Partnering withPartnering withSchool Nurses in the School Nurses in the

Medical Home Medical Home

Critical Issues in School HealthCritical Issues in School HealthMay 20, 2010May 20, 2010

Sandra Carbonari, M.D., FAAPSandra Carbonari, M.D., FAAPRenae Vitale, LCSWRenae Vitale, LCSWMegin Coleman, BSNMegin Coleman, BSN

Northwest CTNorthwest CTMedical Home InitiativeMedical Home Initiative

American Academy of American Academy of PediatricsPediatrics

Division of Children with Special Needs

The National Center of Medical Home Initiatives for Children with Special Needs

Children and Youth with Children and Youth with Special Health Care Special Health Care NeedsNeeds

Children (0-21 yrs) who exhibit or are expected Children (0-21 yrs) who exhibit or are expected to exhibit symptoms of a chronic illness for 12 to exhibit symptoms of a chronic illness for 12 months.months.

Chronic illness is defined as a medical, Chronic illness is defined as a medical, developmental, behavioral or emotional developmental, behavioral or emotional condition that requires care and related condition that requires care and related services of a type or amount beyond that services of a type or amount beyond that required by other children of the same age.required by other children of the same age.

CT Medical Home InitiativeCT Medical Home Initiative

Funding Sources:Funding Sources:

Maternal and Child Health BureauMaternal and Child Health BureauAuthorized under Title V of the Social Security ActAuthorized under Title V of the Social Security Act

Part of the U.S. Department of Health and Human Services, Part of the U.S. Department of Health and Human Services,

Health Resources and Services AdministrationHealth Resources and Services Administration

CT State Department of Public HealthCT State Department of Public Health

Medical Home InitiativeMedical Home InitiativeNorthwest CTNorthwest CT

The Core TeamThe Core Team

Project DirectorProject Director

Care CoordinatorsCare Coordinators

Parent PartnerParent Partner

Physician ChampionPhysician Champion

PC-MHPC-MH Patient –Centered Medical HomePatient –Centered Medical Home

An approach to providing An approach to providing comprehensive primary care for comprehensive primary care for children, youth and adultschildren, youth and adults

A health care setting that facilitates A health care setting that facilitates partnerships between individual partnerships between individual patients, and their personal patients, and their personal physicians, and when appropriate, the physicians, and when appropriate, the patient’s family.patient’s family.

Medical Home Definition

Primary care Family-centered partnership Community-based, interdisciplinary,

team-based approach to care Preventive, acute and chronic care Quality improvement

Medical home care is:

Accessible Family centered Coordinated Compassionate Continuous Culturally effective

Medical Homes: Integrated Health System

Patients and Families Primary Care Physicians Specialists and subspecialists Hospitals and Healthcare Facilities Public Health Community

Joint Principles of theJoint Principles of thePatient-Centered Medical HomePatient-Centered Medical HomeMarch 2007March 2007

American Academy of Family American Academy of Family PhysiciansPhysicians

American Academy of PediatricsAmerican Academy of Pediatrics American College of PhysiciansAmerican College of Physicians American Osteopathic AssociationAmerican Osteopathic Association

Medical Home Joint Principles

Personal physician Physician directed medical practice Whole person orientation Care is coordinated and/or integrated Quality and safety are hallmarks of a medical

home Enhanced access to care Payment appropriately recognizes the added

value

www.medicalhomeinfo.org

What we know about medical home care:

Family satisfaction increases Provider satisfaction increases Reduced ED use Reduced hospital days Reduced redundancy Reduced cost of care per child (CCHAP) Increase in immunization rates and

preventive care visits (CCHAP)

…and it is the kind of

quality health care that we all

want, need and deserve

for ourselves

and our families.