Birth Defects Follow-up Manual for Local Public Health
Contents
1. may be requested for a case The case will then go off your workflow and be closed 20 MDH DEPARTMENT oF HEALTH Protecting maintaining and improving the health of all Minnesotans Appendix 1 Birth Defects Contact Information Barbara Kough Operations Coordinator MEDSS Help Email Barbara Kough state mn us health medss state mn us 651 201 5631 Birth Defects General Email Address Karen Peterson HEALTH birthdefects state mn us Nurse Specialist Karen peterson state mn us 651 201 3585 Important MDH Websites EHDI and Birth Defects website for Local Public Health Contains forms training materials tools and resources for LPH http www health state mn us divs cfh program cyshn Iph cfm Birth Defects Monitoring and Analysis Program http www health state mn us divs cfh program cyshn bdmaintro cfm Children and Youth with Special Health Needs http www health state mn us divs cfh program cyshn MEDSS login https apps health state mn us medss login do Find a local Health Department or Community Health Board http www health state mn us divs opi gov find 21 Appendix 2 Timeline of Birth Defects Follow Up by Local Public Health Agencies 2010 2014 85 counties sign New LPH wizard for reporting in MEDSS 22 Appendix 3 Conditions included in the Minnesota Birth Defects Information System 2013 births The Minnesota Department of Health MDH tracks 46 different birth2. 90 Days contains all low acuity cases assigned to your county with in the last 90 days There is no reimbursement for completing follow up for these cases e BD LPH Request Address Check contains cases for which MDH has requested your assistance in locating a more recent address for a family so MDH can resend the parent letter packet For detailed information on how to access the case status workflows in MEDSS refer to the BD HL MEDSS User Manual MEDSS Tracking Reports The MEDSS tracking reports are available to you in MEDSS as another way to help you to track the cases that have been sent to you There are two different ways you can track cases by sent date or by completed date Sent date is the date you were notified of the case by MDH e Completed date is the date MDH reviewed a case you indicated was complete and determined that all necessary follow up had been completed Detailed instructions on how to create these reports in MEDSS can be found in the BD HL MEDSS User Manual 16 MDH DEPARTMENT oF HEALTH Protecting maintaining and improving the health of all Minnesotans Invoicing for Completed Birth Defects Follow up and Trainings Invoicing for the Birth Defects program is done on a quarterly basis and is done in conjunction with the EHDI program You only need to fill out one invoicing form for work completed for EHDI and Birth Defects and for any trainings completed within the invoicing period The quarterly
3. DEPARTMENT oF HEALTH Protecting maintaining and improving the health of all Minnesotans Documenting Your Follow up in MEDSS When you have completed your follow up with the birth defects cases you will need to report the outcome of your follow up to MDH using MEDSS The Birth Defect Local Public Health Wizard is divided into sections The first three sections are Child s Information Child s Diagnosis and Contact Information Parent Guardian These sections display background information you will need for follow up They include child s age and birth information diagnostic information collected from the medical records that were reviewed acuity and any comments from MDH Any contact information we have collected on the parent or guardian is also provided to assist with follow up If you become aware of a change in guardianship we ask that you provide the name and contact information in the comments box within the wizard and contact a birth defects staff about the changes and updates A birth defects staff will then enter the changes within MEDSS To be reimbursed for medium and high acuity level cases you will need to complete the following sections within the Birth Defect Local Public Health Wizard e Health Care Information optional o Does the child have a primary care provider o Primary care providers name o Primary care providers clinic o Type of insurance the child currently has e State and Local Services o Is this the
4. Epidemiologists Review abstract and If clarification is needed verify coding gt flag for MD Review Surveillance nurse Surveillance nurse ORB Letter is returned to sender Last updated 8 2013 Appendix 6 Letter sent to parents of children with birth defect DATE ADDRESS CITY MN ZIP Dear Parent s of CHILD S NAME Public health s goal is to help all children thrive grow and be as healthy as possible To do this the Minnesota Department of Health MDH collects information about certain health conditions that are present from birth MDH works closely with hospitals and clinics to find children with these health conditions Collecting this information helps to look for causes and may help prevent them in the future Some of these health conditions are very serious but many are not The MDH recently learned your child has or had one of these conditions You may be surprised to be hearing from us especially if your child s condition is minor Your local health department may contact you about educational financial or support services in your area You may also call MDH toll free at 1 800 728 5420 to speak to a nurse about your child and available resources Once you know what is available you decide which services may be helpful for your child and family The law allows MDH to collect information about these health conditions and strictly protects the information that is collected The law also allows you to r
5. and your address and phone number The information is always kept secure and only a minimum number of program staff can access it so if you don t mind us keeping the information no response is necessary Appendix 8 HIPAA HIPAA and Medical Information Related to the Birth Defects Information System Disclaimer of Legal Advice The following is Minnesota Department of Health MDH analysis of how Minnesota Statutes sections 144 2215 to 144 2219 interact with the Health Insurance Portability and Accountability Act HIPAA Privacy Rule 45 CFR parts 160 and 164 This is not legal advice and you should not rely on it as legal advice Consult with a lawyer for legal advice Does the Health Insurance Portability and Accountability Act HIPAA permit disclosure of specific patient medical information related to birth defects to MDH and contractors working on behalf of MDH including local public health agencies without patient authorization Answer The Minnesota Department of Health has concluded that HIPAA permits a provider and or the provider s medical records department or staff to disclose a patient s medical information pertaining to birth defects in accordance with Minnesota Statutes sections 144 2215 to 144 2219 without the patient s authorization This conclusion is based on review of the HIPAA Privacy Rule available on the website of the U S Department of Health and Human Services DHHS http www hhs gov ocr privacy hipa
6. been assigned to them Tracking reports sent No Use MEDSS Workflows Yes monthly for hearing screening follow up Invoicing reports sent No Use MEDSS Workflows Yes quarterly for hearing screening follow up Invoicing frequency High volume agencies can invoice monthly at least quarterly High volume agencies can invoice monthly at least quarterly Parent Letter Opt Out Yes No MEDSS Birth Defects EHDI Data Entry Wizards Wizard Local Public Health Local Public Health New Address Request Tasking Yes No Updating Addresses For New Address Requests used to resend Updating addresses is part of the normal parent letter use separate Workflow and Wizard If new address identified during normal LPH follow up update address on Persons tab follow up for hearing loss cases Update address on Persons tab Acuity assigned to case Yes No Workflows Cases ready to invoice Yes Yes Cases waiting for MDH Review Yes Yes Documentation Not Completed Yes Yes Low Acuity Cases in Last 90 Yes No Days Request Address Check Yes No 24 Appendix 5 Birth Defects Process Flow Chart Note All steps are completed by MDH Birth Defects program staff except the blue boxes where LPH Key Contacts are indicated Receive Case Reports from Vital Records Epidemiologists Receive abstracts from Mayo
