speech-language pathologist webinar series: comprehensive ...€¦ · kendra mcinturf, ms ccc-slp...
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Speech-Language Pathologist Webinar Series:
Comprehensive Communication Care
Webinar #2
Continuing Education Information
• This webinar series meets the ASHA CE standards.
• Attendees must view at least 2 of the 3 webinars scheduled in 2017 to receive
any credit.
• Attendees must pass the post-test evaluations with 75% accuracy and
complete a satisfaction survey for each webinar to receive any credit.
• 2 courses equals .3 CEUs/3 contact hours – 3 courses equals .45 CEUs/4.5
contact hours.
• Due to this being a series, the certificate of attendance for the 2017 webinars
will only be awarded after December 31, 2017.
• The CEU process for this series is self-reporting. Please retain a copy of the
certificate of attendance in the event that you are audited by either ASHA or a
licensure board.
• CEU questions? Contact Elisa Green, Iowa Speech-Language Hearing
Association, at [email protected] or 563-333-3929.
T R I N I T Y D E I B E R T , M S C C C - S L P
K E N D R A M C I N T U R F , M S C C C - S L P
Collaboration and Continuity of Care in AAC Services
Authors
Trinity Deibert, MS CCC-SLP
AAC Specialist with Providence Home and Community Services
Kendra McInturf, MS CCC-SLP
AAC Specialist with Providence Home and Community Services, former AT Services Coordinator with the ALS Association OR and SWWA Chapter
Collaboration and Continuity of Care in AAC Services
Model of AAC service delivery which
Was formed by and represents a partnership between the Oregon SW Washington ALSA Chapter, the Providence ALS Center, and the Communication Specialty Team with Providence Home Health.
Promotes continuity of care
Avoids AAC abandonment
Supports PALS in their ability to communicate from diagnosis to end of life.
Collaboration and Continuity of Care in AAC Services
Agenda
Program Evolution
Benefits and Limitations
Home Health Funding
Hospice AAC Services
Mentorship and Training
Case Studies
Program Evolution
2002, Oregon and SW Washington Chapter launched. Third hired staff member is an SLP.
Home visits, evals, loan equipment program, Portland Providence ALS Clinic
Second Evolution:
Increase in number of PALS (people w/ ALS) served. AT (Assistive Technology) Coordinator no longer able to provide number of follow-up visits necessary
Home health services partnership initiated to address outlying PALS
AT Coordinator provided mentorship to community clinicians
Program Evolution, cont.
Third Evolution:
Continued growth in number of PALS served prohibited AT Coordinator from being primary evaluation provider
PALS referred to outpatient services and home health for evaluations and treatments
Providence ALS Clinic director requests new position to address PALS AAC needs in home health and outpatient
2015, Home Services AAC Specialist position created
Program Evolution, cont.
Current Evolution: AT Coordinator:
Early and ongoing education ALS Clinics Home visits
Equipment demo Equipment loan Support for community clinicians Referral network
Home Services AAC evaluations Funding Implementation Ongoing Support
Values Driving this Model
Prevention of AAC abandonment.
“SLP contributes toward the order of communication
device. All instructions of device use done by sink, swim, vendor or support from others in ALS community…. Of course, when the device is procured through a loaner closet or other means outside of a
new procurement through supplier it is sink or swim.”
-MaryEllen Woodman, cALS
Values Driving this Model
Providing communication support throughout the disease progression.
“Support for devices and on going training is lacking,
to say the least. Evolving needs of pALS, as the disease progresses and needs change - is NOT addressed and simple tech trouble-shooting is left to the pALS & cALS& advocates within the community.”
-Elizabeth Chapoton, cALS
Empowering PALS to be in the driver’s seat of their care.
Values Driving this Model
Maintaining connections with family, friends, healthcare providers and community.
“When an insurance provider refuses coverage the SLP
typically does not invest the effort to challenge a denial expecting the patient to just accept a denial.”
