U9H46904

Transforming Pediatrics for Early Childhood - Oregon Pediatric Improvement Partnership, OHSU, 707 SW Gaines Dr, Portland OR 97239
Colleen Reuland, MS; 503.494.0456, reulandc@ohsu.edu, oregon-pip.org

Years 1-4: 1,000,000yr establishment of high-quality early childhood prevention approaches and connection to services that address children's holistic needs and prepare them for kindergarten has been a policy focus for children insured by Oregon's Medicaid/Children Health Insurance Program (CHIP) for nearly a decade.

The Oregon Pediatric Improvement Partnership (OPIP) has been a central and key partner since 2010 in supporting ground-level implementation aligned with these state policies and priorities.

For this project, OPIP will build off existing systems, to leverage and inform general policy and payment requirements for prenatal care and children birth-to-five enrolled in Medicaid/CHIP, in order to focus on how primary care practices can improve equitable access to a continuum of early childhood development (ECD) services.

A community-based approach will be used to improve the capacity and quality of ECD supports available in patient-centered primary care homes (PCPCH), while also addressing the workforce strengthening and care coordination needs to ensure high-quality ECD services.

There are 4 components to Oregon's approach:

1. A learning collaborative will be conducted with four diverse PCPCH practices in the Portland metro tri-county region, where over half of the children covered by Oregon's Medicaid/CHIP reside. This region is also served by Oregon's largest coordinated care organization, HealthShare of Oregon, which has accepted risk and receives a global budget to ensure quality of care for nearly 90% of the tri-county prenatal-birth to five population. These sites serve a large number of Medicaid/CHIP-enrolled children residing in the region, and also have a large proportion of children identified as health complex (i.e. having both medical and social complexity). The learning collaborative will provide training, implementation supports, and data for each site, with goals to increase the number of ECD experts placed and trained to serve children birth-to-five, to increase the quality and continuum of ECD services overall and specifically for children with health complexity, and to share with other sites the successes and barriers encountered. These efforts will include a focus on promotion of early social-emotional health, developmental and social-emotional screening, social determinants of health screening, and care coordination and service linkage. Semi-annual in-person learning sessions will be provided on the breadth and depth of ECD services. At each session, regional and practice-level needs assessment data will be shared to guide improvements, families will present on their priority needs and ways to ensure a family-centered focus, and local advocacy and community-based organizations will share the unique needs and experiences of historically marginalized populations. Each site will then receive tailored "at the elbow" support to guide implementation of an individualized action plan. This includes monthly calls/site visits with the core team to provide technical assistance on process implementation, the ECD expert(s) to support provision of ECD services within the site, and the staff performing care coordination, referral tracking and linkage functions to support connection to community services.

2. Local (Portland metro) system & policy leaders will be both informed by practice learnings and given opportunity to inform practice efforts, targeting solutions that address sustainability, barriers and spread to other practices.

3. State-level policymakers will be engaged to ensure efforts are informed by and synergistic with state policies, and to advance solutions to sustain comprehensive, holistic ECD service needs.

4. OPIP will develop trainings & tools informed by practice implementation to support spread to.

Oregon Health & Science University

NOT APPLICABLE

93.110 - Maternal and Child Health Federal Consolidated Programs

HRSA Office of Federal Assistance Management (OFAM) [HHS - HRSA]

Maternal and Child Health Bureau (MCHB) [HHS - HRSA]

Oregon United States

State-Wide

Transforming Pediatrics for Early Childhood (TPEC) (HRSA-22-141)

Amendment Since initial award the total obligations have increased 301% from $995,736 to $3,991,230.