Project Description:
1) People with intellectual/developmental disabilities (IDD) are an under-recognized group who suffer from health disparities. Due to advances in the medical care of children with IDD, people with IDD are living longer and require additional supports for themselves and their families as they age. Changes in policy over the last few decades have meant that the overwhelming majority of people with IDD live in the community, and rely on physicians in their communities for care.
Health care settings are not accessible to people with IDD. The majority of physicians have limited knowledge regarding the health and psychosocial needs of this population, primarily due from a lack of exposure and training. Despite having higher rates of chronic disease than the neurotypical population, people with IDD are less likely to receive preventive care and screenings. They are also less likely to be asked preventive health related questions.
2) The goal of the this project is to provide both didactic and experiential training to family medicine residents in the field of developmental medicine the care of individuals with IDD across the lifespan.
3) This a three year curriculum which is integrated into the family medicine teaching clinic at Banner University Medical Center South in Tucson, Arizona. Residency faculty are members of the University of Arizona Department of Family and Community Medicine.
A model coordinated primary care program (MCPCP) for adults with IDD, is embedded in the clinic, and family medicine residents act as primary care providers for these patients, under the supervision faculty. Elements of the clinical program include enhanced access to care, physical accessibility, case management, a visit template, and staff/provider education.
Family medicine residents receive a twelve-hour lecture series on care of people with intellectual/developmental disabilities. Dr. Bassford is the lead physician and provides quality assurance and clinical oversight for the 110 patients who participate in the program. She and the program case manager, Valerie Mata, perform chart reviews for preventive examinations and referral follow up, as well as contact patients and/or family/support staff for preventive referrals, influenza vaccines, etc.
The program case manager attends visits with patients to assist with referrals and issues in real time, as well as to model person first language and other desired behaviors. Dr. Bassford is available to answer questions by telephone, by EHR, or to examine patients with the residents.
As of the 2018-2019 academic year, third year family medicine resident provided one home visit to a program patient, accompanied by Dr Bassford and Ms Mata. Before the visit they reviewed the patient chart and an article on home visits,. After each visit, they completed a home visit check list.
Beginning in the 2019-2020 academic year, each second and third year family medicine resident will pay one home visit to two of their continuity patients with IDD each year, accompanied by Dr. Bassford and Ms. Mata. They will additionally make one visit annually for each of these two patients to another community-based site relevant to their health and well-being. This may include such places as a work place, day program, volunteer setting, wheelchair assessment visit, habilitation visit, or skilled nursing facility.
4)To assist family medicine residents to develop the skills necessary to care for youth adult patients with intellectual and developmental disabilities in a full range of residential settings. The resident should demonstrate knowledge of the physical, emotional, and social needs of adults with I/DD through the aging process, and familiarity with family, work, social, and community resources available to support their goals.
Keyword(s):
education, medical, resident, developmental medicine
Unserved or Under-served Populations:
Racial or Ethnic Minorities, Disadvantaged Circumstances, Limited English, Geographic Areas, Urban