7. conditions in Minnesota children Many of these conditions are very severe Other conditions are not life threatening and may be repaired shortly after birth or resolve on their own These conditions might not be commonly referred to as birth defects Cardiac Conditions Heart Conditions Aortic Valve Stenosis Atrial Septal Defect ASD PFO Coarctation of the Aorta Common Truncus Ebstein s Anomaly Endocardial Cushion Defect AV Canal Hypoplastic Left Heart Syndrome Patent Ductus Arteriosus PDA Pulmonary Valve Atresia and Stenosis Single Ventricle Tetralogy of Fallot Transposition of the Great Arteries Tricuspid Valve Atresia and Stenosis Ventricular Septal Defect VSD Total anomalous pulmonary venous return TAPVR Central Nervous System Conditions Brain Spine Conditions Anencephalus Encephalocele Hydrocephalus Microcephalus Spina Bifida Chromosome Conditions e Down Syndrome e Trisomy 13 e Trisomy 18 Ear Conditions e Anotia Microtia Eye Conditions e Aniridia e Anophthalmia and Microphthalmia e Congenital Cataract Last updated 8 2013 Gastrointestinal Conditions Stomach Esophagus Intestinal Liver Conditions Biliary Atresia Esophageal Atresia Hirschsprung s Disease Pyloric Stenosis Rectal and Large Intestinal Atresia Stenosis Genitourinary Conditions Genital Urinary Kidney Conditions Bladder Exstrophy Hypospadias Obstructive Genitourinary Defect Renal Agenesis
8. first time your agency has been notified about this child Medicare Medical Assistance TEFRA MinnesotaCare WIC Follow Along Program Parent to Parent or Family Support Organizations o Did you discuss any other programs services optional e Federal Programs Early Intervention Part C SSI o Early Intervention Part C o SSI e LPH Follow up Information o What tier you would like to be reimbursed for depending on the choice other options will drop down which must be filled out such as checked all available databases sources of information spoke with the parent etc o Other database sources information checked LPH comments optional o LPH check this box when documentation is ready for MDH review 0o0000 0 O 14 During the course of your follow up you may find that the family has relocated to a different county Document the new address in LPH comments text box Use your professional judgment to determine if the family would benefit from connection to services in the new county If the family would benefit from services refer to the new county MDH will not automatically refer a case to a second county if the first county has provided complete documentation The second county would not be eligible for reimbursement from MDH If you are not able to provide documentation that qualifies for reimbursement MDH will refer the case to the second county agency If you receive additional information on a case for which you have already i
9. in MEDSS you will not be reimbursed for it Within three months of notification for follow up the key contact or designee should try to contact the family to identify needs document current services being used and discuss any additional services that may be beneficial and for which the family is eligible The key contact should ensure referral and connection to appropriate services These may include as needed e primary care ideally a medical home e transportation e specialty care e parent to parent support and e early intervention e other professionals services e financial resources All eligible children should be connected to Part C Early Intervention Services and Supplemental Security Income SSI Some of the birth defects monitored make the children categorically eligible Key contacts are responsible for assigning cases to other staff for follow up if appropriate Agencies must report the results of their follow up in MEDSS in order to be reimbursed As part of follow up it is expected that all address and contact information will be updated in MEDSS until follow up has been completed and invoiced Update the contact information in the Address Information tab located within the Persons tab of the child s record in MEDSS Instructions are available in the BD HL MEDSS Manual This process is different from the address assistance requests which MDH initiates when the parent letter mailing was returned to sender and are reimbursed
10. invoicing schedule is listed below Invoicing Period Invoice Due Date January 1 March 31 April 30 April 1 June 30 July 30 July 1 September 30 October 30 October 1 December 31 January 30 You must bill for all work completed during an invoicing period by the invoicing due date You do not need to submit an invoicing form if you did not complete any EHDI or Birth Defects notifications or trainings during an invoicing period For birth defects cases the contract states follow up must be completed within 3 months of notification and invoiced by the next due date Older birth defects cases that have not been completed or invoiced in a timely manner will be closed out every quarter according to this schedule Late cases will not be reimbursed however you may continue to work with the family in your regular role at your agency Instructions for completing the EHDI and Birth Defects invoice and the most recent version of the invoicing form can be found in the forms section of MDH s website for Local Public Health located at http www health state mn us divs cfh program cyshn content document pdf invoice pdf Information on reimbursement rates can be found in Appendix 9 and an example of the form is available to see in Appendix 10 17 MDH DEPARTMENT oF HEALTH Protecting maintaining and improving the health of all Minnesotans LPH Frequently Asked Questions Why can t I save ch
11. parent letter mailing has been successfully delivered When the key contact receives the email or task requesting a current address so the parent letter can be re sent the key contact will have to check the BD LPH Request Address Check workflow to locate the case The key contact is temporarily given access to the case in MEDSS while looking for the family s current address The key contact documents the results of their search using the New Address Request Wizard Please refer to the left column of the flow chart of this process in Appendix 5 No information should be entered into the Local Public Health Wizard at this time After completing the New Address Request Wizard access to the case is removed If LPH was unable to find a new address MDH will mark the case as Lost to Follow Up and LPH will not be notified of the event again If a new address is located the MDH parent letter mailing will be resent After the two week waiting period the appropriate LPH agency will be notified of the case for follow up MDH will reimburse the agency 75 even if the address assistance search did not result in a new address This reimbursement is only for circumstances when MDH specifically requests address assistance to resend the parent letter mailing The standard updating of addresses that takes place later during follow up to ensure services is included in the tier payment Refer to BD HL LPH MEDSS User Manual for more information on using the New Addr
12. separately Strategies of Follow up LPH agencies provide most of the case management and direct service referrals for birth defects in Minnesota How you follow up on these cases will depend on the resources and health services available in your community Therefore there is no correct way to follow up on these cases We trust that you will use your knowledge and expertise to achieve this goal to the best of your ability While there is no one way to follow up on birth defects cases there are some strategies that MDH considers to be best practice While it is not expected that you use all of these strategies for every case it is expected that you use your best judgment to determine when it is appropriate to use these strategies 10 There are two different ways you can help facilitate follow up e By contacting the child s parents or guardians directly e By contacting the child s health care providers or service providers You can use one or both of these methods based on what you deem will be most effective for the particular case you are working on More information on best practice for each of these strategies is listed below Before contacting the family be aware that the birth condition s listed in the Diagnosis Code and Description fields in the Child s Diagnosis section of the wizard are the confirmed birth defect s that our program tracks If the child has other health issues or extenuating circumstances
