scholarly journals Overview of States' Use of Telehealth for the Delivery of Early Intervention (IDEA Part C) Services

2012 ◽  
Vol 4 (2) ◽  
Author(s):  
Jana Cason ◽  
Diane Behl ◽  
Sharon Ringwalt
Keyword(s):  
Early Intervention ◽  
Service Delivery ◽  
Rural Areas ◽  
Service Delivery Model ◽  
Delivery Model ◽  
C Programs ◽  
Part C ◽  
Idea Part C ◽  
Provider Shortages

Background: Early intervention (EI) services are designed to promote the development of skills and enhance the quality of life of infants and toddlers who have been identified as having a disability or developmental delay, enhance capacity of families to care for their child with special needs, reduce future educational costs, and promote independent living (NECTAC 2011).  EI services are regulated by Part C of the Individuals with Disabilities Education Improvement Act (IDEA); however, personnel shortages, particularly in rural areas, limit access for children who qualify.  Telehealth is an emerging delivery model demonstrating potential to deliver EI services effectively and efficiently, thereby improving access and ameliorating the impact of provider shortages in underserved areas. The use of a telehealth delivery model facilitates inter-disciplinary collaboration, coordinated care, and consultation with specialists not available within a local community.  Method:  A survey sent by the National Early Childhood Technical Assistance Center (NECTAC) to IDEA Part C coordinators assessed their utilization of telehealth within states’ IDEA Part C programs.  Reimbursement for provider type and services and barriers to implement a telehealth service delivery model were identified.  Results:  Representatives from 26 states and one jurisdiction responded to the NECTAC telehealth survey.  Of these, 30% (n=9) indicated that they are either currently using telehealth as an adjunct service delivery model (n=6) or plan to incorporate telehealth within the next 1-2 years (n=3).  Identified telehealth providers included developmental specialists, teachers of the Deaf/Hard of Hearing (DHH), speech-language pathologists, occupational therapists, physical therapists, behavior specialists, audiologists, and interpreters.  Reimbursement was variable and included use of IDEA Part C funding, Medicaid, and private insurance.  Expressed barriers and concerns for the implementation of telehealth as a delivery model within Part C programming included security issues (40%; n=11); privacy issues (44%; n=12); concerns about quality of services delivered via telehealth (40%; n=11); and lack of evidence to support the effectiveness of a telehealth service delivery model within IDEA Part C programming (3%; n=1).  Reimbursement policy and billing processes and technology infrastructure were also identified as barriers impacting the implementation of telehealth programming.  Conclusions:  Provider shortages impact the quantity and quality of services available for children with disabilities and developmental delay, particularly in rural areas.  While many states are incorporating telehealth within their Early Intervention (IDEA Part C) services in order to improve access and overcome personnel shortages, barriers persist. Policy development, education of stakeholders, research, utilization of secure and private delivery platforms, and advocacy may facilitate more widespread adoption of telehealth within IDEA Part C programs across the country.

scholarly journals The Development of Statewide Policies and Procedures to Implement Telehealth for Part C Service Delivery

2016 ◽  
Vol 8 (2) ◽  
pp. 77-82 ◽  
Author(s):  
Beth Cole ◽  
Arlene Stredler-Brown ◽  
Becki Cohill ◽  
Kristina Blaiser ◽  
Diane Behl ◽  
...  
Keyword(s):  
Early Intervention ◽  
Service Delivery ◽  
Current Practice ◽  
Service Delivery Model ◽  
Part C ◽  
Disabilities Education Act ◽  
Policies And Procedures ◽  
Education Act ◽  
Provider Shortages ◽  
Part C Early Intervention

The use of telehealth has been discussed nationally as an option to address provider shortages for children, birth through two, enrolled in Part C of the Individuals with Disabilities Education Act (IDEA) Early Intervention (EI) programs. Telehealth is an evidence-based service delivery model which can be used to remove barriers in providing EI services to children and their families. In 2016, Colorado’s Part C Early Intervention (EI) program began allowing the use of telehealth as an option for providers to conduct sessions with children and their caregivers. This article outlines the process taken to develop the necessary requirements and supports for telehealth to be incorporated into EI current practice.

