Find State ESMs

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs (https://www.mchlibrary.org/evidence/state-esms-results.php?q=ASQ&NPM=6&State=&RBA_Category=&MCH_Pyramid=&Recipient=&Status=Active) for this NPM or search for other strategies or promising practices (https://www.mchevidence.org/tools/npm/6-developmental-screening.php).

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities related to systems-building

Goal: To increase from 43 (WMG, 2015) to 100 the number of provider sites including, but not limited to, child care centers, health care providers and other community-based organizations completing and reporting ASQ/ASQ-SE results to WMG

Numerator: Number of sites reporting ASQ/ASQ-SE results to WMG

Denominator: N/A

Significance: According to the Spark NH’s Framework for Action 2016, 1 in 5 New Hampshire children under the age of 5 are at risk for developmental or behavioral concerns. Yet the majority of New Hampshire’s children do not receive standardized screening designed to identify these concerns in the early years (Spark NH, 2015). As a result, some children with delays do not have access to early identification and services that could change the trajectory of their learning and ability to thrive.

Data Sources and Data Issues: NH’s statewide developmental screening system, Watch Me Grow (WMG), maintains a database that tracks individual ASQ/ASQ-SE results, referrals and information regarding the providers administering the tool. The data is generally reported on annually. The data system is being evaluated for capacity to follow up on referrals and outcomes.

Year: 2020

Unit Type: Simple Count, Unit Number: 100

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs (https://www.mchlibrary.org/evidence/state-esms-results.php?q=referral+service&NPM=6&State=&RBA_Category=&MCH_Pyramid=&Recipient=&Status=Active) for this NPM or search for other strategies or promising practices (https://www.mchevidence.org/tools/npm/6-developmental-screening.php).

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities related to systems-building

Goal: That 100% of high risk screens are referred to an early intervention program and our documented.

Numerator: Percentage of high risk screens referred to early intervention/Part C

Denominator: N/A

Significance: Research shows that healthcare providers’ knowledge of and referral patterns to early intervention services and other community services is quite low. It is important that we increase knowledge through academic detailing and other onsite outreach efforts. Specific attention will focus on ensuring that children identified at risk for developmental delays following a screen are actually linked with and receive the interventions recommended by the referring provider

Data Sources and Data Issues: MCH Program, Marshall Health Information System

Year: 2020

Unit Type: Text, Unit Number: Yes/No

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy 6.2 "Provider Training" (https://www.mchevidence.org/tools/strategies/6-2.php). Find other NPM 6 provider-level strategies in MCHbest.

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Enabling services level of pyramid

Essential Public Health Services: 3. Inform and educate the public

Service Recipient: Activities directed to families/children/youth

Goal: Increase the number of participants who received training about Bright Futures Guidelines for Infants, Children, and Adolescents by 10% in the next year.

Numerator: The number of participants who received training about Bright Futures Guidelines for Infants, Children, and Adolescents.

Denominator: N/A

Significance: Bright Futures Guidelines provide the most up-to-date information on preventive screenings and services by visit for infants, children, and adolescents. The Guidelines provide visit-by-visit anticipatory guidance for health care providers.

Data Sources and Data Issues: MSDH Mississippi First Steps Early Intervention Program (MSFSEIP) 2018

Year: 2020

Unit Type: Simple Count, Unit Number: 1,000

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy 6.1 "Home Visiting Programs" (https://www.mchevidence.org/tools/strategies/6-1.php). Find other NPM 6 caregiver-level strategies in MCHbest.

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 8. Build and support a workforce

Service Recipient: Activities directed to professionals

Goal: By 2020, 90% of new home visitors trained to provide ASQ from a ‘certified ToT.’

Numerator: Number of home visitors trained to provide ASQ by a ‘certified ToT’ within 6 months of hire

Denominator: Number of new home visitors who have been employed for at least 6 months

Significance: This measure will ensure that all home visitors follow fidelity to the ASQ tool and ensure standardization of assessments throughout the state’s home visiting programs. Improved quality of assessments indicates stronger identification of developmental delays which result in stronger referrals to provide quality developmental resources for families in need.

