LOCAL CHAMPIONS: DEVELOPING COMMUNITY EXPERTS IN DD

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LOCAL CHAMPIONS DEVELOPING COMMUNITY EXPERTS IN
DD

• Sharon Witemeyer, MD, Erin Bouquin, MD, Toni
  Benton, MD and Judy Liesveld, CNP
• Continuum of Care Project at the University of
  New Mexico Health Sciences Center, Albuquerque, NM

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Limited numbers of experts in Developmental
Disabilities

• 100 physician members of SDBP (Society of
  Developmental and Behavioral Pediatrics)
• 502 physician members AAMR
• 10 physicians in fellowship training
• 4 physicians in NM with formal training in DD

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DD EXPERTS

• In New Mexico there were a number of individual
  practitioners without formal training in
  developmental disabilities who were interested in
  the field.

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DD EXPERTS

• NW Judy Liesveld CNP
• NE Erin Bouquin M.D.
• METRO
• Sharon Witemeyer M.D. Toni Benton M.D.
• SE SW
• Kathy Burke M.D.

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CONTINUUM OF CARE PROJECT MISSION STATEMENT

• The mission of the Continuum of Care Project is
  to increase the capacity of New Mexicos health
  care system to provide lifelong quality health
  care for people with developmental disabilities
  and related chronic conditions.
• We do this by
• creating learning opportunities
• promoting best practice policies, and
• offering specialized developmental disabilities
  services

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EDUCATION OF MEDICAL STUDENTS AND RESIDENTS

• Seminars
• Case Studies
• Clinic Rotation
• Community Based Visits

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TECHNICAL ASSISTANCE TO PRACTITIONERS STATEWIDE

• Continuing Medical Education
• Information Regarding Community Resources
• Phone Consultation
• Consultations via Specialty Clinics
• Relevant Literature

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SUPPORT TO FAMILIES, CASE MANAGERS AND COMMUNITY
PROGRAMS

• Information and Referral
• Guidelines
• Training
• Specialty Clinics
• Consultation
• Mediation

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Overview of the New Mexico DD Service System

• After Early Intervention
• Transitions as children grow up.

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New Mexico Land of Enchantment

• 121,598 square miles--fifth largest state
• 390 miles North to South--350 miles East to West
• Elevation ranges from 2842 feet to 13,161 feet.
• Terrain varies from desert to mountains
• 1.5 million inhabitants

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The New Mexico Experience

• One of only two states lacking an ethnic majority
  in its population, New Mexico is comprised of
  many cultures. The original peoples are
  represented by 21 pueblos and tribes,
  alphabetically ranging from Apache to Zuni.
  Hispanic conquerors and settlers joined the
  Native Americans in this land, followed by the
  Anglos, who today represent less than half of the
  population.

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The New Mexico Experience

• In the past 400 years, New Mexico has been
  celebrated for its Indian clay pottery and for
  its contemporary ceramics and new materials--both
  abundant here today for its mineral and
  agricultural products, as well as its position as
  a growing leader in high-tech manufacturing as a
  source of spiritual inspiration and home to the
  hard-edge science of three national laboratories.

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The New Mexico Experience

• Say it another way from Billy the Kid to Robert
  Oppenheimer, from Lew Wallace to Georgia
  OKeeffe from then--to now.
• Peck, R. (1998). The New Mexico experience
  1598-1998 A confluence of cultures. Albuquerque,
  NM Sierra Publishing Group, Inc.

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One of Our Fifty is Missing

• Phoney Conversation
• After purchasing a discount phone card, Tony
  Francomano of Albuquerque called customer service
  to inquire about usage fees. When Francomano
  told the agent that he was from Albuquerque, she
  replied, You cant use the card in Mexico.

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One of Our Fifty is Missing

• Francomano tried in vain to convince the
  representative that New Mexico was part of the
  U.S., even telling her that we became a state in
  1912. That doesnt matter, the representative
  said. Its just like calling from Canada.
• From New Mexico Magazine/September 2000.

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NEW MEXICO NEW ENGLAND
Figure 1. Map of Relative Distances

• Figure 1. Map of Relative Distances

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LOCAL CHAMPIONS

• IDENTIFICATION PROCESS
• Trainees in Family Practice Residency program
  at UNM
• Toni Benton M.D. and Erin Bouquin M.D.
• Former Employees of Institution
• Sharon Witemeyer M.D. and Judy Liesveld CNP

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LOCAL CHAMPIONS

• IDENTIFICATION PROCESS
• Previous experience with DD population in
  private practice
• Kathy Burke M.D.
• Parent of an individual with a developmental
  disability
• Rick Madden M.D.

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SUPPORTING LOCAL CHAMPIONS

• EDUCATION
• CME
• Conference participation
• Purchase of Books and Journals
• DISTANCE LEARNING
• MEMBERSHIP IN PROFESSIONAL ORGANIZATIONS
• NETWORKING
• By telephone, e-mail, quarterly retreats

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LOCAL CHAMPIONS

• Regional health care providers with special
  interest in developing expertise in the field of
  developmental disabilities supporting the
  Continuum of Care mission.

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CONTINUUM OF CARE PROJECT

• MISSION
• The mission of the Continuum of Care Project
  is to increase the capacity of New Mexicos
  health care system to provide lifelong quality
  health care for people with developmental
  disabilities and related chronic conditions.

