BUILDINGBUILDING COMMUNITYCOMMUNITY CAPACITYCAPACITY FORFOR EHDIEHDI SERVICESSERVICES STATEWIDESTATEWIDE

A Model

Eric Cahill, M.S., CCC-A Kelly Daniel, M.S., CCC-A Lou Ann Jones, M.S., CCC-A Carolyn Kisler, M.A., CCC-A

Commission for Children with Special Health Care Needs KENTUCKY’S FAMOUS FOR…

KentuckyKentucky HBHB 706706 Spring 2000 Kids Now (Kentucky Invests in Developing Success)

„ Mandated UNHS for all birthing hospitals in KY w/40+ births/yr. „ Selected CCSHCN to manage UNHS „ Set strict guidelines for reporting & data January 1, 2001 full management. implementation MandatedMandated RiskRisk IndicatorsIndicators

ƒ HighHigh BilirubinBilirubin ƒ PPHNPPHN (Persistent(Persistent ƒ CraniofacialCraniofacial PulmonaryPulmonary AnomaliesAnomalies Hypertension)Hypertension) ƒ FamilyFamily HistoryHistory ofof HearinHearingg ƒ SyndromesSyndromes LossLoss ƒ Sepsis,Sepsis, Seizures,Seizures, ƒ HearingHearing ScreeningScreening MeningitisMeningitis ResultsResults ƒ OtotoxicOtotoxic MedicationsMedications ƒ LowLow APGARAPGAR ƒ Pre/perinatalPre/perinatal ƒ LowLow BirthBirth weightweight ConditionsConditions ƒ AnoxiaAnoxia oror apneaapnea KentuckyKentucky BirthBirth HospitalsHospitals

Birth Hospitals in yellow KentuckyKentucky DiagnosticDiagnostic TestTest CentersCenters

Level 1 Centers-Blue Level 2 Centers-Red DiagnosticDiagnostic AudiologyAudiology ResourceResource ListList

