III.B Overview of the State
The Maternal and Child Health Block Grant Application and Annual Report, submitted annually to the Maternal Child Health Bureau (MCHB), provides an overview of initiatives, State-supported programs, and other State-based responses designed to address the maternal and child health (MCH) needs in New Jersey. The Division of Family Health Services (FHS) in the NJ Department of Health (NJDOH), Public Health Services Branch posts a draft of the MCH Block Grant Application and Annual Report to its website in the second quarter of each calendar year to receive feedback from the maternal and child health community.
The mission of the Division of Family Health Services (FHS) is to improve the health, safety, and well-being of families and communities in NJ. The Division works to promote and protect the health of mothers, children, adolescents, and at-risk populations, and to reduce disparities in health outcomes by ensuring access to quality comprehensive care. The Division’s ultimate goals are to enhance the quality of life for each person, family, and community, and to make an investment in the health of future generations.
A brief overview of NJ demographics is included to provide a background for the maternal and child health needs of the State. While NJ is the most urbanized and densely populated state in the nation with 9.0 million residents, it has no single very large city. Only seven municipalities have more than 100,000 residents.
NJ is one of the most racially and ethnically diverse states in the country. According to the 2019 New Jersey Population Estimates of race, 54.3% of the population was white (alone not Hispanic), 12.7.0% was black, 9.6% was Asian, 0.1% was American Indian and Alaska Native, and 1.9% reported two or more races. In terms of ethnicity, 20.9% of the population was Hispanic. The racial and ethnic mix for NJ mothers, infants, and children is more diverse than the overall population composition. According to 2018 birth certificate data, 27.6% of mothers delivering infants in NJ were Hispanic, 44.4% were white non-Hispanic, 13.1% were black non-Hispanic, and 11.0% were Asian non-Hispanic. The growing diversity of NJ's maternal and child population raises the importance of addressing disparities in health outcomes and improving services to individuals with diverse backgrounds.
MCH priorities continue to be a focus for the NJDOH. FHS, the Title V agency in NJ, has identified 1) improving access to health services thru partnerships and collaboration, 2) reducing disparities in health outcomes across the life span, and 3) increasing cultural competency of services as three priority goals for the MCH population. These goals are consistent with the Life Course Perspective (LCP) which proposes that an inter-related web of social, economic, environmental, and physiological factors contribute in varying degrees through the course of a person’s life and across generations, to good health and well-being. Social determinants of health (SDOH), the conditions in the environments in which people live, learn, work, play, worship, and age, have a significant effect on health, functioning, and quality of life. Healthy People 2030 identifies five key areas of SDOH as economic stability, education, social and community context, health and health care, and neighborhood and built environment. In consideration of SDOH, there is a heightened need for integrating both health and non-health partners, as well as state, and external partners in addressing infant, maternal mortality, the opioid crisis and other public health issues facing NJ.
The selection of the NJ's eight State Priority Needs is a product of FHS's continuous needs assessment. Influenced by the MCH Block Grant needs assessment process, the NJDOH budget process, the New Jersey State Health Improvement Plan, Healthy New Jersey 2030, Community Health Improvement Plans and the collaborative process with other MCH partners, The process of identifying NJ priority needs is further detailed in the Needs Assessment Summary Section 3.C. FHS has selected the following State Priority Needs (see Section II.C. State Selected Priorities):
SPN #1) Increasing Equity in Healthy Births,
SPN #2) Reducing Black Maternal and Infant Mortality,
SPN #3) Improving Nutrition & Physical Activity,
SPN #4) Promoting Youth Development Programs,
SPN #5) Improving Access to Quality Care for CYSHCN,
SPN #6) Reducing Teen Pregnancy,
SPN #7) Improving & Integrating Information Systems, and
SPN #8) Smoking Prevention.
These goals and State Priority Needs (SPNs) are consistent with the findings of the Five-Year Needs Assessment and are built upon the work of prior MCH Block Grant Applications/Annual reports.
Consistent with federal guidelines from the MCH Bureau, Title V services within FHS will continue to support enabling services, population-based preventive services, and infrastructure services to meet the health of all NJ's families. During a period of economic hardship and federal funding uncertainty magnified by the COVID-19 public health emergency, challenges persist in promoting access to services, reducing racial and ethnic disparities, and improving cultural competency of health care providers and culturally appropriate services.
