U9H46905

Transforming Pediatrics for Early Childhood - Address: 250 Washington Street, Boston MA 02108
Project Director: Stephanie Doyle
Contact Phone Number: 857-406-0439
Email: STEPHANIE.E.DOYLE@MASS.GOV
Website: HTTPS://WWW.MASS.GOV/ORGS/BUREAU-OF-FAMILY-HEALTH-AND-NUTRITION
Funds Requested: $1,000,000

The Massachusetts Department of Public Health (MDPH) requests $1,000,000 for its Transforming Massachusetts Pediatrics for Early Childhood (TMPEC) program to equitably expand upon significant state efforts that have integrated early childhood development (ECD) specialists into pediatric practices.

For decades, Massachusetts (MA) has been on the cutting edge of integrating early childhood experts into pediatric care to address the holistic needs of children and families. We will scale implementation over the next several years to assist with the institutionalization of pediatric primary care reforms in the state's proposed Medicaid 1115 demonstration waiver.

Needs Addressed:
This proposal addresses two main barriers to full statewide ECD integration into pediatric primary care: 1) inequitable access to ECD services and 2) financial sustainability of the model.

Approximately, 15% of MA children three to five years old have an emotional, developmental, or behavioral problem, which is slightly higher than the national average of 13%. While over 60% of infants and toddlers in MA are estimated to receive coordinated, comprehensive care within a medical home, only 43% low-income infants and toddlers received the same care.

In addition, Latinx parents report significantly more difficulty accessing a referral to developmental services and supports than white parents (23% vs. 9%).

A significant barrier to widespread implementation of integrated care is financial sustainability, especially in practices that serve predominantly patients insured by MassHealth (Medicaid). Recognizing the unique needs of children and pediatric practices, MassHealth has proposed to create tiers of payments in its pending 1115 waiver that would provide sub-capitated rates robust enough to include promotion, prevention, and early intervention for young children.

Proposed Services:
The overall goals of TMPEC are to: 1) increase equitable access of young children and their families to high quality, culturally competent, holistic early childhood services by building capacity in integrated pediatric primary care in Massachusetts and 2) demonstrate a pathway to sustainability through MassHealth's ground-breaking 1115 demonstration waiver.

We propose to support integrated care teams at 16 pediatric practice partners that predominantly serve low-income young children and their families insured by MassHealth. Integrated care teams will be comprised of ECD experts and family partners (caregiver peers with lived experience who provide wraparound services and support and reflect the cultures and communities they serve).

Pediatric practice partners will use an evidence-based model (HealthySteps, Team Up, or MA Launch/MyChild) that best meets the needs and strengths of their practice and patient population. To ensure the success of the teams, we will provide team coaching, a learning community, specialized family partner technical assistance, and training in partnership with experts from the Boston Public Health Commission, the Department of Mental Health, the Massachusetts Association for Infant Mental Health- Birth to 6, Team Up for Children, and Zero to Three/Healthy Steps.

To sustain this work and the lessons learned, we will work collectively with the Early Childhood Integration Workgroup and Young Children's Council to develop and implement a plan to address key barriers and for sustainability that includes demonstrating the effectiveness of this intervention to primary care practices that can qualify for a higher capitated tier of value-based payments from MassHealth.

Population Groups Served:
Our population of focus is low-income young children and their families who...

Massachusetts Department Of Public Health

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]

Massachusetts United States

State-Wide

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

Amendment Since initial award the total obligations have increased 300% from $1,000,000 to $4,000,000.