Improving the Delivery Health Care that Supports Young Children's Healthy Mental Development: Update on Accomplishments and Lessons from a Five-State Consortium

The five states that participated in the second Assuring Better Child Health and Development (ABCD II) Consortium were successful in improving child development services, increasing the rate of identification of children in need of developmental services, and improving the likelihood that those identified with a potential need received appropriate follow-up services. The results of the 3-year project are detailed in a new report from the National Academy for State Health Policy (NASHP), Improving the Delivery of Health Care that Supports Young Children’s Healthy Mental Development: Update on the Accomplishments and Lessons from a Five-State Consortium. In their projects, all five ABCD II states (California, Iowa, Illinois, Minnesota, and Utah) were able to increase the rate of screening of young children, through the use of an objective screening tool, in selected physician practices in which the states tested approaches. Most of the states also demonstrated an increase in the percentage of children referred for follow-up services, such as secondary developmental surveillance, assessment, rehabilitation, evaluation by a child psychologist, early intervention, and school services. To achieve their goals, the states used a combination of partnerships among state agencies, clinicians, and provider organizations; education, training, and support activities; identification and modification of policy barriers in Medicaid and other state programs; identification of follow-up resources for clinicians; and using quality improvement projects to produce and sustain improvements. The new report is a valuable tool for other states interested in improving child development services. It discusses:

• the five states’ accomplishments and lessons in measuring screening, referral, and follow-up;
• strategies that the states developed for supporting and facilitating improvements in the delivery of services; and
• lessons learned in eight key areas of strengthening primary health services and systems that support the healthy mental development of young children.

The Assuring Better Child Health and Development program is sponsored by the Commonwealth Fund and administered by NASHP; the program has been ongoing since 2000. ABCD II was designed to strengthen primary health care services and systems that support the healthy mental development of young children, ages birth to three. The program focused on preventive care of children whose health care is covered by state health programs, especially Medicaid. The goals of ABCD II were to:  

• Create models of service delivery and financing that promote high quality care supporting children’s healthy mental development, especially those with less intense needs (those who need only preventive care and those who are identified as “at risk” or in need of low-level intervention); and
• Develop policies and programs that assure that health plans and pediatric providers have the knowledge and skills needed to furnish care in a manner that supports a young child’s healthy mental development.

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ABCD II Report	603.6 KB