Early Childhood Developmental Screening & Services

1. Early Childhood DevelopmentalScreening & Services Rhode Island Department of Health Blythe Berger, ScD Kristine Campagna, MEd

2. Goals • School success: Healthy & Ready to Learn • Prevention • Reduce the impact of delays/risks • Children in stable, quality child care • Common language • Coordination of services

3. Background • Community interest (Pediatric and Child Care) • RI Survey • Missed opportunities to identify issues early • Lack of standardized tools • Need for common language • Participation of key agencies/partners • AAP recommendation around screening • Interest in coordination between programs providers and streamlining resources

4. Building Blocks • RIte Care/Medicaid (EPSDT) • Universal Newborn Screening • Child Care Support Network • Healthy Child Care RI-Child Care Health Consultation • Watch Me Grow RI • RI LAUNCH • KIDSNET • RI Chapter AAP • Successful Start

5. Partners/Resources • RI Chapter of the AAP • Successful Start Partnership • Hospitals (Hasbro Children’s, Memorial, Bradley) • State Agencies (Medicaid, EI, Home Visiting, Child Outreach, Child Welfare) • Health Plans • RI LAUNCH-SAMSHA • Healthy Tomorrows Partnerships for Children

6. System Components (PC) • Initial presentation • Provide initial set of tools • Provide a system template implementing screening, including: • How to tools get into the chart? • When do parents get the tools? • How do tools get scored? • How do care providers get the results? • What happens if the screening shows problems • Provide information about referrals at local and state level • HEALTH staff provide on site TA and support to implement the system • Practices report data on screenings and referrals

7. System Components (CC) • Initial presentation • Provide tools • Provide a system template for implementing screening • Who screens the children? • At what time periods do children get screened? • Where is the information kept? • How is information from screening get shared with parents? • What happens if the screening shows problems? • How is linkage with the primary care providers made? • Consultants provide on site TA and support to implement system • Child Care providers report data on screenings and referrals • Link child care providers to resources for referral

8. Current Status • Child Care • Developmental screening is being conducted in 363 Child Care classrooms • Classrooms show 95% screening rates after 6 months • Primary Care • 84 physicians in 25 sites are doing standardized developmental screening • Tools • Ages 0-5 Ages and Stages/Ages and Stages SE/ECSA • Ages 6-8 PEDS and Pediatric Symptom Checklist

9. Follow up • HEALTH staff collect data about referrals • RI LAUNCH- on site assessment (child care, primary care • Non LAUNCH sites-referral to primary care provider and/or appropriate resources • Child Care Support Network • Child Care Health Consultation • Home Visiting • Other clinical services

10. Challenges • Physician/staff time • Reimbursement • Training physicians & child care providers • Coordination between child care providers, physicians, and parents • Referral processes/Tracking • Availability of Specialty Services

11. Opportunities • Increasing interest in standardizing screening • Recognized Best Practice • Providers can get additional resources through the project • Mental health consultation to child care and primary care • Reimbursement through health plans for screening and follow up activities-health care reform

12. Outcomes • System focused on prevention • Children and families get services at the earliest possible opportunity • Families perceive care as coordinated • Care providers are resources (not drains) for each other • The system makes better use of resources • The system is ongoing and sustainable