Training: Developmental Screenings and Referrals in Community Health Centers

1. Training: Developmental Screenings and Referrals in Community Health Centers

2. Why are we here together today?

3. Learning Objectives #1: Participants will be able to navigate the developmental screening and referral process in Sonoma County for children under the age of 3. #2: Participants will be able to navigate the developmental screening and referral process in Sonoma County for children ages 3 to 5. #3:Participants will learn basic information about supportive services in the community that families can access if additional support is requested or during school breaks.

4. Why it Matters? A Critical Statistic Nearly 85% of brain growth occurs by age 3

5. A simple graphic… Less than 1 in 3 children in California receive timely developmental screening

6. Children insured with Medicaid have twice the prevalence of developmental disabilities as commercially insured kids Children from families below the federal poverty level have higher rates of developmental disabilities Latino children are diagnosed with autism an average of 2 ½ years later than White non-Latino children Kids at our health centers are at higher risk for developmental delays

7. Parents are worried… …yet less than half report being asked about development at well checks.

8. Definitions • Surveillance: The process of recognizing children who may be at risk for developmental delay (DD) • Screening: The use of standardized tools to identify and refine that recognized risk • Evaluation: A complex process aimed at identifying specific developmental disorders that are affecting a child.

9. Who should be screened—and when? • American Academy of Pediatrics recommends: • Routine surveillance for DD at every well child visit. • Routinescreening at 9, 18 and 24-30 months. • Ages & Stages Questionnaire (ASQ-3); in addition, M-CHAT-R autism screen at 18 and 24-30 months • Screening should also be performed any time parent or clinician has concern about possible delays. • Evaluationfor children with worrisome screening results: medical evaluation, referral to community developmental resources.

10. 19 month pilots: October 1, 2015- April 29, 2017 3 Health Centers Santa Rosa Community Health Centers Sonoma County Indian Health Project Petaluma Health Center Health Center Pilots to Improve Developmental Screening and Referrals

11. First 5 Sonoma County Redwood Community Health Coalition (RCHC) Community Health Centers Sonoma County Office of Education (SCOE) Sonoma County Special Education Local Area Plan (SELPA) North Bay Regional Center (NBRC) Early Learning Institute (ELI) Easter Seals Child Parent Institute (CPI) Sonoma County Department of Health Services, MCAH Home Visiting Programs Partnership Health Plan of California Matrix Parent Network and Resource Center Advisory Group Established and Meeting Regularly

13. For developmental evaluations: Refer to Early Learning Institute (ELI) inONE of the following four ways: Use P2P or Join the Network to send electronic referral (Contact RCHC for Assistance) Complete online referral form: http://earlylearninginstitute.com Call the Early Learning Institute (ELI): (707) 591-0170 leave a message – parent will receive a call back Send a Fax: (707) 591-0171 Referral Process for Children Ages 0-3* *Up to 3rd Birthday

15. Refer to neighborhood school district: https://secure.sonoma-county.org/vote/districtlookup.aspx?sid=1070#StreetAddress Referral Process for Children Ages 3+

16. How to Determine Which School District to Refer Children 3+ years of age:

17. *keep scrolling down to about ¾ the way down the list for school district

18. Find the Elementary School District Name

19. Alternative to Using Website • You may also contact the main receptionist at the Sonoma County Office of Education, (707) 524-2600, to obtain the name of the school district corresponding to a particular street address.

20. Use this website to find school contact information: https://www.scoe.org/pub/htdocs/finddistrict.html?district=101 OR you can use the RCHC reference sheet! And then….

21. Reference Sheet

22. Updated 7/8/16 First 5/RCHC Referral Process for Children Ages 3+ for Special Education Referrals Health center staff will scan and e-mail (encrypted) or fax Special Education referral form with parent contact information and parent signature to district contact to initiate referral. Save scanned document in electronic health record and give parent the hard copy with the contact name and phone number (from SCOE website) in case they want to follow-up. Child Aged 3+ is identified as needing referral for Special Education Health center referral coordinator, medical assistant or navigator searches for school district contact information on SCOE’s website: https://www.scoe.org/pub/htdocs/finddistrict.html (screen shot on next slide) If district is unknown, click the link to access the County of Sonoma’s District Lookup By Address website: https://secure.sonoma-county.org/vote/districtlookup.aspx?sid=1070 Then refer back to SCOE’s website to locate district and contact information (look for “Special” Services contact or “District Secretary” or “Superintendent” for smaller districts) Health center referral coordinator, medical assistant or navigator will assist parent or guardian in completing the Special Education Referral Form and Consent Form (make sure the parent signs and has listed contact information) Parent or guardian will be contacted by school personnel (within 15 calendar days unless during school break greater than 5 days)

25. Referrals for Developmental Evaluations • Referrals for children ages Birth up to 3rd Birthday, refer to Early Learning Institute (ELI) • Referral for children ages 3 through 5, refer to Neighborhood School District *If at any point you or a parent has questions and/or do not know where to refer, you can contact the ELI Navigator: (707) 591-0170

26. Important Reminders • Always ask parents and guardians to notify the health center about treatment determined by ELI or the School District. • Confirm the parent and guardian contact information on the referral is correct. • Always include completed consent form with the referral form to ensure that treatment information can be shared with the child’s provider.

27. Supportive Services for Families

28. Questions?

29. Thank you! RCHC appreciates the support of First 5 Sonoma County If you have any questions, please contact: Michelle Rosaschi, MPH Population Health Coordinator mrosaschi@rchc.net (707) 285-2977 office