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Dr. Ed Schor , Vice-President, Commonwealth Fund – Moderator Dr. Charles Bruner , Director, Child & Family Policy Center & Chair, Member Leadership Council of Voices for America’s Children – Paper Presenter. Alan Weil , Director, National Academy for State Health Policy

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Dr. Ed Schor , Vice-President, Commonwealth Fund – Moderator

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Dr ed schor vice president commonwealth fund moderator

Dr. Ed Schor, Vice-President, Commonwealth Fund – Moderator

Dr. Charles Bruner, Director, Child & Family Policy Center & Chair, Member Leadership Council of Voices for America’s Children – Paper Presenter

Alan Weil, Director, National Academy for State Health Policy

Bruce Lesley, President, First Focus -- Respondents

The Commonwealth FundImproving Children’s Healthy Development Through Federal Child Health PolicyWebinar Presentation

Co-sponsored by Voices for America’s Children, the National

Academy for State Health Policy, and First Focus


Dr ed schor vice president commonwealth fund moderator

The Case for Federal Leadership in Promoting Comprehensive Well-Child, Preventive and Developmental Health Services

  • Child health insurance coverage improves access to health care

  • Children’s healthy development can be improved through comprehensive primary, preventive, and developmental health services provided through that coverage

  • Exemplary health services and recognized practice guidelines (Bright Futures) exist for providing such primary care but are not yet part of routine practice

  • The federal government finances primary health care for a large share of America’s children, including the majority of the most vulnerable children

  • The federal government can play a leadership role in promoting the adoption of exemplary primary, preventive, and developmental health practices


Dr ed schor vice president commonwealth fund moderator

Improving Children’s Healthy Development – A Multi-Part Strategy

Health Insurance Coverage

Use of Primary Health Services

Follow-up for Needed Medical and Other Services

Healthy Child Development

=

Providing access to coverage (Medicaid, SCHIP, and private insurance)

Getting children enrolled (outreach and easy enrollment)

Providing a medical home and well-child visits

Providing comprehensive screening (physical, dental, mental, environmental)

Providing effective referrals to further assess and treat medical and other health-related needs

Higher health trajectory and greater safety and success

Reduced need for remediation and chronic disease management


Dr ed schor vice president commonwealth fund moderator

The Importance of Well-Child Care as an

Early Detector of Young Children’s Needs

Sources:

Preventive Health Visit: National Survey of Children's Health; EPSDT 416 Forms, Centers for Medicare and Medicaid Services (CMS); WIC - FDA, Food and Nutrition Services, Office of Analysis, Nutrition, and Evaluation; Formal Child Care: Census Bureau Special Report: Who’s Minding the Kids?; Head Start: National Head Start Association, Program Fact Sheets; Part B: U.S. Department of Education, Office of Special Education Programs, Data Analysis System; Part C: IDEAdata.org  Data Tables for Office of Special Education Programs State Reported Data


Dr ed schor vice president commonwealth fund moderator

The Importance of Medicaid and SCHIP

in Providing Child Health Coverage

Children Enrolled in Medicaid or SCHIP by Child Age, Nation 2007

Source: 2007 ASEC supplement to the Current Population Survey


Dr ed schor vice president commonwealth fund moderator

ABCD Initiatives

Assuring Better Child Health & Development

The Evidence Base for Improving Children’s Healthy Development through Primary Developmental Services

Help Me Grow


Dr ed schor vice president commonwealth fund moderator

Current Federal Proposals on Child Health Coverage and Quality

  • HR976. SCHIP reauthorization contains “quality” provisions that speak primarily to developing child health quality measures

  • S1226. Children’s Health Care Quality Act speaks primarily to hospital and chronic health care services for children

  • S2376 Medical Home Act has a primary focus upon children with chronic health conditions

  • Limited emphasis upon primary, preventive and developmental child health services within these proposals.


Dr ed schor vice president commonwealth fund moderator

Expanding Federal Policy Leadership to

Improving Children’s Healthy Development

  • Core set of primary care child health service outcomes

  • Structure within CMS focusing upon strengthening primary and preventive child health

  • Additional research on child health quality and outcomes in primary care

  • Incentives to states to promote evidenced-based practices in primary care

  • Coverage of services and care coordination that lead to improved child health


Dr ed schor vice president commonwealth fund moderator

Risk Factors

Improving the trajectory of child

health and development involves

increasing protective factors and

reducing risk factors -- which requires

a broad definition of child health

services.

Children’s Health and Development

Protective Factors

0

Age

Opportunities Are to Affect the Trajectory of Children’s Health,

with Long-Term Benefits to Children and Society


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