Presentations on community-based services, medically complex case management, hepatitis C, and pregnancy and oral health in people with disabilities at American Public Health Association conference

October 27, 2015

UMass Medical School experts will present on community-based services, pregnancy complications and oral health in individuals with disabilities at the American Public Health Association’s annual meeting and exposition Oct. 31 through Nov. 4 in Chicago.

Presentations by experts at UMass Medical School’s Commonwealth Medicine division will include access to new medications for hepatitis C, a satisfaction survey and overview of Community Case Management (CCM), falls prevention in individuals with intellectual disabilities, and pregnancy complications and birth outcomes in women with disabilities.

Monday, Nov. 2

Impact of Physical Disability on Women’s Experiences Throughout Pregnancy, Childbirth and Postpartum

Researchers found the most significant impact of physical disability was experienced by women during childbirth, when their disabling conditions, at times, impacted the mode of delivery, anesthesia and other aspects of care.

Linda Long-Bellil, PhD, JD, Center for Health Policy and Research, Commonwealth Medicine
Monika Mitra, PhD, Disability, Health and Employment Unit, Commonwealth Medicine
Suzanne C. Smeltzer, RN, EdD, FAAn, College of Nursing, Villanova University
Lisa Lezzoni, MD, MSc, Mongan Institute for Health Policy, Harvard Medical School

 

Pregnancy Characteristics and Birth Outcomes Among Women with Disabilities Identified Through Medical Claims

As with self-reported disability, disability identified through claims is associated with lower socioeconomic status, pregnancy complications and poor birth outcomes. Future analyses will compare self-reported disability with Access Risk Classification System disability categories and evaluate the association between specific disabling conditions, pregnancy risk and outcomes.

Karen Clements, ScD, Disability and Community Services, Commonwealth Medicine
Monika Mitra, PhD, Disability, Health and Employment Unit, Commonwealth Medicine
Jianying Zhang, MD, MPH,
Center for Health Policy and Research, Commonwealth Medicine

Access to New Medications for Hepatitis C for Medicaid Members

Sofosbuvir and simeprevir are highly effective for treating chronic hepatitis C, but are expensive. To better understand patient prioritization, the presenters examined characteristics associated with prior authorization requests for the two drugs among MassHealth, the Massachusetts Medicaid program, members with Hepatitis C.

Karen Clements, ScD, Disability and Community Services, Commonwealth Medicine
Robin Clark, PhD, Department of Family Medicine and Community Health, UMass Medical School
Pavel Lavitas, PharmD, BCPS, Clinical Pharmacy Services, Commonwealth Medicine
Parag Kunte, MPH, Center for Health Policy and Research, Commonwealth Medicine
Camilla Graham, MD, Division of Infectious Diseases, Beth Israel Deaconess Medical Center
Elizabeth O’Connell, MS, Center for Health Policy and Research, Commonwealth Medicine
Kimberly Lenz, PharmD, Office of Clinical Affairs, Commonwealth Medicine
Paul Jeffrey, PharmD, Office of Clinical Affairs, Commonwealth Medicine

Tuesday, Nov. 3

Exploring Health Disparities Among People with Intellectual and Developmental Disabilities: What are the Issues and Do Race and Ethnicity Play a Role?

This presentation will examine racial and ethnic health care disparities within national data, exploring trends in access, use, morbidity and mortality. The discussion will focus on root causes/social determinants of disparities for minority individuals with intellectual and developmental disabilities, and suggestions for future policy and programmatic action.

 Alexandra Bonardi, OTR/L, MHA, Eunice Kennedy Shriver Center, UMass Medical School
Valerie Bradley, MA, Human Services Research Institute, Cambridge

 

Identifying Effectiveness and Areas for Improvement in an Innovative Program Serving Medically Complex Individuals with Disabilities

CCM, a partnership between UMass Medical School and MassHealth, serves children and adults with complex and challenging medical conditions and disabilities. The program created a single point of entry for receiving coordinated services, enabling members to stay home while reducing the burden of care on families. A satisfaction survey conducted to monitor CCM’s effectiveness found high levels of satisfaction with the program, and identified ways to increase positive impact as CCM increases its member base.

Bittie Behl-Chadha, PhD, Office of Survey Research, Commonwealth Medicine
Kerri Ikenberry, RN, BSN, Disability and Community Services, Commonwealth Medicine
Susan Brown, MS, OTR/L, Disability and Community Services, Commonwealth Medicine
Theresa McGauley-Keaney, MPA, RRT, Disability and Community Services, Commonwealth Medicine
Carla Hillerns, MPA, MUP, Office of Survey Research, Commonwealth Medicine

Community Case Management: An Approach to Service Coordination for Medically Complex Individuals

Navigating and accessing community-based services and supports can be challenging for medically complex individuals and their caregivers. As health care organizations move to create person-centered systems of care, there are best practices they should keep in mind. Many of the best practices are evidenced through CCM. Those attending the presentation will learn about the CCM eligibility process, review demographic, populations and programmatic characteristics, and become familiar with the service coordination activities available to members.

 Kerri Ikenberry, RN, BSN, Disability and Community Services, Commonwealth Medicine

Developing the Evidence for Falls-Prevention Interventions in People with ID Living in Community Settings

People with intellectual disabilities experience a falls risk that is similar to the population over age 65, but at much younger ages. UMass Medical School researchers examined a clinical falls prevention-intervention targeted toward adults with intellectual disabilities living in community settings. Researchers will complete the analysis in May.

Courtney Dutra, MPA, Eunice Kennedy Shriver Center, UMass Medical School
Alexandra Bonardi, OTR/L, MHA, Eunice Kennedy Shriver Center, UMass Medical School
Emily Lauer, MPH, Eunice Kennedy Shriver Center, UMass Medical School

A Systematic Review of Oral Health Interventions to Reduce Disparities in Adults with Intellectual Disability: Results of a Novel Approach

Research consistently shows that people with intellectual and developmental disabilities experience poorer oral hygiene, higher prevalence and severity of periodontal disease, and higher incidence of untreated caries when compared to the general population. In a systematic review funded by the National Center on Birth Defects and Developmental Disabilities (NCBDD) at the Centers for Disease Control and Prevention (CDC), researchers evaluated evidence for a wide range of interventions that offer the potential to reduce those disparities. Interventions that were identified include: sedation, education and behavioral interventions for treatment and prevention, prevention strategies such as fluoride and chlorhexidine, and access issues related to financing and funding.

Christine Clifford, MHP, Eunice Kennedy Shriver Center, UMass Medical School
Alexandra Bonardi, OTR/L, MHA, Eunice Kennedy Shriver Center, UMass Medical School
Matthew Holder, MD, MBA, AADMD

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