Based on NJ’s eight selected SPNs as identified in the Five-Year Needs Assessment, NJ has selected the following nine of 15 possible National Performance Measures (NPMs) for programmatic emphasis over the next five-year reporting period:
NPM #1 Well Woman Care,
NPM #4 Breastfeeding,
NPM #5 Safe Sleep,
NPM #6 Developmental Screening,
NPM #9 Bullying
NPM #11 Medical Home,
NPM #12 Transitioning to Adulthood,
NPM #13 Oral Health, and
NPM #14 Household Smoking.
State Performance Measures (SPM) have been reassessed through the needs assessment process. Four existing SPMs will be kept, and one old SPMs will be dropped. The existing SPMs which will be continued are:
SPM #1 Black Non-Hispanic Preterm Infants in NJ,
SPM #2 Hearing Screening Follow-up,
SPM #3 Referral from BDARS to Case Management Unit, and
SPM #4 Age of Initial Autism Diagnosis.
Table 1 - Title V MCH Block Grant Five-Year Needs Assessment Framework Logic Model (See Supporting Document #1) summarizes the selected nine NPMs and aligns the impact of Evidence-Based Informed Strategy Measures (ESMs) on NPMs and National Outcome Measures (NOMs). The purpose of the ESMs is to identify state Title V program efforts which can contribute to improved performance relative to the selected NPMs. The Logic Model is organized with one NPM per row. The Logic Model is the key representation which summarizes the Five-Year Needs Assessment process and includes the three-tiered performance measurement system with Evidence-Based or Informed Strategy Measures (ESM), National Performance Measures (NPM), and National Outcome Measures (NOMs). The Logic Model represents a more integrated system created by the three-tiered performance measure framework which ties the ESMs to the NPMs which in turn influence the NOMs.
The following is a brief overview of MCH services to put into context the Title V program within the State’s health care delivery environment. Healthy Women Healthy Families (HWHF) grants have been awarded in fiscal year 2019 (start date of July 1, 2018) through a request for proposals process. The goal of this initiative is to improve maternal and infant health outcomes for women of childbearing age (defined by CDC as 15-44 years of age) and their families, especially black families, through a collaborative and coordinated community-driven approach. This is being done using a two-pronged approach: 1) county level activities focus on providing high-risk families and/or women of childbearing age access to resource information and referrals to local community services that promote child and family wellness and 2) Black Infant Mortality (BIM) municipality level activities focus on black NH women of child-bearing age by facilitating community linkages and supports, implementing specific BIM programs, and providing education and outreach to health providers, social service providers and other community level stakeholders. BIM activities include breastfeeding support groups, fatherhood support groups, Centering (group prenatal care), and Doulas. Using two models, Central Intake Hubs (CIH) and Community Health Workers (CHW), the HWHF Initiative works to improve maternal and infant health outcomes including preconception care, prenatal care, interconceptual care, preterm birth, low birth weight, and infant mortality through implementation of evidence-based and best practice strategies across three key life course stages: preconception, prenatal/postpartum and interconception.
Central Intake Hubs (CIH) are a single point of entry for screening and referral of women of reproductive age and their families to necessary medical and social services. The Community Health Worker (CHW) model performs outreach and client recruitment within the targeted community to identify and enroll women and their families in appropriate programs and services. CIHs work closely with community providers and partners, including CHWs, to eliminate duplication of effort and services. Standardized screening tools are used and referrals to programs and services are tracked in a centralized web-based system (SPECT – Single Point of Entry and Client Tracking). HWHF and Doula grantees have received additional training on the NJCHART system, which is a new electronic health assessment and referral tracking system which can help ensure that all participating HWHF women are receiving prenatal care, have a primary care physician and/or an obstetrics and gynecology provider. Additionally, all HWHF newborns within the NJCHART system will have a record of insurance and pediatric medical provider information.
New Jersey is taking a targeted approach to reducing BIM rates through the enhancement of existing programs and creating new programs with the emphasis on this priority population. New Jersey recognizes the importance of a statewide collaboration of existing and non-traditional partners to address the SDOH which will be instrumental in moving the needle on Black Infant Mortality reduction. As a result, partners from the Department of Labor and Workforce Development, Division of Community Affairs, Department of Education, Department of Transportation, Department of Children and Families, Department of Human Services, the Office of the Attorney General and the Community will strategically collaborate to reduce black Infant mortality. FHS will be working very closely with NJDOH Office of Population Health and has created an FHS-Population Health Team (FHS-PHT) with the purpose of (a) ensuring health in all policies, (b) Leverage resources and inter- and intra-departmental collaborations, and, (c) addressing health disparities using a multi-sectorial approach.
