Header: Guam Early Hearing Detection and Intervention Project, Guam Center for Excellence in Developmental Disabilities Education, Research, and Service, University of Guam, Unibetsedåt Guahan, Office of Academic & Student Affairs, Dean Circle House 24/26 • UOG Station • Mangilao, Guam 96923 (671) 735-2466 (V) (671) 734-6531 (TTY) (671) 734-5709 (Fax) Website: www.guamehdi.com E-mail: nenehearing@guamehdi.com Guam EHDI Advisory 2nd Quarterly Meeting (Year 3) Tuesday November 04, 2008 Guam Marriott Resort & Spa Members Present Ms. Lina Leon Guerrero Mr. David Zieber represented by Bobbie Maguadog & Edwina Degayo Ms. Avelina Opena Mr. Richard Flores Ms. Joyce Flores Mr. Dennis Triolo represented by Ms. Polly Triolo Ms. Ann Marie Cruz Ms. Lenny Josef Ms. Magarita Gay represented by Ray Salas & Sandy Okada Mrs. Polloi Triollo Members Absent Dr. Robert Leon Guerrero Mr. Edmund Cruz Ms. Bridgette Flores-Lobo Ms. Josephine Santos Ms. Belinda Gonzalvo Ms. Maria Victoria Guiao Ms. Glenda Leon Guerrero Dr. Manuel De Castro (left island) Dr. Velma Sablan Mr. John Cruz Ms. Pat Mantanona Mr. Joseph Mendiola (Joe) Guam EHDI Staff Members Present Ms. Elaine Eclavea Ms. Vicky Ritter Ms. Lizzy Borja Mr. Joseph J. Mendiola Ms. Indira Kazuma Meeting Notes Meeting was called to order by Ms. Joyce Flores, Co-Chairperson, at 11:52a.m. 1. Mrs. Flores requested for members to review the minutes of the last advisory committee meeting held on April 28, 2008 & July 30 2008; However, because a quorum is not present, minutes was not approved. 2. Mrs. Flores turn the floor over to Ms. Borja who asked the members to refer to the copy of the resource manual that was disseminated to members. 3. Ms. Borja added that the structure of the meeting today is to give the members the opportunity to provide the feedback on the procedures of the Guam EHDI project as written in our resource manual which, was updated in September. One of the objectives for the meeting today is to give the members the opportunity to make Page 2 recommendations and provide feedback on our new goals and objectives on the new grant which will be the “loss to follow up”. 4. Mrs. Eclavea proceeded in reviewing and updating goals and objectives. She requested that members provide input based on policy and procedures: are we meeting goals we set and what are some improvements/ strategies that would help us? 5. Mrs. Eclavea added that the purpose of the grant is to ensure that all infants and toddlers have access to early hearing evaluations and Early Intervention Services. This new grant looks at the “loss to follow up” of screening, evaluation, and Early Intervention Services. 6. Mrs. Eclavea reviewed Goal One: minimize missed referral rate by increasing the infant return rate from 47% to 96% for those infants that need second screening. Data is showing that we are screening every baby born at rate of approximately 98%. Every baby born on Guam gets hearing screened prior to discharge. When we wrote this grant we were at 47% and only 40% of those infant returned for second screening. 7. Mrs. Eclavea stated that second screening data is shown by year. In 2006, three thousand four hundred fourteen (3,414) infants were born on Guam. Of that, 2,909 infant were born at Sagua and GMHA. Navy does not report any data to Guam EHDI. 8. Mrs. Eclavea continued that 2,800 of the babies were screen prior to discharge. Of that, 488 failed the initial screen. Those that failed initial screen have to come back for second screen. Twenty percent (20%) of the babies did not return for the second screening. In 2007 there were 2,975 infants screened prior to discharge. Four hundred fifty (450) or 50% of our babies failed initial screen which is still within our target range. The national is 4% to 8%. We are down to 12% and the percentage keeps going down. Back in 2007, nineteen percent (19%) of the infants did not complete their second screening. 9. Mrs. Ritter added that in 2006, 26% failed initial screening and 74% returned for second screening. 