Early Childhood Health Integration Initiative

Early ChildhoodHealth Integration Initiative

Heather J. Dubiel MS, RNJodi Hardin, MPH

Early Childhood Health Integration

What we will cover…1. Colorado Early Childhood Systems Building

Context2. Early Childhood Councils3. Early Childhood Health Integration Initiative

Funding, Objectives, Timeline4. Targeted Child Health Outcomes5. Technical Assistance6. Early Childhood Health Integration In Action


Early Childhood Systems Building Context for Health Integration HB 1062: Early Childhood Councils Development of Early Childhood Colorado

Framework Alignment: mission of The Colorado Trust and

outcomes on the framework Program support vs. Systems support

Opportunity for sustainable local change


Early Childhood Colorado Framework

Specific, Measureable Outcomes

Specific, Measurable Outcomes

Specific, Measurable Outcomes

COLORADO’S EARLY CHILDHOOD COUNCILS


Early Childhood CouncilsRole of the Councils in Colorado

Early Childhood Councils

Membership Early Childhood Domains


Direct Funding Sources

THE INITIATIVE

Early Childhood Health IntegrationAn effort to……better integrate health…into Colorado’s broader early childhood development system…as a means of improving health outcomes for children.


The Colorado Trust The Colorado Trust is a

grant making foundation; access to health for all Coloradans.

$5 million over five years Building local systems that

integrate health Improve child health

outcomes


Grant Objectives Planning grants Multi-year grants to build early childhood system Engage health providers in local early childhood

systems building Track and measure systems development and

child health outcomes Develop and support best practices for

integrating health services Address health disparities


Timeline


Systems Building Outcomes


Child Health Outcomes

Required (one or more):

Increased access to preventive oral and medical health care. Increased number of children covered by health insurance. Increased number of children who receive a Medical Home

approach. Increased number of children who are fully immunized. Increased percentage of primary care physicians/ dentists

accepting Medicaid/Child Health Plan Plus. Increased percentage of women giving birth with timely,

appropriate prenatal care.


Child Health Outcomes

Optional:

Increased knowledge of the importance of health and wellness. Increased number of environments providing early identification

and mental health consultation.


Example Council Objectives Reduce the number of families

who experience "dropoff" from Medicaid/CHP+

Increase the number of children who have had a first dental visit by age three.

Increase the number of early care and education facilities that adopt and implement policies/practices for integrating health and wellness education practices into their operations.

Decrease the number of children who are ‘eligible but not enrolled’.

Increase the rate of early detection of health and mental health issues for young children.

Increase the number of immunization records in CIIS.

Increase the number of early care and education providers using the Pyramid Model.

Increase the number of children receiving fluoride varnish and oral health screening in preschools.

Increase awareness and knowledge of the medical home approach.


Evaluation


SystemsOutcomes

Child HealthOutcomes

TECHNICAL ASSISTANCEEarly Childhood Health Integration

Early Childhood Health Integration Technical Assistance

Current Cohorts


Technical Assistance Mechanisms1. Targeted technical assistance

2. General technical assistance

3. Health content-specific technical assistance

Develop/revise grant applications

Interface with health partners

Acquisition of resources

Develop HI job descriptions

Joint problem-solving

Early Childhood Health IntegrationTargeted Technical Assistance


General Technical Assistance: State Level Technical Assistance Collaboration

Colorado Department ofEducation

Colorado Department ofHuman Services

Colorado Department ofPublic Health


General Technical Assistance

Regional Meetings

Technical Assistance Days

Toolkit Resources


Health Content Technical Assistance: Statewide Health Initiatives Collaborative

Early Childhood Health IntegrationHealth Content Technical Assistance

Health Data

Assessment Checklist

Learning Circles

Action Guides

Early Childhood Health Integration Summit

Early Childhood Health Integration Technical Assistance

Learning Circle Topics

Successes, Challenges, Lessons Learned

INITIATIVE IN ACTIONEarly Childhood Health Integration


In action: Larimer County

The Early Childhood Council of Larimer County (ECCLC) was one of 12 original Consolidated Child Care Pilots established by legislation to help support and build local early childhood systems. ECCLC has evolved from a grassroots movement to an established 501(c)(3).


Larimer County: Planning Phase

Preliminary goals: medical home, awareness of health and wellness, social emotional

Health stakeholder engagement: planning and steering committee

Needs Assessment: Parent Health Survey, Mental Health Survey, Health education matrix

Final goals: Insurance outcome added, health and wellness goal removed


Larimer County: Implementation Coordinating Larimer County Medical Home

Coalition Cultural competency training for health providers Collaborate with EPSDT to pilot Medicaid/CHP+

enrollment efforts through high-need child care facilities/schools

Establish relationships with emergency departments and urgent care facilities to engage in medical home efforts

Develop community system to support the Pyramid Model in early care and education

Successes, Challenges, Lessons Learned


In the words of the councils“I’ve not been involved in any of this community collaborative

work before. It seems really chaotic.”Pediatrician comment early in the planning process…

“There are so many goals. Who will do all this work?”Same pediatrician part way through the planning process…

“For all your work and great communication, thank you a hundred times over. I have great faith in you and the team.”

Same pediatrician at the end of the planning process


In the words of the councils“Working together as doctors, nurses, service providers, and community

organizers, we were able to develop a proposal for The Colorado Trust that is thorough and relevant from all perspectives. The collaborative spirit that surrounded us in this effort was amazing! Everyone checked their egos at the door and kept the ultimate goal in mind—improving the lives of kids.”

“We feel finally that there is true potential to sustainably impact community mechanisms for health referrals, ECE facility practices and effectively partner with parents to promote knowledge.”

“The “aha” moments for our council have [involved] the collaborative spirit which has formed due to The Colorado Trust Grant among the health profession of all four counties.”

“Thirty two individuals from a variety of organizations participated in the planning. This effort built several new connections within the medical community and expanded [the council’s] efforts in the health and mental health domains.”


Next Steps September 2010 Applicants Implementation Year One Report Technical Assistance: Effective/Strategic

Collaboration, Health Equity, Policy, Local Systems Evaluation

Sharing Lessons Learned Evaluation


Questions?Heather Dubiel RN, MSColorado Department of Public Health and

[email protected]

Jodi Hardin, MPHOffice of Lieutenant Governor Barbara O’Brien [email protected]

mailto:[email protected]

mailto:[email protected]

Documents

Early Childhood Health Integration Initiative