant - The Children's Hospital of Philadelphia Pediatric Residency Program
Through The Initiative, the Community-Based Pediatrics and Advocacy Program (CPAP) at The Children's Hospital of Philadelphia teaches residents to become pediatricians who are as comfortable and competent in their role as child advocates as they are in the medical practice; who can be effective advocates for an individual child and family, as well as all children in their community; and who can work in partnership with private and public community-based agencies to promote the well-being of children. Through this educational process, we integrate an expanded focus on community-based pediatrics and advocacy through the Hospital.

The ultimate goal of the Dyson Initiative is the development of pediatric professionals with greater skills and interest in community-based medicine, advocacy, and the capacity to improve the health of children in their communities. Here you can learn how diverse programs around the country are educating residents about community pediatrics and fostering practical community experiences.

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AAP Chapter Educating Physicians In Community Integrated Care (EPIC)/Medical Home Program
Educating Practices in Community Integrated Care for Children with Special Health Care Needs Overview Powerpoint doc download

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Children's Health Insurance Program Reauthorization Act (CHIPRA) Grants
Pennsylvania is a lead on one of 10 CHIPRA grants, representing single-state projects and multi-state collaborations, from HHS to improve health care quality and delivery systems for children enrolled in Medicaid and the Children's Health Insurance Program (CHIP). The money will help states implement and evaluate provider performance measures and utilize health information technologies such as pediatric electronic health records and other quality improvement initiatives.

Partners in State

American Academy of Pediatrics (AAP) Chapter - Pennsylvania
Academy chapters are organized groups of pediatricians and other health care professionals working to achieve AAP goals in their communities. Chapters are the channels of representation for individual members of the Academy. Please contact your local chapter for additional state resources.

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American Academy of Family Physicians (AAFP) Chapter - Pennsylvania
The American Academy of Family Physicians is one of the largest national medical organizations, representing more than 94,000 family physicians, family medicine residents, and medical students.

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Family Voices Chapter - Pennsylvania
Family Voices aims to achieve family-centered care for all children and youth with special health care needs and/or disabilities. Through a national network, they provide families tools to make informed decisions, advocate for improved public and private policies, build partnerships among professionals and families, and serve as a trusted resource on health care.

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Family-to-Family Health Information Centers (F2F HICs)
F2F HICs are non-profit organizations that help families of children and youth with special health care needs (CYSHCN) and the professionals who serve them. F2F HICs are in a unique position to help families because they are typically staffed/run by parents of CYSHCN themselves, and as parents, they have traveled through the maze of services and programs designed to help CYSHCN. Staff at F2F HICs understand the issues that families face, provide advice, offer a multitude of resources, and tap into a network of other families and professionals for support and information. Family Voices, through the National Center for Family / Professional Partnerships, provides technical assistance, training, and connections to other F2F HICs and partnering organizations.

Parent Education & Advocacy Leadership Center
Address: 1119 Penn Avenue, Pittsburg, PA 15222
Phone: 412/281-4404 | Toll free: 866/950-1040
Primary Contacts: Joan Badger, Liz Healey
(MCHB: 6/2007-5/2010)

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Title V Block Grant to States
Title V of the Social Security Act is one of the largest Federal block grant programs. It leads the nation in ensuring the health of all mothers, infants, children, adolescents, and children with special health care needs (CSHCN). Title V is administered by the Maternal and Child Health Bureau (MCHB) as part of the Health Resources and Services Administration, U.S. Department of Health and Human Services.

MCH Contact
Melita J. Jordan, CNM, MSN, APRN C, Director, Bureau of Fanily Health
Address: PA Department of Health, 7th & Forster Streets, Harrisburg, PA 17120
Phone: 717/787-7192 | Fax: 717/772-0323 | E-mail: mejordan@state.pa.us

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Title V and Children with Special Health Care Needs
MCHB Objective: Support development and implementation of comprehensive, culturally competent, coordinated systems of care for the estimated 18 million U.S. children who have or are at risk for chronic physical, developmental, behavioral or emotional conditions and who also require health and related services of a type or amount beyond that required by children generally.

CSHCN Contact
Michelle Connors, Director, Div of Community Systems Development & Outreach
Address: PA Department of Health, 7th & Forster Streets, Harrisburg, PA 17120
Phone: 717/772-2763 | Fax: 717/772-0323 | E-mail: mconnors@state.pa.us

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Early Hearing Detection & Intervention (EHDI) Contact(s)
State EHDI programs promote universal newborn hearing screening, develop effective tracking and follow-up as a part of the public health system, promote appropriate and timely diagnosis of the hearing loss, prompt enrollment in appropriate Early Intervention, ensure a medical home for all newborns and strive to eliminate geographic and financial barriers to service access.

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State Newborn Screening & Genetics Programs
Pennsylvania Newborn Screening Program and Contact Information
From the National Newborn Screening and Genetics Resource Center Web site

Pennsylvania Genetic Services and Contact Information
From the National Newborn Screening and Genetics Resource Center Web site

Newborn Screening and Genetics Collaborative – HRSA Region 2
Translating research into practical health care services and systems to improve the health and quality of life of individuals with heritable disorders through Collaboration and Partnership

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Early Intervention/Part C Coordinator
The Program for Infants and Toddlers with Disabilities (Part C of IDEA) is a federal grant program that assists states in operating a comprehensive statewide program of early intervention services for infants and toddlers with disabilities, ages birth through age 2 years, and their families.

