Early identification of problems that may compromise health and well-being is a core public health service. As reflected in the 2015 Needs Assessment, many children do not receive timely or adequate developmental screening. Data from the combined 2016 and 2017 National Survey of Children’s Health (NSCH) noted only 22.3% of Louisiana parents with children from 9 to 35 months old received a parent-report screener about their child’s development. In addition, we know that social factors such as trauma, parental involvement, and community safety may leave some children more at risk than others. The science around brain development continues to highlight early childhood as a particularly sensitive developmental period, and that Adverse Childhood Experiences (ACEs) can have a lifelong impact on health and wellbeing.

While we know from data collected in the Louisiana Early Childhood Risk and Reach Report and the State Child Death Review that many Louisiana children experience significant challenges, early identification of risk, linkage to appropriate supports and interventions, and promotion of safe, stable, nurturing relationships with families can improve developmental outcomes. In FFY 2018, Louisiana Title V promoted child health through investments in and strategic partnerships with the major programmatic initiatives described below

Title V Strategies and Alignment with Priority Needs

Priority Need: Bolster local level capacity to promote and protect health and well-being of children, caregivers and families.

One of the main areas of work in the child health domain is to advance the development of comprehensive local-level early childhood systems. Title V has supported this work for many years with the publication of system-level reports such as the Louisiana Early Childhood Risk and Reach Report that shows the state’s investments in early childhood programming and their reach in every area of the state. In alignment with the national Title V priorities, strengthening developmental screening has been a particular area of focus, with much of Louisiana’s Title V developmental screening and developmental health strategies emerging out of the complementary actions of state and local level bodies described below.

State Young Child Wellness Collaborative: In 2014, the Title V Program established the State Young Child Wellness Collaborative (SYCWC) to bring together various state and community agencies to work toward improving systems of care for children in Louisiana. The primary role of the SYCWC is to drive state system change and to ensure community priorities have visibility at the state-level. The body also serves as the state-level advisory board for MIECHV, Project LAUNCH (Linking Actions for Unmet Needs in Children’s Health), and the Early Childhood Comprehensive Systems (ECCS) Impact grant. The SYCWC has representation from MIECHV, Title V, the Governor’s Office, Medicaid, IDEA Part C/EarlySteps, Louisiana Department of Education-Early Ed. Division, LA LAUNCH, LDH-Office of Behavioral Health, Dept. of Children and Family Services (DCFS)- Child Welfare, Prevent Child Abuse LA (PCAL), Tulane Institute of Infant & Early Childhood Mental Health, and the Louisiana Chapter of the American Academy of Pediatrics (LAAP) .

A key function of this group has been the creation of a state-level platform for highlighting, understanding, and responding to the ways in which centralized early childhood systems elements are functioning at the community level. During FFY 2018, the group continued to build this capacity through the work of the MIECHV, LA LAUNCH and ECCS Impact grants. BFH provided the staffing time to facilitate the meetings, support the tracking and follow-up communications related to identified deliverables, and keep the group focused on their identified priorities.

In late 2017, major concerns around sustainability and availability of key early childhood services around the state highlighted a need to revisit the SYCWC strategic direction and assess how the group could be most effective in leading and/or bolstering efforts to address these concerns within the scope of their role as a state-level early childhood advisory council. As part of this process, the SYCWC worked to define a collective vision for improved developmental outcomes for young children and thriving Louisiana families around three areas of focus: family engagement, sustainability and growth, and alignment of systems. The SYCWC also identified strategic priorities and has since begun work to re-engage key partners who had dropped off since the group’s inception, including representatives from LDE and DCFS, and to map Louisiana’s early childhood system. With the mapping exercise, the SYCWC has entered the early stages of developing a Collective Impact approach to better support Louisiana’s children and families.

Local Young Child Wellness Councils: In addition to the SYCWC, BFH has provided support for two Local Young Child Wellness Councils (LYCWC).  The primary role of the LYCWCs is to identify areas for collective improvement and drive community-level systems change. These groups have engaged in collective work to identify and create opportunities for measurable systems improvements and to increase coordination within the early childhood system (ECS).