Diagnostic Audiology Resource List (Centers are grouped by Area Code and then alphabetized by City) •Level 1 Centers in North• See bottom of the front page for a description of Level 2 and 1 Centers • Level 2 Centers in • Commission for Children with Special 5850 US 60 Box 11 606-929-9155 See bottom of this page for a description of Level 2 and 1 Centers Ashland, KY 41102 800-650-1329 The Heuser Hearing Institute/ 117 E. Kentucky St. 502-584-3573 Health Care Needs, Ashland The Hearing Center 1505 Carter Ave. #1 Ashland, KY 41101 606-324-0465 Louisville Deaf Oral School Louisville, KY 40203 Kosair Children's Hospital, Audiology 231 East Chestnut St. Louisville, KY 40202 502-629-7710 Southern ENT Associates-Ashland 613 23rd St., Plaza B #310Ashland, KY 41101 606-326-0271 •Level 2 Centers in • Commission for Children with Special 214 W First Street 606-784-3049 St. Elizabeth Medical Center, One Medical Village Drive 859-301-5740 Health Care Needs, Morehead Morehead, KY 40351 800-928-3049 Speech & Audiology Edgewood, KY 41017 •Level 1 Centers in Area Code 606 South• Commission for Children with Special 110 Johnson Lane 606-546-5109 740 S. Limestone 859-257-3390 Health Care Needs, Barbourville Barbourville, KY 40906 800-348-4279 Lexington, KY 40536 Communicative Disorders Southeast Kentucky Audiology 1707 Cumberland Falls Hwy #U7 Corbin, KY 40701 606-528-9993 Kentucky ENT 1720 Nicholasville Rd. #501 Lexington, KY 40503 859-278-1114 ARH-Daniel Boone Clinic 37 Ball Park Road 606-574-8303 •Level 2 Centers in Area Code 606 North• Harlan, KY 40831 866-528-9993 King's Daughters Medical Center, 480 23rd Street 606-327-4682 A R Head & Neck Center 200 Medical Center Drive Hazard, KY 41701 606-439-4466 Audiology Ashland, KY 41101 Southern ENT Associates-Paintsville 404 Euclid Avenue 606-788-9304 Paintsville, KY 41240 •Level 2 Centers in Area Code 606 South• Commission for Children with Special 5000 KY Route 321 Highlands Regional Medical Center 606-889-1761 255 Church Street, Suite 101 Pikeville, KY 41501 606-432-4494 East Kentucky Eye, Ear, Nose and Throat Health Care Needs, Prestonsburg Prestonburg, KY 41653 800-594-7058 •Level 2 Centers in Area Code 270 East• Cumberland Otolaryngology Consultants 402 Bogle St #3 Somerset, KY 42503 606-679-7426 Commission for Children with Special 495 Three Springs Rd. 270-746-7816 •Level 1 Centers in Area Code 270 East• Health Care Needs, Bowling Green Bowling Green, KY 42104 800-843-5877 Sims & Boggess ENT 1325 Andrea #206 Bowling Green, KY 42104 270-782-7768 •Level 2 Centers in Area Code 270 West• Ewing ENT 105 Greenbriar Dr. #A Campbellsville, KY 42718 270-465-3595 Hearing Services of KY, Inc. 1717 High St. #2C Hopkinsville, KY 42240 270-886-8468 Commission for Children with Special 580 B Westport Road 270-765-6982 Commission for Children with Special 1600 Breckenridge St 270-687-7038 Health Care Needs, Elizabethtown Elizabethtown, KY 42701 800-995-6982 Health Care Needs, Owensboro Owensboro, KY 42303 877-687-7038 Wolf & Yun, MD, PSC 906 Woodland Dr. #102 Elizabethtown, KY 42701 270-765-5127 102 C Physicians Blvd Glasgow, KY 42141 270-651-2433 •Level 1 Centers in Area Code 502• Wilson ENT Ewing ENT 325 W Walnut #200 Lebanon, KY 40033 270-692-5600 Ireland Army Community Hospital Early Department of the Army 502-624-9552 •Level 1 Centers in Area Code 270 West• Intervention Services , KY 40121 For Army Dependents Only Trover Clinic 200 Clinic Drive Madisonville, KY 42431 270-825-7377 Clinical Audiology of Louisville 4001 Dutchmans Lane, Suburban Plaza #4C 502-893-5105 Morgan-Haugh Medical Group 1111 Medical Center Circle Mayfield, KY 42066 270-247-8100 Louisville, KY 40207 Murray State University- 125 Alexander Hall Murray, KY 40271 270-809-2446 Commission for Children with Special 982 Eastern Pkwy, Building B 502-595-4459 Speech & Hearing Clinic Health Care Needs, Louisville Louisville, KY 40217 800-232-1160 Midwest ENT 2841 New Hartford Road Owensboro, KY 42303 270-691-6161 x251 Audiology & Hearing Center 150 Brett Chase #B Paducah, KY 42003 270-554-6000 •Level 1 Centers in Area Code 859• Commission for Children with Special 400 Park Ave, Bldg D 270-443-3651 Cardinal Hill of 31 Spiral Drive 859-525-1128 Health Care Needs, Paducah Paducah, KY 42001 800-443-3651 Florence, KY 41042 Ear, Nose & Throat Group 2601 Kentucky Ave #201 Paducah, KY 42003 270-575-0079 Cincinnati Children's Hospital, 2765 Chapel Place Drive 859-344-4735 Purchase ENT 225 Medical Center Dr #304 Paducah, KY 42003 270-441-4301 Outpatient Clinic, KY Crestview Hills, KY 41017 Resources for Surrounding States Illinois Newborn Hearing Program, Caldwell & Cook Hearing Services, Inc 3940 S. Danville Bypass 859-236-3865 800-322-3722 Danville, KY 40422 Division of Specialized Care for Children Indiana Depart of Health, Head & Neck Surgery Associates 20 Medical Village Dr. #268 Edgewood, KY 41017 859-341-1100 888-815-0006 Head & Neck Surgery Associates 40 N Grand #101 Fort Thomas, KY 41075 859-781-4900 Audiology Coordinator for UNHS/EHDI Department of Health, Head & Neck Surgery Associates 7575 US 42 Florence, KY 41042 859-283-9100 614-387-0135 Infant Hearing Program Bluegrass ENT, Georgetown 1140 Lexington Road #205 Georgetown, KY 40324 859-277-3725 Newborn Hearing Program, Early Hearing 615-262-6160 Bluegrass ENT, Lexington 1401 Harrodsburg Rd. #A580 Lexington, KY 40504 859-277-3725 Detection and Intervention Commission for Children with Special 333 Waller Ave #300 859-252-3170 Department of Health, 866-493-1090 Health Care Needs, Lexington Lexington, KY 40504 800-817-3874 Newborn Hearing Program Lexington Hearing & Speech Center 162 North Ashland Lexington, KY 40502 859-268-4545 Office of Maternal Child and Family 800-642-8522 Bluegrass Hearing Clinic 1036 Amberly Way #A 859-623-4458 Health, Newborn Hearing Program 800-642-9704 Richmond, KY 40475 Missouri Department of Health and Senior Services, 800-877-6246 Newborn Hearing Program

