Creating a Comprehensive Early Childhood Comprehensive System of Care

The Goal
Reduce gaps and improve coordination of early childhood services.

The Challenge
Deficiencies in our current delivery systems are preventing many young children from attaining optimal health and development¹

The Strategy
Design the system for the most medically complex and for the highest users of the services and systems, and you will meet the needs of all.

The Program - The State Maternal and Child Health Early Childhood Comprehensive Systems (ECCS) Initiative
Purpose of ECCS: To Support State Maternal and Child Health Agencies and their partner organizations in collaborative efforts to strengthen the State’s early childhood system of services for young children and their families.

Ultimate Goal: The implementation of a comprehensive early childhood system that promotes the health and well-being of young children, enabling them to enter school ready and able to learn.

• Overview
• 2005 Grant Guidance
• State Contacts
  • State Strategic Plans
  • State Logic Models
• Help with your Plan
• Publications
• Web sites/Organizations
• 2005 ECCS Conference

Each grantee must address five core service components that can each make specific contributions to healthy development and school readiness:

1. Access to medical homes for all children - Access to medical homes providing comprehensive physical and child development services for all children including children with special health care needs. Access to medical homes providing assessment, intervention, and referral of children with developmental, behavioral, or psycho-social problems.
• In this sub-criterion, reviewers looked at the following:
  Do the applicant’s SECCS planning activities or plan integrate the development of access to and insurance support for medical homes providing comprehensive physical and child development services for all children, including children with special health care needs? Do the planning activities or the plan include assessment, intervention, and referral of children with developmental, behavioral, and psycho-social problems? Do the planning activities or the plan address the HCCA objective of access to medical homes and health insurance for children in child care settings?
2. Mental health and social-emotional development - Availability of services to address the needs of children at-risk for the development of mental health problems. Service delivery pathways to facilitate entrance of at-risk children into appropriate child development and mental health delivery systems.
3. Early care and education services - Early care and education services from birth through five years of age that support children's early learning, health, and development of social competence.
4. Parent education - Services that provide support to parents in their role as prime educators of their children.
5. Family support services - Services that address the stressors impairing the ability of families to nurture and support the healthy development of their children

The Data:

Health Status
• Most young children in the United States (85%) are reported to be in excellent or very good health, while about three percent have a disability.
• While relatively few children have an identified disability, nearly half of parents of young children have at least one concern about their child’s physical or behavioral development.
• More than 50 percent of developmental problems are not identified until school entry.
• About 37 percent of white children have one or more risk factors compared to 66 percent of African-American and 72 percent of Hispanic children. ¹

Access to Health Care
• Most young children (89%) have private or public insurance, and many uninsured children are actually eligible for a public program but have not been enrolled.
• Hispanic children are twice as likely as other children to be uninsured.
• About 32 percent of Hispanic children go to community health centers or public clinics for care, compared with about 12 percent of non-Hispanic white children.
• Mothers with uninsured children, as well as mothers with less than a high school education, are more than three times as likely as other mothers to have no prenatal care in the first trimester of pregnancy. ¹

Medical Home and Health Care Quality
• Nearly all young children have a usual source of well-child care. However, fewer than one half of children four to 35 months of age (46%) see a particular person for well-child care.
• Parents of uninsured children are less likely to receive counseling about parenting issues that influence the child’s health and development
• Fewer than half of parents ever recall their child’s development being assessed by the health care provider, although professional guidelines call for assessments at most visits.
• About 11 percent of children zero to five years old with special health needs lack a personal physician. Almost 16 percent did not receive needed care within the past year, and 21 percent report that the quality of coordination between their child’s physician and other providers is only fair or poor. ¹

Help with Your ECCS Plan
Partner Organizations and Resources Fact Sheet

Checklists for "Finishing Your Plan" and "Formatting Your Plan
Health Systems Research (HSR) developed two checklists for "Finishing Your Plan" and "Formatting Your Plan" workshops that were held at the recently completed "Building Comprehensive Systems for Early Childhood" meeting.