The first LYCWC was established through LA LAUNCH, an initiative funded through the Substance Abuse and Mental Health Services Administration (SAMHSA) to promote the wellness of young children ages birth to 8, focusing on the improvement of social, emotional, cognitive, physical, and behavioral health. The LAUNCH LYCWC includes representation from the three-parish region served by the project (Lafayette, Acadia, and Vermillion), and it has more than 30 members from child welfare, early care and education, family supports, physical and behavioral health, and early intervention, as well as parent and parent-serving organization representation.

The second LYCWC was established in Morehouse parish in Region 8 as part of an ECCS Impact grant project. The Morehouse parish LYCWC was modeled on the SYCWC and the LA LAUNCH LYCWC, and membership includes representatives from representation from the Mayor’s office, MIECHV, early care and education, public and private primary care and mental health providers, parents, and family-focused organizations. The Morehouse Parish School Board and Morehouse Community Medical Centers, an FQHC providing the majority of services to young children living below the poverty level in Morehouse Parish, also have representation.

Areas of work for LYCWCs have included: coordinating enrollment into early childhood services and programs through a single community-based point of entry (“no wrong door” approach), increasing developmental screening rates across settings serving young children, and promoting awareness of early childhood issues. Title V has contributed to the work of these local groups through leadership, staffing, administrative, and communications support to ensure alignment between state and local level strategies.

Priority Need: Ensuring high performing essential maternal and child health screening and surveillance systems in Louisiana

Screening Systems:

Louisiana Developmental Screening Guidelines (LDSG): As a part of the Title V work around developmental screening, the SYCWC formed a developmental screening workgroup that was tasked with formulating guidance around comprehensive developmental screening for young children in Louisiana. In 2016 the workgroup researched, selected, and endorsed a limited group of screening instruments across key developmental domains to be promoted in primary care and other settings. The LDSG expanded screening beyond developmental milestone, autism, and maternal depression screening as recommended by Bright Futures, and follows the 2014 Standards for Systems of Care for CYSHCN, the 2012 AAP Policy Statement on childhood adversity and toxic stress, and the 2015 AAP Clinical Report addressing screening for social and emotional risk.  As part of this work a Louisiana operational definition for DS was composed, “All children in Louisiana should receive periodic, developmentally appropriate, comprehensive screenings as part of a well-child visit or other preventive visit and in response to parent concern or triggering events such as hospitalization, trauma, or sudden onset of new symptoms.  Comprehensive screenings include screening for physical health, oral health, mental health, developmental and psychosocial needs, with consideration of family culture and language.”

The LDSG were created to support pediatric and family medicine providers who serve children 0-5 years with the tools to implement and maintain robust screening services at the practice level. These services aim to ensure that children experiencing challenges to their development will be promptly identified, referred for evaluation, and linked to early intervention services when indicated. BFH developed a comprehensive work plan around dissemination of the LDSG, supporting implementation of screening services at the clinic level, and working with key stakeholders who serve the early childhood population around establishing/improving communication channels and tracking mechanisms to support an effective early childhood system of care.

Work to disseminate the LDSG continued in FFY 2018. After the first Developmental Screening Coordinator left her position in FFY 2017, a new DS Coordinator was hired and onboarded in September 2017, increasing work capacity in this area. Continued collaboration with the BFH communications team on the development of resources to support dissemination of the LDSG yielded additional public facing communication tools. In FFY 2017, this workgroup created a fact sheet for the LDSG and a Technical Assistance Request Form to streamline recruitment into the TA pilot. Building on the existing communications tools, in FFY 2018, the workgroup created referral tip sheets for each of the nine LDH regions in each domain of screening recommended in the LDSG - a total of 36 unique tip sheets. These referral tip sheets are designed to help familiarize providers with developmental resources and supports for families in their region.

