Medical Homes in Virginia
 This page is designed to keep you informed about events and activities happening in Virginia that will help improve access to medical homes for children with special health care needs (CSHCN).

Medical Home Initiatives
This section provides information on state medical home initiatives/programs. States that are a part of the mentorship network will have a "Promise to the State" which outlines how they will achieve ensuring that all children have a medical home by 2010. This is based on the Healthy People 2010 goals which is a 10 year action plan to achieve and measure success for all CSHCN.

Virginia Medical Home Team Contact:

Name: Colleen A. Kraft, MD - Medical Home Plus
Contact: Phone: 804-559-0447 | Email: docmom3@aol.com

Virginia Medical Home Web site - Medical Home Plus, Inc.: www.medhomeplus.org/

Vision: To provide a leadership role in facilitating family, professional and community partnerships that improve the quality of life for all.

Mission: Medical Home Plus, Inc. facilitates access to supports and services for children and youth, especially those with special needs, and their families

Virginia was selected to be part of the National NICHQ Medical Home Learning Collaborative - A fifteen-month collaborative activity to improve care for the growing population of CSHCN. This initiative focused on 3 practices in the state and assisted them in completing a quality improvement process to provide medical homes to their patients with special needs. It also assisted in building the capacity of Virginia's CSHCN and other health department programs to support and extend this approach after the completion of the project period.

Through the National Medical Home Learning Collaborative, the practices and Medical Home Plus fostered a substantial relationship with the Title V program as part of the process was for Title V programs to develop the capacity to support the work of Collaborative teams and to increase understanding of community primary care practices.

Medical Home Plus promoted themselves as the premier resources to improve collaboration at the state and community level. They approached Title V, the AAP Chapter, Schools, and explained how they could partner and be a resource. The Medical Home Plus project is a model of community based health care that provides training, resources, technical assistance and support for children with special health care needs and their families. This project was able to be implemented through a grant partnership with United Way/Success by Six.

Update

Family/Youth Partnerships Champions Incentive Grant - Incentive Award FAQs
Goal: To develop strong, ongoing partnerships with YSHCN, families of CYSHCN, and other stakeholders and community agencies through the formation of one state advisory committee and six regional advisory committees at each of the Care Connection for Children centers (CCC). The state and CCC advisory councils will provide a vehicle to achieve system improvements for CYSHCN.|
For more information contact: Nancy R. Bullock, CHSCN Program
Phone: (804) 864-7706 | Email: nancy.bullock@vdh.virginia.gov

Related Grant Initiatives
This section provides information on current state grants that are working on medical home initiatives. This includes the grant abstract as well as key contacts for the grant.

Healthy Tommorrows for Children Grant 2002-2007
Child Health Integrated Cultural Outreach Services (CHICOS)
Purpose: The CHICOS project is building CHIP of Virginia’s capacity to meet the health and family support services needs of Limited English Proficient (LEP) children and their families. CHIP of Virginia is a statewide network of 11 local programs offering health-focused home visiting for families with young children (0–6 years). CHIP nurses and outreach workers offer health and developmental screenings for young children, help to enroll them in insurance programs, give referrals to medical and community services, and provide parent education. CHICOS allows CHIP to: (1) hire language minority home visiting staff, (2) translate CHIP documents; (3) mobilize foreign language materials so they are readily available to local CHIP programs and other groups serving children, and (4) train CHIP staffs in cultural competence. CHICOS will increase CHIP’s enrollment of language minority children by 88% over 5 years. Within 1 year of enrollment, at least 90% of these children will have a medical home and be fully immunized. For more information on this project go to: www.medicalhomeinfo.org/states/state /Downloads/Richmond,%20VA%202002.doc.

For more information on the Healthy Tomorrows Grant Program go to: www.aap.org/commpeds/htpcp/index.html For more information on HTPCP projects, please e-mail your name, address, telephone, and fax numbers with your specific request to healthyt@aap.org.

Partners in the State
This section provides information on who in the state (individuals and agencies) are working together to create medical homes for children.