LevelLevel II andand LevelLevel IIII CentersCenters

„ Level 2 Centers provide complete diagnostic follow-up assessment „ Otoscopy „ Tympanometry „ Ipsilateral Acoustic Reflex „ Contralateral Acoustic Reflex „ Otoacoustic Emissions with diagnostic capabilities „ Distortion Product or Transient „ Ear Specific Behavioral Observation Audiometry „ Speech Awareness Threshold evaluation and „ Speech Reception Threshold evaluation „ Play audiometry „ Frequency Specific ABR „ Bone Conduction ABR „ Real Ear Measures

„ Level 1 Centers provide diagnostic follow-up assessment with referralreferral to a Level II center if necessary „ Otoscopy „ Tympanometry „ Ipsilateral Acoustic Reflex „ Contralateral Acoustic Reflex „ Ear Specific Behavioral Observation Audiometry „ Speech Awareness Threshold evaluation and „ Speech Reception Threshold evaluation „ Play audiometry „ Either: „ Otoacoustic Emissions with diagnostic capabilities (Distortion Product or Transient) or „ Screening ABR, with threshold information available KentuckyKentucky DiagnosticDiagnostic CentersCenters andand BirthBirth HospitalsHospitals

Birth Hospitals- Yellow Level 1 Centers-Blue Level 2 Centers-Red KentuckyKentucky DiagnosticDiagnostic TestTest CentersCenters

Level 1 Centers-Blue Level 2 Centers-Red KYKY CHALLENGESCHALLENGES IDENTIFIEDIDENTIFIED

„ PERSONNELPERSONNEL ISSUES:ISSUES: „ HOSPITAL STAFF TURNOVER „ EHDI STAFF TURNOVER „ QUALITYQUALITY OFOF DIAGNOSTICDIAGNOSTIC AUDIOLOGYAUDIOLOGY SERVICESSERVICES „ ACCOUNTABILITYACCOUNTABILITY „ FRACTUREDFRACTURED SERVICESERVICE AVAILABILITYAVAILABILITY THOUGHOUTTHOUGHOUT THETHE STATESTATE MCHBMCHB GrantGrant

„ ChoseChose toto buildbuild locallocal capacitycapacity „ CommitteeCommittee ofof StakeholdersStakeholders „ IdentifyIdentify barriersbarriers uniqueunique toto theirtheir communitycommunity „ ShareShare informationinformation –– TeamTeam buildingbuilding MeetingMeeting THREETHREE COMMUNITIESCOMMUNITIES

„ DifferentDifferent demographicsdemographics andand levelslevels ofof need.need. „ PilotPilot programsprograms werewere askedasked toto developdevelop workingworking solutionssolutions toto statedstated goalsgoals andand objectivesobjectives „ DuplicationDuplication ofof successfulsuccessful programmingprogramming inin otherother areasareas ofof thethe statestate CommunityCommunity PartnersPartners IdentifiedIdentified

