1. 1 This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number B04MC28087, Maternal and Child Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. PROMOTING EQUAL OPPORTUNITIES FOR OPTIMAL CHILD DEVELOPMENT

2. 2 This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number B04MC28087, Maternal and Child Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. BACKGROUND: Nationally 1 in 4 children under age 5 are at moderate to high risk for developmental, behavioral, or social delays. Less than 50% of primary care providers are implementing developmental screening as a routine component of well child care

3. 3 This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number B04MC28087, Maternal and Child Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. BACKGROUND: Nationally 40% decrease in teen pregnancy 20% decrease in teen arrests 17% increase in high school graduation 27% increase in employment

4. 4 This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number B04MC28087, Maternal and Child Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. BACKGROUND: Colorado Colorado Medicaid billing reflects that only 47% of kids birth to three are screened at EPSDT visits. This number decreases significantly for 3 & 4 year olds. 99% of children with significant delays who received Early Intervention services in 2014-15 showed improvements in their acquisition and use of knowledge and skills (Annual report of Early Intervention Services submitted to JBC 11-1- 15) Transportation Lack of understanding Fear

5. 5 This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number B04MC28087, Maternal and Child Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. LOCAL PUBLIC HEALTH SUCCESSES There is strong agreement from workgroup partners that processes are effectively supporting the development of a coordinated surveillance-to-services system.

6. 6 This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number B04MC28087, Maternal and Child Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. LOCAL PUBLIC HEALTH SUCCESSES ABCD community processes are helping local partners demonstrate shared leadership and accountability by coming together with a shared purpose and through strong collaboration on resource development.

7. 7 This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number B04MC28087, Maternal and Child Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. LOCAL PUBLIC HEALTH SUCCESSES Community processes may be “moving the needle” on the number of screenings in the community. The majority of communities have experienced an increase in the total number of referrals from 2014 Q1-2 to 2015 Q1-2. Developed tools and/or materials and have begun dissemination. Larimer County KIDSLarimer County KIDS Have used data and/or evaluation findings to determine next steps and change course if needed.

8. 8 This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number B04MC28087, Maternal and Child Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. OVERVIEW OF STATE LEVEL WORK Starting with the 2016-20 priority implementation, state strategies are directed and coordinated by staff members at CDPHE with Assuring Better Child Health & Development (ABCD) providing technical assistance for local strategies Changes were made to: Delineate state MCH strategies from ABCD agency strategies Offer state health department support in coordination of efforts with other state agencies (i.e. HCPF, CDHS, CDE) Create a mechanism for identifying and implementing policy & systems changes that improve developmental screening, referral and intervention services from the state level

9. 9 This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number B04MC28087, Maternal and Child Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. Selection of Strategies Based on the assumption that this is an ongoing strategy-not starting from scratch Quality Standards have been determined ABCD Quality StandardsABCD Quality Standards That barriers have been discussed and prioritized and protocols are developed to implement quality standards Equal opportunity is the focus for ensuring optimal child development Families have a active role in influencing policy and process change

10. 10 This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number B04MC28087, Maternal and Child Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. Local Action Plan Are barriers identified and do you have “actionable” community based solutions to address these Are protocols developed and documented for all partners Partners indicate the technical assistance they need to implement the protocols Transportation Lack of understanding Fear Solution PlanDoStudyAct

11. 11 This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number B04MC28087, Maternal and Child Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. Local Action Plan Policy Family Engagement

12. 12 This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number B04MC28087, Maternal and Child Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. PRIORITY READINESS ASSESSMENT Need and Fit Common Agenda Use of data to drive action Parent input

13. 13 This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number B04MC28087, Maternal and Child Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. PRIORITY READINESS ASSESSMENT Capacity & Competency.50 FTE Personal successes Understand the system High level facilitator-Can move the group from discussion to action. Comfortable in supporting intra agency system change

14. 14 This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number B04MC28087, Maternal and Child Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. PRIORITY READINESS ASSESSMENT Partnerships Who’s included Who’s missing-What outreach has been done Who else in the community can move this work forward

15. 15 This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number B04MC28087, Maternal and Child Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. ExplorationInstallation Initial Implementation Full Implementation 2-4 Years Implementation Stages Effective Implementation Stages

16. 16 This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number B04MC28087, Maternal and Child Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. ExplorationInstallation Initial Implementation Full Implementation Assess needs Examine intervention components Consider Implementatio n Drivers Assess fit Assess needs Examine intervention components Consider Implementatio n Drivers Assess fit Acquire Resources Prepare Organization Prepare Implementatio n Drivers Prepare staff Acquire Resources Prepare Organization Prepare Implementatio n Drivers Prepare staff Activate Data Systems Manage change Strengthen Implementatio n Drivers Initiate Improvement Cycles Activate Data Systems Manage change Strengthen Implementatio n Drivers Initiate Improvement Cycles Achieve and improve Fidelity and Outcomes Monitor & manage Implementatio n Drivers Achieve and improve Fidelity and Outcomes Monitor & manage Implementatio n Drivers Drivers and Stages Together Effective Implementation 2-4 Years

17. 17 This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number B04MC28087, Maternal and Child Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. PRIORITY READINESS ASSESSMENT Funding Peripheral activities Other funding sources/activities-Similarities and Differences

18. 18 This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number B04MC28087, Maternal and Child Health Services. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.