Vermont’s System for Universal Developmental Screening (Birth to 8 Years) Lauren M Smith, LCMHC Project Director, Project LAUNCH
Vermont Child Health Improvement Program (VCHIP) ● Population-based maternal and child health services research and quality improvement program ● Founded in 1999 at UVM ● Public/private partnership between the Health Department, UVM, VT AAP, and others ● www.vchip.org
Examples of VCHIP Projects Quality Improvement Evaluation ● AIM Training ● Blueprint for Health ● Immunizations ● Youth in Transition ● Developmental & Autism ● Suicide Prevention Screening ● Autism System’s Integration ● Opiate-exposed Newborns Grant ● Mental Health ● CSHN Evaluation ● Late Preterm Infants ● VT Immunization Registry ● Youth Health Improvement ● Healthy Babies, Kids, and Initiative Families ● Chronic Illness
Vermont Context 2009-2013 ● 2000 – Medicaid partnered with CAHMI to examine parents’ perceptions of the delivery of preventive and developmental care to Medicaid beneficiaries ● 2004 – VCHIP QI project to improve practice-based developmental care with a focus on anticipatory guidance and parental education
Vermont Context ● 2008 – AAP-VT/VDH/VCHIP held 8 regional meetings to introduce Bright Futures guidelines, share the vision of Children’s Integrated Services, and promote local collaboration ● 2008/2009 – Health Department, through EPSDT, endorsed nationally recommended developmental and autism screening guidelines
Vermont Context ● 2009 – VCHIP researched and analyzed existing developmental and autism screening tools to develop a list of “preferred” tools that was adopted by Medicaid and private insurers in VT for reimbursement in primary care
Agreed Upon on Common Definitions
Vermont Context ● 2009/2011 – Health Department/DVHA partnered with VCHIP to design and conduct a practice-based improvement project to improve developmental and autism screening for children 0 – 3 years in primary care settings ● 2012/Aug 2013 – VCHIP, through CSHN SIG grant, conducts targeted training on developmental and autism screening tools in primary care practices
More Room for Improvement 7 out of every 10 children in Vermont had one or more factors that put them at risk for a developmental delay 26% of children in 2012 received all three of their recommended developmental screenings by their 3 rd birthday
Project LAUNCH Long Term goal – For all children to reach social, emotional, behavioral, physical and cognitive milestones – to thrive in school and beyond Population Focus – birth to 8 • Funded by the federal Substance Abuse and Mental Health Services Administration (SAMHSA); Awarded to VT Dept. of Health; Administered by Building Bright Futures • Five year grants to states, tribes, and local communities supporting the implementation of a series of evidence based strategies to promote young child wellness.
Goals and Strategies Project LAUNCH Prevention and Project LAUNCH Goals Promotion Strategies ● Increase workforce knowledge of ● Enhanced home visiting through children’s social and emotional focus on social and emotional well- development and preparation to being deliver high-quality care ● Screening and assessment in a ● Improve coordination and range of child-serving settings collaboration across disciplines at ● Integration of behavioral health into the local, state, tribal, and federal levels primary care ● Mental health consultation in early ● Increase integration of behavioral care and education health into primary care ● Family strengthening and parent ● Expand use of culturally relevant, skills training evidence-based prevention and wellness promotion practices Each grantee implements or expands ● evidence-based programs and practices Increase access to screening, assessment and referral to services in five key areas for children and families
VCHIP’s Scope of Work Provide training, technical Provide training, assistance, and and quality quality improvement improvement coaching to child coaching to care providers primary care providers Convene stakeholders to develop a shared vision for UDS System Increase screening of children across various settings using evidence based tools in a more consistent manner
Partners ● AAP-VT ● Northern Lights Career Development Center ● Building Bright Futures ● VAFP ● Burlington School District ● VT Association for the ● Champlain Valley Head Education of Young Start Children ● Child Care Resource ● Vermont Family Network ● Children’s Integrated ● Visiting Nurses Services Association ● Early Care and Education ● Vermont Department of Providers (x4) Health ● Families ● Vermont Department of ● Howard Center Children and Families ● LUND
Themes from Workgroup Meeting 1 longitudinal family communication monitoring centered workforce accessibility medical home development and reach centralized data
Definitions
Policy Statement
Policy Recommendations Expand promotion and prevention strategies to support optimal development for all children and families Realign existing system components to increase access to services which strengthen families and decrease environmental stressors to build resiliency and protective factors. Engage professionals that care for children birth to age eight to promote increased attention to prevention and promotion strategies that support positive child developmental and family outcomes.
Policy Recommendations Eliminate barriers to interdisciplinary collaboration and communication in support of universal developmental screening Build relationships across organizations and settings that serve children and families, establish clear expectations for communication and follow-up, and coordinate services that are family-centered and strengths-based. Provide training and technical assistance to professionals caring for children birth to age eight by providing a common vision, language, and framework to support implementation of Vermont’s System for Universal Developmental Screening .
Policy Recommendations Create an accessible data system which houses developmental screening results in real time and makes them available to collaborating service providers and families Ensure professionals caring for children birth to age eight have access to a data system that captures every child’s developmental screening results over time. The data system will increase efficiency across service providers by allowing easy access to screening results, providing more timely interpretation, and facilitating follow-up for children with a developmental concern. Explore linkages with other data systems related to child outcomes, particularly the Building Bright Futures Early Childhood data reporting system.
Policy Recommendations Ensure all children receive culturally responsive and appropriate developmental care Provide professionals caring for children birth to age eight with access to culturally competent resources and training to support ongoing developmental surveillance, screening, and intervention services, when appropriate.
Policy Recommendations Increase the knowledge, skills, and capacity of professionals caring for children birth to age eight to assess each child’s developmental progression through Vermont’s System for Universal Developmental Screening Provide training and support to programs/staff to develop and/or enhance systems to monitor every child’s developmental progression, engage families in ongoing communication about their child’s development, conduct structured developmental screening, and make appropriate linkages to support services.
Policy Recommendations Increase community readiness and the capacity of families with children birth to age eight to understand their child’s developmental progress and participate in Vermont’s System for Universal Developmental Screening Provide tools, resources, and training to strengthen family and caregivers’ awareness of the importance of supporting early childhood development and families’ participation in Vermont’s System for Universal Developmental Screening.
How Will We Accomplish This?
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