Success in Minimizing LosstoFollowup Hallie W Morrow M

Success in Minimizing Loss-to-Follow-up Hallie W. Morrow, M. D. , M. P. H.

Challenges in California • Size • Diversity • Mobility

Size • Population of California • 34, 000 • Population of Los Angeles County • 9, 500, 000 • Population of Alpine County • 1, 200

Size • 540, 000 Births per year • 320 Birthing hospitals • Largest – 7300 deliveries • Smallest – 60 deliveries

Diversity • Geographic • Race/ethnic • Linguistic

Geographic Diversity • Large metropolitan areas

Geographic Diversity • Large metropolitan areas • Agricultural areas

Geographic Diversity • Large metropolitan areas • Agricultural areas • Mountains

Geographic Diversity • Large metropolitan areas • Agricultural areas • Mountains • Desert

Geographic Diversity • Large metropolitan areas • Agricultural areas • Mountains • Desert • Coastal

Race/Ethnic Diversity • 47% Non-Hispanic White • 32% Hispanic • 11% Asian/Pacific Islander • 6% African American • 1% American Indian • 3% Other

Linguistic Diversity • 33% of Californians speak a language other than English in the home • 20% of Californians have Limited. English-Proficiency • 50% of low-income Californians have a primary language other than English.

Linguistic Diversity • 1, 570, 000 students speak a language other than English in the home • 105 languages are spoken in Fresno County schools

Mobility • Urban • Migrant workers • Mexican border

Infrastructure

Infrastructure • Interwoven with the Title V CSHCN and the EPSDT programs • Inpatient and outpatient provider standards • Hearing Coordination Centers • Single point of referral to IDEA Part C

Hearing Coordination Centers • Serve specific geographic areas • Certify and re-certify hospitals as meeting standards • Collect data • Track appointments for individual infants

Hearing Coordination Centers • Contact providers if no results are received • Refer to local EPSDT program if infant no shows appointments or provider cannot contact the family

Hearing Coordination Centers • Generate correspondence to infant’s PCP • Contact all families of infants identified with hearing loss

Hearing Coordination Centers • Assure referral to EI has been made • Quality assurance monitoring

Referral to Early Intervention • Created single point of referral for all California children 0 -3 years of age with a hearing loss

Data Management • No statewide data management system • Each HCC developed Access database • All information and results infant reported on paper reporting forms

California Program Data 2004 (Preliminary) 175 Hospitals participating

California Program Data 2004 (Preliminary)

California Program Data 2004 (Preliminary)

California Program Data 2004 (Preliminary)

Summary • Infrastructure! • Receive and review individual infant data in real time • Take action if not getting appropriate services