University Centers for Excellence in Developmental Disabilities (UCEDDs) aim to positively affect the lives of people with disabilities by building and strengthening systems that support full community participation. The ExceLens series highlights the valuable work of the UCEDDs within university systems, the community, and in the lives of people with disabilities across the lifespan and their family members.

Sonran Center for Excellence in Disabilities - Community Services: Model Services 

Adults with intellectual developmental disabilities (IDD) have the right to access competent, accessible care in their own communities. Lack of primary care practices that provide this care contributes to health disparities in adults with IDD. Models of care for primary care practices must be developed and disseminated, and health care providers must be educated, in order to improve access to competent care and reduce health disparities for adults with IDD in Arizona (AZ) and in the nation. 

Clinical Innovation:
A model primary care program for adults with IDD at a University of Arizona (UA) family medicine (FM) residency teaching practice provides enhanced access to care and case management to approximately 110 adult patients with IDD, physical accessibility, staff and medical provider education, and quality initiatives. The model program has demonstrated improved access to care and reduced costs. Moreover, the clinical program has served as the foundation for educating future physicians through the resident and medical student curricula. 

Education: The clinical program became the backbone of a required curriculum in developmental medicine for the 24 UA FM residents who practice at this clinic in Tucson AZ. This includes a twelve-hour lecture series and team care of patients with IDD in the FM clinic with the program case manager, Ms. Valerie Mata, and oversight by Dr. Bassford, who directs the program. In 2019, teams of one second-year and one third-year FM resident, with Dr. Bassford and Ms. Mata, began providing one home visit each year to one of their continuity patients with IDD. This four-person team follows the patient throughout the year, providing ongoing care at the family medicine office or other settings as needed. Each resident team additionally makes one visit annually to another community-based site relevant to this patients health and well-being. 

As part of the participation of UA College of Medicine in Tucson (COM-T) in the National Curriculum Initiative in Developmental Medicine (T. Bassford and L. Tomasa, UA investigators), a two-week fourth-year elective for UA COM-T students was developed, built on the clinical program and residency curriculum. Students complete directed readings, participate in outpatient clinical care of patients with IDD in the UAFM teaching practice, and participate in-home visits with the team. Additionally, students gain an understanding of the larger context of disability though experiences with Sonoran UCEDD faculty and community collaborators in employment, guardianship and supported decision-making, and Self-Advocacy.  

Dissemination: In the spring of 2021, plans for dissemination of the clinical model to Mariposa Health Center (MHC), a Federally Qualified Health Center (FQHC) serving a rural county on the AZ-Mexico border, were developed with clinical leadership there. Technical assistance will be provided by the Sonoran UCEDD through October 2022. In the summer of 2021, the clinical model and residency curriculum in developmental medicine were expanded to a second UA FM residency site in Tucson, AZ. Funding was identified at the site for case management, patients began enrollment in July 2021, and the curriculum was initiated at that time.