MMI service provision during the COVID-19 outbreak

Dear members of the MMI family,

These are challenging days for us all. I am writing to tell you that the Munroe-Meyer Institute is committed to ensuring that our high-quality services are being provided to our clients and families during the COVID-19 pandemic.

The safety and health of community is paramount, and the institute is working to identify ways to provide essential services and ongoing support to those who depend on us in the face of necessary safety guidelines.

It took hard work, innovation and versatility, but the providers of MMI are meeting the challenge and continue to serve you. As always, MMI stands ready to help. We will get through this together.

Karoly Mirnics, M.D., Ph.D.
Director

Below is a synopsis of how each department is addressing the challenge of providing care in the face of social distancing guidelines.

Developmental Medicine

Developmental Medicine has moved most patient appointments to telehealth visits. The department has rescheduled some outstate clinics and increased telehealth services for rural families. The department is responding to an increasing number of patient phone calls and are checking in with some of its more vulnerable families. The department has been providing support and resources for patients and families as they manage home-schooling, the decreased access to behavioral health and ancillary services, and the anxiety and uncertainty resulting from the coronavirus pandemic.

Education and Child Development

The Education and Child Development Department has identified activities that can be addressed at this time in lieu of assessing children in schools, usually the primary emphasis in the spring. For program evaluation clients, the focus has shifted to completing assessments that can be done remotely and conducting focus groups and interviews. The department’s clinics are adopting a teleconsultation model.

Genetics

Clinical genetics and telegenetic counseling services continue and have moved online via telehealth directly to patients’ homes. The department operationalized telegenetics visits at MMI’s Diagnostic Clinic in addition to Children’s Hospital & Medical Center to shift all genetics clinics to telemedicine. MMI has equipped the Fred & Pamela Buffett Cancer Center and the Olson Center for Women’s Health with telemedicine carts for patients who are physically coming in to the facility for other visits. Methodist Hospital has transitioned to telemedicine genetic counseling for prenatal services. Boys Town has not made any transitions at the moment, but telemedicine has been offered.

Human Genetics Laboratory

Clinical testing continues in the Human Genetics Laboratory, with client meetings transitioned to Zoom and a schedule for specimen pick-up at the hospital to reduce exposure risk and use of personal protective equipment.

iCASD (Integrated Center for Autism Spectrum Disorders)

Despite the disruption in direct-care services, the staff of iCASD continues to support MMI clients and families. iCASD has transitioned much of its work to telehealth, and staff are focused on helping caregivers implement strategies in the home. The in-person CARE (Community Autism Resource Education) Program also is being transitioned to an online format where parents can watch and ask questions at their convenience. While direct assessment for diagnostic evaluations has been suspended, staff is gathering information from parents and teachers during this time to be ready to start assessments as soon as possible. Collaborators at other centers are critical partners during this time, sharing ideas for new ways of approaching the department’s work and commitment to services offered.

  • Autism Care for Toddlers (ACT) Clinic has transitioned all of its services to telehealth, providing virtual caregiver training on a regular basis in order to support clients and their families.
  • Early Intervention Program has transitioned to telehealth services, with an emphasis on caregiver training. The program has been working with families to reassess goals and support them during this unique and challenging time.

Occupational Therapy

Occupational therapy continues to provide services to outpatient clients via telehealth. The staff of 18 occupational therapists that provides occupational therapy special education support through a contract with Omaha Public schools is continuing to do so in collaboration with Omaha Public School staff using Microsoft Teams. This support will continue through the end of the school year.

Pediatric Feeding Disorders

The Pediatric Feeding Disorders Program continues to serve patients and families via face-to-face and telehealth services. The department has expanded telehealth services and caregiver training in day treatment, SEEDS (Starting Early: Eating and Developmental Skills) and outpatient programs.

Physical Therapy

Physical therapy outpatient services continue and have moved online via telehealth. The department’s teaching, educational and Children’s Respite Care Center services also are now online. The department is developing a frequently-asked-questions fact sheet on telehealth for families and clients that will be posted on the department’s web page.

Psychology

Psychology has moved almost entirely to delivery of behavioral health service via telehealth. The department is well-positioned for this transition as it started delivering telehealth services more than a decade ago. Psychology also has, through its Mental Health Technology Transfer Center (MHTTC), ramped up training and technical assistance to others in the region trying to migrate to telehealth.

Recreational Therapy

The Recreational Therapy Department sent a survey to pediatric families to gauge interest in activity bags and videos and asking how the department can support families. The department has created activity bags for 53 families, created a “Dead Moose” song video and emailed it to families, uploaded videos of providers reading books, created a YouTube video of some fun stretching exercises to keep campers healthy, and is putting together an interest survey to send to adult families in order to reach adult client populations. The Millard Social Skills team continues to meet with middle school, high school and transition students via Zoom.

Severe Behavior

The Severe Behavior Program is leveraging a continuum of face-to-face and telehealth services to provide behavior analytic caregiver training and supports related to current treatments, while maintaining patient, family, and staff safety at the forefront.

Speech-Language Pathology
The Speech-Language Pathology Department has moved almost all of its outpatient therapy and evaluation services in Omaha, Lincoln, and Hastings to teletherapy, offering individual services via teletherapy to clients who usually receive group services. The department is offering a few remaining essential evaluations in person that require augmentative and alternative communication equipment or a modified barium swallow study. The department continues to work with inpatients at Nebraska Medicine. Dr. Jessica Gormley has led a nationwide team to develop communication tools for inpatients of all ages on ventilators during the COVID-19 pandemic.

UCEDD
The University Center for Excellence in Developmental Disabilities (UCEDD) is in close communication with MMI staff to speak to any concerns or questions raised by clients or providers. Meetings are also held twice per month to discuss ideas to increase virtual interaction with patients, families and members of the MMI community. UCEDD staff are examining strategies to reorganize programs that may be affected by the impact of COVID-19. The MMI-UNO Trailblazer program members have weekly Zoom meetings, and all peer-mentor activities have been converted to a digital format and are now done as a group online. All Trailblazer College and Career Exploration activity has been converted to an online format.

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