Group

  1. Eda-Cristina Leon-Abuchaibe DO SE and Eastern Idaho Pediatric Cardiologist – Assistant Professor University of Utah Pocatello, ID
  2. Molly Steckel Idaho Medical Boise, ID
  3. Snyder, Scott MD AAP Idaho / Boise, ID
  4. Erin Bennett Idaho AHA
  5. Iverson, Sherry AAP
  6. Whitnee Hogan Pediatric Cardiology Fellow
  7. Jaquie Watson Idaho Department of Health
  8. Teresa Cirelli Idaho Medical Association
  9. Perry Brown MD Pediatrics Boise, ID
  10. Uranga, Mark MD Pediatrics Boise, ID
  11. Emily McClure
  12. Kelly Memphis ACC Advocacy
  13. Spencer D
  14. Elizabeth O Donell MD Neonatologist Pocatello/Idaho Falls

Links:

AAP – American Academy of Pediatrics

CDC –

March of Dimes

AHA – American Heart Association

ACC – American College of Cardiology

EMAIL COMMUNICATION

Molly Steckel
/ Sept 16
/

Hello Dr. Uranga and all,

IMA wholeheartedly agrees that it is best if the desired outcome can be achieved without the need for legislation. We are working to assess the current lay of the land and developing a strategic plan moving toward uniform screening requirements throughout Idaho.

We’ll keep you all posted as we work on this issue and appreciate being kept up on the progress others are making. Hopefully by keeping the lines of communication open, we can avoid duplicating efforts.

Thanks and have a great weekend!

Molly Steckel

Policy Director

Uranga, Mark MD
/ Sep 14 (3 days ago)
/

Cristina, thank you for bringing your passion to this issue in Idaho. I am fully supportive of screening all kids for CCHD. I worked to implement this at St. Luke’s, first in the Treasure Valley, and then supported people moving it system wide. I also spoke at the Idaho Perinatal Project a few years ago, where I learned that nearly every hospital represented there was performing the test. I have been leery of legislation because of its clunky nature. One of my early quandaries as director of the newborn nursery was considering whether erythromycin ointment could be delayed two hours to support breastfeeding, without violating the 1921 law to have a “germicide” “instilled immediately upon birth.” Violating that law is a misdemeanor, subject to fine of 10 to $100. No one has been prosecuted for not putting in antibiotic eye.

Also, I am not sure that it is necessary. I know that most hospitals are now performing the screen. I am sure that there are some that are not. Might it be a more effective outreach to simply address those on an individual basis?

Getting this group talking is a great way to get these questions answered. If there is a need for legislation, and it can be reasonably drafted, then I would support it. If I am to ask our legislators to support a bill, I want to stand on firm ground.

Thanks again,

Mark Uranga, MD

Idaho AAP and St. Luke’s Boise Nursery Director

From: "Watson, Jacqueline - CO 4th" <
Date: September 8, 2016 at 10:55:22 AM MDT

Hello,
Here is a link to CCHD Implementation Tool Kit from Children's National Medical Center in DC:
Also, the Association of Public Health Laboratories NewSTEPs Program offers technical assistance to states on CCHD implementation, including webinars and sample legislation from other states:
Jacquie Watson, MHS, Manager
Maternal and Child Health Programs
From: Eda-Cristina Leon-Abuchaibe <
Date: September 7, 2016 at 6:54:28 PM MDT

Here are the answers from pediatric cardiologist in SE/Eastern Idaho perspective

Can you provide a little more detail on current practices? Specifically:
1. Do you know if Luke's is the only facility doing CCHD screening for all infants in their care?

No - EIRMC, Portneuf and more recently Bingham Memorial are doing it - also local providers from the areas I cover

2. Do you bill specifically for CCHD screening or is it unbilled or lumped in with other newborn care services?

This can be included as part of the newborn evaluation - it is not usually a separate bill

For example - if kid born at home it can be included ln the first week newborn exam bill

If done at nursery - it can be as part of first physical exam and/or nursery the cost ranges usually 5-15 dol

This link has a summary on rationale how to implement costs etc

AAP AHA Utah Health Department CDC all have algorithms posted and specific steps for state implementation and reporting

3. If you do bill for it, what is the CPT code that is used?
4. What is the cost? 5-15 dol
5. Prior to Luke's doing voluntary screening on all infants, how did you determine when CCHD screening would be done (parent request, clinical indication, physician preference, etc.)?
6. Are you able to provide me with the toolkit or an instruction sheet from the toolkit?