„ WesternWestern KentuckyKentucky--ChristianChristian CountyCounty „ CentralCentral KentuckyKentucky –– LincolnLincoln TrailTrail DistrictDistrict HealthHealth DepartmentDepartment „ EasternEastern KentuckyKentucky –– PikePike CountyCounty CHRISTIANCHRISTIAN COUNTYCOUNTY

„ OneOne birthingbirthing facilityfacility „ Jennie Stuart Medical Center-Level II NICU „ Birthrate-819 births for 2006 „ Refer Rate of 3.7% „ Additional Resident County births recorded at smaller hospitals or “at home”. LTDHDLTDHD

„ 77 counties:counties: Grayson,Grayson, Hardin,Hardin, Larue,Larue, Meade,Meade, Nelson,Nelson, Washington,Washington, MarionMarion „ 55 birthingbirthing facilitiesfacilities „ Approximately 1250 births/year „ County resident births also recorded in 10 additional hospitals PIKEPIKE COUNTYCOUNTY

„ TwoTwo birthingbirthing facilitiesfacilities „ Williamson ARH „ Birthrate –203 „ Refer rate – 7% „ Pikeville Medical Center Level II NICU „ Birthrate – 863 „ Refer rate – 2.6% BUILDBUILD COMMUNITYCOMMUNITY CAPACITYCAPACITY FORFOR EHDIEHDI ATAT LOCALLOCAL LEVELLEVEL

„ GoalGoaldevelopmentdevelopment 11:: FacilitateFacilitate ofof thethe communitycommunity partnerpartner teamsteams

„ Physician/pediatrician „ Audiologist „ Speech pathologist „ Educational Cooperative „ Teacher of the Deaf/Hard of Hearing „ Parent of deaf or hard of hearing child „ Deaf or hard of hearing consumer „ Birthing hospital personnel BUILDBUILD COMMUNITYCOMMUNITY CAPACITYCAPACITY FORFOR EHDIEHDI ATAT LOCALLOCAL LEVELLEVEL

„ GoalGoalaccessibilityaccessibility 2:2: IncreaseIncrease ofof objectiveobjective audiologicalaudiological andand medicalmedical diagnosticdiagnostic servicesservices forfor referralsreferrals fromfrom UNHSUNHS screeningsscreenings BUILDBUILD COMMUNITYCOMMUNITY CAPACITYCAPACITY FORFOR EHDIEHDI ATAT LOCALLOCAL LEVELLEVEL

„ GoalGoalnumbernumber 33:: IncreaseIncrease ofof infantsinfants thethe receivingreceiving diagnosticsdiagnostics byby 33 monthsmonths ofof ageage followingfollowing aa referralreferral fromfrom UNHSUNHS toto hospitalhospital dischargedischarge andand thethe reportingreporting followfollow thethe CCSHCNCCSHCN databasedatabase --upup toto --EHDIEHDI BUILDBUILD COMMUNITYCOMMUNITY CAPACITYCAPACITY FORFOR EHDIEHDI ATAT LOCALLOCAL LEVELLEVEL

„ GoalGoalcommunitycommunity 44:: ToTo improveimprove knowledge,knowledge, acceptanceacceptance andand supportsupport forfor thosethose infantsinfants andand youngyoung childrenchildren identifiedidentified asas DeafDeaf oror HardHard ofof HearingHearing andand theirtheir familiesfamilies ChristianChristian CountyCounty CHRISTIANCHRISTIAN COUNTYCOUNTY

„ OneOne birthingbirthing facilityfacility „ Jennie Stuart Medical Center-Level II NICU „ Birthrate-819 births for 2006 „ Refer Rate of 3.7% „ Additional Resident County births recorded at smaller hospitals or “at home”. CHRISTIANCHRISTIAN COUNTYCOUNTY Obstacle/barriersObstacle/barriers ProposedProposed OutcomeOutcome ToTo EHDIEHDI followfollow-- solutionsolution upup Community Private Practice Purchased Hospital selected Audiologist lacked equipment - initially equipment with technology and ability to bill housed at local hospital audiologist and for services. who billed for services arranged for and contracted with space and billing Audiologist provider. services. Equipment now housed at Private Practice Audiologist Facility and Hospital has a direct referral pathway to Audiologist. CHRISTIANCHRISTIAN COUNTYCOUNTY