13. they have updated contact information e Send a letter to the family that stresses the importance of early intervention programs and urge them to get in contact with you or their primary care provider e Ifthe family is receiving WIC services try to connect with them at their WIC appointment e Ifthe family is receiving home visiting services ask the home visiting nurse for assistance in talking with the family and arranging follow up e Ifthe family is receiving early intervention Part C ask the service provider s for assistance or information to assist with connection with the family When talking with the family keep in mind the common barriers families encounter in following up You may need to assist the family with obtaining transportation to and from appointments or in signing up for available public health insurance programs You may also need to educate the family on the importance of early intervention For families who do not speak English you may 11 need to arrange interpreter services to communicate or assist them in obtaining an interpreter at medical appointments When you connect with the family there are a number of things you should ask them about An important topic to discuss initially is the child s health care coverage status Does the child have adequate health insurance This will help you determine if lack of insurance is preventing access to services If so check if the child is eligible for public insurance and
14. Hypoplasia Muscular Skeletal Conditions Muscle Bone Conditions Congenital Hip Dislocation Diaphragmatic Hernia Gastroschisis Omphalocele Reduction Deformity Lower Limbs Reduction Deformity Upper Limbs Oral Conditions Nose Mouth Conditions e Choanal Atresia e Cleft Lip and Palate e Cleft Palate without Cleft Lip Other Health Conditions e Fetal Alcohol Syndrome FAS Appendix 4 Similarities and Differences with Birth Defects and EHDI Programs Program Details Birth Defects EHDI Number of conditions 46 reportable birth defects 1 hearing loss only Type of cases Volume of cases Notification for Birth Defects f u New address requests if needed for resending parent letter BD cases 1600 notifications year Address requests Varies Hearing screening f u CHL f u Hearing Screening f u 350 year CHL f u 200 year Follow up on all cases is required Low acuity follow up not required or Yes reimbursed LPH HIPAA exemption Yes Yes Goal of LPH notification is to Yes Yes assure family connection to appropriate services Communication Methods _ Birth Defects EHDI Notification method 2x month cases added to documentation not complete workflow mass email sent to all key contacts to remind to look at workflow Hearing Screening f u follow up form faxed emailed to key contact CHL f u individual email sent to key contact notifying them of new case has
15. MDH DEPARTMENT oF HEALTH Birth Def 2014 efects Program Local Public Health Follow up Manual Minnesota Department of Health Children amp Youth with Special Health Needs Birth Defects Unit June 2014 MDH DEPARTMENT oF HEALTH Protecting maintaining and improving the health of all Minnesotans Table of Contents Birth Defects Monitoring amp Analysis Program BDMAP Overview amp Background s0sse0e0 3 Statutory A 0H A care seep a paces ess E RE yen ce ee eset cae EA EA SERSA 3 Expanded Birth Defects Program Follow tp scssicateceseetetesiceerstdc ne reeieiie cas eine eens 3 Data 12 OMB CUOM aicncasetnanccseseauspenscaavonsaenseaadnaossnstosnnnodaatans sansenwultannnsedeanin sauntea E aE EEA EEEE EE 4 How Does the Birth Defects Program Benefit Minnesota nsssseseesssseesssessessseseseeessseessresseesseesseeeesene 4 The Birth Defects Program s Partnership With cccccssscssssscssssscssssscssssccssssscssssscsssessssscsssssssssssssees 5 Local Public Health CPB sicccccccsccenscsscsccsoscccoscsssoesnsossssosessesocesonseseosednsosvonscovonaedecvuescecsceesedsensoeccesonsoesssesnecs 5 MDH Birth Defects Program and EHDI Growing Together ow eee eeeeseceseceeneeeneeceeeeseeesneessaeenseesees 5 Differences and Similarities of the Programs eeeeseeseesrseseesessersresressetsresresersreseestesersresstesseseeesresseeer 5 Key Contacts esinta nnie aE RE EEE REA EEA E ER EEEE AERE EEEE A
16. STES EPLE ISES ARSS EE SEES Eo 16 MEDSS Case Stat s WORE OW S jacepaszeancnsenascersecostaneqsadsesestanaesateagauneananshentaun AEE EESE r eaa n Tanara e Ri 16 MEDSS Train Reports isessisiiiimcsssenireiiasies resnie ne A n aE NEE iaa EES aa aaa EE Eiaeia 16 Invoicing for Completed Birth Defects eesseoesooessoesssecssecesocesocessocessecssocesocescosecocesscessocesocsssosesoesssesssesee 17 Follow up and Trainings 5255 ve cacavata caus cau cena seu sixenanabesu anne anuadeanunvaunaaconaunsercesensuaastencteteusseunxeasacheteoerenneancaniee 17 LPH Frequently Asked Questions 5 issvissocssssssesssessseseacsssecsseseussssansseosonssensssesonssseesssesseessvesssesnes disuse sedeonsouns 18 MDH DEPARTMENT oF HEALTH Protecting maintaining and improving the health of all Minnesotans Appendix 1 Birth Defects Contact Information soesoessesooescsssessossocssessossocssessossocssessossooesesssssoossosss 21 Appendix 2 Timeline of Birth Defects Follow Up by Local Public Health Agencies 2010 2014 22 Appendix 3 Conditions included in the Minnesota Birth Defects Information System 23 Appendix 4 Similarities and Differences with Birth Defects and EHDI Programa 00 24 Appendix 5 Birth Defects Process Flow Cha rt ccsscsssssssssscsscssscssccsscscssccssssssssssscssscessocsessessssees 25 Appendix 6 Letter sent to parents of children with birth defect sccssccssscsssss
17. TE Ga 5 Key C nt cts R sponsIDIES sop sehen aia cied does sce w aca etises ananta iaaea aatia aeaieie kinei eaii 5 Training for Key Contacts essensies e E EAE E 5 R so rces for LPH saasaa a E a rr Ue aE E e E EE E PEPE E E a EEE ERS 6 Confirmed Birth Defects caciiessanscaconasiaieceassatectacnseaceanatouaeencosdeasscgusausouneqebecsauavaaestsccenscbaseanechesenensausqasecvencaee 7 OVVIE Weet E R ee a E 7 Par ntal Opt Out ProcESShii isinsin a na a a a a E Aai 7 Birth Defects Address ASSist ance ssscsscsscnssccissscacessss ceases sscesasacissssontscess taxieasi ssu sosser ss sssi sa sises ss ssis 5e 9 Birth Detects Follow Up s ssissrsssssissessssesssssssssceesosvsssossssstoesosesstess ssov s esSeevss Ss Otor ESS KESE erba ESSso SEKSO r V S 9 G alof FOW TP sorceress tare aiio EERE TA E E R a 9 Strategies OI UP axa saascapoenis eanieacpaasecn E a E E ee 10 Connecting with the FONILY cancis sic saucn ssusasaanansnatesecaciuaasen pussies oueaientnelswcavctage ed aus eesnmaneseedsoanaunmelansees 11 Contacting the family when another Public Health Nurse PHN is involved cccsccceseceeeseeeeeteees 12 Confidentiality and HIPAA ais cccs ass eere si Retanastvae EE EEE EEE es AES NERES 12 Documenting Your Follow up in MEDSS sesssesssessseessccesocesooesocesssecssocesocsscosesocesscessocesocssooessoeessesssosee 14 Tracking ASS sesceaccavecuossseucvacstevscanesausvanasacessanctasuasesuede sande esed eS SSPE SPONSES ISSA SEs SOSEER Ee SCEN O
18. a administrative privacyrule index html The medical information being disclosed must be related to the birth defect diagnosis management and related interventions This may include but is not limited to personally identifiable information on the patient information on tests and procedures conducted results of tests and procedures conducted diagnoses referrals to other providers and services and other pertinent information Rationale HIPAA governs the use and disclosure of protected health information PHI It applies to health plans health care clearinghouses and health care providers who transmit certain health claims information electronically These entities are covered entities under the rule A covered entity must obtain a written authorization from the individual for the use and disclosure of PHI unless the disclosure is to the individual for treatment payment or health care operations or the disclosure falls under one of the specified exceptions The HIPAA Privacy Rule specifically 45 CFR 164 512 addresses the uses and disclosures of PHI for which an authorization or an opportunity to agree or object is not required Section 164 512 b permits a covered entity to disclose PHI to i A public health authority that is authorized by law to collect or receive such information for the purpose of preventing or controlling disease injury or disability including but not limited to the reporting of disease injury vital
