Private and Public Partnerships Developed to Improve Services for Children with Special Health Care Needs (CSHCN) Presentation to 3rd International Conference on Patient and Family Centered Care Monday, July 30, 2007 by Marcia O’Malley Executive Director, Family TIES of Nevada Debra Wagler Health Program Manager, Nevada State Health Division

MISSION Nevada State Health Division promotes and protects the health of all Nevadans and visitors to the state through its leadership in public health and enforcement of laws and regulations pertaining to public health. Nevada Partners MISSION To increase the hope, confidence, and independence of people with disabilities and chronic health conditions of all ages and their circle of support through training, information, emotional support, and advocacy.

Nevada’s Services Landscape  Early Intervention Services  Public School Districts  Public Health Agencies  Community Service Organizations  Physicians and other medical service providers  Mental Health Service Providers  Public Assistance Agencies

 Pediatric Specialists  Mental Health Providers  Respite care  Child care  Dentists that accept Medicaid  Very few services in remote areas of the state Gaps

Why?  Tremendous population growth  24.9% change between 2000 and 2006  Distribution of the population

Why?  Lack of resources  Medicaid reimbursement process is cumbersome  Some caregivers have unrealistic expectations  Transient families  High turnover in education and medical professionals  Staff are overwhelmed  Language and cultural barriers

Survival of the Fittest Partnering is a necessity to meeting the needs! Partnering is a necessity to meeting the needs!

Meaningful Involvement Recruited for the Genetics Subcomittee Assisted with needs assessments Participated on hiring committees and RFP review panels

Partnerships for Information & Referral

Real Choice Systems Change Grantees  Office of Disability Services Personal Care Assistance  Medicaid HIWAA (Money Follows the Person)  Family TIES of Nevada Family to Family Health Information and Education Center  Nevada Bureau of Family Health Services Systems Change for CSHCN  Nevada Division of Aging Services Aging and Disability Resource Center

Medical Home Initiative  Family Centered Organizations  Nevada PEP (Parent Training Information Center)  Family TIES of Nevada  Northern Nevada Center for Independent Living  State Agencies: Title V, Medicaid,  Community Health Nurses  Medical providers  Hospital Associations  FQHC  Tribal clinics  University Departments  School of Social work and nursing school  Epidemiology  Office of Rural Health

Health Insurance Coverage  Statewide Governing Council  Regional Coalitions (Northern & Southern Nevada) Provides assistance and resources in the areas of:  Medicaid  Medicare  Private Insurance  The Uninsured

Early Period Screening, Detection, and Treatment  Community-based Organizations  Nevada PEP (Parent Training Information Center)  Family TIES of Nevada  Head Start  Great Basin Primary Care Association  State Agencies: Title V, Medicaid, DCFS, Welfare, Early Intervention Services, WIC  Community Health Nurses  Governor’s Council on Developmental Disabilities (SPAC)  Public  FQHC  Tribal clinic staff  Inter Tribal Council Network  Nevada Public Health Foundation  Private  Managed Care Organizations  Physicians

What worked? What didn’t?

Information & Referral STRENGTHS  Statewide collaboration  Cross promotion and referral  Draws on assets of each partner CHALLENGES  Requires cross training of all front line staff  Resource databases need to have current listings

Real Choice Systems Change Grantees STRENGTHS  Statewide collaboration on a management level  Shared resources CHALLENGES  Less involvement and support from state admin  Lack of sustainability plan

Medical Home Initiative STRENGTHS  Topic of Interest  Organizations identify benefit of participating  Cross referring  Shared tracking and monitoring system CHALLENGES  Status of medical home in Nevada  Lack of resources  Lack of education and awareness

Health Insurance Coverage STRENGTHS  Topic of Interest  Organizations identify benefit of participating  Cross referring CHALLENGES  Growing, transient population  Lack of resources  Lack of education and awareness

STRENGTHS  Resources are available  Organizations identify benefit of participating  Cross referring Early Period Screening, Detection, and Treatment CHALLENGES  Staff turnover  Keeping EPSDT a priority  Maintaining a statewide network

Common Elements for Success  A common goal!  Meaningfully involvement!  Everyone gets something out of it!

Contact Marcia O’Malley Executive Director, Family TIES of Nevada Toll-Free: Website: Debra Wagler Health Program Manager Systems Change for CSHCN, Bureau of Family Health Services, Nevada State Health Division Phone: Website: health.nv.gov/cshcn/CSHCN