VERMONT: a State Example of Building Coordinated Services for Young Children Carlota Schechter Consultant, Help Me Grow National Center Connecticut Children’s Medical Center Hartford, Connecticut

The Help Me Grow National Network 23 States and Growing! Alabama California Colorado Connecticut Delaware Florida Iowa Kentucky Louisiana Michigan Minnesota Missouri New Jersey New York Oregon Puerto Rico South Carolina Utah Vermont Washington West Virginia Wyoming District of Columbia

Connecticut: Implementing HMG for 13 years Vermont: Started implementation Fall 2015 Maine: Started the planning Spring 2015 HMG in New England States

Vermont and Connecticut

Vermont – State Context Federal Funding State Government Private Sector Funding /Initiatives

Vermont – Federal Grants Early Childhood Comprehensive Systems D70 – Implementation Grant Project LAUNCH Early Learning Challenge

Governor Agency of Human Services Department of Health Maternal & Child Health Department for Children and Families Child Development Division Agency of Education University of Vermont Department of Pediatrics VT Child Health Improvement Program (VCHIP) Vermont – State Government

Governor ELC Grant Manager Agency of Human Services Immunization Registry Department of Health Children with Special Health Needs Maternal & Child Health MIECHV – Nurse Family partnership Department for Children and Families Universal Developmental Screening Child Development Division Early Childhood Comp. System Child Care Assistance; Licensing; Quality Rating System; Early Childhood Professional Development Agency of Education Early Childhood Special Education University of Vermont Department of Pediatrics VT Child Health Improvement Program (VCHIP) Co-administer: State Preschool Program Children’s Integrated Services (Part C) Vermont – State Government

A resource for pregnant or post partum women and families with children from birth to age 6 Early Intervention (Part C of IDEA) Early childhood and family mental health Home Visiting and family support Specialized Child Care There are 12 CIS regions in the state Now part of an Integrating Family Services model. Children’s Integrated Services

Vermont – Private Sector Building Bright Futures Permanent Fund for Vermont’s Children Let’s Grow Kids (home-based child care) Vermont Birth to Five (advocacy) Vermont Early Childhood Alliance (advocacy) Other community and family funds

Vermont’s Early Childhood FRAMEWORK Our Commitment to Realizing the Promise of Every Vermont Child Vermont’s Early Childhood FRAMEWORK Our Commitment to Realizing the Promise of Every Vermont Child Vermont’s Framework

Governor ELC Grant Manager Agency of Human Services Immunization Registry Department of Health Children with Special Health Needs Maternal & Child Health MIECHV – Nurse Family partnership Department for Children and Families Universal Developmental Screening Child Development Division Early Childhood Comp. System Child Care Assistance; Licensing; Quality Rating System; Early Childhood Professional Development Agency of Education Early Childhood Special Education University of Vermont Building Bright Futures Director Department of Pediatrics VT Child Health Improvement Program (VCHIP) Co-administer: State Preschool Program Children’s Integrated Services (Part C) Vermont – State Government

Guam: The Help Me Grow System Vermont Building Bright Futures Regional Councils VT Child Health Improvement Program 1 Centralized Telephone Access Point 2 Community Outreach 3 Provider Outreach 4 Data Collection and Analysis 4 Core Components of a Help Me Grow System Vermont’s Help Me Grow

Vermont Child Health Improvement Program: Developmental Screening in Vermont A population-based maternal and child health services research and quality improvement program of the University of Vermont.

The Challenge: In 2012 only 26% of children received all three recommended developmental screens by their 3 rd birthday. The Response: Vermont’s System for Universal Developmental Screening “A collaborative process to… understand every child’s developmental progression, and respond appropriately to meet each child’s developmental needs.” Vermont’s System for (UDS) Universal Developmental Screening

Funding: Project LAUNCH – 2012 grant for 5 years (Linking Actions for Unmet Needs in Children’s Health) Goal: Increase screening of children across various settings using evidence based tools in a more consistent manner Project LAUNCH’s Prevention & Promotion Strategies 1. SCREENING AND ASSESSMENT IN A RANGE OF CHILD-SERVING SETTINGS Vermont’s System for UDS

Vermont’s UDS Documents 1.Vermont’s System for UDS (circle) 2.Vermont’s Process for UDS (flow chart) 3. Common Definitions in Support of UDS 4. Policy Brief with Recommendations Available at: SLinks.pdf

VT UDS Process – 4 Settings There are no wrong doors – On going monitoring of children’s development happens in many settings ”Developmental screening for all children can be initiated across setting utilizing a brief, standardized tool.”

But, even with Help Me Grow there are no wrong doors for connecting children to services. 19 Help Me Grow is a centralized access point

Strategies Convene stakeholders to develop a shared vision for UDS System Provide training, and quality improvement coaching to child care providers Provide training, technical assistance, and quality improvement coaching to primary care providers Vermont Project LAUNCH

Chittenden County Rollout: Started in Fall of 2014 Behavioral health workers trained and placed in 7 settings: A Health Center A Clinic Several Child Care Centers A Home Vising program UDS Pilot Project

Immunization Registry Designed, developed, and operated by the Vermont Department of Health Input and support from VT chapter of American Academy of Pediatrics, VT academy of family physicians, and the VT state school nurse association. State Health Information Registry

SPHINX Vermont’s Shared Public Health Information Exchange A person-centered database serving multiple program Single web-based application includes Immunization Registry Childhood Hearing Screening Blood Lead Levels NENSP (Bloodspot) Metabolic Screening Developmental Screening Vaccine Inventory (currently in development) Shared demographic data including primary care provider Access is granted to users by specific program area and feature

SPHINX Developmental Screening Screening Results of the ASQ3, ASQ-SE and MCHAT can be entered by providers who conduct screenings Results for any one person may be viewed by users with view level permissions regardless of the child’s medical home or provider who entered the screening results. Users with appropriate permissions can run reports including Screening History – all screenings results recorded for a specific child Due for Screening – lists children in a primary care practice who are due or past due for a screening per the per AAP/Bright Futures periodicity schedule Follow-Up Report – lists children in a primary care practice in need of follow-up screening or referral Activity Report – Measures a practice’s rate of screening the children associated with their by age group and screening tool over a given period of time per AAP/Bright Futures periodicity schedule

Guam: The Help Me Grow System Note: Only includes features within the program area that the user has permission to use.