communities coordinating for healthy development : minnesota’s abcd iii initiative
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Communities Coordinating for Healthy Development : Minnesota’s ABCD III Initiative. National Academy for State Health Policy Annual Conference October 5, 2011. Castellano. Project Overview. Purpose of the project - PowerPoint PPT PresentationTRANSCRIPT
Communities Coordinating for Healthy Development: Minnesota’s ABCD III Initiative
National Academy for State Health Policy Annual Conference
October 5, 2011
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Project Overview
• Purpose of the project– To improve linkages between primary care
providers, medical specialists, and other child and family service providers in the community to support the healthy development of Minnesota’s children ages birth to 3 years
– Build upon previous initiatives (ABCD II and ABCD Screening Academy)
– Focus is on referral, care coordination and building a system within the community
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Project Structure
• 4 pilot community teams including: a clinic and early intervention, plus public health, Head Start, and others
• Clinic has a designated care coordinator • Clinic conduct universal developmental and
mental health screening• Early Intervention program willing to work
with clinic staff to improve referrals
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CCHD Participating Communities
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Team Project Participation
• Attend annual in-person learning collaboratives• Participate in monthly technical assistance
phone calls and/or webinars• Hold regular, local team meetings (monthly)• Use Model for Improvement PDSA cycles for QI• Participate in project evaluation activities
(monthly data submission, annual surveys)
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Technical Assistance to Teams• Attend team meetings• Assist with quality improvement process• Help teams figure out how to collect the evaluation
data at their site• Provide sample forms and materials from other sites
or states• Assist in setting up and using the Access database for
tracking• Topical webinars over the lunch hour• Annual learning collaboratives
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Technical Assistance Webinars
• October 2010 - Screening and Referral• November 2010 - Help Me Grow and Care Coordination• February 2011 – Implementing screening tools and a referral
system (Park Nicollet Clinic System)• March 2011 – Data gathering and tracking for HMG (Wilder
Research)• April 2011 – Coding and Billing• May 2011 – ABCD III Baseline Data• Upcoming – Help Me Grow/IEIC restructure and how to
engage and involve parent partners
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Community Based Activities
• Community teams meeting regularly• Clinic consent forms in use• Teams using referral/feedback forms between
HMG and clinic• Written protocols for clinic flow and
clinic/early intervention communication• Clinics using Access database or other tracking
system to support care coordination
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Health Care Home Helps• Parallel activities to HCH requirements and
measures:– Access data base meets all HCH referral tracking
requirements – Care coordinator role similarly defined– Expectations regarding follow-up– A clinic improvement team in place w/parents
• Most participating clinics viewed ABCD III as step toward preparing for Health Care Home certification
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Systems Based Activities
• Joint Human Services and Education Dept. trainings to enhance billing for early intervention services
• Continued work on consent forms w/Dept. of Ed• Enhancing early intervention statewide on-line referral
to give providers local contact info for follow-up• Refining data base• MOC4 application• Developing standardized referral and feedback forms
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St. Luke’s Clinic Referral Process
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St. Luke’s Clinic Referral Process
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St. Luke’s Clinic Referral Process
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Evaluation & Measurement• Frequency: baseline and each subsequent year
of the grant for most measures• Five surveys:– Parent– Provider– Help Me Grow/Early Intervention staff– Clinic administrators – Care Coordinators
• Clinic tracking data, monthly reports
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Provider Referrals
Understanding of developmental referral options
Understanding of mental health referral options
Comfortable referring to HMG
Kinds of services children receive @ HMG
Comfortable referring to medical specialists
Comfortable referring to community services
Confident most appropriate referral made
0 2 4 6 8 10 12
Strongly Agree
Somewhat agree
Somewhat disagree
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Parent Survey
• Majority of parents said they completed a questionnaire of child’s development (63%) and mental health (56%) some time in the last year
• Less than ½ of those whose provider noted a concern were referred to HMG
• Parents reported referrals most often to specialists (18%), followed by community services (10%), Early Intervention (7%)
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Parent Survey
• Providers discussed next steps with ½ of those receiving mental health screening and 62% receiving developmental screening
• 12% of families indicated they were receiving care coordination from their clinic
• 7% said that they need someone to coordinate their child’s care
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Early Intervention Referrals since January, 2010
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What We’ve Learned
• Office flow very individualized, everyone has to invent their own wheel, would be hard to role out en masse
• Written protocol an important step• State agency restructure of EI changed local contacts• Clinics in the midst of other projects (EMR) struggled• Helps for clinic and EI staff to meet each other• Some EI programs discouraging “too many” referrals – 2
way communication helps build trust on both sides• Previous clinic experience with QI important, or teach it
to them
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Contacts• Glenace Edwall: 651.431.2326
[email protected]• Susan Castellano: 651.431.2612
[email protected]• Meredith Martinez: 651.431.2623
[email protected]• Ruth Danielzuk: 651.431.2061
[email protected]• Catherine Wright: 651.431.2336
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