Data Sources and Data Issues: In-house data from Health Start’s training matched with in-house data from MIECHV, HRPP, Health Start (number of new hires).

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: This ESM measures access to/receipt of care, thus doesn’t align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities related to systems-building

Goal: Increase the proportion of children birth to age 19 that received a well child appointment in the past year.

Numerator: Number of EPSDT screenings performed in the Simple County health departments in the past year

Denominator: Number of children birth to age 19 who received services in the Simple County health departments in the past year

Significance: Early identification of developmental disorders is critical to the well-being of children and their families.

Data Sources and Data Issues: Simple County Health Departments Electronic Health Records

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: No similar strategy found in the established evidence for this NPM. See similar ESMs (https://www.mchlibrary.org/evidence/state-esms-results.php?q=online+tool&NPM=6&State=&RBA_Category=&MCH_Pyramid=&Recipient=&Status=Active) for this NPM or search for other strategies or promising practices (https://www.mchevidence.org/tools/npm/6-developmental-screening.php).

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: Increase the number of parent-completed early childhood developmental screens using an online ASQ screening tool.

Numerator: The number of parent-completed early childhood developmental screens using an online ASQ screening tool for children 0 - 5 years old.

Denominator: 1

Significance: 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. Promoting parent-completed early childhood developmental screening using an online ASQ screening tool (ESM6.1) through the ECCS Impact Program will raise community awareness of available parent-completed developmental screening tools and will lead to an increase in NPM #6 (Percent of children, ages 10 through 71 months, receiving a developmental screening using a parent-completed screening tool).

Data Sources and Data Issues: Developmental Screening data using the online ASQ Tool from the ECCS Impact Grant with NJ DCF.

Year: 2020

Unit Type: Simple Count, Unit Number: 10,000

Measure Status: Active

Evidence Level: This ESM measures access to/receipt of care, thus doesn’t align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities related to systems-building

Goal: Increase the percentage of children with Medicaid coverage receiving a brief emotional behavioral assessment using a standardized tool.

Numerator: Medicaid claims data for children ages 9 through 71 months for whom CPT code 96127 was billed.

Denominator: All children ages 9 through 71 months with Medicaid coverage.

Significance: Emotional/behavioral assessments are important to detect delays early and link the families to services needed.

Data Sources and Data Issues: Medicaid claims data.

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Quality Improvement Programs in Health Care Settings" (https://www.mchevidence.org/tools/strategies/6-3.php). Find other NPM 6 practice-level strategies in MCHbest.

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Enabling services level of pyramid

Essential Public Health Services: 4. Support and mobilize partners

Service Recipient: Activities directed to professionals

Goal: Increase providers' competencies by establishing a learning collaborative that develops a strong family/professional partnerships by Implementing a quality improvement learning collaborative to improve developmental screening practices (e.g. t

Numerator: Number of providers who report they utilize their training in improving family/professional partnerships to improve developmental screenings.

Denominator: Total number of providers who serve children up to 35 months.

Significance: There is strong evidence that interventions during pregnancy and early childhood have some of the greatest impacts on children’s lifelong health and development. Although parents’ knowledge and practices greatly affect their children’s healthy development, parenting education is lacking at the population level. A national study of new parents found that information was cited as one of their greatest needs. In a California study, the majority of parents (including 70% of Spanish-speaking parents) believed they did not have adequate knowledge to care for their young children. It has been difficult to reach parents who face barriers of literacy, language, poverty or disability with easy-to-use and engaging information. The First 5 Kit for New Parents is an innovative, evidence- based approach to reach new parents with information about parenting practices and community resources. The “Kit” is a low-cost, multi-media collection of information for parents of children 0-5 years and their providers. It includes DVDs (featuring celebrities, experts and diverse parents), and printed materials that were written to be widely accessible to parents, including those with limited literacy, and those who speak Spanish, Cantonese, Mandarin, Vietnamese, Korean or English. Since 2001, the Kit has been distributed free of charge to 500,000 California parents each year through diverse perinatal and childcare programs. The Kit model was evaluated in a 3-year longitudinal survey of intervention and comparison groups of English- and Spanish-speaking parents and providers. Findings showed high Kit usage (87%) and satisfaction (94%). Parents in the intervention group showed significantly greater knowledge gains and reported better practices than parents in the comparison group. Providers considered the Kit a valuable resource to incorporate into their educational programs. The Kit model has now been adapted and extended to four other states and has reached over five million families.