10. Mrs. Eclavea noted that we want to reduce or decrease the number of the infants that fail to return. What are some of the strategies to reduce the loss to follow up? Footer: 2 of 5 Page 3 Strategies to “reduce loss to follow up” * Stressing the importance of the follow to the parents * Public Awareness ( news, neighbors, Mayors, Guam Public School System (GPSS) and Day Care) * Hearing screening result would be included on the discharge check list * Home visiting * Community outreach screening * Pre-natal Classes * More Family/ friendly materials * Open clinic hours to accommodate working parents * Reminder calls before appointment * Be mobile with follow up screening 11. Mrs. Eclavea reviewed Goal Two: all infants who screen positive will have a full diagnostic audiological evaluation before 3 months of age. Reduce the time lag from referred to audiological evaluation from average of 8 months to an average of 1 to 3 months. 12. Ms. Triolo recommended that Guam EHDI obtain a staff audiologist to support Guam EDHDI’s audiological needs, since Dr. Triolo will not be able to provide services to Guam EHDI. 13. Mrs. Eclavea added that we currently have a new audiologist on Guam and we are trying to get her on board with Guam EHDI. 14. Ms. Triolo recommended that the new grant proposal include funding for at least a part-time audiologist. 15. Mrs. Eclavea reviewed Goal Three: infants with hearing loss will receive appropriate early intervention services. Last year’s grant was to reduce the time lag from 10 months to 2-6 months. The data showed 16 children that were referred for full diagnostic audiological evaluations (DAE) in 2006. Of the 16, only 10 children received DAE within 3months of age, 2 children received IFSP within 2 months of age, and 8 of them refused services from Early Intervention. We have 8 infants and toddlers that have hearing loss that won’t get the services they need. 16. Mrs. Eclavea asked members for some recommendations. Footer: Page 3 of 5 Page 4 Recommendations: * Part-time or full-time audiologist * Interpreters readily available * One stop screening/DAE center at Public Health Clinic * Flagging Public Health Clinic Charts (review protocol at well baby check up at Public Health Clinic) * Communication with PCPS * Communication through Public awareness that the follow up is “FREE” 17. Mrs. Eclavea continued with Goal Four: infants and children with late onset, progressive or acquired hearing loss will be identified at the earliest possible time. We have 271 high risk babies, 149 returned for their 6 month follow-up and 45% were missed. 18. Mrs. Eclavea asked the members for recommendations on how to reduce the 6 month loss to follow up. 6 month loss to follow-up * Communication with PCPs * Training for Physicians * More aggressive with GEIS with Bio-Risk automatic referrals; Presence at GMHA/Sagua * Have high risk families fill out a reminder card and GEHDI will mail it out 1 month before appointment, and make a follow-up reminder call. * Presentation to Chuukese community, for example, after Chuukese mass * Find where Federated States of Micronesia communities congregate and provide outreach at that location 19. Mrs. Eclavea discussed Goal Five: infants with hearing loss will have medical home and parent to parent support. What are some suggestions and recommendations? * Post card for release of information to Guam EHDI Family Support Group leaders Parent to Parent Support * Presentations/Table display at GPSS Parent Teacher Organization meetings * Promotional items with Family Support Group contacts * Invite parents of infants who have Bio-Risk factors to Family Support Group meetings Footer: 4 of 5 Page 5 Open Discussion: 20. Mrs. Eclavea informed the members that one of the recommendations on the new request for proposal is to expand the council to have more stakeholders. We currently have nine members. Mrs. Josef is actually a parent of a child with hearing loss, but she is also pediatric physical therapist for the Navy. There was an earlier recommendation to invite Dr. John Garrido to be a Guam EHDI advisory member. Mrs. Eclavea also recommended inviting Dr. Mary Spencer from the University of Guam, Dr. Lee Meadows at Seventh Day Adventist Clinic, and Dr. Maria Alano, the neonatologist that has taken over for Dr. De Castro, who as left the island. 21. Ms. Borja informed the members that there will be a Healthy Mothers, Healthy Babies and Daddies Too Fair on November 9th, sponsored by AMBROS at the Agana Shopping Center. Guam EHDI will have a display and the parents are invited to promote the Family Support Group as well. 22. Mr. Salas informed the members that Public Health is also sponsoring a Healthy Mothers, Healthy Babies Fair on November 29th at the Agana Shopping Center. 23. Meeting was adjourned at 1:00pm.