NASDDDS
2004 Annual Meeting
November 17-19, 2004

Holiday Inn Select Old Town
480 King Street
Alexandria, Virginia
TEL: (703) 549-6080

Ensuring Access to
High Quality Health & Dental Care

Meeting Presentations

All of the presentation files are in PDF format and require Adobe Acrobat Reader. To view a presentation file, click on the appropriate PDF icon ().

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KEYNOTE ADDRESS II:
A Healthy State for Everyone: Health Promotion and Wellness for Individuals with Developmental Disabilities

Presenter: Sheryl White-Scott, MD (St. Charles Developmental Disabilities Program at St. Vincent Catholic Medical Centers of New York)

White-Scott(Keynote II).pdf (943 KB)

The current health care system in America has shifted to include health promotion and wellness as a major focus of health care. Individuals with developmental disabilities need to be fully integrated in disease prevention and health promotion. Dr. White-Scott provided an overview of health promotion, wellness, and strategies to address the specific needs of individuals with developmental disabilities.

PLENARY SESSION:
Addressing the Ethical Dilemmas of Providing Health Care - Including End-of-Life Care - to Individuals with Severe, Chronic Disabilities

Moderator: Pat Wear II (Kentucky DMH/MR Services)

Presenters: Marianne Meacham (Massachusetts DMR), Betsy B. Johnson (Massachusetts DMR), and Tina Kitchin, MD (Oregon DHS)

Johnson(Plenary).pdf (105 KB)
Kitchin(Plenary).pdf (111 KB)

Ms. Meacham opened this plenary session by presenting the framework for legal decision-making that is the context for treatment decisions, including end-of-life treatment decisions. Ms. Johnson discussed ways to address difficult treatment dilemmas including issues of end of life. Other concerns include Do Not Resuscitate orders, hospice, and treatment issues such as cancer and Alzheimer's disease. Finding a person to make medical decisions for people who are not capable of making those decisions while maximizing their control and independence can be very difficult. Dr. Kitchin described a process of appointing a health care representative along with its legal basis in Oregon.

LUNCH PRESENTATION:
NASDDDS Yesterday and Today: Celebrating 40 Years of Service

Presenter: Bob Gettings, Executive Director, NASDDDS

Gettings.pdf (2520 KB)

BREAKOUT SESSIONS I:
Improving Access to High-Quality Health Services

SESSION I-A: Using Health Care Indicators to Improve Individual and Systemic Health Care Outcomes

Presenters: Tina Kitchin, MD (Oregon DHS); Anthony J. Asciutto (Medstat); Marcia Hill (Delmarva Foundation); and Sarah Taub (HSRI)

Kitchin(I-A).pdf (180 KB)
Asciutto(I-A).pdf (1019 KB)
Taub(I-A).pdf (294 KB)

Dr. Kitchin shared the tools and processes of Oregon's Risk Tracking Record that identifies and responds to risks in a 24/7 residential system. The record identifies health conditions that are known to place individuals at risk of serious health complications and death. She will also discuss certain conditions that require the development and use of standardized health protocols for certain conditions. Mr. Asciutto and Ms. Hill reviewed and discussed strategies that the Florida Statewide Quality Assurance Program has implemented, through the Delmarva Foundation and its partners, to facilitate more effective use of data at the local district level and foster organizational change that supports the achievement of results important to consumers. Ms. Taub presented new cross-state health care indicator data from the National Core Indicators (NCI) project and discuss efforts by participating NCI states to expand the use of health data. NCI has been collecting and reporting health care indicators for seven years.

