Medical Home Competencies for LEND Trainees
LEND programs operate within a university system, usually as part of a University Center for Excellence (UCEDD) or other larger entity, and collaborate with local university hospitals and/or health care centers. This set-up gives them the expert faculty, facilities, and other resources necessary to provide exceptional interdisciplinary training and services. There are currently 39 LENDs in 32 states and the District of Columbia. Collectively, they form a national network that shares information and resources and maximizes their impact. They work together to address national issues of importance to children with special health care needs and their families, exchange best practices and develop shared products. They also come together regionally to address specific issues and concerns. LEND programs grew from the 1950s efforts of the Children's Bureau (now the Maternal and Child Health Bureau) to identify children with disabilities as a Title V program priority. They are currently funded under the 2006 Combating Autism Act and are administered by the Health Resources and Service's Administration's (HRSA) Maternal and Child Health Bureau (MCHB). While each LEND program is unique with its own focus and expertise, they all provide interdisciplinary training, have faculty and trainees in a wide range of disciplines, and include parents or family members as paid program participants or staff. They also share the following objectives:
But there is more to a medical home than these three areas. Medical home competencies were written in order to ensure that LEND trainees have an understanding of, appreciation for, and experience in the medical home model of practice. These competencies focus on the parts of a medical home that do not overlap with general LEND instruction With the support of the Maternal and Child Health Bureau (MCHB), a group of LEND directors and staff from the AAP National Center for Medical Home Implementation began working on the development of medical home competencies in January 2009. After examining LEND curricula, existing LEND competencies in Maternal Child Health Leadership, and AAP documentation on the medical home the group was confident that through basic LEND instruction, LEND trainees are able to achieve a high level of understanding and competency in the areas of greatest conceptual and curricular overlap:
Setting these areas aside, we found three competency areas that are unique to the medical home and where trainees would benefit from additional instruction. These areas are
Medical Home experts from the AAP and LEND Directors will be surveyed to examine the competency areas for gaps and overlap. They will be asked to suggest activities that will ensure trainees in both primary health and allied health professions understand and demonstrate the ability to implement medical home concepts in their career. The small group will then synthesize the suggested activities and complete this document. Beginning in the fall of 2009, the “Medical Home Competencies for LEND Trainees” document became available to all LEND programs to test and pilot locally. Suggestions will be requested in the summer of 2010, and revisions will be made accordingly. It is the workgroup’s goal that a final set of medical home competencies for LEND trainees will be available in the fall of 2010, as LEND programs revise their curricula in preparation for a new five-year federal funding cycle that begins in the fall of 2011. |
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Leadership Education in Neurodevelopmental and Related Disabilities (LEND) programs provide long-term, graduate and post-graduate level interdisciplinary training as well as interdisciplinary services and care. The purpose of the LEND training program is to improve the health of infants, children, and adolescents with disabilities. This is accomplish by preparing trainees from diverse professional disciplines to assume leadership roles in their respective fields and by insuring high levels of interdisciplinary clinical competence.
LEND curricula and the medical home model intersects in many areas, namely interdisciplinary teamwork and service provision, family centered care, cultural competency, and leadership in policy and advocacy. These are things all LEND trainees are well versed in, regardless of their discipline, area of emphasis, or degree level. Because these areas are also the core areas of a medical home, many LEND trainees are going on to use the basics of a medical home model in their careers, even though it may not have been labeled “medical home training” during their coursework. 