19. anges I made in MEDSS The circle keeps spinning The issue you are having with the circle continuously spinning may be a compatibility issue between your computer s browser and the MEDSS system When this happens we suggest checking with your agencies informatics technicians to see if changing the browser is an option Fire Fox seems to be the most compatible with MEDSS Sometimes it has something to do with Java If you continue to have issues please let us know and our MEDSS informatics technicians will connect with your informatics technician to resolve the issue Why can I only see the old tier level option to select for reimbursement Due to a glitch in MEDSS the new 2014 tier levels are not always showing up in all events cases You should contact MDH Birth Defects staff Barbara Kough so she can adjust it so that the correct tier level choices are available Will MDH ever want to see the birth defects key contact s phone notes or written documentation of services provided or contact made with families As long as you document your activities contacts and follow up to families in MEDSS using the Local Public Health Wizard you will satisfy our statutory requirement to assure connection of appropriate services for kids with birth defects M S 144 2215 Subd 2 2 and meet our criteria for reimbursement There is no need for you to retain those records from our perspective This speaks only to MDH s requirement and does not ad
20. ata Surveillance System This is the online database that MDH uses to store information about confirmed birth defect cases in Minnesota LPH will report information about their follow up on confirmed birth defect cases in MEDSS MEDSS login page https apps health state mn us medss login do Registry A system of ongoing registrations such that cases of a disease or other health relevant condition are defined in a population and can be related to a population base Birth and death registration systems are examples 35 Surveillance ongoing systematic collection analysis interpretation and dissemination of health data on an ongoing bases Surveillance is conducted to identify potential public health threats or patterns of disease occurrence and risk in a community See also Minnesota Public Health Data Access Glossary of Terms https apps health state mn us mndata glossary 36
21. be sure to provide the family with the assistance signing up If the child is under age three ask about their enrollment status with Part C Help Me Grow If the child has not been connected with Part C Early Intervention yet ask them if it would be okay for you to make a referral For children three or older make sure that the family has been connected to their school district for Part B services If they have not ask them if it would be okay for you to make a referral Finally while you are talking with the family you may want to determine if there are any financial or social service programs that they may be eligible for This would be a good opportunity to assist them in getting enrolled in these programs Contacting the family when another Public Health Nurse PHN is involved For situations where another PHN from your agency has already made contact with the family you would not have to contact the family again for follow up if all of the following are true e The primary PHN spoke to the family within the past three months e PHN was aware of the birth condition listed in MEDSS at the time of the visit contact e PHN is assured that the family is aware of and or receiving all appropriate services for the confirmed birth condition e You would not have anything more to offer the family such as financial assistance resources or another service You would be eligible to invoice at a Tier 2 200 reimbursement for obtaining the information
22. ct can be mild severe or incompatible with life Congenital means existing at birth Congenital disorder A disorder that is present at birth The causes of a congenital disorder include infection injury genetics environmental factors and others Event Event is the term used to describe where information about a person s disease or condition is stored in MEDSS One person may have multiple events in MEDSS if they have several different conditions tracked by MDH for example a child could have both a hearing loss and birth defect event Each event will be tied to the person s core person information name birth date address but is stored separate from other events in MEDSS Each event can only be viewed by users who have permission to view that type of condition in MEDSS Event ID this is the number associated with a confirmed birth defect case in MEDSS When LPH is notified of a new birth defect the email will contain this number LPH should also use this number to invoice for completed cases Help Me Grow The Early Intervention program in Minnesota Medical Home A team based health care delivery model that provides comprehensive and continuous medical care to patients with the goal of obtaining maximized health outcomes Monitoring performance and analysis of routine measurements using statistical methods aimed at detecting changes in the environment or health status of populations MEDSS Minnesota Electronic D
23. dress any potential need for retaining them from your agency s perspective This is a decision that should be made locally by each individual agency Does MDH have a letter template that LPH can use when sending letter to families MDH does not have a template for a follow up letter to families as each county may offer different programs staffing etc MDH has decided to leave the letter format and content up to individual local public health agencies to develop and use as they see appropriate During the course of my follow up I learned the child is deceased Do I continue documenting my follow up in MEDSS Will I be reimbursed You will still be reimbursed If you learned of the death through your initial research and did not speak with the family or a provider use Tier One at 75 reimbursement MDH will waive the letter call attempts requirements if the child has passed away but you still have to select those check boxes to complete the case Just put documentation in your notes comments If you learned of the death from a provider you can bill for Tier Two and would still need to complete the service status fields If you learned of the death from the parents it would be 400 reimbursement You still need to complete the required 18 fields use your best judgment to assess whether the parent would be willing to discuss the services they were receiving for their child Please put any information about the child s death e g cau
24. dy been notified of the child Birth Defects staff immediately contacts the agency asking them to discontinue trying to reach the family on behalf of the Birth Defects program As a precaution agencies are also asked to remove any identifying information connected to that child they might have from the birth defect notification However the LPH agency continues to retain information on the child they may have because of prior involvement with other programs If LPH has completed follow up and documented it in MEDSS prior to the family opting out they still invoice for the case Please refer to the right column of the flow chart of this process in Appendix 5 MDH DEPARTMENT oF HEALTH Protecting maintaining and improving the health of all Minnesotans Birth Defects Address Assistance When a parent letter mailing is returned to MDH as undeliverable MDH staff may ask the LPH key contact from the county in which the family last resided for help finding the family s current address Once the parent letter is returned to sender MDH staff will either send the LPH key contact an email or send a task through MEDSS to ask for assistance This family has not yet received the parent letter mailing they do not know that their child has been included in the BDIS nor that they have the right to remove their identifying information opt out The request for address assistance is a separate process than follow up which begins two weeks after the
25. e trends of birth defects to detect emerging health concerns and identify affected populations e Ensure appropriate services are provided to affected families e Prevent birth defects through targeted education e Educate health professionals and the public regarding birth defects and e Stimulate research on risk factors treatment prevention and the cure of birth defects Statutory Language The 2004 Legislature amended the birth defects statute MS 144 2215 to enable establishment of the Minnesota Birth Defects Information System BDIS This included clarifying language on goals data sources reporting without liability data privacy an opt out clause and guidelines on conducting research The definition of a birth defect is consistent with that used by the Centers for Disease Control and Prevention CDC other states and national organizations This language became effective March 2005 when the MDH received a federal grant to support implementation of a regional birth defects program During the 2010 legislative session financial support was provided to expand birth defects activities statewide Expanded Birth Defects Program Follow up In its initial years the Birth Defects program depended on the MDH Children with Special Health Needs program staff to assist families with available services appropriate for their children After a few years local public health agencies began to get more directly involved with the Birth Def