SESSION I-B: Improving Collaborative Working Relations Between Community Service Agencies and Health Care Providers

Presenters: Jill Morrow, MD (Pennsylvania OMR) and Gail Grossman (Massachusetts DMR)

Morrow(I-B).pdf (111 KB)
Grossman(I-B).pdf (546 KB)

Communication between health care providers and community service agencies is crucial for people's health. However, there are many barriers on both sides that impede the ability to communicate effectively. Dr. Morrow and Ms. Grossman explored these barriers, both from the perspective of the health care provider and the community service provider, and offer suggestions to avoid communication difficulties. The presentation outlined the Massachusetts DMR Health Promotion and Coordination Initiative. The Initiative sets up a system of standards for health screening, observation, and recording of health status, an integrated service planning process, and clinical consultation. The Initiative enhances the ability of direct support professionals to be health care advocates with the generic health services providers.

SESSION I-C: Improving Health and Dementia Care Services to Older Americans with Developmental Disabilities

Presenters: Lawrence T. Force, PhD (New York State OMRDD), Matthew P. Janicki, PhD (RRTCADD, University of Illinois at Chicago), and Thomas F. Kelly, MD (Delaware DHS/DDD)

Kelly(I-C).pdf (431 KB)

Individuals with intellectual disabilities are living longer lives; the increase in longevity has impacted policies, programs, and clinical interventions. In this session, Dr. Force provided an overview of New York state's Office of Mental Retardation and Developmental Disabilities' training platform on "Aging with Dignity." Dr. Janicki offered practical solutions and options to adapt current service programs in order to support individuals with intellectual disabilities and Alzheimer's disease and/or dementia. Dr. Kelly discussed relevant health promotion and clinical issues: healthy aging, fall prevention, mobility/frailty, and the burden of chronic illness.

BREAKOUT SESSIONS III:
Promoting Wellness Among People with Disabilities

SESSION III-A: Combating High Risk Behaviors: Preventing Obesity, Smoking, and Alcohol Abuse

Presenters: Paula M. Minihan, PhD, MPH (Tufts University School of Medicine) and Linda Bandini, PhD, RD (Shriver Center/UMASS Medical School)

Minihan&Bandini(III-A).pdf (1669 KB)

This session focused on personal health behaviors that impact the health of people with developmental disabilities but are not under the control, or perhaps even the influence, of health care providers. These include healthy eating, physical activity, limited sedentary behavior, not smoking, avoiding secondhand smoke, not using illicit drugs, and not abusing alcohol. Promoting healthy living while protecting consumer choice and self-determination presents challenges, particularly in state residential systems committed to supported living.

SESSION III-C: Reducing Mortality and Morbidity Through the Use of Improved Risk Management Strategies

Presenters: Andrew D. Eddy, MD, MS (Ohio DMRDD), Betsy B. Johnson (Massachusetts DMR), and Cindy Brown, RNC/FNP (Monson Developmental Center)

Eddy(III-C).pdf (303 KB)

Dr. Eddy highlighted data from Ohio's statewide Major Unusual Incident reporting system and mortality review process and will discuss how this data has been used to develop strategies to address health and safety issues and improve outcomes. Ms. Johnson and Ms. Brown presented an overview of a systemic response to mortality and morbidity: strategies for improving outcomes.

SESSION III-D: Developing an Effective Medication Management Program for Persons with Developmental Disabilities

Presenters: Kay Green (Missouri DMH/MRDD), Kent Stalder (Missouri DMH/MRDD), and Jill Morrow, MD (Pennsylvania OMR)

Green&Stalder(III-D).pdf (104 KB)
Morrow (III-D).pdf (304 KB)

Ms. Green and Mr. Stalder from Missouri's Division of Mental Retardation and Developmental Disabilities shared information on their programs and processes for monitoring and managing medications for persons living in division-funded community living arrangements. Information on the division's Medicaid Administration regulation, role of community nurses, and the service coordination monitoring process will be provided. Medication management requires a partnership between the caregiver(s) and the medical community. Dr. Morrow explored how Pennsylvania looks at medications from both the context of the medical provider and the provider of mental retardation services including teaching about observation about medication effects, communicating with health care providers, and working to avoid medication errors.

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