Help Me Grow National Replication Project

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Help Me GrowNational Replication Project

• Joanna Bogin
• Connecticut Childrens Medical Center
• Hartford, Connecticut
• National Smart Start Conference
• May 7, 2009
• Supported by a generous grant from The
  Commonwealth Fund

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What is Help Me Grow?

• A system for linking families to existing
  services and supports for children at risk for
  developmental and/or behavioral delays
• Birth to 8
• Does not provide direct services
• A template that can be tailored or modified based
  on states needs

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Components of the Help Me Grow System
Ongoing Monitoring/Evaluation
Steering Committee
Administrative Entity
Call Center/ Access Point
Pediatric Outreach
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ASSUMPTIONS

• Children with developmental/behavioral problems
  are eluding early detection
• Many initiatives exist to provide services to
  young children, their families
• A gap exists between child health and child
  development/early childhood education programs
• Children and their families would benefit from a
  coordinated, region-wide system of early
  detection, intervention for children at
  developmental risk

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COMPONENTS

• Training child health providers in effective
  developmental surveillance and screening
• Creating a resource inventory of community-based
  programs supporting childrens development and
  families
• Developing a referral and monitoring system to
  link young children and their families with early
  childhood services and support
• Performing data collection and analyses of
  childrens developmental status and regional
  resources

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• Call Center/
• Access Point

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Child Development InfolineFeatures

• Free and confidential service
• Tele-interpreters TTY capacity
• Hours of operation- M-F, 8am-6pm
• Computerized resource inventory
• Data collection/client tracking systems
• For FY08, CDI received over 20,000 incoming
  calls, made over 48,000 outgoing calls to
  complete referrals

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Child Development InfolineCare Coordinators
provide

• Assessment of needs referrals to services
• Education on development, behavior management and
  programs
• Ongoing developmental monitoring
• Advocacy and follow up

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Data collection

• Information Collected- child specific data
• Demographics
• Primary care provider
• Presenting concerns
• Reason(s) for call
• Actions taken
• Referrals made
• Outcome

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Child Development InfolineData Collection System
(DOC)

• Challenges
• Coding cases- ensuring consistency in coding
• Follow up contacts
• Complexity of cases
• Identifying gaps/barriers
• Developing reports

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Advantages of utilizing a call center

• One stop shopping
• With one call, a care coordinator can triage to a
  number of different services, based on needs of
  child and family
• Can also access other 2-1-1 call centers
• Blended funding is cost effective
• Collaboration among partnering programs ensures
  smooth referral process for families

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• Community
• Outreach

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How Community Liaisons promote Help Me Grow

• Facilitates Community Networking Meetings
• Maintain list serv
• Experts on programs, services, and initiatives in
  regionsLiving resource directory
• Provide Trainings for community, parents and
  child health providers
• Support telephone care coordinators
• Identify gaps and barriers

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Community Networking Breakfasts

• If you build it they will come
• Hundreds of service providers across the State
• Allows providers time to share information, widen
  their connections to a broader group, assist one
  another to develop solutions to challenging
  situations
• Formalizes informal relationships
• Influence agencies to become more family
  friendly
• Speakers provide information on new resources
  initiatives

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Help Me Grow Connecting Families to Community
Services A program of the CT Childrens Trust
Fund Invites you to a Community Networking
Breakfast On Thursday December 4, 2008 The
Village for Families Children South Community
Room 331 Wethersfield Avenue Hartford, CT
06114 AFCAMP African - Caribbean - American
Parents of Children with Disabilities a parent
advocacy organization whose central mission is to
educate, empower, and support parents of children
with disabilities Sheila Harris, parent school
coordinator will provide information about the
services offered to families monthly support
groups, advocacy, special education, juvenile
court, and DCF A continental breakfast will be
served Bring program brochures/flyers or
business cards to share with others Please post
or pass on this notice
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Creative Brainstorming

• Car seats
• Informal community support
• Teen parenting classes
• Book

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Lessons Learned

• Community Networking efforts maximize access to
  services and lead to the optimal use of existing
  services
• Community Liaisons who perform research,
  outreach, and advocacy are a critical program
  component.
• Community Liaisons should be housed in call center

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• Pediatric
• Outreach

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CAVEAT

• Detection without referral/intervention is
  ineffective and may be judged unethical
• (Perrin E. Ethical questions about screening.
  J Dev Behav Pediatr 199819350-352)

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If you build it, they will come

• Probably not, because
• Child health providers are busy
• Systems are in place that produce good enough
  results
• Practice change does not come easily

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Why Child Health Services?