26. ects program to assist these children When the program began expanding in 2010 MDH extended its existing partnerships with local public health and tribal agencies for referral to services and programs available in the communities where these families live By 2013 all 87 counties and one tribe were part of the follow up working to assure services are offered to children with birth defects who are included in the BDIS A timeline showing the birth defects follow up by local public health agencies is provided in Appendix 2 Data Collection Minnesota began active birth defects surveillance on June 1 2005 Birth conditions being tracked in 2014 include almost all of the birth defects recommended by the National Birth Defects Prevention Network NBDPN Appendix 3 lists the conditions tracked by Minnesota for 2013 births The birth defects program website includes a link to the most current and comprehensive surveillance data report http www health state mn us divs cfh program cyshn cyshndata cfm birth A selection of the birth defects monitored is included in the Minnesota Public Health Data Access Portal developed by the Minnesota Environmental Public Health Tracking Program https apps health state mn us mndata birth_basic Their website provides tables and charts general information about the birth defects data and measures as well as prevention messages How Does the Birth Defects Program Benefit Minnesota There are many programs in
27. emove your child s name and other identifying information from the birth defects database If you choose to remove this information you must sign the enclosed Opt Out form and return it to MDH If you have questions or concerns about the database or want more information before deciding to remove your baby s name please contact us by email at health birthdefects state mn us If you do remove your child s name please realize that in the future MDH and your local public health department will not be able to contact you with information about services or about the prevention treatment or cause of your child s condition Sincerely Barbara Kough Operations Coordinator Birth Defects Monitoring amp Analysis Unit P O Box 64882 St Paul Minnesota 55164 0882 26 Appendix 7 Parent Frequently Asked Questions My child doesn t have a birth defect why did you send this letter Our program tracks a wide range of birth conditions A complete list is on the back of this page Some of the conditions we track are very minor and may have already been corrected or healed naturally Examples of these conditions are pyloric stenosis a narrowing of the stomach valve causing eating problems ASD VSD PDA and PFO a small hole in the heart causing a heart murmur or hypospadias a boy s urinary problem Your doctor might not refer to these conditions using the term birth defect We send letters to let you know about our pr
28. en you are asking for 400 00 reimbursement or if you are requesting 200 00 reimbursement for reporting follow up recently completed by another PHN in your agency that was prior to notification from LPH see section Contacting the family when another PHN is involved in this manual These fields require communication with the parent or legal guardian The only communication that meets criteria for this reimbursement must include correspondence that has an immediate response such as a phone conversation A letter does not meet the requirements e Select discussed this service with parent check box if you informed the parent about a program or explained the purpose of the program but did not provide a phone number or assistance e Select assisted with application or enrollment checkbox if you provided a phone number assisted with completing worksheets or paperwork or provided contact information If you did not talk with the parents you can only complete the current status field and should leave the discuss assist fields blank Instructions and screen shots of required documentation is available in the BD HL MEDSS User Manual Appendix 10 Invoice Form EHDI amp Birth Defects BD Local Public Health Follow up CHB Courty Tribal Gov t Name Invoicing Period to Person Completing the Form Number Email Date Phone Number of Allowable Amount PHN s TRAININGS Amount bil
29. ess Request Wizard Birth Defects Follow Up Goal of Follow up The main goal of your follow up on children with a confirmed birth defect is to ensure that they are connected with all of the appropriate early intervention financial health and community services that are available in your area When there is a case within in your area requiring follow up you will receive an email from MDH notifying you about it MDH sends out notifications for follow up about every two weeks You may not have a new case every time we send out notifications All cases requiring follow up will be in your BD LPH Documentation Not Completed workflow in MEDSS Cases for which 9 no reimbursement for follow up is available are found in the BD LPH Low Acuity Cases in Last 90 Days workflow Please refer to Appendix 5 for a flow chart of this entire process When MDH sends you a case for follow up the parent or guardian should already have received the parent letter mailing the letter lets parents know that your agency may contact them about educational financial or support services in the area For follow up purposes the MDH nurse specialist assigns an acuity level to each case based on the severity of the child s birth defect s This is intended to help you prioritize follow up Agencies will be reimbursed for reporting follow up with families whose children have a medium or high acuity condition While you may follow up on low acuity cases and document them
30. events such as birth or death and the conduct of public health surveillance public health investigations and public health interventions Under the HIPAA Privacy Rule 45 CFR 164 501 public health authority is defined as an agency or authority of a State that is responsible for public health matters as part of its official mandate Therefore to the extent that a public health authority is authorized by law to collect or receive information for public health purposes covered entities may disclose PHI to the public health authority without the patient s authorization Minnesota Statutes section 144 2215 requires the Commissioner of Health to establish and maintain an information system containing data on the cause treatment prevention and cure of major birth defects The Commissioner must design the Birth Defects Information System to allow the Commissioner to monitor incidence trends of birth defects to detect potential public health problems predict risks and assist in responding to birth defects clusters more accurately target intervention prevention and services for communities patients and their families inform health professionals and citizens of the prevalence of and risks for birth defects and conduct scientific investigation and surveys of the causes mortality methods of treatment prevention and cure for birth defects Minnesota Statutes section 144 2217 classifies information on individuals collected
31. fects Tier One payment of 75 00 per case for e Attempting to obtain required information on services used from the child s Part C Early Intervention Service Coordinator other service provider and or the child s family but not being able to successfully obtain this information The process must be documented in the LPH Wizard in MEDSS Attempts at contact must include at least two attempts by phone and a letter sent to the family to assess current services used and to offer assistance in connecting to other services as appropriate Birth Defects Tier Two payment of 200 per case for e Attempting to contact the family and complete documentation of current services in the LPH Wizard in MEDSS by reviewing data sources and contacting service providers to obtain required information on connection to services Attempts to contact the family must include at least two attempts by phone and a letter sent to the family to assess current services used and offer assistance in connecting to other services as appropriate Birth Defects Tier Three payment of 400 per case for e Successful contact with the family by phone or in person and complete documentation of current services in the LPH Wizard in MEDSS The nurse will ensure referral application and or connection to other services as needed When documenting in MEDSS whether you discussed and or assisted the family with services or information you should only check these boxes wh