Eda Cristina Leon-Abuchaibe DO

-----Original Message-----
From: Molly Steckel [mailto:
Sent: Wednesday, September 07, 2016 2:55 PM
Hi Scott and others,
Can you provide a little more detail on current practices? Specifically:
1. Do you know if Luke's is the only facility doing CCHD screening for all infants in their care?
2. Do you bill specifically for CCHD screening or is it unbilled or lumped in with other newborn care services?
3. If you do bill for it, what is the CPT code that is used?
4. What is the cost?
5. Prior to Luke's doing voluntary screening on all infants, how did you determine when CCHD screening would be done (parent request, clinical indication, physician preference, etc.)?
6. Are you able to provide me with the toolkit or an instruction sheet from the toolkit?
Thank you!
Molly Steckel
Idaho Medical Association
208.344.7888 O
208.866.2136 C
-----Original Message-----
From: Snyder, Scott MD [mailto:
Sent: Tuesday, September 6, 2016 1:45 PM
To provide some historical context, past efforts for this type of legislation have met with some reluctance. We therefore implemented CCHD screening voluntarily at St. Luke's Children's, then attempted to provide a toolkit for implementation at other hospitals and birth centers around the state.
I am very supportive of pushing for legislation, but we can keep this in mind if the legislative efforts are unsuccessful, to hopefully ensure that no Idaho infants with CCHD get missed.
Scott
-----Original Message-----
From: Erin Bennett [mailto:
Sent: Tuesday, September 06, 2016 12:19 PM
Hi Christina,
I am working with the ACC to get some questions answered that have been relayed to me from some others that have worked on this issue in the past. I think based on those answers we'll want to discuss with the Department of Health and Welfare if there are any other clarifications they need in order to move this forward. I think once we have some of those things answered, we can draft appropriate legislation, based on the resolution passed at IMA to run by all the organizations that might be impacted. I would want to ensure full support of all players before taking it forward to the Legislature to improve the chance of success. Maybe you and I can discuss more offline, and then we can set up a quick meeting to share with everyone and get the input/ feedback from any internal meetings they've had, and go from there? Let me know if that works and we can get something figured out.
Thanks!
Erin Bennett
Government Relations Director
Idaho Division
-----Original Message-----
From: Iverson, Sherry [mailto:
Sent: Sunday, September 04, 2016 11:07 AM
The Idaho Chapter has had some conversations with Erin Bennett at the American Heart Association but have not been working on details. I have included Perry Brown and Mark Uranga who are our legislative representatives and Dr. Uranga is also the newborn nursery medical director at St. Luke's which will bring a lot of expertise. Thanks. Sherry
Original Message-----
From: Molly Steckel [mailto:
Sent: Friday, September 02, 2016 1:31 PM
Hi Cristina,
IMA had a meeting last week to determine staff assignments on resolutions that passed our House of Delegates. Teresa Cirelli, IMA's Reimbursement Director, and I will be working on your resolution. Teresa and I will meet next week to come up with a strategy. If others on this email string have done work on this or have any ideas, please let us know.
Thanks!
Molly Steckel
-----Original Message-----
From: Eda-Cristina Leon-Abuchaibe [mailto:
Sent: Thursday, September 1, 2016 11:35 PM
Hi
Is there anything else that can be done to promote a policy so that newborn screen for critical congenital heart disease in Idaho becomes a more regulated process ? Attached is a resolution that was adopted at IMA meeting but I have not heard any other updates since the meeting.
Where does Idaho AAP, Idaho AHA, Idaho Health Department stand with this?
Thank you for your time let us know how we can work together to help move this forward ?
Eda-Cristina Leon-Abuchaibe, DO