Another significant communications achievement was the creation and dissemination of screening instrument training webinars for 6 of the screeners recommended in the LDSG. Each webinar is 15-20 minutes long and provides information on what the screener covers, and how to administer and score the screener and share results. The webinars also provide a brief rationale for early identification and intervention, and give pointers for implementing screening systems in primary care settings. The webinars were created in-house by the DS Coordinator, and feedback on each was gathered from colleagues in various BFH programs. The webinars were posted to the BFH YouTube channel, and linked to the channel from the Partners for Family Health Website. At the time of reporting, the ASQ-3 Training Webinar video had over 700 views. 

Developmental Screening Technical Assistance Pilot: The library of resources created in FFY 2017 and FFY 2018 were combined into a technical assistance package that was piloted in LDH Region 4 beginning in FFY 2018. Initial outreach efforts focused on providers identified from community systems mapping work completed in FFY 2017, and consisted of mailing a packet of resources with an invitation to participate in the technical assistance pilot. This strategy yielded no responses, at which point the DS Coordinator and RN Program Consultant decided to leverage community connections established by Project LAUNCH staff in the region. LAUNCH Mental Health Consultants provided a warm handoff between the providers they consulted with and DS staff, resulting in successful engagement with four primary care clinics in the region. Additionally, a Federally Qualified Health Center in LDH Region 8 was alerted to the program via the ECCS Impact Grant operating in both LDH regions 4 and 8 and also joined the pilot, resulting in participation of five total clinics.

For each clinic, DS staff initially sought buy-in from at least one primary care physician in the practice, and subsequently the clinic manager if there was one. Securing sufficient buy-in to schedule time for DS staff to meet with clinic staff proved to be more challenging than anticipated in some clinics, and so getting the TA off the ground took some extra work. The TA Request form allowed DS staff to customize the TA to each clinic, which varied widely in patient volume, staff capacity, and existing screening practices. TA typically consisted of one in-person training and discussion with clinic staff, additional calls with the clinic manager as necessary, and provision of online screening instrument training webinars for staff to watch when their schedules allowed.

At the end of FFY 2018, an opportunity to participate in the CDC and Harvard T.H. Chan School of Public Health (HSPH) Program Evaluation Practicum was identified. This program matches state health departments with HSPH students to collaboratively create an evaluation plan for a program administered by the health department. DS staff and the CSHS epidemiologist decided to apply and began their application at the end of FFY 2018.

Additional Outreach Efforts: Multiple presentations were also given, including at two regional Resource Information Workshops put on by CSHS, the Lead Poisoning Prevention Advisory Board, students and faculty at the LSU Human Development Center (LSU HDC), physicians and clinical staff at Children’s Hospital New Orleans, the Region 4 Young Child Wellness Council, a Child Care Directors meeting in Morehouse Parish, Healthy Start staff in Lafayette, families at a Children’s Health Fair in Vermilion Parish, and Clinical Practice Consultants at United Healthcare, among others. Presentation content varied somewhat by audience, but the core content included brief background on early brain development; the purpose and unique contributions of developmental screening, surveillance, and monitoring; the LDSG; using Learn the Signs. Act Early. materials to engage parents in developmental monitoring; and tips for providing resources and making referrals. Clinical and child care staff were also trained on the administration and scoring of specific screening tools.

Learn the Signs. Act Early (LTSAE): In FFY 2018, the Developmental Screening Coordinator was selected as the Act Early Ambassador to Louisiana, representing the Learn the Signs. Act Early. program. This program is run collaboratively between the Centers for Disease Control’s (CDC) National Center for Birth Defects and Developmental Disabilities and the Association of University Centers on Disabilities (AUCD). LTSAE aims to improve early identification of children with autism and other developmental disabilities by creating materials to engage parents in developmental monitoring. These materials include age-specific milestone checklists, a milestone tracker app available for both Apple and Android, children’s books written to be developmentally specific to two and three year olds, and trainings for medical and child care providers.

