Quality Improvement in Care Coordination for Very Young Children June 19, 2012

1. Quality Improvement in Care Coordination for Very Young ChildrenJune 19, 2012 Communities Coordinating for Healthy Development Minnesota’s ABCD III Initiative

2. Project Goals • Care Coordination: Information flows between clinic and other community providers, clinic coordinating child’s care • Standard methods and forms for referral and feedback between Early Intervention and clinic • Increase appropriate children referred to EI • Families experience coordinated care • Reimbursement – still working on that

3. Communities Coordinating for Healthy Development www.dhs.state.mn.us/CCHD

4. MN Communities Coordinating for Healthy Development • 4 sites/teams located around the state • Team: at least one clinic, and one Early Intervention site • Other community-based providers included: Public Health, WIC, Head Start • Meet monthly, develop Plan, Do, Study, Act (PDSA) cycles for team and in each setting to implement change

5. Participating State Agency Staff • Department of Human Services • Maternal and Child Health (EPSDT) staff • Children’s Mental Health staff • Department of Health • Title V staff • Health Care Home staff • Department of Education • Early Intervention staff • Early Childhood Screening staff • MN Child Health Improvement Partnership • AAP Chapter, Foundations, Advocacy Organizations

6. Technical Assistance to Teams • Provide training in and TA around Quality Improvement methods: PDSA cycles and learning collaboratives and clinic QI process • Forms and process development, and • Improving state policy and infrastructure to support local providers • Access database to track referral and follow-up

7. State Policy Improvement • Standard form to release/obtain consent • Standard form and web site clinics can use to refer to Early Intervention • Standard fax back forms for Early Intervention to provide results to clinic • Develop a complementary system for using both on-line and direct referral

8. Increased Referrals to Early Intervention

9. State Agency Participation • Gives direct feedback to state staff on policy success at point of implementation • Pulls together necessary staff at the state level to ensure that policies at the agency level encourage local collaboration • Helps improve EPSDT services and meet federal requirements to coordinate among state agencies

10. Health Care Home (Medical Home) • Access Database for tracking child’s referral and follow-up – required element • Work with Health care home certification staff to promote CCHD in their materials • Project meets 2nd year certification requirements to coordinate with a community partner • Care coordination issues different with Early Intervention than medical referrals

11. Contact Information • Coordinator:Tessa Wetjen 651-431-2061 tessa.wetjen@state.mn.us. • Co-PI: Susan Castellano: 651.431.2612 susan.castellano@state.mn.us • Co-PI: Glenace Edwall: 651.431.2326 glenace.edwall@state.mn.us