Asthma Educator Sharing Day October 28, 2016
Tobacco Use vs. Asthma What Can I Do?
Smoking and Asthma One of the biggest triggers of asthma. Every year in Michigan, over 1,740 non-smokers die as a result of exposure to secondhand smoke. Adult asthma hospitalizations decreased by 8% after passage of Michigan s Smokefree Air Law in 2010. Over 1,200 people with asthma called the Michigan Tobacco Quitline in fiscal year 2016.
Provide practical counseling When was the last time you used tobacco? When was the last time you tried to quit? Review past quit experience Success Triggers for relapse Anticipate triggers, challenges Alcohol can lead to relapse Other smokers limit exposure May I share some information?
Patient Resources The Michigan Department of Community Health has online information including Medicaid benefit information www.michigan.gov/tobacco American Cancer Society offers printed material and sponsors the Great American Smokeout on the third Thursday in November. Call 1-800-227-2345. www.cancer.org American Heart Association offers printed material. Call 1-800- 242-8721. www.americanheart.org American Lung Association offers quit smoking classes, printed material, cessation website. Call 1-800-586-4872. Telephone referral and cessation advice is available by calling 1-866-784-8937. www.lungusa.org
Medicaid Covers It! In person Counseling Billing codes 99406 and 99407 Telephone Counseling All Medicaid plans have a Quitline. Most partner with the 1-800-QUIT-NOW line. Quit Medications All 7 FDA-Approved Medications
The Michigan Tobacco Quitline
What are Quitlines? Not a hotline/one-time fix Not scripted Not operated by volunteers They are evidence-based They have medical directors They have a professional organization that provides guidance
Why Quitlines? Work in conjunction with physician intervention. Can provide the treatment intensity that often cannot be provided in a clinical setting due to time constraints. Provide feedback to physicians and health plans on patient progress. Increase access to treatment and reduce barriers. Can provide assistance in multiple languages. Can provide assistance before and after normal business hours.
The Quitline Today Michigan Launched with National Jewish Health in October 2011 Since inception of the NJH Quitline in 2002, they have served over 1 million callers, with over 100,000 being from Michigan!
Who Qualifies for Telephone Counseling? Medicaid members Medicare Veterans Uninsured County Health Plans Youth (no insurance information is collected) Prenatal callers Those Diagnosed with Cancer
The Michigan Tobacco Quitline How to Reach Us 1-800-QUIT-NOW (784-8669) 1-855-DEJELO-YA (1-855-335356-92) 1-877-777-6534 (TTS) Calls answered 24 hours, 7 days a week. Answering machine after hours (call backs in 24 hours or less) https://michigan.quitlogix.org Provides Referrals to local programs Intensive counseling proactive sessions Unlimited reactive calls for one year Free NRT to the uninsured Self-help materials Text-messaging Online coaching
Quitline Counselors Trained in motivational interviewing techniques. Counselors have a minimum of a bachelors degree. Counselors receive clinical supervision from a licensed psychologist. A Medical Director is on staff and provides oversight. Receive 4+ weeks of training and ongoing review.
Quitline Service Delivery Every participant is viewed as an unique participant. Coach assesses motivation and works with caller according to where they are in stages of change. All calls are scheduled by the participant in order to accommodate their schedule. All participants can call into to the Quitline 7 days/week to discuss any issue at no additional cost.
Prenatal Protocol Began February 1, 2012 By the end of fiscal year 2016, 1,201 women registered There are specially trained counselors who have been dedicated to working with prenatal callers Prenatal enrollees will receive 9 counseling calls-5 prior to delivery and 4 post-partum Prenatal enrollees receive incentives for participation
Prenatal Incentives Studies have shown that incentives are effective in the prenatal population. Prenatal Calls - For each counseling call an enrollee completes with her coach, she will receive a $5 Visa gift card. (5 in total) Postpartum Calls - For each counseling call completed after delivery, the enrollee will receive a $10 gift Visa gift card. (4 in total)
Quality Assurance All calls are recorded for Customer Service Reps and Coaches 3 calls are reviewed for every staff member every month Supervisors and trainer review and provide feedback/ scoring Ongoing training for Motivational Interviewing and cultural competency Call stats monitored every day throughout the day Complaints can be easily reviewed if we have the name of the caller, and date/time of call
Quitline-Online Program https://michigan.quitlogix.org/
Services Available Online
Text Messaging The current text messaging program includes: Library of over 300 messages 2-way messaging Messages related to support and relapse prevention Tips, motivation, and encouragement Messages customized by tobacco type Messages assessing mood, craving, and tobacco status Coaching call appointment reminders (as appropriate on the day prior to appointment) NRT shipment status updates Congratulatory messages Re-engagement messages Must opt-in at intake Over 55% of Michigan participants have opted into the text messaging program.
Nicotine Replacement Therapy Michigan Tobacco Quitline NRT All participants medically screened- some conditions require a medical consent form from physician Patches, Gum and Lozenges offered to eligible groups Up to 8 weeks of NRT available Shipped directly to the participant s home Only available to those 18 and older No cost to the participant Prenatal must have signed approval from physician
Fax Referral Fax Referral Forms Online at Michigan.quitlogix.org NJH receives referral form Call within one business day 3 attempts in the requested time frames or over a 10 day period Fax back to provider When referral is received When patient enrolls When patient receives NRT When patient completes the program If patient is un-reachable If patient declines to participate in the QuitLine
Michigan Quit Line Fax Referral Form for Health Care Providers https://michigan.quitlogix.org/
National Jewish Health Website Screenshot Click Here for Fax Referral Form
2015 Outcomes All outcome surveys completed by a third party- Pegus Research. The below are 30-day Quit Rates.
Frequently Asked Questions Hold times Maximum hold time is 7 minutes, then call is forced to voicemail Prompt to leave a voicemail every 1:20 during hold Languages served by the Quitline Several Spanish-speaking coaches employed by NJH One Arabic-speaking coach employed by NJH All other languages translated real-time during call by Language Line How many attempts do we make to reach someone? Fax referrals: 3 attempts Missed scheduled appointment: 3 attempts Does the Quitline serve callers using other types of tobacco? Yes! We serve callers using all types of tobacco This includes the e-cigarette
Frequently Asked Questions Cont d Can we ship to P.O. Boxes? Yes! Welcome kit materials are sent USPS and can be sent to a P.O. Box. NRT orders for P.O. Boxes will be sent via USPS- no tracking is available on these. How long does it take to get an NRT order? NJH sends a file to their NRT fulfillment vendor every day. Most orders are shipped the following business day from Colorado Orders shipped via UPS or USPS (P.O. Boxes) Order will be placed on doorstep if no one is home. UPS orders can be tracked via the website or by calling a coach
Contact Information Karen S. Brown Public Health Consultant Michigan Department of Community Health 517-335-8803 Brownk34@michigan.gov www.michigan.gov/tobacco Or visit the Quitline at: https://michigan.quitlogix.org/ Order materials at 517-335-8376