Addressing Intimate Partner Violence During the COVID19 Pandemic
August 6, 1-2 PM
Presenter: Stacy A. Ogbeide, PsyD, MS, ABPP
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COVID-19 has created isolation, job losses and increased stress. All these factors increase the risk of domestic violence, which has risen sharply with the pandemic.
Stacy A. Ogbeide is a Board-certified clinical health psychologist who focuses on identifying, screening and referring to treatment for intimae partner violence. Dr. Ogbeide will help clinicians address intimate partner violence in their practice so patients can connect to the help they need to be safe at home.

Acting on the “ACT” Score: What an Asthma Control Test Can Do for You
The first in a series of webinars focused on treating, managing and measuring asthma
Featuring: Dr. Nicholas Antos, Children’s Wisconsin
August 17, 2020, Noon – 1 PM
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Asthma affects over 400,000 adults and more than 100,000 children in Wisconsin. Helping people with asthma properly manage and control their disease is a top public health priority.

WCHQ and the Wisconsin Department of Health Services, Asthma Program are hosting a series of webinars to help clinicians measure and improve care for their patients with asthma.

The first webinar on August 17 will feature Nicholas J. Antos, MD. Dr. Antos, a pediatric pulmonologist at Children’s Wisconsin, will present the ACT measure, which is a new measure developed by WCHQ. Dr. Antos will describe how the ACT is used in practice, explain why the ACT makes a difference with patients, how it can be utilized by health systems and, using a personal story, he will describe how it is used in the clinic.

Adolescent and Child Health Assembly
September 17, 9 – 11:45 AM
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The pandemic put a temporary hold on in-clinic visits, which impacted the delivery of preventive services. A very important aspect of keeping adolescents and children healthy involves well care. WCHQ members have been sharing their best practices related to bringing children back up to date on well-child visits and immunizations. This webinar will focus on immunizations, well-child and preventive care for children and adolescents while coping with the challenges of COVID-19.

WCHQ is pleased to announce Dr. L. J. Tan as our keynote speaker. Dr. Tan is an internationally recognized expert on issues ranging from vaccine safety to emerging infection diseases. Dr. Yolanda Wolff, MD will share how Children’s Wisconsin has maintained well-child visits through telehealth and immunization clinics. Alexandria Cull Weatherer, MPH with the Wisconsin Cancer Collaborative will explain the importance of HPV vaccination during COVID-19.

Alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT) in the Clinical Setting
September 29, 12 – 1 PM
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Screening, Brief intervention. Referral. With early intervention, those at risk for substance abuse disorders can avoid more severe consequences later. Laura Saunders is an expert at SBIRT. She has designed, facilitated and delivered motivational interviewing and SBIRT training in person and online. Join her to learn more about this important clinical tool.

WCHQ quickly pivoted to meet members’ needs for collaboration and information sharing on COVID-19 related issues.

Members asked to meet more frequently as the situation unfolded and urgent issues arose related to telehealth, closing and reopening clinics, continuing care for patients with chronic illnesses, well childcare and immunizations and behavioral health issues.

WCHQ will continue to facilitate collaboration among members throughout the COVID response, including best practices for implementing vaccination clinics and administering the vaccine to staff, patients and in the community, as that information becomes available.

Here is a brief summary of the July improvement work, by clinical topic:

Adolescent and Child Health
This month members discussed best practices related to procedures during the pandemic, including scheduling well child visits through telehealth and in the clinic, best practices related to immunization clinics for this population and testing. WCHQ members reported a significantly higher demand for COVID-19 testing consistent with statewide trends. Wisconsin has worked toward expanding its capacity to complete and process testing. The number of labs performing testing went from 2 in March to 83 in July (WI DHS, 2020). The testing capacity of the state went up from 120 in March to 24, 156 in July (WI DHS, 2020).

Members shared information on methods to help meet the demand for testing, such as opening more testing sites and implementing drive-through testing. There remain concerns about the availability of testing kits and supplies as well as the delay in receiving testing results. To address delays, many members are utilizing in-house lab testing rather than depending solely on outsourced lab results. WCHQ is focused on supporting members to continuously adapt and modify clinical practice and testing workflows as the pandemic continues.

Related Resources:

Off-Site COVID-10 Testing Center Considerations Infographic

Wisconsin COVID-19 Summary Statistics: Cumulative Data

To join the conversation, please contact Sarah (Wright) Sky.

Chronic Disease

WCHQ members are continuing to reopen clinics and increasing face-to-face visits while taking necessary extra precautions to ensure patient and staff safety. As clinics catch up on the backlog of patients from the past few months, staff are working extra hours or extending clinics hours to see more patients in a day.

In July, WCHQ facilitated a presentation from researchers at the University of Wisconsin Institute for Clinical and Translational Research (UW ICTR) Neighborhood Health Partnerships Program (NHP). Interested WCHQ members have the opportunity to design new health system and clinic-level diabetes reports for this program. The reports will provide local, timely and actionable data to support community health in Wisconsin. WCHQ members interested in joining in the co-design process for these reports should contact Lauren Bednarz.

WCHQ members are welcome to join the Chronic Disease meetings at any time. Contact Cara Winsand to learn more about this team.

Oral Health
Members of the WCHQ Oral Health Collaborative are meeting frequently to help dental practices continue to reopen safely. WCHQ facilitated sharing of best practices and discussion of strategies to address challenge. This month’s focus was on how to support staff who are struggling with the “new normal.”

