Rhode Island LAUNCH

1. Rhode Island LAUNCH

2. RI LAUNCH: Building on the Successful Start Results-Based Framework Inputs & Resources Core Components Infrastructure Change Outputs Outcomes Successful Start Statewide Early Childhood Systems Building ·  Infrastructure, Organization, & Partnerships ·  Early Childhood Systems Plan ·  Implementation of Project & Strategic Plan Goals • Diminished Service Delivery Boundaries • Organized Management Structure • State, Academic, Community, Family Partnerships • State Financing • Third Party Financing • Cross-Sector Goals • Sector-Specific Goals • Systems Capacity • Quality of Services • Service Integration • State & Community Policy Change • Program Evaluation AllChildren Healthy &Ready to LearnEarly childhood & family services that promote healthy early childhood physical, cognitive, and emotional development Parent Education & Family Support Early Care & Education Medical Homes Social-Emotional Development

3. LAUNCH Setting:Providence, RI • Providence • Populatoion: 173,600 • 26,700 children 1-8 years • Latino (Puerto Rican, Dominican) and African American most prominent racial-ethnic groups (approx 75% minority in Providence) • 51% single parent; 28% < HS education; 43% living in poverty • Hasbro Children’s Hospital • St Joseph’s Health Center Pediatric Clinic

4. Goal 1: Support Primary Care Providers • Promote developmental and behavioral health screening in medical homes • Locate mental health consultants in pediatrician offices where screening is implemented

5. Goal 2: Link Parent Support and Education to Primary Care • Assess parent and family functioning in primary care • Implement empirically validated parent training for targeted families • Identify third-party reimbursement mechanisms for empirically validated parenting interventions

6. Screening Tools

7. Anticipated Outcomes

8. Table 1: Evaluation of Outputs and Outcomes Results

9. ResultsChild and Family Change

10. ResultsProvider Change

11. Positive Change • Improved linkages made for children and families with identified behavioral health concerns (through the CWS process or by family/pediatrician judgment) • Belief that children were getting identified earlier, and thus getting appropriate referrals earlier. LAUNCH seen to actively facilitate the referral process for children and families and improve access to community-based supports. • Co-location of a MHC within pediatric clinic reported to reduce logistical challenges and stigma associated with families following through with behavioral health referral. • Clinic providers noted RI LAUNCH clinicians were an important part of their support network to address behavioral health concerns

12. Challenges • Barriers remain to getting children connected supportive services • family engagement and motivation • limited community referral options for young children, esp. for mental health • language and cultural barriers • transportation • lack of health insurance • Reported variability about perceived value of CWS • Issues with receiving results before the family’s encounter is complete • Perception the screen is inaccurate • Belief that the CWS is unlikely to identify children providers would otherwise miss as having a developmental or behavioral need. • Need for continued education and training in certain aspects of early childhood development and behavioral health.

13. Sustainability • Race to the Top-Early Learning Challenge will expand LAUNCH activities to practices statewide serving High Needs Children • Support Providers to screen electronically • Support Providers to engage in QI around screening rates • Support providers to link families to appropriate services • Use LAUNCH experience to inform PCMH