• "Finishing Your Plan" Checklist
  A checklist to help you to develop an Action Plan to complete the17 required components to your ECCS plan
• "Formatting Your Plan" Checklist
  A checklist that can be used to make sure you have included the 17 required elements in your plan

Building Comprehensive Systems for Early Childhood Conference
Building Family Centered Medical Homes Presentation
Hilton Washington DC/Silver Spring
September 19, 2005

Speakers:
Paula Duncan, MD, Laura Aird, MS, Lauri Levin, MSW

Session Overview:
Defining Medical Home
Integrating medical home into SECCS
Education of child health professionals
Measurement based office system change
Improved links to community systems
Improved access to medical home
Linking to early care and education
Linking to state medical home initiatives

View additional presentations and materials from the conference at: www.hsrnet.net/eccs/materials.htm

Brief Explores EPSDT’s Role in Early Childhood Comprehensive Systems

Maximizing the Use of EPSDT to Improve the Health and Development of Young Children reviews research about Medicaid; the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program; and young children and the role of EPSDT in Early Childhood Comprehensive Systems (ECCS).

The brief, published by the National Center for Children in Poverty, examines the role of EPSDT in financing early childhood services such as newborn screening, early intervention, home visiting, and early childhood mental health treatment and how ECCS leaders across the country are working to ensure access to health care and a medical home for all young children. State EPSDT performance rates and interagency collaborative efforts to improve EPSDT performance in the context of ECCS are discussed. Tips for states and federal guidance for the EPSDT child health benefit under Medicaid are also presented. The brief is intended for use by ECCS leaders and partner stakeholders in improving the health outcomes of young children from families with low incomes. The brief is available at http://nccp.org/media/tst06b.pdf.

Publications
Building State Early Childhood Comprehensive Systems: Publications from the National Center for Infant and Early Childhood Health Policy at UCLA

• Building Bridges
• Environmental Scan
• Strategic Financing: Making the Most of the SECCS Initiative
• The Role of SECCS in Promoting Cultural Competence and Effective Cross-Cultural Communication
• Strategies for Integrating Developmental Services and Promoting Medical Homes
• Addressing Social-Emotional Development and Infant Mental Health In Early Childhood Systems
• Family Support: Fostering Leadership and Partnership to Improve Access and Quality
  More Publications are available by clicking here.

Web sites/Organizations
American Academy of Pediatrics Child Health Topics:
www.aap.org/topics.html
Browse through health topics such as: Behavioral and Mental Health, Community Health, Diseases and Conditions, Family Health, Healthy Development, Navigating the Health Care System, Populations with Unique Health Care Needs. Direct link to Early Childhood information from the AAP: www.aap.org/healthtopics/stages.cfm#early

American Association for Home-Based Early Interventionists (AAHBEI): www.coe.usu.edu/skihi/AAHBEI.html
The American Association for Home-Based Early Interventionists serves parents and those working in the field of early home intervention with infants, toddlers, and preschoolers with special needs. It is a group of families and professionals working together to help the children they serve reach their maximum potential.

The ABCD Reading Room: www.nashp.org
This Web site is designed to provide state policymakers with easy access to research and resources related to early childhood health and development. Topics include (1) relevant findings from the science of early childhood development, (2) preventive health care guidelines and new directions, (3) promoting young children's mental health, (4) measurement and quality improvement in early childhood services, (5) comprehensive and systematic approaches to early childhood services, and (6) early childhood services costs and financing strategies.

Circle of Inclusion: circleofinclusion.org/index.html
The Circle of Inclusion Web Site is for early childhood service providers and families of young children. This web site offers demonstrations of and information about the effective practices of inclusive educational programs for children from birth through age eight.

Division for Early Childhood:
www.dec-sped.org/
This nonprofit organization advocates for individuals who work with or on behalf of children with special needs, birth through age eight, and their families. It was founded in 1973 and is dedicated to promoting policies and practices that support families and enhance the optimal development of children. Children with special needs include those who have disabilities, developmental delays, are gifted/talented, and are at risk of future developmental problems.