32. for the Birth Defects Information System as private data on individuals The data may only be used for the purposes in Minnesota Statutes sections 144 2215 to 144 2219 Summary In summary Minnesota Statutes sections 144 2215 to 144 2219 authorize MDH and local public health authorities to collect health information pertinent to the diagnosis cause treatment prevention and cure of birth defects Therefore providers their medical records departments and their staff can share medical information with MDH and contractors working on behalf of MDH including local public health agencies pertaining to birth defects diagnosis management and related interventions without patient authorization For questions about this analysis contact Dave Orren MDH Chief Legal Counsel 651 201 5742 Minnesota Department of Health March 24 2014 Forms available at http www health state mn us divs cth program cyshn content document pdf hipaabdis pdf Appendix 9 Reimbursement for Birth Defects cases Birth Defects Address Assistance payment of 75 00 per case for researching current address when MDH requests assistance for families whose parent packet was returned to sender because their contact information in MEDSS is not current This is separate from follow up There are three tiers of reimbursement based on follow up provided and services reported Tier status is determined by key contact based on criteria described below Birth De
33. from another service provider Do the following to complete the Local Public Health Wizard in MEDSS e In the Is this the first time your agency has been notified about this child field select No e For each service for which the PHN discussed and or assisted the family select the Yes check boxes and enter the current status Document any other services the family is currently receiving e Select Tier 2 for reimbursement e In the Indicate type of provider s contacted field select all that apply Use the Other check box and enter the PHN in the Specify text box e Inthe LPH Comments field document that another PHN is involved with the family as well as any other pertinent information such as the date the PHN spoke to the family and the PHN was aware of the confirmed birth condition Confidentiality and HIPAA Some clinics may be hesitant to share information with you due to HIPAA As a contractor with MDH you are doing public health surveillance work that is HIPAA exempt See Appendix 8 HIPAA and Medical Information Related to Birth Defects Diagnosis and Intervention for 12 MDH s legal interpretation of why the work you do relates to birth defects and is HIPAA exempt You can make a copy of this document and send it to the clinic to show them that they will not be violating HIPAA This document is also available at http www health state mn us divs cfh program cyshn Iph cfm resources 13 MDH
34. he system called an opt out After abstraction and a nurse case review verifies that a child has been diagnosed with a birth defect MDH mails a letter to the parents or guardians providing them information about the birth defects program and basic information about services that may be available to them A copy of the parent letter is available in Appendix 6 The parent letter mailing also furnishes an opt out form which parents or guardians must complete and return if they choose to have their identifying information removed from the database The Birth Defects program waits two weeks to allow parents time to return the opt out form before any information is shared with authorized entities that may help the family obtain services Local public health agencies are the only authorized groups with which we share identifying information and that is done only if the parents have not opted out Parents or guardians can send in the opt out form any time to have their information removed however local public health may have already been notified of the family after the two week delay has passed When an opt out form is received MDH de identifies the case in MEDSS and sends a confirmation letter to the family telling them that their identifying data has been removed from the system Once the opt out has been processed the case no longer contains names or other personal identifying information in MEDSS If the local public health agency has alrea
35. known to the birth defects program they will be listed in the wizard under the MDH Clinical Diagnosis Comments field Since the birth defects program only tracks selected conditions other health issues may not necessarily be finalized diagnoses Please do not rely on the additional information to be as accurate or current the information is provided so you are aware that the child may have other serious health conditions in addition to the confirmed birth defect s listed Connecting with the family MDH will provide the LPH key contact with contact information from the child s birth certificate and or medical record You can use this information to try to reach the family to determine what kind of support is needed to get the child appropriate services If the telephone number appears to be correct and functional e g it is not disconnected and is accepting voicemail messages you should attempt to contact the family at least two times by telephone If you leave a message for the family allow about two weeks between calls for the family to respond You may find that the family does not respond to your voicemail messages or that the contact information received from MDH is no longer correct Here are some recommended strategies that may be helpful to get in contact with the family e Check other public health databases for updated contact information e g WIC Child and Teen Checkups Home Visiting e Call the primary care provider to see if
36. lable on page 10 Training for Key Contacts All key contacts are expected to participate in trainings that MDH determines necessary to perform program requirements The county will be reimbursed for required training up to a maximum of one staff per county per program If a key contact changes MDH will reimburse the county for a new key contact to complete the required training Resources for LPH Many of the materials provided in this Follow up Manual plus additional resources are available online The EHDI and Birth Defects website for LPH and tribal governments is http www health state mn us divs cfh program cyshn Iph cfm Go to this website to access the most up to date versions of forms and trainings Key contacts and others involved in the Birth Defects program also receive a monthly newsletter from the EHDI and Birth Defects programs This newsletter contains important information about program updates and hearing loss or birth defects resources Newsletters are sent via email Please take time to look through the newsletter each month to make sure you have the most up to date information about the programs The newsletter is also available online at http www health state mn us divs cfh program cyshn Iph cfm newsletters MDH DEPARTMENT oF HEALTH Protecting maintaining and improving the health of all Minnesotans Confirmed Birth Defects Overview Hospitals and clinics report to MDH a limited set of information each
37. lder so key contacts will still occasionally receive a notification of a child who has recently turned two Remember each county has the discretion to decide not to follow up with older children Please let us know if you receive older cases more frequently than you feel is reasonable What should I do when my county is referred a case that should go to a different county MEDSS system selects a county based on the zip code listed in the hospital record If you receive a case that should go to a different county you should contact MDH Birth Defects staff Barbara Kough so she can remove jurisdiction from your county and refer to the correct county What tier can I bill for when I reach a member of the extended family but am unable to reach the parent guardian or service provider When we use the term family we mean the parent or legal guardian It was never the intention of the Birth Defects program to have key contacts discussing services and programs with members of the extended family We only feel comfortable discussing the private information related to the child s medical condition with the person who has the authority to make decisions regarding the child s health and program enrollment This is in line with how EHDI reimburses cases as well If you speak to the parent or legal guardian you can bill for Tier 3 400 once you have documented your follow up If you speak to a service provider or another health provider you ma
