AMCHP 2006 ANNUAL CONFERENCE
EARLY CHILDHOOD: BUILDING THE FOUNDATION FOR LIFELONG HEALTH
March 4-8, 2006
RUTH PEROU: Hopefully they're able to adopt this. But I think that a lot of it was early on. There's a lot of networking. There's a lot of laying the whole infrastructure of getting people ready for change. I was just at the American College of Medicine and we were talking about suicide prevention. And one of the keys is that during transition is when you have your highest rate of suicidal behaviors.
And transitions are very difficult processes for us as human beings. And so anything that we could make, not that providers are all going to go commit suicide. But anything that we can do to make these transitions smoother and easier, to create a change, to create any kind of paradigm shift, everything that we can do in terms of education, resources, networking and stuff like that, I think makes this whole process easier to implement.
But the other key is also to showing them that these are services that they want to be providing anyways. These are questions that they're asking that their patients are saying their clients are saying I need these services. And so they're providing primary and specialty medical care. Early childhood education and developmental disabilities assessment and mental health, family and social support, you're talking about. If these families are worried about WIC or paying their rent or stuff like that, I mean for some of them who are still coming to the clinics, they still want all their needs met. So I know it's a lot to ask of pediatricians, but maybe it's something that they can make a referral for, because that's going to impact that child's health and well‑being.
And the tell advocacy and legal services; you don't stop at: Can I refer you for mental health? There are all these Social Services that are relevant for these families.
And again the triage and referral. There's that 1‑800 number or 1888 number. They loved it. These are different scenarios, and this may address some of the questions you were having earlier in terms of like whether or not you refer. If there are clear concerns then you get feedback and you bring them back for contact and information.
If the same family has limited access, and there's a different process that they go through. But again you may have scenarios that are in place but I think that the bulk of it has to do with that pediatrician and their relationship with that family and what decision they end up making, because there could be other factors that aren't on screening tools. Other family factors that are going on that you just can't say. It's like I'm going to base my decision on one blood test.
UKNOWN PERSON: CDP?
RUTH PEROU: I'll have to go back and look.
UKNOWN PERSON: Child development (inaudible).
RUTH PEROU: I don't know. I'm sorry.
UKNOWN PERSON: It's an actual person.
RUTH PEROU: These are Paul's slides.
UKNOWN PERSON: (Inaudible) family.
RUTH PEROU: It's probably the child development professional.
UKNOWN PERSON: Somebody who actually, besides the phone number it's a person who will follow‑up with the family?
RUTH PEROU: Well, it's depending on the practices. And again some of these questions would be for Paul, but depending on the practices and what they needed to do to become compliant with doing developmental surveillance and developmental screening. So there's not always an additional staff member that's on board like with Healthy Steps, I know sometimes they have a child development specialist that's available on staff. I don't think that's specific to what's going on in Connecticut.
And I have these in handouts, so I can hand them out to folks if you're interested in looking at the specific processes.
And here are some of the data that during the first year of operation, 155 children were referred and then overall for three years, 500. And 80%, greater than 80% were preschool age or higher ‑‑ or younger, I'm sorry. The majority of the referrals were for a single need. 68% of them. The interesting part here is that some of these were for parenting assistance or support. They weren't all to the early intervention system.
So what he was able to find was a 67% of referrals were to services at no cost to either the family or the health plan. These were existing community resources that were being underutilized. And so they by doing this work with Child Serve, they were able to more efficiently deal with all this early childhood services and early health services that these families needed these services in support and they were available in the community but they weren't being referred and it did not overburden the early intervention system.
I mean that's really relevant research and information. And again extensive outreach required to ensure access to services and programs. This might be what you're seeing with families, within that community and those practices, even after you make a referral, there are still several steps to ensure follow‑through, and they are not just all at the family level but some of them are. They're also at the, you know, at the resources and the service providers and so forth and so it's a fairly complicated situation. It's like was it Judy Powellfry was saying this is not rocket science. Rocket science is easy, this is much more complicated all the variables you need to keep up with.
In physics you can throw out a constant and create something and you've got the equation solved, but here there's so many multiple processes in play that you have to monitor and keep up and ensure that all those things that that dance continues and that that dance is different for every family and for every community.
Just more data from the Child Serve. Again, showing that it can be successful. It can be implemented statewide. Referrals are being made. Children are being screened and they're receiving appropriate services. And then whether or not the healthcare providers were familiar with child serve, where they are making referrals and were they satisfied with the program.
Advocacy opportunities. Really looking at outreach to communities and expanding this from birth to three and children with special healthcare needs. And again the term he used here is enhancement, not expansion. The key is that a lot of these services are already in existence and we're not tapping into them. So let's be more efficient as a community, as a society and still, you know, promote the health and well‑being of our children.
So the next steps are the Help Me Grow Initiative. This is being funded through the Children's Trust Fund. Again, this is to help pediatric professionals, parents and child care providers identify and support at risk children with developmental and behavioral concerns. So these kids, again, promoting the optimal potential and well‑being for children who are at risk or have some concerns. And I think that the pilot project has been smaller, not Connecticut‑wide but he's just getting this started.
Again, supported by the Children's Trust Fund and other partners, the same lessons that he learned from Child Serve, he's been implementing into Help Me Grow, support from the Commonwealth Fund, Child Health and Development Institute of Connecticut and State Chapter of American Pediatrics.
That's a nice slide. So it's showing all the different entities that are involved in the Help Me Grow campaign. Again, the child development community liaison. This is the individual that just keeps track of every resource that's available to families and to children who are at risk or have special healthcare needs. And always maintaining it up‑to‑date. So web‑based resource.
The child development information line. Education and training and another key that I mean we find extremely that we keep having to talk about this is this evaluation component. Because we've not done a great job of showing all the data that these programs actually work and what is their impact.
So I'll just go through the last slide. And this is the (inaudible) and I'll pass this out. But it's got great resources of data that he's published and Paul and his group actually have been what the Annie Casey Foundation, they go and they do training to specific communities. So they're available. If somebody is willing to pay for them to come over or they can get supplemental funding, they're actually exporting this to a lot of different communities so they can learn more that this, that you can actually do this. You can actually implement this community‑wide or as in Connecticut state‑wide that you can conduct developmental surveillance and you can promote optimal development for all children.
So that was it. And I'm done. Do you have any questions? I have some handouts, please come and take them. And thanks to Lisa.