Title V Transformation Tools

Title V Transformation Tools

TransformationRecommendations to Support NPM 6 – Developmental Screening

Jump To: Skills | Knowledge

Significance. The Title V Maternal and Child Health Services Block Grant to States Program guidance1 defines the significance of this NPM as follows:

Early identification of developmental disorders is critical to the well-being of children and their families. It is an integral function of the primary care medical home. The percent of children with a developmental disorder has been increasing, yet overall screening rates have remained low. The American Academy of Pediatrics recommends screening tests begin at the nine month visit.

Background. The Maternal and Child Health Bureau (MCHB) Title V Maternal and Child Health Services Block Grants to States Program has established 15 National Performance Measures (NPMs) for the 2015-2017 grant cycle. In order to effectively address the NPMs, MCH professionals need to think about not only the evidence and strategies to make change, but also the capacity of the workforce to carry out these activities. These lists identify online learning materials, resources, and evidence-based strategies and programs to support the knowledge sets and skills needed to advance each NPM.

Introduction. Six skill sets have been identified by the National MCH Workforce Development Center to support implemenation of this NPM: (1) population health; (2) strategic planning and program design; (3) strategic alliances and effective partnerships; (4) consumer engagement and cultural and linguistic brokering; (5) policy and program implementation; and (6) communication.

In addition, two knowledge areas specific to the NPM topic area have been highlighted that are keyed to the evidence base and promising practices: (1) developmental screeningbackground, recommendations, and guidelines and (2) developmental screening policies and strategies.

The MCH Navigator, in collaboration with the Center, has developed this crosswalk to guide MCH professionals to online learning opportunities and implementation resources to support these skill sets.

Please click on the Read More buttons below for additional information, learning materials, and implementation resources. You can also email us with suggestions for additions.

Skills

Six skill sets have been identified to support implemenation of this NPM:

1. Population Health

A renewed focus on MCH population health is key to achieving the NPMs in the era of health transformation. These skills enable Title V professionals to analyze how program interventions and their related health outcomes are distributed among a state’s MCH population. Population health skills complement all of Title V’s work, including program design and implementation, strategic partnerships and communication.

2. Strategic Planning & Program Design

Effective strategic planning and program design requires the ability to base programs on defined goals and desired outcomes. Strategic planning should include a monitoring and evaluation system to track and monitor progress and inform program alterations as needed. Program design skills must ultimately be coupled with implementation, where program design is carried out.

Skills:

  1. Skills to identify whether programs for which Title V provides oversight, such as home visiting and care coordination, are including evidence-based developmental screening tools
  2. Ability to establish mechanisms that ensure that children with identified developmental risks and conditions are linked to a family-centered, community-based, and coordinated system of care

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3. Strategic Alliances & Effective Partnerships

The wide array of stakeholders and partners in the field of MCH, from providers and insurers to women and children, require a set of skills in strategically aligning Title V goals with those of their partners. In the Title V world, there is an increasing interest in engaging unlikely or nontraditional partners to achieve the NPMs. The skills in this category take that into account and include unique partner groups linked to this measure.

Skills:

  1. Ability to convene multiple disciplines and systems (e.g., education, early childhood education, health, housing,) to assess, coordinate and increase rates of screening
  2. Ability to build and/or sustain effective partnerships with primary care providers and early childhood systems, including:
    1. Partnership with clinicians and child care health consultants
    2. Training for clinicians and child care health consultants
  3. Ability to build alliances with local chapters of the American Academy of Pediatrics (AAP), other child-serving organizations, and clinical provider organizations to:
    1. Support developmental screening
    2. Implement quality improvement projects
    3. Establish learning collaboratives

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4. Consumer Engagement/Cultural & Linguistic Brokering

Consumers are arguably the most important stakeholders in MCH work, thus skills in consumer engagement and cultural and linguistic brokering are essential to moving the needle for each NPM. In some cases, consumer engagement includes negotiating with other stakeholders on behalf of MCH populations. Closely linked with this skills category are skills in communication and strategic alliances.

Skills:

  1. Ability to partner with parent support groups to promote developmental screening
  2. Ability to assess cultural practices around developmental screening in partnership with parent groups
  3. Ability to partner with consumers to test screening tools for cultural appropriateness
  4. Ability to engage and empower families to be able to seek care and discuss their child’s health and health care needs
  5. Ability to ensure that evidence-based screening tool options are available in the most prevalent local languages

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5. Policy & Program Implementation

These skills ensure that MCH priorities are integrated into all aspects of policy and program implementation, as well as ensuring that policies and programs selected are well-aligned with NPMs and other MCH program goals. Implementing policies and programs with fidelity also requires skills in the implementation science drivers: technical and adaptive leadership; selection; training; coaching; systems intervention; facilitative administration; and decision support data systems.

Skills:

  1. Skills to ensure high quality screening tools are embedded in programs for which Title V has authority
  2. Ability to ensure that screening providers have access to tools and best practices and are trained to use the tools in an evidence-based manner
  3. Ability to refer/connect (or support local public health to refer/connect) children identified through positive screenings to existing services in public health and health care systems
  4. Ability to determine legal authority behind existing memoranda of understanding with governmental agencies
  5. Ability to develop memoranda of understanding with Medicaid and other payers to develop policies that address use of developmental screenings, particularly coverage of standardized developmental screening tools for children at their 9-, 18-, and 30-month visits
  6. Ability to effectively use electronic medical records to support screening as appropriate
  7. Ability to support public and private practitioners in efforts to make accommodations for assessing children with special health care needs

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6. Communication

Communication skills support the creation and delivery of effective messages between MCH professionals, professional and community partners, and populations served by Title V. Effective communication ensures the delivery of appropriate messages to audiences in the way that they were intended and is key to all aspects of MCH work. These skills are linked closely with skills in strategic partnerships and cultural and linguistic brokering.


Knowledge

In addition to skills, each NPM requires a knowledge base that will help Title V progress effectively in the measure. Knowledge should be considered at the foundation of achieving all measures.

1. Developmental Screening Background, Recommendations & Guidelines

  1. Knowledge of early brain and child development, including knowledge of:
    1. Typical vs. atypical development
    2. Autism spectrum disorder
  2. Knowledge of rationale for developmental screening
  3. Knowledge of evidence-based screening tools, including their strengths, weaknesses and contexts for use
  4. Knowledge of best practices for integrating developmental screening into non-medical settings
  5. Familiarity with Bright Futures

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Evidence Base:

2. Developmental Screening Policies & Strategies

  1. Knowledge of state and federal fiscal policies that support and/or fund developmental screening, including current Medicaid/Children’s Health Insurance Program (CHIP) coverage for screening
  2. Knowledge of Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program coverage and guidelines
  3. Knowledge of reimbursement strategies to secure payment for developmental screenings

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See other online learning resoures related to health transformation, collected in the Health Transformation Learning Laboratory.

 

1 Health Resources and Services Administration. 2014. Title V Maternal and Child Health Services Block Grant to States Program: Guidance and Forms for the Title V Application/Annual Report, Appendix F, p. 79.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UE8MC25742; MCH Navigator for $180,000/year. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.