-MaryEllen Woodman, cALS
Values Driving this Model
Improving healthcare and personal safety.
“Living in this hospital without communication would be deadly. I am able to manage my care with it and keep caregivers from making me a victim most of the time. Most of my injuries in the last decade happened when my computer wasn’t available to me (leg broke, ligament damage to knee, severe sprained finger, cyst opened on abdomen without numbing, nerve damage to an arm from scalpel incision without numbing site of cut).”
-Ron Miller, pALS
Benefits and Limitations of Model
Benefits
Continuity of care
High level of skilled support (not just ST!)
Individualized treatment v. cookie cutter
Resources and equipment availability
Low occurrence of abandonment
Limitations
Requires multiple collaborative and proficient professionals
Requires leadership support
Requires equipment resources
Home Health Funding
There is a skilled need in our communities
Drives the interdisciplinary team and comprehensive care
Increased eyes-on/spreading workload
No patient that has a higher need!
Maintenance v. frequent care plan change d/t progression
Improve or maintain patient outcomes/star ratings!
Increased number of visits/avoiding LUPAs
Home Health Funding, cont.
It is a covered benefit!
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c07.pdf
Q.O.L. Impact
Quality of life
Unfinished business
Verbalizing concerns
Directing care
Adorations
Hospice ST Services
ADVOCACY!
High Value of Service:
Supporting hospice clinicians
Meeting continued skilled needs of patient
Demonstrate Fiscal Awareness
Make the visits count!
AAC Training and Mentorship
ALSA Informational/Handout Packets
ALSA Sponsored Trainings
Covisits
Listservs and resource-sharing
Network of AAC-savvy SLPs
Continuing Education
ISAAC
SIG 12, Augmentative Alternative Communication
A lot of good websites! (See final slide for list of resources)
Future Directions
Telemedicine issues
Inpatient access and support
Further develop eval/demo/lending equipment library
Offer education to affiliated medical staff to ensure effective communication with users of AAC
Develop better system for data tracking to demonstrate efficacy.
Case Study 1: Leslie
Seen at ALS Clinic by AT Coordinator: introduced device
AT Coordinator completed home visit for demo
Home health services completed evaluation and funding paperwork
Patient referred to hospice, referral deferred by patient to allow for AAC delivery
Home services completed a few number of sessions with the goal of becoming functional
Transition to hospice
Home health AAC visits completed while on hospice to develop proficiency
Case Study 2: David
AT Coordinator completed home visit, set up loaner device for demo and training With expectation that patient would receive immediate outpatient
services
Outpatient evaluation Patient unable to return to outpatient clinic, began to experience
difficulty due to lack of support
AT Coordinator home visit for further demo/training Funding report completed by outpatient SLP and AT
CoordinatorHome health services initiated
User profile programming initiated Personal device received, user profile transferred to allow for
immediate use
Case Study 3: Suzanne
Patient was receiving home health AAC services
Device funding initiated
Patient allowed insurance to lapse
AT Coordinator provided support to patient while uninsured
Insurance reinstated
Patient returned to home health AAC services
Received personal device
Patient continued to receive AAC support through hospice
Case Study 4: Monty
2012:AT Coordinator completed home visits for AAC eval and ongoing support
2014: Transitioned to Home Health, was assigned a community SLP without a strong AAC background
Patient self-advocated to be seen by the home health AAC specialist
2014-present: Weekly/biweekly visits from Home Health AAC Specialist for skilled services to support patient’s ongoing and complex AAC access.
A Few Resources
www.alsa.org/als-care/augmentative-communication/ webor.alsa.org/site/PageNavigator/OR_8a_augmentativ
e.html www.amyandpals.com www.isaac-online.org www.asha.org/SIG/12/ www.ohsu.edu/xd/research/centers-institutes/institute-
on-development-and-disability/reknew/index.cfm Listservs:
alsa.simplelists.com/ www.qiat.org/ http://www.resna.org/listserves