The Act Early Initiative supports Ambassadors in nearly every US state and territory to work collaboratively within their state to integrate the LTSAE materials in young child-serving systems, with the goal of improving early identification and connection to early intervention and other needed supports and services. As Act Early Ambassador to Louisiana, the DS Coordinator created a work plan to integrate LTSAE materials into the Developmental Screening Technical Assistance package to primary care providers, as well as into the statewide MIECHV program.

Primary care integration proceeded seamlessly, and the materials were provided to all providers participating in the TA project. Information about the program was also immediately integrated into all developmental screening presentations given, including the screening instrument training webinars. A link to the LTSAE website was also included on the Developmental Screening page on the newly created Partners for Family Health website.

MIECHV integration was also very successful, but due to the much larger workforce and reach of MIECHV compared to the developmental screening TA, implementation proceeded at a slower pace. After consulting with MIECHV leadership, it was determined that piloting integration of materials in one home visiting team from each model (Nurse Family Partnership in the Monroe area and Parents as Teachers in the Shreveport area) would help inform successful statewide integration. Regional leadership identified a home visitor from each team willing to work with the Ambassador to determine which materials would be most useful, when to introduce the materials to families, and what context would be helpful for home visitors to appreciate the value of the materials. Training presentations were created for each team and reviewed by MIECHV leadership and the volunteer home visitors.

Medicaid Policy Recommendations: Over the past few years, it has become clear that working with Medicaid to implement a reimbursement policy that will incentivize DS is critical to the widespread adoption of the LDSG. In the absence of Medicaid incentives for screening, significant effort is needed to secure provider buy-in to implement systems of developmental screening in their clinics using the recommended screening instruments. During FFY 2018, discussions with Medicaid were continued to inform and explore reimbursement strategies for developmental screening as part of the Louisiana Medicaid Early and Periodic Screening, Diagnostic and Treatment (EPSDT) schedule. 

A policy proposal on the expansion of developmental screening submitted to Medicaid in FFY 2017 was determined not to be feasible for adoption in FFY 2018. However, the BFH Director and BFH Health Systems Strategy Manager facilitated ongoing dialogue with Medicaid staff in order to inform potential policy and managed care contract changes.  These efforts continue to evolve as Medicaid restructures their leadership, staff readiness to adopt change grows over time and the Medicaid department moves towards value based care models of payment.  

During FFY 2018, BFH staff consulted with Johnson Group Consulting to analyze and create a vision for maternal and child health policy within the Louisiana Department of Health. Recommendations were created as a result of this work, including improving performance of and access to pediatric medical homes, increased use of developmental screening, increased access to developmental supports and services for young children identified by developmental screening, financing additional home visiting capacity, increasing access to infant and early childhood mental health services, and adoption of a shared measurement and accountability framework for perinatal and early childhood services. These recommendations were used to inform language in the new Medicaid Request for Proposals, to which Managed Care Organizations submitted applications in FFY 2019.

One promising development with Medicaid in FFY 2018 was the addition of screening for maternal depression to the EPSDT schedule at 1, 2, 4, and 6 months of child age, aligning with the American Academy of Pediatrics’ Bright Futures guidelines. As this addition was not accompanied by the adoption of a relevant CPT code or additional reimbursement for the increased burden of work, this domain of screening was still included in discussions with the Medicaid Quality Staff.

Surveillance Systems:

Regional and State Child Death Review (CDR):  As described in the previous sections, Title V supports a mortality epidemiologist and a statewide network of 9 Regional MCH Coordinators who work within their communities on critical maternal and child mortality surveillance activities. For CDR, the MCH Coordinators abstract comprehensive information from vital records, coroner, law enforcement, and medical reports, and summarize cases information on deaths among children under the age of 15 years for local panel review and systems action. The local panels are complemented by a state CDR that serves as a platform to elevate local level issues that require state-level action or the support of state CDR partners to generate change. Local and state-level Child Death Review Panels are comprised of subject matter expertise in infant and child health and safety. In addition to the 9 Regional MCH Coordinators, Title V provides funding support for the mortality epidemiologist, leadership, communications support, and policy and legislative support.