Obstacle/barriersObstacle/barriers ProposedProposed OutcomeOutcome ToTo EHDIEHDI followfollow-- solutionsolution upup LocalLocal HospitalHospital hashas ResearchedResearched OrderedOrdered NICU,NICU, butbut OnlyOnly andand purchasedpurchased DecemberDecember 20052005 doingdoing OAEOAE screensscreens ABRABR screenerscreener DeliveredDelivered andand forfor hospitalhospital staffstaff trainedtrained FebruaryFebruary 20062006 CHRISTIANCHRISTIAN COUNTYCOUNTY Obstacle/barriersObstacle/barriers ProposedProposed OutcomeOutcome ToTo EHDIEHDI followfollow-- solutionsolution upup ReferralReferral pathwaypathway CoordinatorCoordinator atat March,March, 20062006 toto undefinedundefined JSMCJSMC andand present:present: directdirect audiologistaudiologist toto referralreferral workwork onon solutionsolution pathwaypathway defineddefined andand implementedimplemented CHRISTIANCHRISTIAN COUNTYCOUNTY

Obstacle/barriersObstacle/barriers ProposedProposed OutcomeOutcome ToTo EHDIEHDI followfollow-- solutionssolutions upup No system/equipment Track home In October 2005. to offer Home birth births, OAE machine loaned infants screening Submit Hearing from CCSHCN. Screen Reports Based on usage of to state equipment, Screen with recommended equipment as purchase of OAE available screening equipment- April 2007 CHRISTIANCHRISTIAN COUNTYCOUNTY

Obstacle/BarrierObstacle/Barrier ProposedProposed OutcomeOutcome toto FollowFollow--upup SolutionSolution Outreach to PurchasePurchase Discussion began neighboring screeningscreening in January 2007 county/Birthing AABRAABR forfor during EHDI hospital-screening coordinator’s equipment could not hospitalhospital technical be repaired, did not assistance visit have a printer or with hospital. database available Equipment purchased- Feb/March 2007 CHRISTIANCHRISTIAN COUNTYCOUNTY

Obstacle/BarrierObstacle/Barrier ProposedProposed OutcomeOutcome toto EHDIEHDI FollowFollow-- SolutionsSolutions upup LackLack ofof knowledgeknowledge PublicPublic BillboardBillboard placedplaced aboutabout newbornnewborn outreachoutreach withwith inin NovemberNovember hearinghearing screeningscreening billboardbillboard 20072007 atat inin neighboringneighboring advertisementadvertisement MuhlenbergMuhlenberg countycounty forfor EHDIEHDI CommunityCommunity HospitalHospital

LincolnLincoln TrailsTrails DistrictDistrict HealthHealth DepartmentDepartment LTDHDLTDHD

„ 77 counties:counties: Grayson,Grayson, Hardin,Hardin, Larue,Larue, Meade,Meade, Nelson,Nelson, Washington,Washington, MarionMarion „ 55 birthingbirthing facilitiesfacilities „ Approximately 1250 births/year „ County resident births also recorded in 10 additional hospitals LincolnLincoln TrailTrail DistrictDistrict HealthHealth DepartmentDepartment

„ IdentifiedIdentified „ ProposedProposed BarriersBarriers solutions/Outcomessolutions/Outcomes „ Difficulty „ Coordination with birth obtaining local hospitals to obtain newborn information on hearing screening results infants in need „ Coordination with pediatric of services practice in Bardstown „ AABR/OAE rescreening equipment purchased „ Results to BCC committee as well as EHDI Program LincolnLincoln TrailTrail DistrictDistrict HealthHealth DepartmentDepartment

„ IdentifiedIdentified „ ProposedProposed BarriersBarriers solutions/Outcomessolutions/Outcomes „ Lack of „ Attempted to recruit a resources and “parent mentor” to be able support for to contact families and parents encourage follow up. „ Unsuccessful to date. LincolnLincoln TrailTrail DistrictDistrict HealthHealth DepartmentDepartment

