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CVTC's New Center Brings in Scarce Resources for Underserved Medical Needs

Posted on: Thursday, 30 March 2006, 21:00 CST

By Cynthia T. Pegram, The News & Advance, Lynchburg, Va.

Mar. 29--MADISON HEIGHTS -- When their daughter Alisha was a baby, the Gupta family faced trips to Charlottesville when she needed a neurological evaluation by a children's specialist.

They know the road well.

On Tuesday, the 5-year-old received her checkup at Central Virginia Training Center where she now lives, but in a clinic that is part of the new CVTC Regional Community Support Center.

"Alisha is medically fragile," said Atul Gupta, her dad. "For her to travel to UVa and back was a dangerous trip. So this solved a lot of my anxiety.

"In a larger sense, it brings a clinic in our hometown. It is something for a lot more families than Alisha. There's been a need."

CVTC is a state residential program for about 550 people with mental retardation.

The regional center is a new program that puts the institution in the role of using its resources to help people who don't live in institutions.

Its addition to the CVTC campus is part of a state plan to use training centers as outreach sites to the community, bringing in scarce resources for underserved medical needs.

For example, Alisha was seen Tuesday by a pediatric neurologist, a specialty not available in Lynchburg.

The Community Support Center plans began in July and now include services in dentistry, psychiatry and the newest -- pediatric neurology.

"It seems like it's working real well," said Denise Micheletti, CVTC director.

According to data maintained by Denise Forbes who coordinates the program, 46 people were treated in the dental program, 15 in the psychiatry clinic, and 19 in the new once-a-month neurology clinic. Some have come from as far away as Harrisonburg, Danville and Roanoke.

Tuesday's pediatric neurological clinic was the second held, and 12 of the patients were from the February waiting list, said Forbes.

CVTC and the University of Virginia department of neurology's Dr. Robert Rust and Dr. William Taft were able to work out an agreement for the Community Support Center.

Taft said the clinic was made possible, in part, because it is "consistent with the mission of the university, which is to distribute health care to the people of the commonwealth. And we have a long history of doing what we call field clinics -- we go to the patients."

Taft's specialty includes epilepsy. "There are many different kinds of epilepsy," he said. "The first goal of successful treatment is understanding what kind it is, and designing medical therapies to help control and prevent seizures."

In the past, only a few medications existed for seizure control, but now dozens are available.

"They're complicated medicines," he said, and part of the neurologist's role is to help select a medication regimen.

"We don't feel we replace the pediatrician's work, but we augment it," said Taft.

Some of the patients would likely have come to Charlottesville for evaluation, but "our waiting list gets to be very long." At the regional center, "we hope to provide more efficient and more expedient care."

A number of years ago, Rust said, UVa had clinics in South Boston, Winchester and at CVTC, but gradually those facilities lost state financial support.

Now, he said, the neurologists drive to far Southwest Virginia to treat patients who simply can't make the trip to Charlottesville. "Sometimes it's a transportation issue, and sometimes people just don't like to go too far from home," he said.

Gupta would like to see the pediatric neurological services available at all five of the state's mental retardation programs -- and use the Training Centers as an outlet with the UVa doctors providing the neurological services.

Rust said they'd like to expand services, but it would take "a lot of different kinds of people working together -- physicians and residents, social workers and nurses, and educational experts."

The Regional Support Center is continuing to expand services. Next will be behavioral training services for those living in group homes. And from there, said Micheletti, "primary care."

As more community placements occur, she said, CVTC has a physician who could help out with clients in the community and those who live in group homes, but don't have a physician to give them annual physicals.

"We could provide that," she said.

To be seen in any of the Regional Community Support clinics, a referral from a Community Services Board is needed, either as a CSB client, or by requesting the referral from a CSB. Eight CSBs are participating.

Beth Ludeman-Hopkins, acting director of Central Virginia Community Services, said that CSBs are a point of entry for many services.

The pediatric neurology clinic, she said, "is a resource we welcome."

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Source: The News & Advance

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