Data Sources and Data Issues: UDS

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Provider Training" (https://www.mchevidence.org/tools/strategies/6-2.php). Find other NPM 6 provider-level strategies in MCHbest.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 8. Build and support a workforce

Service Recipient: Activities directed to professionals

Goal: 100% of medical providers trained will report using an evidence-based screening tool by 2025.

Numerator: Number of medical providers trained who report using an evidence-based screening tool

Denominator: Number of medical providers trained who complete an evaluation

Significance: Too few children receive a developmental screening using a standardized parent-completed tool. Providers, especially pediatricians, report that use of a standardized screening tool increased from 21% in 2002 to 63% in 2016. Progress has been made, but more is needed. Unfortunately, AAP screening guidelines have not yet been uniformly embraced. All providers serving children must embrace screening guidelines and, be trained to increase their knowledgeable of using a standardized developmental screening tool.

Data Sources and Data Issues: Training evaluation will be distributed via the Wisconsin Medical Home Initiative using Survey Monkey, and reported to the Wisconsin Title V Program. No data issues anticipated.

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: This ESM measures access to/receipt of care, thus doesn’t align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities related to systems-building

Goal: Increase the proportion of Medicaid enrolled children who receive at least one developmental screening

Numerator: # eligible Medicaid children ages 1-5 with at least one developmental screening during year

Denominator: # eligible Medicaid children ages 1-5 and continuously eligible for EPSDT for 90 days

Significance: This ESM will measure an expected outcome of strategy #4-A: Participate on the Illinois Early Learning Council to facilitate coordination between early childhood systems to assure that health is recognized as an integral component of improving children’s educational outcomes as well as overall health and well-being. Through the inter-disciplinary work with the Illinois Early Learning Council, IDPH helps to support system improvements to improve early childhood outcomes, including developmental screening. It is expected that this infrastructure-building work will help to improve screening rates specifically among Medicaid children.

Data Sources and Data Issues: DATA SOURCE: Illinois Department of Healthcare and Family Services (Medicaid), CMS-416 EPSDT reporting form

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: This ESM measures access to/receipt of care, thus doesn’t align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: To increase the number of children receiving a developmental screenings using a standardized tool.

Numerator: Number of children receiving a developmental screening using a standardized tool.

Denominator: Members 9-35 months

Significance: Parents Evaluation of Developmental Status (PEDS), Ages and Stages (ASQ-3 and ASQ:SE-2) and Early Language Milestone Screen are the most commonly used standardized developmental screening tool. Collection of this data will allow the Title V MCH Program to track the number of medicaid enrolled children receiving a developmental screening.

Data Sources and Data Issues: Nevada Title V/MCH Program, Office of Analytics

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Provider Training" (https://www.mchevidence.org/tools/strategies/6-2.php). Find other NPM 6 provider-level strategies in MCHbest.