American Academy of Pediatrics (AAP) Chapter: www.virginiapediatrics.org/

American Academy of Family Physicians (AAFP) Chapter: www.vafp.org/

Title V Children with Special Health Care Needs (CSHCN) Program: www.vahealth.org/specialchildren

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.

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.

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.

Name: Pat T. Dewey, M.Ed., Program Manager
Contact: Tel: 804-864-7713 | Fax: 804-864-7721 | Email: pat.dewey@vdh.virginia.gov

Infant and Toddler Connection - 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.

Name: Mary Ann Discenza, Part C Coordinator
Contact: Phone: (804) 371-6592 | Fax: (804) 371-7959
Email: maryann.discenza@co.dmhmrsas.virginia.gov
Web Site: www.infantva.org/default.htm

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:

Name: Phyllis Mondak, 619 Coordinator
Contact: Phone: (804) 225-2675 | Fax: (804) 371-8796 | Email: pmondak@mail.vak12ed.edu
Web Site: www.pen.k12.va.us/

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.

Name: Brenda Laws, ICC Chair
Contact: Phone: (757) 442-7599 | Fax: (757) 442-4578 | Email: luvdoves@intercom.net

Resources/Documents
State Waiver Information: www.cms.hhs.gov/MedicaidStWaivProgDemoPGI/08_WavMap.asp
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.

Educational Initiatives
This section provides information on training initiatives on the medical home. Some states will discuss their outreach projects in relation to physicians, families, and the community.

PEATC Events Calendar: www.peatc.org/calendar.htm
This calendar lists some, but not all, disability related events in or around the Commonwealth of Virginia.

Screening Initiatives
This section provides information on surveillance and screening initiatives in the state.

Developmental Surveillance and Screening Policy Implementation Project (D-PIP)
Alexandria-Lake Ridge Pediatrics from Alexandria, VA is participating in the Developmental Surveillance and Screening Policy Implementation Project (D-PIP). The D-PIP has selected 17 practices from across the United States to implement the AAP policy statement (scheduled for publication in July 2006) “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.

Additional information on the D-PIP is available at: www.medicalhomeinfo.org/screening/DPIP.html

State Newborn Screening & Genetics Programs: genes-r-us.uthscsa.edu/resources.htm

  • State Newborn Screening Program Links
  • State Genetics Program Links
  • Regional Genetics and Newborn Screening Collaborative Links
  • Newborn Screening State Contact Fact Sheet

Family Corner
Care Connection for Children Resource Directory www.vahealth.org/specialchildren/directory/health.asp
This directory, created for parents, children, health providers and community organizations, allows you to search a list of local and Virginia resources for contact information on various medical conditions, advocacy and support groups, insurance, community support organizations and public and private agencies providing services for children with special health care needs.

Information is available by locality (city, county, region, Virginia), medical condition, type of service and name of organization.

Early Hearing Detection & Intervention (EHDI) Information for Parents:
Description of EHDI Program www.medicalhomeinfo.org/screening/State/virginia.html

Family Voices: www.familyvoices.org/st/VA.htm
Partnering with professionals and families to advocate for health care services that are family-centered, community-based, comprehensive, coordinated and culturally competent.

NAMI of Virginia (National Voice on Mental Health):www.namivirginia.org/
Education, advocacy and support for persons with brain disorders (mental illnesses) and their families

Parent Educational Advocacy Training Center
www.peatc.org
The Parent Educational Advocacy Training Center assists the families of children with disabilities through education, information and training. PEATC has information on support groups, on-line resources, parent resource centers, and other helpful information. PEATC builds parent-professional partnerships to promote success in school and community life through:

  • Information and assistance to families in understanding and negotiating the education and service systems for their children with disabilities;
  • Training for families and professionals that model partnerships and encourage active learning; and
  • Collaboration with and technical assistance to schools, state and local agencies, parent resource centers and community organizations.

State Resources on the Internet: www.medicalhomeinfo.org/states/index.html#res

Note: The information provided on the state pages was submitted by the state medical home teams.As this is not an exhaustive list, please let us know if you have additions for your state resource page. You can contact us at: medical home@aap.org.

http://www.medicalhomeinfo.org/states/state /virginia.html

Last Updated August 10, 2006