AAP Health and Child Care Partnership program (formerly known as Healthy Child Care America): healthychildcare.org
HCCA seeks to ensure that all children experience quality child care within a nurturing environment and have a medical home. Its principles are based on the fact that families, child care providers, and health professionals in partnership can promote the healthy development of young children in child care settings and increase access to preventive health services and safe physical environments

The Individuals with Disabilities Education Act: www.nectas.unc.edu/idea/idea.asp
Part C of IDEA, the Program for Infants and Toddlers with Disabilities is a federal grant program that assists states in operating a comprehensive statewide program of early intervention services for infants and toddlers with disabilities, ages birth through age 2 years, and their families. In order for a state to participate in the program it must assure that early intervention will be available to every eligible child and its family.

Love And Learning: Birth To Three Reading and Language Development Resources for CSHCN. Also applicable for older non-verbal children) www.loveandlearning.com/index.shtml
Also available are letters from parents who have used these materials over the last 15 years and copies of articles about other projects including the latest article published by the European Down Syndrome Association.

This link is for accessing the published articles concerning the Reading Program Geared to Children with Special Needs.
www.loveandlearning.com/articles.shtml

National Association for the Education of Young Children: www.naeyc.org/
The National Association for the Education of Young Children (NAEYC) is the nation's largest and most influential organization of early childhood educators and others dedicated to improving the quality of programs for children from birth through third grade.

The National Center for Children in Poverty (NCCP): www.nccp.org/
NCCP was just awarded a prestigious five-year cooperative agreement from the National Bureau of Maternal and Child Health to create Project THRIVE: Linking Policies for Child Health, Early Care and Learning, and Family Support.

Collaborating with state and other leaders in the field, THRIVE will increase awareness and provide policy analysis that helps states strengthen and expand early childhood systems to ensure that young children and their families have access to high-quality health care, developmental services, and parenting supports.

National Center for Early Development and Learning: www.fpg.unc.edu/~ncedl/
A national early childhood research project supported by the US Dept. of Education's Office of Educational Research and Improvement. NCEDL focuses on enhancing the cognitive, social, & emotional development of children from birth through age eight.

National Child Care Information Center: nccic.org/
The National Child Care Information Center (NCCIC), a service of the Child Care Bureau, is a national clearinghouse and technical assistance center that links parents, providers, policy-makers, researchers, and the public to early care and education information.

National Early Childhood Technical Assistance Center (NECTAC): www.nectac.org
This program provided responsive technical assistance (TA) to the programs supported under the Individuals with Disabilities Education Act (IDEA) for infants and toddlers with disabilities (Part H of IDEA) and for preschoolers with disabilities (Section 619-Part B of IDEA) in all states and participating jurisdictions, and to projects funded by OSEP under the Early Education Program for Children with Disabilities (EEPCD).

National Head Start Association: www.nhsa.org/
NHSA is the only nonprofit organization that specifically represents Head Start's millions of impoverished children and families before Congress and offers training and support to Head Start staff.

NICHCY: National Dissemination Center for Children with Disabilities www.nichcy.org/
Compiles disability-related resources in each state, and is a source of information on:

• disabilities in infants, toddlers, children, and youth,
• IDEA, which is the law authorizing special education,
• No Child Left Behind (as it relates to children with disabilities), and
• research-based information on effective educational practices.

Pathways Awareness Foundation:www.pathwaysawareness.org/
A national non-profit organization dedicated to raising awareness about the benefit of early detection and early therapy for children with physical movement differences. The web site, designed for both parents and professionals, contains valuable information about children’s physical development including a growth and development chart where you can track a child’s physical, play and speech milestones from 3 to 15 months.

WINGSPAN Strengthening Children's Skills for Life
http://www.wingspanworks.com/
Wingspan offers training programs and engaging curricula for classrooms and parent groups that capture August 8, 2008y tested and backed by extensive research, Wingspan's curricula and training programs help teachers and parents develop young children's social skills, problem-solving abilities, self-control, and independence.

ZERO TO THREE: National Center for Infants, Toddlers and Families: www.zerotothree.org
This organization's mission is to help children best navigate their first three years of life in order to develop a solid intellectual, emotional and social foundation. The site has separate sections for parents and professionals.

1. Halfon, N, Uyeda, K, Inkelas, M, Rice, T. Building Bridges: A Comprehensive System for Healthy Development and School Readiness. UCLA Center for Healthier Children, Families and Communities. 2004.

Last Updated August 8, 2008