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 8. Build and support a workforce

Service Recipient: Activities directed to professionals

Goal: By 2025, 100% of LHDs providing direct child health services will have received training on the use of valid and reliable developmental, psychosocial, social determinants of health, and behavioral health screening tools for children

Numerator: Number LHDs whose child health staff receive training on appropriate use of valid and reliable developmental, psychosocial, social determinants of health, and behavioral health screening tools for children during state fiscal year

Denominator: Number of LHDs providing child health services

Significance: The risk for developmental delay is increased in the population of low income children seen in LHDs. The appropriate use of evidence-based tools in developmental, psychosocial, and behavioral health screening for children greatly improves the ability to elicit and identify developmental concerns from parents. Formal tools are much more effective than in informal interview. Screening examines the general population to identify those children at most risk. Children identified with concerns are at risk for developmental delay and are referred for further evaluation. Evaluation goes beyond screening to ascertain diagnosis and develop recommendations for intervention or treatment. This is generally not done by the primary care medical home, unless co-located or integrated professionals are in the practice. The evaluation determines the existence of developmental delay or disability which generates a decision regarding intervention. Ongoing periodic screening gives a longitudinal perspective of an infant or child’s developmental progress. All concerns must be clarified and a need for a referral for further evaluation and intervention needs to be determined. Early referral for diagnosis and intervention helps to: - prevent or reduce the impact of developmental delays - identify, build and reinforce developmental strengths in the child and family - prevent fully developed developmental conditions or disorders; and - support school readiness.

Data Sources and Data Issues: The Pediatric Medical Consultant in the Children & Youth Branch will collect this information annually as she provides the majority of these trainings.

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Implementation of Quality Standards" (https://www.mchevidence.org/tools/strategies/6-4.php). Find other NPM 6 practice/patient-level strategies in MCHbest.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities related to systems-building

Goal: Increase developmental monitoring of children enrolled in WIC to ensure early identification of delays and facilitate connection to services when needed.

Numerator: Number of children enrolled in WIC who had a completed Act Early checklist

Denominator: Number of infants and children enrolled in WIC who are due for certification or mid-certification appointments

Significance: Early identification of developmental disorders is critical to the well-being of children and their families. Children from low income groups, such as those served by WIC, may experience delays in access to screening and diagnostic services and miss the opportunity to benefit from early intervention services. The WIC Developmental Milestones Program is based on the CDC’s “Learn the Signs. Act Early.” It was developed in Missouri to integrate LTSAE into WIC clinics, promote referral for early identification, and encourage children’s healthy growth and development. Because of its initial success, the program was replicated and refined in four Missouri Simple Counties, then expanded statewide and nationally through support from the CDC and the Association of Public Health Nutritionists. The Massachusetts WIC Program launched a pilot program with 7 local programs in 2019 and will initiate statewide rollout implementation by December 2020. https://health.mo.gov/living/families/wic/pdf/wic-developmental-milestones-executive-summary.pdf https://asphn.org/learn-the-signs-act-early/

Data Sources and Data Issues: Massachusetts WIC data system

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Home Visiting Programs" (https://www.mchevidence.org/tools/strategies/6-1.php). Find other NPM 6 family-level strategies in MCHbest.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities related to systems-building

Goal: Increase the percent of children, ages 9 through 71 months, receiving a developmental screening using a parent completed screening tool (NFP and MIECHV Programs)

Numerator: # of children receiving a developmental screening

Denominator: # of children enrolled in MIECHV program

Significance: Developmental screening using a validated screening tool at regular intervals is an important part of making sure a child is healthy. When a developmental delay is not recognized early, children must wait to get the help they need. The earlier a child with a delay is identified, the sooner they can start receiving support for the delay and may even enter school more ready to learn.

Data Sources and Data Issues: MIECHV program data

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy 6.3 "Quality Improvement Programs in Health Care Settings" (https://www.mchevidence.org/tools/strategies/6-3.php). Find other NPM 6 practice-level strategies in MCHbest.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities related to systems-building

Goal: To increase the percent of children who receive a developmental screening

Numerator: Number of children, ages 9 through 35 months, that received a parent-completed developmental screening tool as part of an infant or child well visit

Denominator: Number of children, age 9 through 35 months

Significance: 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 (AAP) recommends screening tests begin at the nine month visit. The developmental screening measure is endorsed by the National Quality Forum and is part of the Core Set of Children’s Health Care Quality Measures for Medicaid and CHIP. Council on Children With Disabilities; Section on Developmental Behavioral Pediatrics; Bright Futures Steering Committee; Medical Home Initiatives for Children With Special Needs Project Advisory Committee. Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening. Pediatrics. 2006 Jul;118(1):405-20. http://pediatrics.aappublications.org/content/118/1/405