„ IdentifiedIdentified „ ProposedProposed BarriersBarriers solutions/Outcomessolutions/Outcomes „ Lack of uniform „ EHDI Brochure, May ’06 parent „ English and Spanish versions educational „ Speech/Language materials. Milestones, May ’06 „ English and Spanish versions „ Opening Doors, in process „ Parent information booklet SpeechSpeech andand LanguageLanguage MilestonesMilestones EHDIEHDI BrochureBrochure EHDIEHDI BROCHUREBROCHURE LincolnLincoln TrailTrail DistrictDistrict HealthHealth DepartmentDepartment

„ IdentifiedIdentified „ ProposedProposed BarriersBarriers solutions/Outcomessolutions/Outcomes „ Lack of available „ Coordination with Danville, diagnostic ABR KY audiologist equipment and „ Diagnostic ABR equipment providers in 3 of recently purchased for 7 counties placement in her practice with Memorandum of Agreement. LincolnLincoln TrailTrail DistrictDistrict HealthHealth DepartmentDepartment

„ IdentifiedIdentified „ ProposedProposed BarriersBarriers solutions/Outcomessolutions/Outcomes „ Many infants „ Ongoing coordination with born outside of Health Department clinics to KY birthing complete Hearing Screening hospitals Report forms for transmittal to EHDI program and LTDHD committee. LincolnLincoln TrailTrail DistrictDistrict HealthHealth DepartmentDepartment

„ IdentifiedIdentified „ ProposedProposed BarriersBarriers solutions/Outcomessolutions/Outcomes „ Lack of EHDI „ CME offerings to area knowledge and physicians by AAP EHDI awareness by Chapter Champion. area physicians PikePike CountyCounty PIKEPIKE COUNTYCOUNTY

„ TwoTwo birthingbirthing facilitiesfacilities „ Williamson ARH „ Birthrate –203 „ Refer rate – 7% „ Pikeville Medical Center Level II NICU „ Birthrate – 863 „ Refer rate – 2.6% PikePike CountyCounty PIKEPIKE COUNTYCOUNTY

Obstacle/barriersObstacle/barriers ProposedProposed OutcomeOutcome ToTo EHDIEHDI followfollow--upup solutionssolutions

LackLack ofof communitycommunity DisseminationDissemination BeganBegan 8/058/05 knowledgeknowledge ofof informationinformation andand continuingcontinuing concerningconcerning thethe andand materialsmaterials • Table sponsored at Pike importanceimportance ofof earlyearly toto targettarget County Baby Shower (August 2005) hearinghearing detectiondetection audienceaudience • Sponsored at table at the WIC (Women, andand interventionintervention Infants, and Children) fair at the Pike County Health Department PIKEPIKE COUNTYCOUNTY

Obstacle/barriersObstacle/barriers ProposedProposed OutcomeOutcome ToTo EHDIEHDI followfollow--upup solutionssolutions

LackLack ofof communitycommunity DisseminationDissemination BeganBegan 8/058/05 knowledgeknowledge ofof informationinformation andand continuingcontinuing concerningconcerning thethe andand materialsmaterials • Article in “The Medical importanceimportance ofof earlyearly toto targettarget Leader” published by the Pikeville Medical Center hearinghearing detectiondetection audienceaudience (September 2005) • Pediatrician Luncheon andand interventionintervention and Dinner - Kentucky AAP Chapter Champion (March 2006)

PIKEPIKE COUNTYCOUNTY

Obstacle/barriersObstacle/barriers ProposedProposed OutcomeOutcome ToTo EHDIEHDI followfollow--upup solutionssolutions

LackLack ofof communitycommunity DisseminationDissemination • Two billboards knowledgeknowledge ofof informationinformation along Highway concerningconcerning thethe andand materialsmaterials 23 (30,000 importanceimportance ofof earlyearly toto targettarget cars per day) April 2007 hearinghearing detectiondetection audienceaudience andand interventionintervention PikePike CountyCounty PikePike CountyCounty PikePike CountyCounty PIKEPIKE COUNTYCOUNTY

