A ssuring B etter C hild Health and D evelopment Initiative

1. Assuring Better Child Health and Development Initiative Funded by: The Commonwealth Fund Administered and Supported by: National Academy for State Health Policy

2. Agenda • Background • Policy Improvements and Pilot Practices • Future • Your experiences

3. WA ME ND MT OR VT ID MN NH MA WI NY SD MI WY RI CT PA IA NJ NE NV OH UT IN DE IL MD CO CA WV VA DC KS MO KY NC TN AZ OK SC AR NM GA AL MS TX LA AK FL PR PR HI ABCD Screening Academy States ABCD Screening Academy States

4. ABCD Screening Academy Purpose To increase use of a general developmental screening tool as a part ofhealth supervision duringwell-child care provided by primary care providers who act as young children’s medical homes.

5. Public/Private Partnership • Dept of Medical Assistance Services • AAP Virginia Chapter • Dept of Health • Stakeholders Group – Bright Futures Collaborative • Managed care health plans • Early Intervention programs • Home visiting programs

6. Policy Improvement • Clarified Medicaid billing for screening www.dmas.virginia.gov/downloads/pdfs/mm-EPSDT_Memo_chart.pdf • Monitored Medicaid claims for CPT 96110

7. Medicaid Paid Claims for Developmental ScreeningFor Children Birth through 5 Years of Age by Month of ServiceVirginia, January 2005 through June 2008 (preliminary) 2006 2005 2007 2008 Source: DMAS, Medicaid paid claims for CPT 96110 by date of service, FFS and MCO; claims paid as of 7/22/08

8. Children with a Medicaid Paid Claim for Developmental Screening Children Birth through 5 Years by Age and Year of ServiceVirginia, Calendar Years 2005, 2006, 2007, and 2008 through Sept 22 (preliminary) Source: DMAS. Children birth to age five with Medicaid paid claims for CPT 96110 by date of service, FFS and MCO; claims paid as of 9/22/08

9. Policy Improvement • Incorporated use of a developmental screening tool into (Pre)School Entrance Health Form (VDH) www.vahealth.org/childadolescenthealth

10. School Health Entrance Form ►

11. Policy Improvement • Developed a laminated referral guide to Part C Early Intervention services. (DMHMRSAS) www.infantva.org/documents/pr-ReferralGuide.pdf keisha.white@co.dmhmrsas.virginia.gov

12. I&TC Referral Guide

13. Policy Improvement • Developed a uniform referral/consent form for sharing information between the Part C Early Intervention program and primary care provider (AAP and DMHMRSAS) www.infantva.org/documents/forms/3094eEI.pdf

14. I&TC Referral/Consent Form

15. Pilot Practices • Piedmont Health District, VDH • Ages and Stages Questionnaire (ASQ) • Augusta Pediatrics, Fishersville • Parent’s Evaluation of Developmental Status (PEDS)

16. Lesson Learned • Screening is just the first step. • There must also be access to follow-up services. • Efforts to identify and help families and clinicians access resources for assessment and treatment are critical to project success. *Source: Improving the Delivery of Health Care that Supports Young Children’’s Healthy Mental Development, NASHP, 2008.

17. ABCD III Enhancing referral and care coordination between pediatric practices and community intervention agencies

18. Your Experiences