38. led Required MDH training s completed 150 00 0 00 Number of Allowable Amount Notifications MOREE RON Amount billed Ar Screening Follow Up Forms Federal CFDA 75 00 0 00 EHDI Tier 1 Confirmed Hearing Loss CHL Notifications MEDSS LPH Wizard Federal CFDA 93 251 75 00 0 00 EHDI Tier 2 Confirmed Hearing Loss CHL Notifications MEDSS LPH Wizard Federal CFDA 93 251 200 00 0 00 EHDI Tier 3 Confirmed Hearing Loss CHL Notifications MEDSS LPH Wizard Federal CFDA 93 251 400 00 0 00 Birth Defects address update in MEDSS State Funds 75 00 0 00 BD Tier 1 Birth Defect notifications MEDSS LPH Wizard State Funds F200 0 00 BD Tier 2 Birth Defect notifications MEDSS LPH Wizard State Funds gt 20000 0 00 BD Tier 3 Birth Defect notifications MEDSS LPH Wizard State Funds pando 0 00 PLEASE SPECIFY TRAININGS NOTIFICATIONS BEING INVOICED ON PAGE 2 TOTAL 0 00 ORIGINAL CERTIFICATION SIGNATURE certify that to the best of my knowledge and belief the data reported on this document is correct and all transactions that support this report were made in accordance with applicable Federal and State statutes and rules Authorized Official Signature Date Submission Options Email scanned signed copy to nicole brys state mn us make sure names of children are not included on invoice OR Fax signed copy to 651 201 3655 AND send email to nicole brys state mn us
39. month about infants discharged from their facilities who were treated for any of the monitored birth defects Diagnostic codes used for billing i e ICD 9 or ICD 10 codes are how these children are identified MDH abstractors then go to the facilities and review the medical records for additional details about the condition Information from the medical record that supports a diagnosis of a birth defect is entered into the birth defects database in MEDSS Each potential case is verified by ensuring it meets strict case definitions that are consistent with national standards If the case definition has been met the abstractors assign the most appropriate birth defect code based on the confirmatory evidence from the medical records Finally an MDH nurse specialist reviews the completed case abstraction to ensure the most accurate and consistent birth defect codes have been assigned If necessary MDH staff may consult with medical specialists for further clarification of complex conditions At this point a birth defects case has been created This process is depicted in the first four boxes in the flow chart in Appendix 5 Parental Opt Out Process Since its start in 2005 the MDH Birth Defects Program has made extensive efforts to assure that the monitoring process meets both statutory and public health needs The law that established the BDIS also gave parents the right to have their own and their child s identifying information removed from t
40. nvoiced and been reimbursed you are not required to notify MDH or update the MEDSS event Additional instructions and screen shots of required documentation is available in the BD HL MEDSS User Manual 15 MDH DEPARTMENT oF HEALTH Protecting maintaining and improving the health of all Minnesotans Tracking Cases Timely completion of follow up for birth defects notifications is important in ensuring that children with birth defects are receiving the services they need LPH agencies especially agencies that receive a high volume of notifications need to create an effective tracking system to ensure all cases sent by MDH are being followed up upon in a timely manner MEDSS Case Status Workflows The MEDSS case status workflows provide an easy way for you to view the status of cases that require some further action before they are fully complete The five birth defects workflows are e BD LPH Documentation Not Completed contains cases where LPH documentation has not yet been completed This list is limited to those cases for which you may be reimbursed e BD LPH Cases Waiting for MDH Review contains cases where LPH has indicated that they have completed their documentation but MDH has not yet reviewed the case to see if it is ready to be invoiced e BD LPH Cases Ready to be Invoiced contains cases for which MDH has reviewed documentation provided by LPH and approved them for invoicing e BD LPH Low Acuity Cases in Last
41. ogram and to let you know you can choose to have your identifying information removed from our system Is this a new condition Do you know something that my child s doctor doesn t know Our letter is worrisome to some parents because it may come as a surprise Our information about your child comes from hospitals and clinics Minnesota State Law allows us to receive this information Please be assured that our program does not have or know any more information about your child than your medical providers Also our program is separate from the heel stick and hearing screening your baby had in the newborn nursery Those programs at MDH would have been in touch with your baby s doctor directly and quickly if something needed to be rechecked Why are we getting this letter so long after our child s birth We work closely with hospitals and clinics to receive data about children born with one of the conditions we track Sometimes the hospital report is not reported to us until several months after a diagnosis is made Therefore you might not receive your letter until much later We send the letters out as soon as we can so you can choose to have your personal information removed if you wish What are we supposed to do with the form we received with the letter You are not required to send the form to us Only send it to us if you want to remove all your identifying information from our database We would remove your child s name your name
42. our state that may benefit children with birth defects and their families Knowledge of the occurrence of birth defects will help MDH link families to the services they need Better tracking of when and where birth defects occur and potential links to risk factors will provide critical information that may help prevent birth defects in the future Despite the fact that 100 000 to 150 000 babies are born each year in the US with major birth defects many of the actual causes of birth defects are not completely understood MDH DEPARTMENT oF HEALTH Protecting maintaining and improving the health of all Minnesotans The Birth Defects Program s Partnership with Local Public Health LPH MDH Birth Defects Program and EHDI Growing Together After the Early Hearing Detection amp Intervention EHDI program s partnership with local public health and tribal governments was initiated the Birth Defects program recognized that a similar partnership could be beneficial for children with confirmed birth defects In 2011 at the time of the contract renewal LPH agencies and tribal governments were given the option to partner not only with the EHDI program but also the Birth Defects program Small grants for the purpose of expanding birth defects service delivery coordination throughout Minnesota were offered to help with the expansion of the program Differences and Similarities of the Programs Although the EHDI and Birth Defects programs at MDH a
43. r resources to help make decisions about education vocational training employment and other services for their children with disabilities Resource Sheet PDF is a resource sheet available online at MDH Children and Youth with Special Health Needs CYSHN 33 Additional Web Resources e MDH General Resource List e MDH Information and Resources for Families e MDH Newborn Disease Specific Fact Sheets e MDH Diseases and Conditions Identified in Children e Best Practices and Medical Specialists in Minnesota e Additional Links and Resources from Family Voices of Minnesota e Links to Helpful Information from Family Voices of Minnesota e New family income guidelines have been published for disabled children s eligibility for SSI in 2014 The income guidelines are located at the official social security website e Information on National Certification of Healthcare Interpreters 34 Glossary Abstraction The process of recording information identified when reviewing documentation in a medical record or other information source and entering the information into data fields in a specified format Information may be recorded on hard copy forms or through formatted data entry computer screens Birth Defect An abnormality present at birth Also called a congenital defect it can be caused by a genetic mutation an unfavorable environment during pregnancy or a combination of both The effect of a birth defe
