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Early Childhood Health Integration Initiative. Heather J. Dubiel MS, RN Jodi Hardin, MPH. Early Childhood Health Integration What we will cover…. Colorado Early Childhood Systems Building Context Early Childhood Councils
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Early ChildhoodHealth Integration Initiative Heather J. Dubiel MS, RN Jodi Hardin, MPH
Early Childhood Health IntegrationWhat we will cover… • Colorado Early Childhood Systems Building Context • Early Childhood Councils • Early Childhood Health Integration Initiative Funding, Objectives, Timeline • Targeted Child Health Outcomes • Technical Assistance • Early Childhood Health Integration In Action
Early Childhood Health IntegrationEarly Childhood Systems Building Context for Health Integration • HB 1062: Early Childhood Councils • Development of Early Childhood Colorado Framework • Alignment: mission of The Colorado Trust and outcomes on the framework • Program support vs. Systems support Opportunity for sustainable local change
Early Childhood Health IntegrationEarly Childhood Colorado Framework
Specific, Measureable Outcomes Specific, Measurable Outcomes Specific, Measurable Outcomes
Early Childhood Health Integration COLORADO’S EARLY CHILDHOOD COUNCILS
Early Childhood Health Integration An effort to… …better integrate health… into Colorado’s broader early childhood development system… as a means of improving health outcomes for children. THE INITIATIVE
Early Childhood Health IntegrationThe Colorado Trust The Colorado Trust is a grant making foundation; access to health for all Coloradans. $5 million over five years Building local systems that integrate health Improve child health outcomes
Early Childhood Health IntegrationGrant Objectives • Planning grants • Multi-year grants to build early childhood system • Engage health providers in local early childhood systems building • Track and measure systems development and child health outcomes • Develop and support best practices for integrating health services • Address health disparities
Early Childhood Health IntegrationChild Health Outcomes Required (one or more): • Increased access to preventive oral and medical health care. • Increased number of children covered by health insurance. • Increased number of children who receive a Medical Home approach. • Increased number of children who are fully immunized. • Increased percentage of primary care physicians/ dentists accepting Medicaid/Child Health Plan Plus. • Increased percentage of women giving birth with timely, appropriate prenatal care.
Early Childhood Health IntegrationChild Health Outcomes Optional: • Increased knowledge of the importance of health and wellness. • Increased number of environments providing early identification and mental health consultation.
Reduce the number of families who experience "dropoff" from Medicaid/CHP+ Increase the number of children who have had a first dental visit by age three. Increase the number of early care and education facilities that adopt and implement policies/practices for integrating health and wellness education practices into their operations. Decrease the number of children who are ‘eligible but not enrolled’. Increase the rate of early detection of health and mental health issues for young children. Increase the number of immunization records in CIIS. Increase the number of early care and education providers using the Pyramid Model. Increase the number of children receiving fluoride varnish and oral health screening in preschools. Increase awareness and knowledge of the medical home approach. Early Childhood Health IntegrationExample Council Objectives
Early Childhood Councils Systems Outcomes Child Health Outcomes Early Childhood Health IntegrationEvaluation
Early Childhood Health Integration TECHNICAL ASSISTANCE
Early Childhood Health Integration Technical AssistanceCurrent Cohorts
Early Childhood Health IntegrationTechnical Assistance Mechanisms 1. Targeted technical assistance 2. General technical assistance 3. Health content-specific technical assistance
Early Childhood Health IntegrationTargeted Technical Assistance Develop/revise grant applications Interface with health partners Acquisition of resources Develop HI job descriptions Joint problem-solving
Early Childhood Health IntegrationGeneral Technical Assistance: State Level Technical Assistance Collaboration Colorado Department of Public Health
Early Childhood Health IntegrationGeneral Technical Assistance Regional Meetings Technical Assistance Days Toolkit Resources
Early Childhood Health IntegrationHealth Content Technical Assistance: Statewide Health Initiatives Collaborative
Health Data Assessment Checklist Action Guides Early Childhood Health Integration Summit Learning Circles Early Childhood Health IntegrationHealth Content Technical Assistance
Early Childhood Health Integration Technical AssistanceLearning Circle Topics
Early Childhood Health Integration INITIATIVE IN ACTION
The Early Childhood Council of Larimer County (ECCLC) was one of 12 original Consolidated Child Care Pilots established by legislation to help support and build local early childhood systems. ECCLC has evolved from a grassroots movement to an established 501(c)(3). Early Childhood Health IntegrationIn action: Larimer County
Early Childhood Health IntegrationLarimer County: Planning Phase • Preliminary goals: medical home, awareness of health and wellness, social emotional • Health stakeholder engagement: planning and steering committee • Needs Assessment: Parent Health Survey, Mental Health Survey, Health education matrix • Final goals: Insurance outcome added, health and wellness goal removed
Early Childhood Health IntegrationLarimer County: Implementation • Coordinating Larimer County Medical Home Coalition • Cultural competency training for health providers • Collaborate with EPSDT to pilot Medicaid/CHP+ enrollment efforts through high-need child care facilities/schools • Establish relationships with emergency departments and urgent care facilities to engage in medical home efforts • Develop community system to support the Pyramid Model in early care and education
Early Childhood Health IntegrationIn the words of the councils “I’ve not been involved in any of this community collaborative work before. It seems really chaotic.” Pediatrician comment early in the planning process… “There are so many goals. Who will do all this work?” Same pediatrician part way through the planning process… “For all your work and great communication, thank you a hundred times over. I have great faith in you and the team.” Same pediatrician at the end of the planning process
Early Childhood Health IntegrationIn the words of the councils “Working together as doctors, nurses, service providers, and community organizers, we were able to develop a proposal for The Colorado Trust that is thorough and relevant from all perspectives. The collaborative spirit that surrounded us in this effort was amazing! Everyone checked their egos at the door and kept the ultimate goal in mind—improving the lives of kids.” “We feel finally that there is true potential to sustainably impact community mechanisms for health referrals, ECE facility practices and effectively partner with parents to promote knowledge.” “The “aha” moments for our council have [involved] the collaborative spirit which has formed due to The Colorado Trust Grant among the health profession of all four counties.” “Thirty two individuals from a variety of organizations participated in the planning. This effort built several new connections within the medical community and expanded [the council’s] efforts in the health and mental health domains.”
Early Childhood Health IntegrationNext Steps • September 2010 Applicants • Implementation Year One Report • Technical Assistance: Effective/Strategic Collaboration, Health Equity, Policy, Local Systems Evaluation • Sharing Lessons Learned • Evaluation
Early Childhood Health IntegrationQuestions? Heather Dubiel RN, MS Colorado Department of Public Health and Environment 303-692-2389 Heather.dubiel@state.co.us Jodi Hardin, MPH Office of Lieutenant Governor Barbara O’Brien 303-866-4713 Jodi.hardin@state.co.us