CKSN UPDATE for December 15, 2003		ABC for Health, Inc.


IN THIS ISSUE:

1. Case Tip: How to Speed Up a Prior Authorization 
2. SmileAbilities Report from the Regional Western CSHCN Center
3. Who's Enrolled in SCHIP?
4. Bullying Resource
5. New Report Says People with Disabilities Struggle to Pay for Care
6. HealthWatch Updates

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1. CASE TIP:  HOW TO SPEED UP A PRIOR AUTHORIZATION

A response to a prior authorization request can take up to 20 days from the date of the initial request.  According to the DHFS web page, most decisions are made within 10 working days. (See the following website for more information: http://www.dhfs.state.wi.us/medicaid2/handbooks/all-provider/pa/pa_response.htm)
To speed up your request: 
* Make sure all the information on the prior authorization form is correct.  Pay special attention to spelling of names, dates of birth, and social security numbers. A PA with incorrect information will have to be resubmitted, delaying the process.
* FAX, rather than mail, the PA request.  This can save mailing transit time. Providers may submit their PA requests to Wisconsin Medicaid by fax at (608) 221-8616. To avoid delayed adjudication, do not fax and mail duplicate copies of the same PA/RFs. Refer to Appendix 9 <. /outpatient_appendix/appendix9.htm> of this handbook for further guidelines on submitting PAs by FAX.
* After faxing the request, follow-up with a phone call to EDS to make sure they've received the PA request. 
You may inquire about the status of the request by contacting Provider Services at (800) 947-9627 or (608) 221-9883 or by accessing the Automated Voice Response system.
Services requiring PA are identified in the service-specific handbooks and in HFS 107, Wis. Admin. Code <./../admin_code/hfs107.pdf> (PDF).

-----------------------------------------------------------------------------------------------------------2.	SMILEABILITIES REPORT FROM THE REGIONAL WESTERN CSHCN CENTER
The Western Regional Children with Special Health Care Needs/Oral Health
Planning Group in partnership with the WI. Dept. of Public Health and
organized "SmileAbilities" - Promoting Optimal Oral Health for Children
with Special Needs.  The event was held on November 14, 2003 in Eau Claire,
WI.  The conference provided oral health information to caregivers and service
providers of young children with special needs.  Oral health topics targeted
the unique needs of atypically developing children that includes patterns
of growth and development, prevention of oral disease, oral hygiene care,
nutrition and clinical/hospital-based dental treatment modalities.  Nancy McKenney, DHFS Oral Health Consultant and Sue Pyper, DFHS Southern Regional.  More information on Wisconsin's Oral Health Program can be found at:  http://dhfs.wisconsin.gov/health/Oral_Health/

------------------------------------------------------------------------------------------------------------3.	WHO'S ENROLLED IN SCHIP?

The Child Health Insurance Research Initiative has found that a higher percentage of children in State Children's Health Insurance Program (SCHIP) had special health needs than the general population. Most enrollees lived in families with working parents with incomes equal to or below 150% of the Federal Poverty Level. (Black and Hispanic children tended to live in families with lower incomes and have poorer health status than their white counterparts.) A solid majority of new enrollees received health care services prior to SCHIP enrollment, particularly preventive care, but nearly half of these children lacked some mental health, dental and vision care, or prescription medications. 
http://pediatrics.aappublications.org/cgi/content/full/112/6/SE1/e499
(Source:  Connect for Kids Weekly, www.connectforkids.org)

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4. BULLYING RESOURCE

The largest investigation to date on bullying and victimization among urban ethnic minority youth finds that there are significant differences between bullies, victims and students who are both, suggesting that different kinds of intervention are in order. Victims suffer emotional distress, but are unlikely to draw attention to their difficulties. Students who are both bullies and victims are by far the most troubled, socially ostracized by their peers, the least engaged in school and the most likely to display conduct problems. Bullies tend to enjoy high social status among their peers, even though classmates tend to avoid their company. 
http://pediatrics.aappublications.org/cgi/content/abstract/112/6/1231
(Source:  Connect for Kids Weekly)

------------------------------------------------------------------------------------------------------------5.	NEW REPORT SAYS PEOPLE WITH DISABILITIES STRUGGLE TO PAY FOR CARE

A national survey released today by the Kaiser Family Foundation finds that many non-elderly adults with disabilities face difficulties paying for needed health care:
-- nearly half (46%) report they go without equipment and other items due to cost; 
-- more than a third postpone care because of cost (37%); skip doses or split pills due to medication costs (36%); and spend less on basics such as food, heat, and other services in order to pay for health care (36%). You can find the report, "The Role of Health Coverage for People with Disabilities," and related material at:
http://www.kff.org/medicare/6106.cfm
(Source:  Jon Peacock, Wisconsin Council on Children and Families, www.wccf.org)

------------------------------------------------------------------------------------------------------------6.	HEALTHWATCH UPDATES

The next meeting of the SOUTHEASTERN REGION will be held on Thursday, December 18 at 5:00 pm at the Aurora Family Service, located at 3200 West Highland Avenue in Milwaukee.  The training, beginning at 6:30, will be on " The Medical Home for a Child with Special Health Needs."

The next meeting of the SOUTHERN REGION will be held on Monday, January 5 from 9 - 11 am at the Harambee Center, Madison Community Health Center, 2202 South Park Street in Madison. The presenter will be Bill Greer, administrator at the Mental Health Center of Dane County.  Access to psychiatric care will be the topic.


If you are interested in joining your regional HealthWatch committee, or want more information about their work, please contact the following people:

Southern Region:  Barbara Katz, ABC for Health, Inc., 608.261.6939 ext 207, barbk@safetyweb.org
Southeastern Region:  Brad Holman, Children's Hospital of Wisconsin, 414.266.3189,
bholman@chw.org or Brad Montgomery, 414.449.4777, opwindows@aol.com
Northern Region:  Deb Blackstone, Family Resource Connection, 715.365.8030,
dblacks@shsmh.org
Northeastern Region:  Steve Gerczak, St. Vincent Hospital, 920.433.8154,
sgerczak@stvgb.org
Western Region:  Rose Marsh, Chippewa County Dept of Public Health, 1-800-400-3678, rmarsh@co.chippewa.wi.us

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SUGGESTIONS OR TIPS FOR THE UPDATE?

We need your help to develop content and tips for our CKSN Update. Please let us know about your ideas or success stories.  Email your suggestions to barbk@safetyweb.org 

The CKSN Update is a bi-weekly electronic newsletter of the Covering Kids with Special Needs project that ABC for Health, Inc. is implementing with its partners, the Title V Children with Special Needs Regional Centers and Family Voices - Wisconsin.  If you would like to submit news and information in future CKSN Updates, please send it to the attention of Barbara Katz.  All submissions should be limited to 150 words.

ABC for Health is a Wisconsin-based, nonprofit public interest law firm dedicated to linking children and families, particularly those with special health care needs, to health care benefits and services.  ABC for Health's mission is to provide information, advocacy tools, legal services and expert support needed to obtain, maintain and finance health care coverage and services.

Barbara Katz, moderator
Parent Consultant
ABC for Health, Inc.
608.261.6939 ext. 207
barbk@safetyweb.org