Injury Surveillance and Child Abuse and Neglect (CAN): Over the years, CDR, PAMR, and MIECHV all identified the need for more robust surveillance and prevention activities around injury, violence, and child abuse and neglect. In 2016, BFH successfully competed for the CDC Core State Violence and Injury Prevention Program (SVIPP) and National Violent Death Surveillance System (NVDRS) grants. With those awards, BFH hired a designated injury epidemiologist who worked closely with the Department of Children and Family Services (DCFS) and with the BFH mortality surveillance epidemiologist to track violence-related related morbidity and mortality of infants and children. This work has led to an increase in CAN-related analytics and an evaluation for DCFS on the Nurturing Parent Program. BFH was also able to provide data and talking points on the relationship between paid family leave and the prevention of CAN to state and national legislators. Title V supports this work through funding the leadership, communications support, and partial funding support for the injury and mortality epidemiologists. In 2018, the injury epidemiologist accepted a new position, and BFH is currently interviewing applicants to fill the vacancy.

Priority Need: Improve social and behavioral health supports, with a focus on child and family well-being and resiliency

Priming Decision-maker Awareness about the Lifelong Effects of Early Experiences - Louisiana Early Childhood Policy Leadership Institute (ECPLI): As a part of an approach to foster awareness of the significance of early relationships on brain development and lifelong health, the Louisiana Title V program continued to contribute funding toward the Tulane University Institute for Infant and Early Childhood Mental Health’s coordination of ECPLI. Originally developed as a part of the BFH ECCS grant in partnership with Tulane, the goal of ECPLI is to develop a cadre of leaders who, while growing in small but meaningful numbers each year, will impact and influence local and state policy and practice to promote safe, stable, nurturing relationships and environments for young children. Participants include emerging and current leaders in the public, private and non-for-profit sectors representing the legislature, health, child welfare, business, the judiciary, and education to promote the well-being of infants, toddlers, and their families. Over the course of the four-month program, participants learn from one another and from national experts addressing up-to-date research on early brain and behavioral development; early experiences; the roots of health disparities; understanding prevention, early intervention; and treatment of abuse, neglect, and trauma. An important component of this effort is to expand the participants’ knowledge of research-based best practices and policy. Addressing the critical impact these leaders can have on moving the work forward, the ECPLI experience the opportunity to establish lifelong, collaborative and rewarding professional relationships.

Priming Community Awareness about the Lifelong Effects of Early Experiences - Louisiana ACE Educator Program: Louisiana Title V continued to support the the LA ACE (Adverse Childhood Experience) Educator Program throughout FFY 2018. The Louisiana ACE Educator Program was created in 2015 through a partnership between BFH and the Tulane Institute of Infant and Early Childhood Mental Health, with the support of the Louisiana ACE Initiative. The ACE Educator Program seeks to build community awareness around ACEs, trauma, and resilience science across the state via a robust and well-informed network of trained educators. This work is part of a larger effort to develop policies and practices that are informed by an understanding of the lifelong impact of childhood adversity and trauma. The program is comprised of a full-time Coordinator supported by Title V and nearly 100 trained volunteer ACE Educators. Educators are available statewide to provide trainings to agencies, organizations and community groups about the profound effects of ACEs across the lifespan, bringing with them experience from a wide range of allied fields and the ability to reach practitioners across sectors.

To date, the program has trained four cohorts of volunteer educators. The first cohort was recruited and selected from applicants located in each region of the state. Recruitment efforts for the second, third, and fourth cohorts were targeted toward individuals working in OPH Regions 7, 9, and 2, respectively, to support coordinated local efforts to reduce the impact of childhood trauma in those areas. Plans for two additional cohort of ACE Educators are currently underway. The fifth cohort will be trained in OPH Region 8 in September of this year. Plans for this cohort have been made in partnership with the Children’s Coalition for Northeast Louisiana, a local nonprofit organization and longstanding Title V collaborator. The sixth cohort will be trained in OPH Region 1 in November of this year. Plans for this cohort have been made in partnership with the Childhood Trauma Task Force, a initiative chartered by the New Orleans City Council. Since its inception, the ACE Educator Program has delivered over 450 presentations to over 10,000 Louisianans, raising awareness and igniting dialog around childhood trauma, developmental health, trauma-informed care and community capacity.