Maureen Cronin, Part C Coordinator
Phone: 717/783-7213 | Fax: 717/772-0012 | E-mail: mcronin@state.pa.us

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Section 619/Special Education for ages 3-5 Coordinators
This program provides free appropriate public education (FAPE) for children, ages 3 through 5 years, with disabilities:

Richard Price, Chief
Phone: 717/ 783-6882 (Price) or 717/ 783-6889 (Beck) | Fax: 717/ 783-6139 | E-mail: rprice@state.pa.us

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State Interagency Coordinating Council (ICC) Chairs
The ICC advises appropriate agencies on the unmet needs in early childhood special education and early intervention programs for children with disabilities, assists in the development and implementation of policies that constitute a statewide system, and assists all appropriate agencies in achieving full participation, coordination, and cooperation for implementation of statewide system.

Tracey Khalife, ICC Co-Chair
Phone: 570/836-1995 | E-mail: khalife@epix.net

Janice Matthew, ICC Co-Chair
Phone: 412/323-4088 | Fax: 412/323-3965 | E-mail: drjmatthew@aol.com

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Medicaid
Medicaid is Title XIX of the Social Security Act and is a federal/state entitlement program that provides medical assistance to certain individuals and families with low incomes and/or special health care needs. Medicaid is of unique importance to children; together with the Children's Health Insurance Program, Medicaid insures over 1 in 4 children in the United States, with millions more eligible but currently unenrolled. The Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program is a critical component of Medicaid, which guarantees that children enrolled in Medicaid are screened for medical or developmental problems early, and that necessary treatments and services are provided.

Medicaid State Director
For the most updated contact, please refer to the National Association of State Medicaid Directors Member List.

State Waiver Information
Waivers are the result of a process that allows state Medicaid agencies to apply for and receive permission from HCFA to provide services not otherwise covered by Medicaid and/or to do so in ways not described by the Social Security Act. Most Medicaid managed care programs require Waivers. The Waivers, which can differ greatly, are known by their numbers (1115, 1119), or as home-and community-based, or as Katie Beckett Waivers.

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Children's Health Insurance Program (CHIP)
CHIP is Title XXI of the Social Security Act and is a state and federal partnership that targets uninsured children and pregnant women in families with incomes too high to qualify for most state Medicaid programs, but often too low to afford private coverage. Within federal guidelines, each state determines the design of its individual CHIP program, including eligibility parameters, benefit packages, and administrative procedures. The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) reauthorized the program through FY 2013, and includes many incentives for states to find and enroll more eligible children in both Medicaid and CHIP. CHIPRA also includes a number of quality provisions that aim to monitor and improve care delivered through the Medicaid and CHIP programs. Each state does have a CHIP program, and the names of these programs differ from state to state.

Children’s Health Insurance State Program Director
For the most updated contact, please refer to the CMS listing of CHIP Directors pdf download.

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Community Health Centers in the State
Federally-funded health centers care for you, even if you have no health insurance. You pay what you can afford, based on your income. Health centers provide checkups when you're well, treatment when you're sick, complete care when you're pregnant, immunizations and checkups for your children, dental care and prescription drugs for your family, mental health and substance abuse care if you need it. For a listing of CHCs in Pennsylvania, please use HRSA’s ‘Find A Health Center’ search engine.

Public Policy/Legislation

Association of Maternal and Child Health Programs (AMCHP) Pennsylvania State Profile pdf download
These state profiles provide a snapshot of how the Maternal and Child Health Block Grant works in specific states. The profiles detail the Federal funds appropriated to each state, state match, specific programs funded, numbers of people receiving services and state health needs.

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AAP Issue Brief: Implementing the Medical Home in Medicaid, CHIP, and Multistakeholder Demonstration Programs pdf download
(AAP Member access only)

The Medical Home Issue Brief serves to provide guidance to AAP chapters working with states to implement medical home projects in Medicaid and CHIP as well as multipayer demonstration programs. It also addresses a number of the policy questions that frequently arise in creating state supports for the medical home.

State Medical Home Data

Child Health Measurement Initiative (CAHMI) Medical Home Portal - Pennsylvania State Profile pdf download
These state profiles provide a state’s medical home performance level for all children or children with special health care needs, based on national survey data.

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National Adolescent Health Information Center (NAHIC) Adolescent Health Database
The NAHIC database includes national and state-level profiles of key measures of the health of adolescents and young adults, based on Healthy People 2010. Known as the Data Project, the online resource contains information on recent progress in key areas of adolescent health. National-level data is available by gender and race/ethnicity and also state-by-state, with summaries and data tables. The site also features information about data collection and presentation, state and national Excel files and guidance for using this data to improve the health of adolescents and young adults.

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2010 KIDS COUNT Databook
The Annie E Casey Foundation has released the 2010 Kids Count report. The annual Kids Count report is a national and state-by-state profile of the well-being of America's children that seeks to enrich discussions concerning ways to secure better futures for all kids. The 2010 Kids Count report data is available as an interactive databook, a complete PDF-format report PDF, and on request, in print. Data and rankings on 10 key indicators of child well-being are available by state, county, and city.

Other Resources

Pennsylvania Medical Home Initiative - Video on Medical Home

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Sample Forms:

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The Child Advocacy Project of Philadelphia
Within this site you will find a user-friendly, comprehensive listing of many social service agencies that exist to improve the lives of families that need our help the most. The Parent Handouts and sample advocacy letters are the backbones of this project. The Parent Handouts are broken down by category and within each handout; you will find a description of the social service agency, their address, and a phone number. You may also find a link to the agencies Web site that you can access and learn more about that agency. You may also download a PDA version of these handouts for quick access to the descriptions of various agencies and their contact information.

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