Abstracts

Rationale: Epilepsy is the 2nd most common neurological condition. It is estimated 86,000 people (2%) in SC have ever had epilepsy. Care needs of PWE & their families are complex & often unmet. SC advocates are pursuing state legislation for changes with a strategic plan. The 1st phase was state authorization of a fact finding study committee. In 2007 a joint resolution Act 168 (House Bill 3135) was enacted & is the 1st SC legislation that addresses services, treatment & barriers to quality of life for PWE in SC. Appropriations by the state were not provided. Methods: A committee of 12 members was appointed to fulfill these objectives: ●provide a definition of epilepsy; ●plan a statewide system addressing prevention, identification, treatment, rehabilitation, & community integration of PWE including designation of a lead agency, a case management system, medical & long-term care monitoring, education, employment, housing, mental health, independent living services, & access to and availability of treatment resources; ●recommendations for expansion of Medicare or Medicaid, & other financial services; ●a data system in which epilepsy can be identified from existing data sources to track & monitor epilepsy epidemiology; ●recommendations for education programs to inform the public about epilepsy, its causes & prevention, employment, first responder treatment, & availability of treatment & services; also explore instituting more programs in public schools & institutions of higher learning, including medical schools; ●recommendations for policy & legislative changes such as insurance, employment, prevention, driving, & safety practices. A website included information about the Joint Resolution with a copy of Act 168, list of committee members, a PWE survey & a contact address. Surveys of physicians, PWE, state agencies, & businesses were done. A statewide interactive video-teleconference was held to allow for input from PWE & their families. Results: Survey results strongly confirm that PWE have many unmet needs for services. The results suggest that some state agencies do not actively extend themselves to PWE, supporting much of the information given by PWE. Physician surveys also suggest lack of information about available services & how to access them. Conclusions: Proposed is a coordinated service delivery system based on community case management & regional epilepsy clinics. Agency referrals & utilization of community resources would be enhanced. A statewide consortium of private practice & academic epilepsy clinics will increase comprehensive care through intradisciplinary consultation. Access to existing services available in SC must be extended by the agencies. Education of PWE, schools, service agencies, & the public is integral. The committee’s report will be presented to the SC legislature July 2008. A second phase requires additional legislation to fund this Comprehensive Care System. A system of efficient utilization of existing community & state resources facilitated by case managers & a consortium of academic & private practice clinics should require minimal state costs.