The Impact of Funding on Part C Systems: Is the Tail Wagging the Dog?

2018 ◽  
Vol 40 (3) ◽  
pp. 229-245 ◽  
Author(s):  
Cynthia O. Vail ◽  
Rebecca G. Lieberman-Betz ◽  
Laura S. McCorkle
Keyword(s):  
Online Survey ◽  
National Level ◽  
Quality Of Services ◽  
Children And Families ◽  
C Programs ◽  
Part C ◽  
Perceived Impact ◽  
Provider Shortages ◽  
The Impact

The purpose of this study was to examine the characteristics of Part C programs and how funding has impacted the quality of services for children and families given ongoing budgetary concerns. Perceptions of State Early Intervention Coordinators (EICs) regarding their state Part C systems were obtained through an online survey. Using survey research methods to collect and analyze data, two primary questions were addressed in the current study: (a) What are the general characteristics of Part C programs that may be related to fiscal issues? and (b) What is the perceived impact of funding on the quality of services for children and families? A majority of respondents indicated their state program implements a primary service provider model, relies heavily on medical funding streams such as Medicaid, and is experiencing provider shortages. In addition, respondents commented on quality, trends, and funding of their state Part C programs. The findings of this study provide insight about the general characteristics of Part C programs, along with the perceived impact of funding on Part C services at the national level for policy makers, administrators, professionals, and families.

scholarly journals The INCENTIVE study: a mixed-methods evaluation of an innovation in commissioning and delivery of primary dental care compared with traditional dental contracting

2016 ◽  
Vol 4 (18) ◽  
pp. 1-126 ◽  
Author(s):  
Claire Hulme ◽  
Peter Robinson ◽  
Gail Douglas ◽  
Paul Baxter ◽  
Barry Gibson ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Service Delivery ◽  
Primary Outcome ◽  
Dental Service ◽  
Service Delivery Model ◽  
Delivery Model ◽  
Related Quality ◽  
Health Related

BackgroundOver the past decade, commissioning of primary care dentistry has seen contract currency evolving from payment for units of dental activity (UDAs) towards blended contracts that include key performance indicators such as access, quality and improved health outcome.ObjectivesThe aim of this study was to evaluate a blended/incentive-driven model of dental service provision. To (1) explore stakeholder perspectives of the new service delivery model; (2) assess the effectiveness of the new service delivery model in reducing the risk of and amount of dental disease and enhancing oral health-related quality of life (OHQoL) in patients; and (3) assess cost-effectiveness of the new service delivery model.MethodsUsing a mixed-methods approach, the study included three dental practices working under the blended/incentive-driven (incentive) contract and three working under the UDAs (traditional) contract. All were based in West Yorkshire. The qualitative study reports on the meaning of key aspects of the model for three stakeholder groups [lay people (patients and individuals without a dentist), commissioners and the primary care dental teams], with framework analysis of focus group and semistructured interview data. A non-randomised study compared clinical effectiveness and cost-effectiveness of treatment under the two contracts. The primary outcome was gingivitis, measured using bleeding on probing. Secondary outcomes included OHQoL and cost-effectiveness.ResultsParticipants in the qualitative study associated the incentive contract with more access, greater use of skill mix and improved health outcomes. In the quantitative analyses, of 550 participants recruited, 291 attended baseline and follow-up. Given missing data and following quality assurance, 188 were included in the bleeding on probing analysis, 187 in the caries assessment and 210 in the economic analysis. The results were mixed. The primary outcome favoured the incentive practices, whereas the assessment of caries favoured the traditional practices. Incentive practices attracted a higher cost for the service commissioner, but were financially attractive for the dental provider at the practice level. Differences in generic health-related quality of life were negligible. Positive changes over time in OHQoL in both groups were statistically significant.LimitationsThe results of the quantitative analysis should be treated with caution given small sample numbers, reservations about the validity of pooling, differential dropout results and data quality issues.ConclusionsA large proportion of people in this study who had access to a dentist did not follow up on oral care. These individuals are more likely to be younger males and have poorer oral health. Although access to dental services was increased, this did not appear to facilitate continued use of services.Future workFurther research is required to understand how best to promote and encourage appropriate dental service attendance, especially among those with a high level of need, to avoid increasing health inequalities, and to assess the financial impact of the contract. For dental practitioners, there are challenges around perceptions about preventative dentistry and use of the risk assessments and care pathways. Changes in skill mix pose further challenges.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals The Impact of a Collaborative Consultation Service Delivery Model for Rural Deaf/Hard of Hearing Students