Obstacle/barriersObstacle/barriers ProposedProposed OutcomeOutcome ToTo EHDIEHDI followfollow--upup solutionssolutions LackLack ofof accessaccess toto PartnerPartner withwith VRAVRA andand ABRABR diagnosticdiagnostic audiologyaudiology locallocal entityentity EquipmentEquipment equipment; closest to obtain equipment; closest to obtain purchasedpurchased MarchMarch LevelLevel IIII diagnosticdiagnostic technologytechnology 2006/ High centercenter 1.51.5 hourshours oror neededneeded inin 2006/ High Frequency moremore awayaway areaarea Frequency Tympanometry/Tympanometry/ ABRABR BoneBone ConductionConduction PIKEPIKE COUNTYCOUNTY Obstacle/barriersObstacle/barriers ProposedProposed OutcomeOutcome ToTo EHDIEHDI followfollow--upup solutionssolutions Continuous monitoring of Work with Pike County DPOAE hearing for ages birth to Health Department to screening at 3 years who are at risk provide periodic OAE the Health for late onset of hearing screening for the birth Department loss who may not to 3 year population. otherwise be receiving Training for staff and hearing services. setting of protocols Work with NCHAM ECHO project for training and protocols. PIKEPIKE COUNTYCOUNTY Obstacle/barriersObstacle/barriers ProposedProposed OutcomeOutcome ToTo EHDIEHDI followfollow--upup solutionssolutions UndefinedUndefined referralreferral AssistAssist andand BeganBegan inin pathwaypathway ;; closestclosest encourageencourage summersummer LevelLevel IIII diagnosticdiagnostic familiesfamilies whowho 20052005 andand centercenter 1.51.5 hourshours oror havehave anan infantinfant continuingcontinuing moremore awayaway whowho referredreferred onon newbornnewborn hearinghearing screeningscreening toto seekseek audiologicalaudiological followfollow--upup PikePike CountyCounty

Birth Hospitals- Yellow Level 1 Centers- Blue Level 2 Centers- Red PIKEPIKE COUNTYCOUNTY Obstacle/barriersObstacle/barriers ProposedProposed OutcomeOutcome ToTo EHDIEHDI followfollow--upup solutionssolutions NoNo formalformal familyfamily WorkWork withwith teachersteachers FamilyFamily supportsupport inin areaarea oror ofof thethe deafdeaf andand Day/FallDay/Fall adjacentadjacent areaarea hardhard ofof hearinghearing inin GatheringGathering thethe areaarea andand (September(September provideprovide aa oneone dayday 2007)2007) learninglearning vacationvacation forfor familiesfamilies withwith childrenchildren whowho areare deafdeaf andand hardhard ofof hearing.hearing. followfollow--upup PikePike CountyCounty PikePike CountyCounty

Family Day PikePike CountyCounty

Family Day STATEWIDESTATEWIDE

Obstacle/barriersObstacle/barriers ProposedProposed OutcomeOutcome ToTo EHDIEHDI followfollow--upup solutionssolutions LackLack ofof aa cohesivecohesive ImproveImprove BeganBegan 7/067/06 –– familyfamily supportsupport collaborationcollaboration continuingcontinuing network.network. betweenbetween professionalsprofessionals andand parentalparental supportsupport groupsgroups forfor EHDIEHDI STATEWIDESTATEWIDE Obstacle/barriersObstacle/barriers ProposedProposed OutcomeOutcome ToTo EHDIEHDI followfollow-- solutionssolutions upup LackLack ofof targetedtargeted ProvideProvide CMECME Began July 05, educationeducation forfor areaarea opportunitiesopportunities Dr. Dan Stewart physiciansphysicians withwith AAPAAP ChapterChapter presented to ChampionChampion physicians at Jennie Stuart regardingregarding EHDIEHDI Medical Center, Hardin Memorial Hospital, Williamson ARH, and Pikeville Medical Center STATEWIDESTATEWIDE

