Meeting 9 Notes
April 18, 2008
Welcome to the Child Health Advisory Committee Meeting!
Members Present: Dennis Cooley, Gerard Lozada, Mary Baskett, Mim Wilkey, Besty Hineman, Nick Rogers, Mary Ann Shorman, Leadell Ediger, Paul Getto, Vicki Hoffman, Penney Schwab (phone), Shannon Cotsoradis (phone)
Staff Present: Linda Kenney, Richard Morrissey, Connie Satzler, Lori Haskett, Sue Bowden
Guests Present: Jeffrey Colvin, Kallie Bechtold
*** Dick Morrissey - remarks on future topics and legislative updates
* BF initiative is at Governor’s office, she is considering. Will review and get back with us after veto session.
* Immunize Kansas Kids (IKK)
IKK – getting ready to implement.
Long list of strategies.
Dozen or so organizations have been involved.
Want to consider creating subgroup to CHAC that focuses on oversight of IKK implementation process.
Expect this (implementation) will be several years, will vary by nature of activity.
Management team for IKK
Is significant pot of money available from KHF to support this process. Management team is supporting process. Many are part of KDHE – including Sue Bowden. Will be responsible for 20 or so strategies. A number of others, other agencies, AAP, and others.
Number of workplans in place related to strategies. Subcommittee in CHAC oversight on implementationt. This group made up of representatives of CHAC.
Excited about this long-term plan. Think it is something that will benefit all kids in state. This is a big leap.
* Expanded newborn screening – another major initiative.
Core panel is starting in June/July. Broad panel – 51 – may expand at some point.
This group may be good group to provide policy oversight. Linkage to experts. This group could do larger policy discussion.
* Legislative handout. Dick reviewed status of various bills and explained how to read handout.
Checkmarks and funding is good news. A number of times a study was assigned to KHPA.
Dick highlighted new funding of interest to CHAC.
Not expecting veto session to be short - probably 2-week time frame.
A few other key bills:
- Immigration reform has not come out
- Abortion reporting requirements
- Graduated driver's license (moved for a while, stalled now, maybe next year)
- Food protection program moved from KDHE to Department of Agriculture. Big program. Inspects 10,500 restaurants, all school cafeterias, lots of activity. KDHE's concern was health issues, EPI issues remain at KDHE. Did get agreement with agriculture colleagues and got amendment in for this. Purpose of this program is to prevent human illness. Linkage with field staff, who will now be in another agency, is critical. This process is underway.
Will there continue to be contracts with counties for food service?
Yes, looking to maintain program the way it is structured now. Will be transferring all staff. Have 8 county contracts. They tend to be the largest counties.
*** Linda Kenney - newborn screening updates
See Linda's presentation with the meeting materials.
Kansas is one of 4 or 5 in nation that charges no fee to hospital or family. Kansas was going to be SGF funded, but funding source has changed. Also includes CIF (Children's Initiative Funds)
Linda is reviewing a diagram which, unfortunately is not in the powerpoint at the moment, but we will add this to the website or presentation (unless proprietary concerns prevent it).
[missed some of the questions]
training/follow-up - hospitals are receiving, batching. Should send them every day. Working with physicians to change this.
Dr. Colvin: In terms of disorders, time is brain cells for these children.
Want to make the 7 days for these samples.
Linda: Usually issue is death or mental retardation for disorders.
Dr. Cooley: As a rule, if there is a positive screening, we call family up and get things going.
Advisory council will be working on timeline issues.
Linda: QA, tightening up this process. We will be reviewing Nebraska's QA process at the next newborn screening advisory meeting. This is very complex, very daunting.
Mary: How can those of us who work with pregnant women help? What can we do?
Linda: Think it would be good to talk with pregnant women about this. Can order AAP brochures for free - they are good. March of Dimes also has nice parent education materials. Gives them good information so feel informed.
*** Dr. Lozada - Vision update.
At last meeting, Julie and Gary gave updates, getting children evaluated at age 3, why this needed to be done.
Started talking about working together on See to Learn, See to Play, possibly creating See to Learn and Play.
Maybe some of our committees shouldn't be separate, maybe they should be combined. Which committees should be organized in the future..
Externally some linkage between KDHE and See to Learn program. Think it is paying off. Think I'm seeing a difference in my practice.
*** Dr. Jeffrey Colvin
See presentation posted online.
Dr. Colvin brought example pediatric vs. adult medical equipment/supplies
IOM study (2007): found that only 6% of hospitals had recommended pediatric equipment. Less than half of hospitals without pediatric capabilities had transfer agreements.