2019 ◽  
Vol 8 (5) ◽  
pp. 1
Author(s):  
Holly F. Pedersen ◽  
Ann Beste-Guldborg
Keyword(s):  
Service Delivery ◽  
Hard Of Hearing ◽  
Rural Areas ◽  
Self Efficacy ◽  
Case Study Research ◽  
Service Delivery Model ◽  
Collaborative Consultation ◽  
School Professionals ◽  
Delivery Model ◽  
The Impact

Educating students who are deaf and hard of hearing (D/HH) is complex; compounding this complexity is the situation in rural areas, where the incidence levels are lower, students are more spread out, and the availability of specialty staff is more limited. The purpose of this mixed-methods action research study was to examine the impact of a collaborative consultation (CC) service delivery model on the knowledge and self-efficacy of school professionals who serve students who are D/HH in rural areas. A case study research design was used on a team of 3 school professionals from a rural school in the Upper Midwest. Findings indicated that CC increased the knowledge and self-efficacy of school professionals serving rural D/HH students. Implications for social change pertain to education administrators, inservice educators, and D/HH students.

The treatment efficacy of multiple opposition phonological approach via telepractice for two children with severe phonological disorders in rural areas of West Texas in the USA

2018 ◽  
Vol 34 (1) ◽  
pp. 63-78 ◽  
Author(s):  
Sue Ann S Lee
Keyword(s):  
Service Delivery ◽  
Rural Areas ◽  
Speech Disorders ◽  
Service Delivery Model ◽  
Delivery Model ◽  
Phonological Disorders ◽  
West Texas ◽  
Speech Pathologist ◽  
The Usa ◽  
Production Accuracy

The goals of the present study were to (1) examine the effects of the multiple opposition phonological approach on improving phoneme production accuracy in children with severe phonological disorders and (2) explore whether the multiple opposition approach is feasible for the telepractice service delivery model. A multiple-baseline, single-participant design replicated across two children, was implemented. Two male children who resided in rural areas of West Texas in the USA participated. One child was 4 years and 10 months old and the other child was 6 years old. Both of the children were diagnosed with phonological disorders without any sensory, motoric, or intellectual disabilities. The children’s articulation was tested using Goldman–Fristoe Articulation Test-2 and probes were administered across the period of the study. The children received a 30-minute phonological intervention via telepractice twice a week for 12 or 16 weeks. An increasing trend for production accuracy for target sounds was observed during intervention for both children. Maintenance also was observed at 2-week and 2-month follow-ups. Standard scores from a standardized articulation test increased during posttest compared to pretest. The multiple opposition phonological approach can lead to improved speech production accuracy in children with severe phonological disorders. Telepractice may be an effective context for a phonological intervention approach as has been found for other domains of speech and language intervention and a useful service delivery model to underserved children with speech disorders who are unable to access a speech pathologist due to various circumstances.

Using the ImPAACT program with preschoolers with Down syndrome: a hybrid service-delivery model

2021 ◽  
pp. 1-16
Author(s):  
Erika M. Timpe ◽  
Jennifer Kent-Walsh ◽  
Cathy Binger ◽  
Debbie Hahs-Vaughn ◽  
Nancy Harrington ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Service Delivery ◽  
Service Delivery Model ◽  
Delivery Model
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