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LOCAL CHAMPIONS

• THE FOLLOWING SLIDES DESCRIBE A VARIETY OF
  TASKS/ASSIGNMENTS UNDERTAKEN BY OUR LOCAL
  CHAMPIONS

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LOCAL CHAMPIONS

• Consultation with Local Practitioners
• Telephone consultations
• Outreach Adult Special Needs Clinics
• (Albuquerque and Belen)
• Joint appointments with PCP
• Telemedicine consultations

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LOCAL CHAMPIONS

• Local consultation and evaluation of individual
  patients. This may be done in person in the
  individuals home, at the Regional Office, a
  Community Providers office or other setting. It
  may simply involve a chart review.

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LOCAL CHAMPIONS

• Consultation with teams, providers and community
  programs.
• Telephone calls
• Attending team meetings
• Researching specific topics in DD and
  providing information
• Presentations on specific topics in DD

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LOCAL CHAMPIONS

• Consultation with individuals with developmental
  disabilities, families and/or guardians of
  individuals with developmental disabilities.

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LOCAL CHAMPIONS

• Curriculum Development
• University of New Mexico Health Sciences
  Center, School of
  Medicine
• Nursing
• Community College Education

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LOCAL CHAMPIONS

• Local Presentations about DD
• Hospital Grand Rounds
• Community Provider Programs
• Schools
• EMS Academy
• NMDDNA (Nurses)
• Local Biomedical Ethics Committees
• Social Workers
• Special Education Students

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LOCAL CHAMPIONS

• Participation in Physician Resident Training
• Albuquerque
• Las Cruces
• Farmington
• Santa Fe

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LOCAL CHAMPIONS

• HDR
• Telemedicine

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LOCAL CHAMPIONS

• Participation in Continuum of Care research
  projects and presentations to National/Internation
  al Conferences
• YAI
• NADD
• AAMR
• AACPDM

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LOCAL CHAMPIONS

• ERIN
• Consultation with Local Practitioners
• Local Presentations on DD Topics

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LOCAL CHAMPIONS

• TONI
• Consultation with Teams, Providers, Individuals
  with DD, Families and Guardians
• Participation in Resident/Medical Student
  Training

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LOCAL CHAMPIONS

• Participation in Physician Resident Training
• Albuquerque
• Las Cruces
• Farmington
• Santa Fe

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LOCAL CHAMPIONS

• JUDY
• Curriculum Development
• Interaction/Consultation with State Regional
  Offices
• Telemedicine

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Curriculum Development

• Involvement in UNM Pediatric Residency Training
• UNM Bachelor of Science in Nursing Program
• Creating awareness--providing information about
  the state system and community programs,
  providing opportunity to work with individuals
  with DD and their families.

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LOCAL CHAMPIONS

• Interaction with State of NM Regional Offices
  (Long Term Services Division)
• Presentations to Regional Offices
• Attending Regional Office meetings
• Consulting on individual patients or answering
  questions regarding individuals with
  developmental disabilities

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Interaction /Consultation with State Regional
Office

• Collaboration with director, social worker,
  planners.
• Technical assistance to community agencies
• Educational presentations
• Information to families
• Networking at quarterly meetings

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Aspiration Pneumonia Project

• Purpose To identify and screen individuals with
  developmental disabilities at risk for morbidity
  and mortality related to aspiration pneumonia.
  To educate case managers, caregivers, nurses, and
  others to assess for aspiration risks and to
  assure safety with eating.
• Initiated by plaintiffs and other concerned
  individuals.

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Aspiration Pneumonia Project

• Collaborative Effort OT/PT, Nursing, Speech
  Language Pathologist--Observation of the
  individual eating, review of health records,
  interviews with caregivers--Screening tool used
  with written recommendations given.
• Workshops--Reducing Preventable Aspiration in
  People with Developmental Disabilities--videotapes
  made for statewide use.

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Telemedicine Opportunities

• Mental Health/Psychiatry Consultations
• SAFE Clinics (Supports and Assessment for Feeding
  and Eating) team at UNM collaborates with the
  local team and individual.

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Distance Education and Telemedicine Interactive
Televideo Network
Farmington San Juan College
Espanola Northern NM Community College
Los Alamos 3 sites UNM-Los Alamos LosAlamos
National Labs 2
Santa Fe GSA Simms Bldg.
Las Vegas 2 sites Las Vegas Medical Center and
Highlands University
Gallup UNM-Gallup
Albuquerque
UNM and UNM Health Sciences Ctr
Santa Rosa Guadalupe Health Services
Los Lunas UNM-Valencia
Public Dial-up Digital Network
Socorro NMIMT
Roswell 2 sites Eastern NM Medical Ctr and La
Casa de Buena Salud
Silver City WNMU
Alamogordo
Carlsbad NMSU-Carlsbad
Las Cruces 2 sites
NMSU Southwest Counseling Center
Legend
Uplink Transmitter
Video Conferencing Unit
Video Conferencing Bridge
Direct Connect Circuit
Dial-up Digital Network
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LOCAL CHAMPIONS

• SHARON
• HDR
• Outreach Adult Special Needs Clinic
• On-line Manual

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LOCAL CHAMPIONS

• Participation in Healthcare Decisions Resources
  (HDR) Committee
• Development of State Guidelines for Healthcare
  Decisions for Individuals with Developmental
  Disabilities, and
• Guidance to teams, families, guardians, community
  providers about end of life decisions and advance
  directives.

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LOCAL CHAMPIONS

• Development of On-line Manual for Direct Care
  Staff
• Your Healthcare Primer for Long Term Care
• http//star.nm.org/manual

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My Webs\CoC Manual\index.htm
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LOCAL CHAMPIONS

• QUESTIONS

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