No children's hospitals in Kansas. Children's Mercy South - but no Emergency Room.
Most hospitals in Kansas are CAH. 2/3 are rural.
EMSC Recommended equipment - bare bones essential equipment that needs to be in an ambulance. Pediatric-specific equipment - some is reusable, others are not reusable but inexpensive. Overall, this equipment is relatively inexpensive.
Continuing education - about 50% of states have pediatric emergency education requirements for recertification. KS has nothing. Have talked with EMTs and paramedics in Kansas - if one way to describe how they feel when pick up severely sick or injured child in Kansas - fear.
Need pediatric representative on Kansas Board of EMS. Almost all neighbors (basically all Midwest states except Nebraska) require this for their states.
Does Kansas Board of EMS support these policies? Basically, no.
Dr. Colvin read several quotes from EMS Board reassessment document - basically, the document by national experts was a very poor evaluation of Kansas' EMS Board.
How large a board?
15 members
How long is their appt?
2-3 years
Made the comparison that if have child representative on the board, will also need to have representation for certain racial minorities. ...no this is completely different. Caring for children is completely different than caring for adults.
Dr. Lozada - think it would be good if we could get additional information regarding the Board itself. Then, we can decide if our recommendation is along a legislative avenue or another direction.
Links for report and EMS board response to report will be posted on the CHAC website.
May need to start with more than children if the whole thing is broken.
Wonder about effectiveness of entire board...even though may be beyond scope of committee.
Now, concerned, even if they adopted these, considering the functioning of the board, may not do any good.
Another problem - if there is an organization versus a named individual on board, no continuity.
We can't look at one aspect, need to look at entire aspect if applicable. This may be one recommendation where we need to recommend that it needs fixed, in general.
Not sure it's so much money as completely disfunctional.
Not only look at pediatric position, but look at make-up of entire Board.
I wonder if Governor knows how bad things are?
Do we want to break into subcommittee for this?
Don't think we need to, everyone is in agreement. We all agree something is wrong.
Go ahead and make a recommendation versus the time it would take to wait until next meeting:
- See handout for exact recommendations on page 5.
Nick: Move to recommend to Govenor - 3 recommendations made by presentation with the addition of look at make-up & function of board be reviewed.
Additionally, may behoove the state to re-evaluate the makeup and function of EMS Board.
Paul: 2nd
All agreed. No opposition.
Reference written recommendation, IOM, NTSA, and funding.
Do not want to wait.
*** Future topics.
Originally charged with 4 topics. Have basically addressed those.
Continue to follow-up with EMSC.
Dr. Cooley reviewed future topics survey from last time.
Mary: Report on Mental Health in children was just completed.
Dr. Cooley: Could we tie in early childhood development?
Mary: all or just social/emotional...certainly that aspect could be tied in.
Nick: Rural - I'm familiar with the dental challenges, but are there challenges in other areas as well? Where are we? What is being done to address?
Access in rural areas - dental, medical.
Might be other problems in addition to access.
Dr. Cooley: Think access is actually the biggest thing.
Paul: Think Jerry Moran is working on this. Might be helpful to contact his office.
Mary Ann: Was thinking dental. Once you identify kids (in screening), what do you do with them?
Mary: Couple of major initiatives going on in Oral Health Kansas
Obesity/physical education: Had subgroup, meet with Fitness Council. Let's have a report on what happened with those recommendations.
Leadell: Just met with people who are very concerned of death of children in child care.
Think it would be helpful for group to hear presentation from them.
Child care as whole is a huge issue.
[missed a few comments]
Possible topic: Quality initiatives that support child care. Leadell could provide information on this.
Is everyone comfortable with structure of meeting?
- Yes.
Gerard: I really like the expert presenters that come in. Think it is good to continue to get this quality of information.
Leadell: Deaths in child care is a real issue. In this year's legislative session, talked about increasing number of children in facility from 10 to 20 - setting ourselves up for worse situation. We can get information like this and become advocates.
Do think we've made good recommendations and had some impact.
Leadell: Another success is newborn screening.
Friday afternoon meeting dates seem okay. Let everyone know a few months ahead of time.
Future topics:
- (4) quality initiatives that support child care
- (1) mental health (Mary Baskett)
- (2) dental
- (3) rural health access
- early childhood development - with mental
- Immunize Kansas Kids - FU as needed
- newborn screening expanded panel (to 51) - FU as needed
(#) represents plan on order to address based on timeliness, convenience, availability of materials, etc.
** Adjourned. **
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