Data Sources and Data Issues: Data Application and Integration Solution for the Early Years (DAISEY): Web-based comprehensive data collection and reporting system/shared measurement system used by all MCH grantees to capture client and visit/service data

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Home Visiting Programs" (https://www.mchevidence.org/tools/strategies/6-1.php). Find other NPM 6 family-level strategies in MCHbest.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities related to systems-building

Goal: Increase the number of children in a home visiting program that receive a developmental screening.

Numerator: Number of children receiving home visiting services, ages 1 through 66 months, that have completed the Ages & Stages (ASQ-3 or ASQE2) questionnaire.

Denominator: Number of children receiving home visiting services, ages 1 through 66 months

Significance: Many children with developmental delays or behavior concerns are not identified as early as possible. As a result, these children must wait to get the help they need to do well in social and educational settings (for example, in school, at home, and in the community). According to the CDC, in the United States, about 1 in 6 children aged 3 to 17 years have one or more developmental or behavioral disabilities, such as autism, a learning disorder, or attention-deficit/hyperactivity disorder. In addition, many children have delays in language or other areas that can affect how well they do in school. However, many children with developmental disabilities are not identified until they are in school, by which time significant delays might have occurred and opportunities for treatment might have been missed. Ohio Department of Health's Home Visiting programs utilize the Ages & Stages Questionnaires, Third Edition. This is a parent completed questionnaire with 9 versions based on the baby's age.

Data Sources and Data Issues: Ohio Comprehensive Home Visiting Integrated Data System (OCHIDS) – currently under development.

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: There is limited research in the evidence base to support this strategy.

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities related to systems-building

Goal: Decrease the percent of children referred to early intervention who do not complete an evaluation from 40.7% (2018-2019) to 38.0% (2025).

Numerator: Number of children referred to early intervention who do not complete an evaluation

Denominator: Number of children referred to early intervention

Significance: Developmental screening is critical to identify a child’s potential developmental delay and need for developmental services. Barriers between child and family-serving systems in Colorado make it difficult to access and share data to know when children are screened, referred and are accessing recommended services. This results in children and families not receiving appropriate and timely services, and providers being unable to coordinate care. The purpose of exploring a resource and referral use case is to improve communication and coordination among providers, partners, and families to: ensure appropriate and timely services; reduce the burden on families; allow information to be shared, in a bi-directional manner; and to inform policy and state and local investments. The value is measured by the completion of a discovery document.

Data Sources and Data Issues: Early Intervention Colorado

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: This ESM measures access to/receipt of care, thus doesn’t align with a specific evidence-based strategy. Consider developing an ESM for one of the specific strategies in your state action plan to measure performance. Check MCHbest for examples to connect to the evidence.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities related to systems-building

Goal: All Connecticut children receive age appropriate developmental screenings, well-child visits, oral health assessments and ACIP recommended vaccines.

Numerator: Number of developmental screening claims code 96110 for children less than 3 years old (1-2 years 364 days old)

Denominator: Number of children less than 3 years old (1-2 years 364 days old) in HUSKY