Obstacle/barriersObstacle/barriers ProposedProposed OutcomeOutcome ToTo EHDIEHDI followfollow--upup solutionssolutions LackLack ofof knowledgeknowledge StatewideStatewide AprilApril 20062006 regardingregarding EHDIEHDI teambuildingteambuilding RepresentativesRepresentatives meeting with meeting with FromFrom allall presentations presentations communitiescommunities by EHDI by EHDI werewere requiredrequired stakeholders stakeholders toto attendattend andand nationalnational programsprograms STATEWIDESTATEWIDE

Obstacle/barriersObstacle/barriers ProposedProposed OutcomeOutcome ToTo EHDIEHDI followfollow--upup solutionssolutions EarlyEarly InterventionIntervention SKISKI--HIHI parentparent 33 dayday trainingtraining education/trainingeducation/training advisoradvisor trainingtraining occurredoccurred inin issuesissues forfor earlyearly June,June, 20072007 WorkingWorking withwith DeafDeaf interventionistsinterventionists 33 dayday trainingtraining andand HardHard ofof HearingHearing workingworking withwith inin JulyJuly 20072007 infants and ChildrenChildren infants and 2525 peoplepeople families. families. trainedtrained ACCOMPLISHMENTSACCOMPLISHMENTS

„ Improved Communication: Among hospitals, families, physicians, diagnostic audiologists and state EHDI reporting system

„ Improved access: Increased the availability of diagnostic audiology services for 0-6 month. Increased re- screening in communities.

„ Increase EHDI Awareness: Outreach activities, to families, CEUs for allied health, CMEs for physicians LessonsLessons learnedlearned

„ TheThe valuevalue ofof havinghaving aa leadlead personperson whowho isis aa ““gogo gettergetter”” andand wellwell organizedorganized inin eacheach locallocal communitycommunity toto workwork andand partnerpartner withwith agenciesagencies „ TheThe valuevalue ofof havinghaving anan individualindividual’’ss knowledgeableknowledgeable ofof communitycommunity barriersbarriers andand thethe resourcesresources thatthat areare availableavailable toto overcomeovercome thosethose barriers.barriers. „ TheThe valuevalue ofof havinghaving individualsindividuals experiencedexperienced inin workingworking withwith communitycommunity basedbased programsprograms SOMESOME FUTUREFUTURE PLANSPLANS

ChristianChristian LTDHDLTDHD PikePike CountyCounty CountyCounty PlacementPlacement ofof CollaborateCollaborate withwith AdditionalAdditional publicpublic diagnosticdiagnostic audiologistsaudiologists inin outreachoutreach withwith followfollow--upup borderingbordering billboardbillboard equipmentequipment inin countiescounties toto advertisementadvertisement ENTENT’’ss officeoffice inin LTDHDLTDHD forfor andand educationaleducational MuhlenbergMuhlenberg provisionprovision ofof materialsmaterials forfor CountyCounty servicesservices EHDIEHDI STATEWIDESTATEWIDE CONTINUOUSCONTINUOUS PARTNERSHIPSPARTNERSHIPS

„ HOSPITALHOSPITAL COMPLIANCECOMPLIANCE GUIDES/VISITSGUIDES/VISITS „ AUDIOLOGYAUDIOLOGY OUTREACHOUTREACH „ PHYSICIANPHYSICIAN OUTREACHOUTREACH „ CEUCEU PRESENTATIONSPRESENTATIONS „ ADVISORYADVISORY BOARDBOARD STATEWIDESTATEWIDE „ COMMUNITYCOMMUNITY BASEDBASED ADVISORYADVISORY BOARDSBOARDS ACKNOWLEDGMENTSACKNOWLEDGMENTS

„ PikePike CountyCounty HealthHealth DepartmentDepartment „ PennyrilePennyrile AlliedAllied CommunityCommunity ServicesServices--ChristianChristian CountyCounty „ LincolnLincoln TrailTrail DistrictDistrict HealthHealth DepartmentDepartment „ MichelleMichelle King,King, CCCCCC--A,A, AUDAUD--EHDIEHDI AdministratorAdministrator StateState ofof KentuckyKentucky „ MCHBMCHB HRSAHRSA GrantGrant 93.25193.251 H61MC00033H61MC00033--0505--0000 COMMENTS/QUESTIONSCOMMENTS/QUESTIONS