Family Coaching and Support through the Louisiana Maternal, Infant, Early Childhood Home Visiting Program (LA MIECHV Program): During FFY 2018, BFH continued to serve as the state’s lead agency for MIECHV, offering no-cost, voluntary family support and coaching services to improve the health and well-being of pregnant women and parenting families with young children. In Louisiana, the MIECHV program includes two of the nationally recognized evidence-based home visiting models--Nurse-Family Partnership (NFP) and Parents as Teachers (PAT).  Families are matched with registered nurses or parent educators who provide personalized education, guidance, and support to meet each family’s individual needs and empower them to reach their goals. LA MIECHV is jointly funded through the federal MIECHV awards, Title V, Temporary Assistance for Needy Families (TANF), and state funding.

NFP provides services and supports to Medicaid, WIC, Supplemental Nutrition Assistance Program (SNAP), TANF, and/or SSI-eligible first-time mothers and families from pregnancy until the child’s second birthday, and serves all parishes with the exception of Caldwell, East Carroll, Madison, Tensas, Union, and West Carroll. PAT provides services and supports to Medicaid, WIC, SNAP, TANF, and/or SSI- eligible expectant or parenting families from pregnancy until the child enters  kindergarten, and serves Shreveport, Monroe and surrounding parishes, and Orleans and surrounding parishes.

In both the NFP and PAT models, the home visitors provide health and developmental screenings for children, maternal mental health screenings, assistance with goal setting and life skills development, parenting guidance on a variety of topics, and connections to resources that help families meet their needs and reach their goals. In addition, NFP offers maternal physical assessments through the post-partum period and PAT offers group meetings to provide opportunities for parents and children to come together to participate in a variety of hands-on learning activities and connect with other families.

LA MIECHV has a dedicated Outreach Team, which consists of Outreach Specialists in each region of the state. Outreach Specialists work within the teams’ local communities to make connections with eligible families, increase program visibility and support, and build collaborative partnerships with providers and maternal and child health organizations in order to link families to LA MIECHV’s supports and services. Outreach Specialists promote the program to families and providers, ensuring that potential participants understand what the program is and how it can benefit them, and helping providers understand when, why and how they should refer patients to the program. 

Mental Health Consultation - Infant Mental Health Consultation and Services to the MIECHV Program: LA MIECHV’s home visiting services are augmented by its Infant and Early Childhood Mental Health (IECMH) Team. Licensed mental health providers are embedded in each of the home visiting teams to provide consultation to home visitors around the social, emotional, and behavioral health challenges experienced by client families. Through consultation, IECMH Specialists work with home visitors to support interactions that promote healthy development and strengthen parents’ efforts to nurture their child’s emotional development. They also work with home visitors to identify emerging problems in parent-child relationships, navigate mental health concerns in the family, and provide resources and referrals for additional support. In FFY 2018, Title V primarily funded the state level leadership for strategy support around models for sustaining, expanding, and aligning the MIECHV IECMH services with other Title V strategies.

Mental Health Consultation - Primary Care: As a part of efforts to support the capacity of primary care providers serving children 0-6 to identify risk factors early, promote family well-being, and address early mental health problems, Title V provided funding support for the Tulane Early Childhood Collaborative (TECC) mental health consultation program. TECC provided on-site and secure remote consultations to providers, consultation evaluations of children to clarify diagnoses, and provider education and resources related to early childhood mental health. This model was the basis for the primary care consultation piloted through Louisiana LAUNCH that is now supported through Title V.