Both Delta Dental of Wisconsin and the Health Policy Institute (HPI) at the American Dental Association (ADA) have been tracking re-opening statistics. According to claims data and practice reported data from Wisconsin, general dental practitioners have recovered to a level very near pre-COVID, close to last year’s levels of production. Preventive services are at or above last year’s level and the number of insured visits per provider are a bit higher than last year or pre-COVID 2020. The levels of recovery, however, appear very different by dental specialty. Pediatric dentists have experienced a robust recovery at or even above last year’s trends. Endodontists have also experienced a near complete recovery with visits per week only slightly below last year. Periodontist appear to be lagging last year’s production levels by about 25% despite an increase in maintenance services per visit, but a decrease in treatment services. Oral surgery has currently only recovered about 40% of last year’s production after experiencing early growth to nearly 75% of last year when dental offices first opened, followed by a second decline to the 40% level in the last several weeks.

Personal Protective Equipment (PPE) supplies remain a concern for oral health providers as they return to normal business. Providers have expressed the desire to be good stewards of PPE thereby ensuring medical providers have what they need. The American Dental Association reported in a recent survey that more than 75% of dental offices surveyed in Wisconsin have more than 14 days’ worth of PPE available and this issue seems to be resolving for dentists in Wisconsin.

Looking ahead, the Oral Health Collaborative is focused on the development of meaningful, publicly reported measures in the dental environment.

Behavioral Health
WCHQ’s Behavioral Health work has been focused on facilitating member discussions on best practices to adapt to the COVID-19 impacts on daily practice, including telehealth visits during COVID-19, and the integration of behavioral health and primary care.

WCHQ will begin publicly reporting several new behavioral health measures in the Fall of 2020 and 2021 including a PHQ-9 utilization measure, and measures of depression remission and response. These measures are challenging to achieve but essential parts of good clinical care. Soon, WCHQ will facilitate improvement meetings to share best practices to achieve success on these measures.

One avenue for success that WCHQ is already promoting through its Value Acceleration Initiative (VAI) is Integrated Behavioral Health (IBH). Using SAMHSA’s 6-Levels of Integrated Care, achieving higher levels of collaboration between primary care and behavioral health can improve patient health outcomes. The collaborative care model shown to better manage the many steps necessary during a patient’s depression treatment continuum (Pence, O’Donnell, & Gaynes, 2012). Having a team approach with an on-demand or in-clinic behavioral health consultant increases the capacity of a primary care practice to routinely screen patients for depression, clinically recognize depression, begin adequate and timely treatment, and track patients with treatment progress (Pence, O’Donnell, & Gaynes, 2012).

To join the conversation or to ask WCHQ for assistance while implementing integrated behavioral health, please contact Sarah (Wright) Sky.

Pence, B. W., O'Donnell, J. K., & Gaynes, B. N. (2012). The depression treatment cascade in primary care: a public health perspective. Current psychiatry reports, 14(4), 328–335. https://doi.org/10.1007/s11920-012-0274-y

It was another successful year for Delta Dental of Wisconsin Foundation’s Cool Water Program, with 56 schools from around the state applying for a water bottle filling station. The selection committee met and choose the top 20 schools, which was extremely difficult considering the time and effort put into each school’s implementation plan to get students to drink more water.

After CDC guidelines were released suggesting turning off or not using standard water fountains during the upcoming school year to prevent the spread of germs, the selection committee met again. It was decided to forego giving water bottles and toothbrushes to each student, and instead select more schools to receive water bottle filling stations this cycle. These stations are touch-free and sensor-activated, meaning more students will have access to drinking water during the school day.

While we all navigate through the COVID-19 pandemic knowing our schools will look different this fall, we can be confident in knowing students in these schools will have access to clean drinking water during the school day:

1. Notre Dame School of Milwaukee - Blessed Theresa Campus, Milwaukee
2. Maple Tree Elementary, Milwaukee
3. Riley School, Milwaukee
4. St. Joan Antida High School, Milwaukee
5. Hawthorne Elementary, Milwaukee
6. Vernon Elementary, Kenosha
7. John Marshall Elementary, Wausau
8. Grove Elementary, Wisconsin Rapids
9. Yeshiva Elementary, Milwaukee
10. Madison Elementary, Marshfield
11. Lincoln Elementary, Whitewater
12. Lincoln Elementary, New London
13. Northwoods Elementary, Eau Claire
14. Star Center Elementary, Lake Geneva
15. Tomahawk Elementary, Tomahawk
16. Whitehorse Middle School, Madison
17. Spring Hill Elementary, Wisconsin Dells
18. Iron River Elementary, Iron River
19. Mellen School, Mellen
20. Marion Elementary, Marion
21. St. Joseph Academy, Milwaukee
22. Lincoln Elementary, Wausau
23. Franklin Elementary, West Allis
24. Humke Elementary, Nekoosa
25. Good Shepherd Lutheran, Watertown
26. Horace Mann Middle School, Wausau
27. Gordon L. Wilson, Baraboo

Schools were selected based on the following criteria:

• Schools need to be within a community with optimally fluoridated water
• Schools must have a free-and-reduced meal rate of 40% or higher
• Schools can apply if they currently do not have a water bottle filling station installed
• Selection will be based on the most creative and impactful implementation plans that will encourage students and staff to drink more water

Applications for the third cycle of the program will be available in February 2021 on the Delta Dental of Wisconsin Foundation’s website, www.deltadentalwi.com/foundation. Schools will be selected and awarded the grants in April, with installation planned for the summer. For information on this project contact Megan Tenpas.