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

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

2. Challenges in California • Size • Diversity • Mobility

3. Size • Population of California • 34,000,000 • Population of Los Angeles County • 9,500,000 • Population ofAlpine County • 1,200

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

5. Diversity • Geographic • Race/ethnic • Linguistic

6. Geographic Diversity • Large metropolitan areas

7. Geographic Diversity • Large metropolitan areas • Agricultural areas

8. Geographic Diversity • Large metropolitan areas • Agricultural areas • Mountains

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

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

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

12. 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.

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

14. Mobility • Urban • Migrant workers • Mexican border

15. Infrastructure

16. 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

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

19. 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

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

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

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

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

24. California Program Data 2004 (Preliminary) 175 Hospitals participating

25. California Program Data 2004 (Preliminary)

26. California Program Data 2004 (Preliminary)

27. California Program Data 2004 (Preliminary)

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