• Universal
• Recognized role
• But child health providers cant know all of the
  resources available for children
• Help Me Grow resource

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Develop Infrastructure for Getting the Word Out
to Practices

• Allows you to
• Change presentation as the program evolves
• Do ongoing monitoring and evaluation (PDSA)
• Add other relevant child health issues

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Academic Detailing

• Include clinical and office staff
• Bring lunch or breakfast
• Include resources that help practices easily
  implement change

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Key Points

• Developmental surveillance at every visit
• Screening at 9, 18, and 24 months
• Connect children to services with Help Me Grow A
  free resource that will save you time

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Who Does Presentations

• Physician Peers
• Partnering organization staff

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What is Help Me Grow?

• A statewide resource that helps you connect
  families to existing resources when they dont
  qualify for eligibility based programs (i.e.
  Birth to Three)
• Connect via telephone
• Researches appropriate resources based on family
  needs
• Provide follow-up with family to ensure a link to
  service
• Report feedback to child health provider

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1
6
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Well-Child Visit
Provider Gets Feedback
Solicit Parent Opinions
Help Me Grow 1-800-505-7000
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5
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Contact Help Me Grow
Parent Connected to Resource
Care Coordinator provides resources
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Developmental Surveillance

• At every visit ask Do you have any concerns
  about your childs learning, development or
  behavior?

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• Evaluation

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Results Based Accountability (RBA) FormatIn
accordance with Connecticuts General Assembly
Appropriation Committee adopted from Friedman
(2005)
Trend Data All performance indicators can fit
into any of the following categories - -
How much did Help Me Grow do?
How well is Help Me Grow doing?
Is anyone better off as a result of utilizing
Help Me Grow?
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How Much are We Doing?
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Who Calls Help Me Grow?
Total Number of Callers
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Nature of Service Request and Presenting Issues

• Families call Help Me Grow for a variety of
  reasons there are typically two or more service
  requests or presenting issues.
• Overall of presenting issues per family has
  increased since three years ago improved phone
  care coordination

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How Well Are We Doing?
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Five Highest Number of Referrals to Service
Programs by Year
Total Number of Referrals
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Is Anyone Better Off?
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Help Me Grow Outcomes

• Rate of families successfully connected to
  services is high each program year.
• Slight decrease in successful outcomes in the
  past year (80) is balanced by increase in
  outcomes that are pending (16).

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Ages Stages MonitoringNumber of families
entering each year and number of four month
screens

• Increase in outreach efforts to pediatric
  offices During the 2007-2008 program
  year, there was a 43 increase in the number of
  families entering the Ages Stages Monitoring
  Program through Child Developmental Infoline

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National Replication Project

• Two year grant The Commonwealth Fund
• Five Sites
• South Carolina
• Oregon
• New York
• Kentucky
• Colorado

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Implications/Lessons Learned

• Collaborative funding
• Cost effective- prevention
• Systems Coordination- avoid frustration of
  maneuvering through the maze of resources
• Family Centered- one stop shopping
• Willingness to focus on families needs give a
  family what they ask for and what can best
  support their needs

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Help Me Grow

• Children with developmental problems are
  eluding early detection. Programs exist to help
  them, but we too often fail to link these
  children with the resources they need. Help Me
  Grow is that link
• Paul
  Dworkin

The Commonwealth Fund is a New York City-based
private, independent foundation. The views
presented herein are those of the author(s) and
not necessarily those of The Commonwealth Fund,
its directors, officers or staff.