Speech-Language Pathologist Webinar Series: Comprehensive Communication Care. Webinar #2

Transcription

1 Speech-Language Pathologist Webinar Series: Comprehensive Communication Care Webinar #2

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, 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 GreenElisaN@sau.edu or

3 Collaboration and Continuity of Care in AAC Services T R I N I T Y D E I B E R T, M S CCC- SLP K E N D R A M C I N T U R F, M S CCC- SLP

4 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

5 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.

6 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

7 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

8 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

9 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

10 Values Driving this Model Prevention of AAC abandonment. new 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 procurement through supplier it is sink or swim. -MaryEllen Woodman, cals

11 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.

12 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

13 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

14 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

15 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

16 Home Health Funding, cont. It is a covered benefit! Guidance/Guidance/Manuals/downloads/bp102c07.pdf

17 Q.O.L. Impact Quality of life Unfinished business Verbalizing concerns Directing care Adorations

18 Hospice ST Services ADVOCACY! High Value of Service: Supporting hospice clinicians Meeting continued skilled needs of patient Demonstrate Fiscal Awareness Make the visits count!

19 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)

20 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.

21 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

22 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 Coordinator Home health services initiated User profile programming initiated Personal device received, user profile transferred to allow for immediate use

23 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

24 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.

25 Q & A? Trinity Deibert: Kendra McInturf:

26 A Few Resources webor.alsa.org/site/pagenavigator/or_8a_augmentativ e.html Listservs: alsa.simplelists.com/