Connecticut
Medicaid Managed Care Council
Quality Assurance Subcommittee
Legislative Office Building Room 3000, Hartford CT 06106
(860) 240-0321 Info Line (860) 240-8329 FAX (860) 240-8307
www.cga.state.ct.us/ph/medicaid

 

Obesity Work Group Meeting Summary: Feb. 26, 2004

Chair:  Paula Armbruster

(Nest Meeting March 18, 9:30 AM ini LOB RM 2600)

Legislative Update:  There are several proposed bills that address childhood obesity:

·             SB 357: from the PH Committee, adds the BMI to the school health assessment, reporting rates of overweight/obesity to local HD and DPH, ensure recess time in the school day, access to dairy products.  Bill status: filed with the Leg. Commission office (LCO).

·              HB 5344 from the Select Committee on Children, addresses recess periods and dairy products in the school.  Status: reported out of the LCO.

·             HB 5351 from the Select Committee on Children, lowers the threshold for schools eligible to participate in the federal school breakfast program. Status: reported out of LCO.

 

Obesity Services Matrix

Several of the MCOs were unable to attend; the group reviewed the updated information and suggested:

·             That there be uniformity about medical review of access to gastric surgery for those <18 years on the matrix,

·             Clarify reimbursement of FQHCs and SBHC in providing obesity-related services.

 

Discussion:  There was continued discussion about the complexity of childhood/adult overweight & obesity.  Sharon Mierzswa stated there is now state-specific obesity-related cost data available for adults.  In CT 4.3% of health care costs are related to obesity, which is 11% of overall state expenditures.  There may be a way to identify obesity-related costs in HUSKY and the potential cost effectiveness of preventive obesity-related services.  Dr. Kamens noted that prevention and intervention is really a moral issue of permitting and/or encouraging harmful life styles.  The work group agreed that recommendations would be made, forwarded to the QA subcommittee and Medicaid Council.  These recommendations, highlighted during the discussion, could include, but not be limited to:

·             Targeting prevention to those with BMI of 85-87%, as an attempt to reverse the growing trend in childhood obesity.  The Shapedown program information was provided (had been emailed prior to the meeting) as an example of a nationally tested family-based weight management program for children & adolescents.  Information can be found at www.shapedown.com

·             Consider further development of community-based programs such as those funded through the DPH grant in Ledyard and East Hartford. The Grostein (?sp) Foundation that supports investing in healthy children may a resource.

·             Encourage health practitioners to adopt specific guidelines in obesity screening and management.

·             Information in Managed Care organizations’ member and provider newsletters that target childhood obesity. 

·             Health practitioner training in early intervention with parents of children 12-18 months to 4 years old in providing parents with anticipatory guidance on the introduction of solid foods into the young child’s life and food as a reinforcement for desirable behavior.

 Paula Armbruster asked Dr. Geertsma and Dr. Karen Dorsey to develop guidelines for the work group consideration at the March 18th meeting.

 

Quality Assurance Subcommittee

Meeting Summary:  February 26, 2004

Chair:  Paula Armbruster

 

QA Subcommittee Focus areas:

 

There was agreement to continue to work on obesity (see above) as well comprehensive adolescent preventive health.  Regarding the latter, the State did not receive the grant that would have focused on life style assessment, documentation and follow up care & referrals.  The MCOs will be developing pilots that target adolescent health care.  The CHNCT has a teen advisory group that focuses on increasing teen preventive care visits.  Dr. Geertsma recommended that interested health practitioners, the MCOs, representatives from SBHC, FQHCs, DPH meet toward the end of April at an evening meeting to discuss the MCO plans and consider how practitioners can work with the MCOs to engage teens in preventive care and identify key components of an adolescent preventive visit.

 

The following represents other areas the subcommittee may consider in the HUSKY A & B program:

 

·             Per Sen. Harp’s (Chair of the Medicaid Council) request: 1) assess adult health in HUSKY and 2) consider a public health approach to hospital/ED use.

ü      Semi-annual report of the common diagnoses (8-10) for hospital admissions:

ü      Semi-annual report of the common diagnoses (8-10) for ED visits

 

 

There was agreement to request data on ED and hospital admissions common diagnoses from the MCOs’ database with a comparison of statewide data from the hospital CHIME database.  The information should be requested by cohort age groups, rather than the broader range of <19 and >19 years. 

 

This discussion will continue at the March meeting, scheduled for Thursday March 18, 10:30 AM.  The Obesity work group will meet at 9:30 on March 18, 2004. Both meetings are scheduled for LOB RM 2600.