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We report on the nature and timing of services provided to children with an intellectual disability (ID) identified by a new comprehensive assessment and care planning tool used to evaluate children's needs for Medicaid Personal Care Services (PCS) in Texas. The new assessment procedure resulted from a legal settlement with the advocacy community. Participants in the study were 1,109 children ages 4-20 with an intellectual disability diagnosis who were assessed between January and April of 2010. The need for assistance is higher on Saturday and Sunday, when school services are not available. We report differences in service patterns for children who vary in ID severity. Finally, we consider the implications of our results for policies and programs that serve families with children with an ID.

In this study, we explored whether psychological distress plays a role in the use of recommended clinical preventive services among community-dwelling older adults. The sample is drawn from respondents 65 years and older who participated in the 2011 Medical Expenditure Panel Survey (MEPS). Logistic regressions with selected covariates were entered in the model to estimate odds ratios (OR) with 95% confidence interval (CI) for the independent effect of psychological distress on the utilization of each of five preventive services. With the exception of breast cancer screening where the uptake of preventive services was significantly lower for older adults with psychological distress (OR = 0.57, p <.001), uptake of other key preventive measures revealed no significant utilization differences between older adults with and without psychological distress. The results suggest that adherence to breast cancer screening guidelines may be increased by improving recognition and treatment of emotional health problems in older women. [ABSTRACT FROM AUTHOR]

Telehealth can overcome access and availability barriers that often impede receiving needed mental health services. This case report describes an interdisciplinary approach to treatment for an individual with chronic physical health conditions and comorbid mental health concerns, which resulted in high utilization (and associated costs) of preventable emergency services. The report describes clinical case progression on anxiety symptoms and emergency service utilization while concurrently highlighting telehealth‐specific practice implications, especially as they pertain to training settings. [ABSTRACT FROM AUTHOR]

Primary care physicians' perceptions of diabetes treatment protocols (DTPs) in the management of type 2 diabetes mellitus (T2DM) were examined at the individual and organizational levels. A 27-item electronic survey was administered to primary care physicians from an integrated multispecialty health care system in Texas. Information was collected on various aspects of DTPs, including attitudes toward these protocols, perceived barriers, and knowledge, as well as utilization of diabetes self-management programs. Besides quality of care, the primary care physicians surveyed generally had mixed feelings regarding DTPs' ability to contribute positively to other aspects of health care; in addition, only a small percentage were familiar with some currently available self-management programs. Given that implementation of DTPs depends on primary care physicians, we should address physicians' attitudes and perceptions toward DTPs so as to increase utilization of these helpful protocols.