Significance: As many as one in four children between the ages of zero and five is at a moderate or high risk for a developmental, behavioral or social delay. (The Health and Well-Being of Children: A Portrait of States and the Nation, 2011-2012) The American Academy of Pediatrics, Recommendations for Preventive Pediatric Health Care, Bright Futures/American Academy of Pediatrics, 2017 recommends that children be screened for developmental delays or disabilities during the 9-month, 18-month, and or 30-month well-child visits (Identifying Infants and Young Children with Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening) and specifically for autism spectrum disorders at 18 and 24 months (Screening Should Occur per "Identification and Evaluation of Children with Autism Spectrum Disorders). Screening for healthy development can help identify potential delay areas for further evaluation and diagnosis, and reduce the likelihood of developing other delays. (Pediatrics 2001; 108(1), 192-196). The rising incidence of autism spectrum disorder and developmental disabilities and heightened focus on early identification and intervention has led to an increased demand on states to develop and improve systems of care to assure all children receive early developmental screening and those with ASD/DD receive timely identification, diagnosis and intervention services. (AMCHP Environmental Scan: State Strategies and Initiatives to Improve Developmental and Autism Screening and Early Identification Systems, August 2014) Developmental screening, consistent with the AAP Guidelines, is highlighted in the Action Agenda for the Connecticut State Health Improvement Plan (SHIP) as part of the Maternal, Infant and Child Health Workgroup. The State Health Improvement Plan is a roadmap for improving the state’s health and ensuring that all people in Connecticut have the opportunity to attain their highest potential.

Data Sources and Data Issues: Data Source: Department of Social Services Claims Data for developmental screening according to claims code 96110 (developmental screening). Claims data provides a good method to track screening.

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: There is limited research in the evidence base to support this strategy.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Public health services and systems level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities related to systems-building

Goal: Expand access to developmental and social-emotional screening for families with children ages birth to five years through the implementation of an electronic screening system.

Numerator: Number of children enrolled in the follow along program that competed a developmental/social-emotional screen electronically

Denominator: Number of children enrolled in the follow along program at a Simple Counties using electronic screening system for follow-along program

Significance: The strategy related to this measure is, “Building the Capacity of Communities by Cultivating Knowledge and Improving Collaboration.” One of Minnesota’s approaches toward building community capacity is funding family-to-family support. Through family-to-family support, the parent/caregiver is linked with another parent who helps answer their questions, provides support, and helps them navigate the system. After receiving family-to-family support, families typically report that they’re more knowledgeable of the system of care and are more competent/confident in navigating the system. Those who are more confident in their ability to navigate and access care may be more likely to have (or gain access to) adequate and consistent insurance.

Data Sources and Data Issues: Data Source: The Brookes Publishing ASQ Enterprise and Family Access screening system will provide data reports. Three staff in the MDH Children and Youth with Special Health Needs Section are assigned AcSimple Count Administrator access to the system and may run eighteen unique reports at any time, such as screening usage, screening scores, and the number of follow up actions. Data reports will be run annually at a minimum. Limitations of Data: Only 79 of 87 Simple Counties have a follow along program. All Simple Counties serve children birth – 36 months, however at least a dozen Simple Counties additionally serve children between 36 – 72 months of age. Simple Counties may voluntarily choose to use the electronic screening system; it is not required. Consistent data collection activities will be jointly developed by MDH and local public health agencies during the first year of use.

Year: 2020

Unit Type: Percentage, Unit Number: 100

Measure Status: Active

Evidence Level: Moderate. Aligns with MCHbest strategy "Home Visiting Programs" (https://www.mchevidence.org/tools/strategies/6-1.php). Find other NPM 6 family-level strategies in MCHbest.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Direct services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: Increase the percent of children enrolled in CHVP with at least one developmental screen using a validated instrument within AAP-defined age range (10-months, 18-months, or 24-month timepoints).

Numerator: CHVP children who were administered the ASQ-3 at the 10-month, 18-month, or 24-month timepoints with date taken falling within the reporting period.

Denominator: CHVP children between the ages of 11 and 25.5 months and eligible for developmental screening during the reporting period.

Significance: The Title V Maternal and Child Health Services Block Grant to States Program guidance defines the significance of National Performance Measure 6 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.

Data Sources and Data Issues: Calculations were made using the most current data extracts from live California Home Visiting Program data management system(s). Previous reporting may differ slightly as a result. The following children are excluded from this measure: a. children who have an identified delay or already are receiving services for developmental delay. b. children who reached 25.5 months during the reporting period and were screened at the 24-month time period in the previous reporting period. c. children who were not screened and have not yet reached 25.5 months at the end of the reporting period

Year: 2020

Unit Type: Percentage, Unit Number: 100