44. re separate teams they are working together to make follow up for children with hearing loss and children with birth defects coordinated Both programs collect data in the same newborn module of the secure Minnesota Electronic Disease Surveillance System MEDSS database the current platform for BDIS Please refer to Appendix 4 for a summary of the two programs differences and similarities LPH agencies may encounter Key Contacts MDH has asked each agency to identify at least one person within their agency to be the Birth Defects key contact and at least one person to be an EHDI key contact This may be the same person for both programs but does not have to be however we ask that no more than two key contacts per program be designated per county Key contacts are expected to coordinate follow up and communicate program changes to other staff working on EHDI and Birth Defects follow up within their county Each key contact must request access to MEDSS and fill out appropriate forms to obtain access Details of forms and process are discussed in the EHDI BD MEDSS Manual Key Contacts Responsibilities The primary responsibility of key contacts is ensuring that follow up on cases occurs in a timely fashion Occasionally MDH will request assistance from key contacts to help find the family s current address prior to follow up Key contacts will also obtain and maintain their access to MEDSS Additional follow up requirements and information are avai
45. se where it occurred such as which hospital at home etc and approximate date of death in the comments field Should I automatically refer a child to Help Me Grow without parent s knowledge Yes Help Me Grow is a program that can assist with referrals to other programs and resources to prevent developmental delays even if the child doesn t qualify for Part C Early Intervention Any Minnesota child that has a diagnosed physical or mental condition with a high probability of resulting in a delay regardless of whether it has been demonstrated may qualify Some of the conditions include hearing Vvision loss prematurity lt 3lb 5 oz cerebral palsy Down Syndrome and some metabolic endocrine disorders See http www health state mn us divs cfh program cyshn delay cfm table for a list of conditions Why is my county receiving referrals for children who are two or three years old In the first years of sending notifications to LPH MDH sent all cases regardless of age to LPH MDH left it up to each LPH agency to determine if it was appropriate to follow up with the family of an older child given the agency s available resources Based on LPH feedback MDH is trying to increase the timeliness of notifications Notifications for older children will continue to decline as we improve our case finding and validation processes There will always be one or two cases that were reported to MDH late or which were diagnosed when the child was o
46. sota provides tools that build partnerships among professionals patients and families and serves as a trusted resource for information to improve health system policies Lasting Imprint is a non profit corporation established by individuals committed to fighting congenital heart defects CHD Lasting Imprint exists to create a supportive community that will inspire people to join in the fight against congenital heart defects through education research and assistance to heart families Minnesota Hands amp Voices provides information support and referral to families learning of their child s hearing loss Parent Guides discuss your concerns with you and will send you information related to hearing loss and other topics of interest They will also refer you to organizations and information sources including other families of children with hearing loss which you may find helpful Minnesota Organization on Fetal Alcohol Syndrome MOFAS is the statewide organization serving as the leading voice and resource on Fetal Alcohol Spectrum Disorders FASD in Minnesota MOFAS provides education and training so FASD is better understood and works to ensure that all women know there is no safe level of alcohol use during pregnancy PACER Center is a parent training and information center for families of children and youth with all disabilities from birth through 21 years old At PACER Center parents will find publications workshops and othe
47. ssssscsscscscsscssseees 26 Appendix 7 Parent Frequently Asked Questions csscccsccssscsssssssscsssscscccsscscsscssscessccscscssscsssneees 27 Appendix HIPAA sisssssssssisinssivcansesesssarsscnsinessveassosisnsdasaevnicaassviseos seendsinsioncasasa vadessponissensvoussansibbeisabsidavns 28 Appendix 9 Reimbursement for Birth Defects Cases sssccscscsssssscscsssscscsccecscsccssscssscesceesessessseees 30 Appendix 10 Inyoice HORM gs ccccssccasccnceseasesnesenscaseceiceseasancceencessoaassaseanacsadseenccaccsensseaceaansateatnctadseanicancdeanie 31 Appendix 11 Special Health Needs Resour ces ccssccsscssccssccscesscssccsssscscccsscsssscsssccsscessessscsssseees 33 Resources for Children amp Youth with Special Health Needs eee eeeeeseceseceeeeeseecneeceeeeseeeeeneeenaeees 33 E OTT a EE A A EEA AEE 35 MDH DEPARTMENT oF HEALTH Protecting maintaining and improving the health of all Minnesotans Birth Defects Monitoring amp Analysis Program BDMAP Overview amp Background The Birth Defects Monitoring amp Analysis Program BDMAP at the Minnesota Department of Health MDH gathers data about selected birth defects diagnosed in the first year of life An estimated 2 000 babies are born in Minnesota each year with a birth defect The mission of the program is to help children thrive grow and be as healthy as possible The primary goals of the Birth Defects Program are to e Monitor incidenc
48. to confirm fax Person Who Attended Training Date of Training Name of Training Hearing Screening Follow Up Forms Invoiced Above Please provide LPH ID do not use child s name if invoice will be emailed For CONFIRMED HEARING LOSS cases invoiced on page 1 please provide the MEDSS Event IDs in the tables below OR attach list of event IDs printed from MEDSS EHDI Tier 1 CHL Notifications MEDSS LPH Wizard Invoiced Above EHDI Tier 2 CHL Notifications MEDSS LPH Wizard Invoiced Above EHDI Tier 3 CHL Notifications MEDSS LPH Wizard Invoiced Above For BIRTH DEFECT cases invoiced on page 1 please provide the MEDSS Event IDs in the tables below OR attach list of event IDs printed from MEDSS Birth Defect Address Updates MEDSS LPH Wizard Invoiced Above BD Tier 1 Birth Defect Notifications MEDSS LPH Wizard Invoiced Above BD Tier 2 Birth Defect Notifications MEDSS LPH Wizard Invoiced Above BD Tier 3 Birth Defect Notifications MEDSS LPH Wizard Invoiced Above Page 1 of 2 Appendix 11 Special Health Needs Resources Resources for Children amp Youth with Special Health Needs Family Voices of Minnesota is a grass roots family organization that aims to achieve family centered care for all children youth and young adults with special health care needs Through state and national networks of families and providers Family Voices of Minne
49. y bill for Tier 2 200 If you are only able to reach a member of the extended family you can bill for Tier 1 75 for the attempts to reach the parent or guardian 19 10 What response option should I chose if the family has moved out of my contact service area The response option child moved out of county should be selected in the If LPH unable to connect with family reason field whenever the family has moved out of the key contact s service area This response is appropriate whether they have moved out of the county state or even the country Any specifics about where the child moved are most helpful to have in the LPH comments field The Other response should be used rarely when none of the other responses apply at all It is hard for us to utilize this information and it often gets missed when the case is reviewed by MDH 11 I thought that LPH has no contractual obligation to follow up on all cases sent to the agency Each agency can determine which cases they will prioritize for follow up Some counties follow up on all cases even those with milder conditions low acuity for which they are not reimbursed Other counties request no reimbursement for some of the medium or high acuity cases The contract states that the county will ensure referral and connection to appropriate services If the key contact feels this has been done with the family and no further follow up is necessary then the no reimbursement
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