Community and Family Level Intervention for Grief and Trauma: Violence and trauma have a life-long impact on health and well-being. As such, Title V continued to provide financial support to Project LAST (Loss and Survival Team) in the greater New Orleans Area for children (0-17) and their families who have been impacted by a traumatic event or loss. Project LAST utilizes a 10-week Grief and Trauma Intervention (GTI) developed by the Children’s Bureau - Project LAST staff. The GTI is recognized by the US Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) National Registry of Evidence-based Programs and Practices. The intervention has been shown to be effective in decreasing PTSD, depressive symptoms, traumatic grief, and global distress. While only serving the greater New Orleans area, this investment has been sustained because of the high incidence of community violence, and because this model of support is one that may ultimately be considered for expansion as a part of the Title V strategy to improve social and behavioral supports.

Priority Need: Actively and meaningfully engage youth and families, building local level leaders across the state.

Engaging Communities through Regional Community Advisory and Action Teams (CAAT): During FFY 2018, MIECHV Supervisors and the 9 Regional MCH Coordinators, in collaboration with other BFH programs continued to lead quarterly regional CAAT meetings. The goal of the CAAT meetings is to provide a forum for diverse stakeholders to come together and develop community-driven solutions for issues affecting the health and well-being of children and families. The CAATs have provided an opportunity to elevate the credibility and visibility of community-identified issues related to mothers, fathers, infants, children, and families within the broader community via presentations, media events, and written reports that emphasize the need for action. The meetings have provided a forum for various BFH programs to present statewide MCH data directly to communities and families. The presentation of statewide data has been useful for helping the CAATs identify key areas of work within their respective communities.

Title V Programmatic Performance and Impact

NPM # 6: Percent of children, ages 10 through 71 months, receiving a developmental screening using a parent-completed screening tool. The combined 2016 and 2017 NSCH data indicates that LA is below the national average in regards to children receiving a developmental screening (LA 22.3%/US 31.1%). The data from both years is cited together because of low response rates and subsequent small sample size. Because of the redesign of the National Survey of Children’s Health, the 2016 data is considered baseline and cannot be compared to 2011/12 results.

ESM 6.2: Number of medical residents receiving developmental, social/emotional, and environmental screening trainings, measured through internal program records. Health care workforce education serves to build service capacity and to increase the percent of children who receive comprehensive screenings within a medical home. In FFY 2018, 23 LSUHSC-New Orleans medical residents were trained on the LDSG.

ESM 6.3: Number of developmental screening and surveillance education programs presented statewide. Education programs aim to build workforce capacity though provider training to increase the percent of children who receive comprehensive screenings and access to early intervention services. In FFY 2018, the DS coordinator conducted a lunch and learn training at the LSUHSC-Human Development Center (HDC) for 65 attendees, trained 10 clinic staff members in LDH Region 4 and 6 clinic staff members in LDH Region 8 as part of the developmental screening technical assistance, co-led an ASQ:SE-2 training at the Lafayette Healthy Start, trained 20 family medicine residents at UHC Lafayette General, trained 8 clinical practice consultants from United Healthcare, and hosted two interdisciplinary Resource Information Workshops with the rest of the CSHS team in Region 9 (137 professionals) and Region 5 (62 professionals). Additionally, the DS Coordinator created 6 screening instrument training webinars that were posted to YouTube, though the number of views from Louisiana in FFY 2018 is not available.

ESM 6.4: Number of developmental screening and surveillance outreach publications disseminated and presentations given. Raising community awareness and increasing provider capacity through outreach education on the importance of developmental screenings at recommended intervals functions to increase the percent of children in Louisiana who receive comprehensive screenings and early intervention referral. Measurement of this ESM is supported by program records. Activities in FFY 2018 included presentations to the LDH Region 4 Young Child Wellness Council, the Vermilion Children’s Health and Wellness Fair, the Region 9 Medical Director, the Lead Poisoning Prevention collaboration meeting, and the Medicaid Quality Committee.