Another program promoting the Life Course Perspective is the Maternal and Infant Early Child Home Visiting (MIECHV) Program which has expanded Home Visiting across all 21 NJ counties with over 6,500 families served annually through HV over the prior five year period. The goal of the NJ MIECHV Program is to expand NJ’s existing system of home visiting services which provides evidence-based family support services to: improve family functioning; prevent child abuse and neglect; and promote child health, safety, development and school readiness. Full implementation of the NJ MIECHV Program is being carried out in collaboration with the Department of Children and Families (DCF) and is promoting a system of care of early childhood (see Support Document #5). NJ is a FY2018 recipient of both a federal MIECHV Formula and Competitive grant. DOH was also awarded approximately $1.2 HRSA American Rescue Plan funding for COVID-19 response efforts for the time period of May 1, 2021 through September 30, 2023. The funding will be used to support families with emergency supplies and prepaid grocery cards needed for both the immediate needs of families in response to COVID-19 and in responding to ongoing COVID-related needs going forward.
The Child and Adolescent Health Program (CAHP) successfully applied in 2010 for two federal grants to prevent teen pregnancy and promote youth development - the Personal Responsibility Education Program (PREP) and the Abstinence Education Program (AEP). In February of 2018, the NJDOH was awarded continuing funding for federal fiscal year 2018 and 2019 for PREP. AEP funding ended September 2018 and was replaced by the Sexual Risk Avoidance Education (SRAE) Grant Program. NJ received the grant award in April 2018. In addition, CAHP now has a Coordinator to direct statewide youth engagement collaboration amongst PREP, SRAE program and WSCC School Health NJ grantees.
The SRAE program focuses on building protective factors for youth aged 12-14 to help delay sexual activity, reduce pregnancy and Sexually Transmitted Infections (STIs)., SRAE also provides engagement opportunities including mentoring, youth leadership and parent education on talking with teens about risks. SRAE is a developmentally appropriate public health approach to sexual health education complimentary to the PREP program which provides extensive education on Sexual Risk Reduction in addition to avoidance. In December of 2018 a competitive RFA was released by NJDOH and new grantees were selected for a two-year grant cycle. All SRAE programming is complete, medically accurate and Lesbian, Gay, Bisexual, Transgender, Intersex, Asexual and Questioning (LGBTIAQ)-inclusive and trauma-informed.
PREP is a school- and community-based comprehensive sexual health education program that replicates evidence-based, medically accurate programs proven effective in reducing initial and repeat pregnancies among teens aged 14-19. Beginning in SFY18 NJ PREP began to implement programing in high schools only. NJ PREP also seeks to help teens avoid and reduce high risk sexual behaviors through the promotion of delay, abstinence, refusal skills, use of condoms and other forms of birth control and reducing the number of sexual partners. NJ PREP provides education on these adult preparation topics: Healthy Relationships, Life Skills and Adolescent Development. NJ PREP has program continuation funds through September 30, 2021 and continues to build on the success of the last six years by supporting three evidence-based models (EBM), two of which, The Teen Outreach Program (TOP®) and Reducing the Risk were selected from the Centers for Disease Control and Prevention’s (CDC) Evidence-based Teen Pregnancy Prevention (TPP) Program List. In addition, CAHP added the NJ-based peer education program, Teen PEP, to the PREP Program beginning 10/1/2018.
New Jersey joined the second cohort of the Leadership Exchange for Adolescent Health Promotion (LEAHP), a National learning collaborative supporting adolescent health, established by the National Coalition of STD Directors (NCSD) and Child Trends in partnership with the National Association of State Boards of Education (NASBE). Cohort 2 began January 2020 and was scheduled to end June 2021, but an extension may be granted due to the pandemic. NJ has created a multi-sector, state-level leadership team with the goal to develop state-specific action plans in support of policy assessment, development, implementation, monitoring, and evaluation to address adolescent health in three priority areas: sexual health education (SHE), sexual health services (SHS), and safe and supportive environments (SSE). The
NJ team is led by Jennie Blakney, (NJDOH), with colleagues from the NJDOE, NJDOH Division of HIV, STD and TB services, DCF and the NJ State Board of Education. Together, with stakeholders, NJ LEAHP will build capacity to assess, develop, monitor, evaluate and implement adolescent health policy for SHE, SHS and SSE; access and leverage lessons learned from national policies in adolescent health and education expertise; strengthen our state leadership knowledge and understanding of adolescent health issues and promote collaborative peer based learning to improve our strategies, policies and leadership related to adolescent health. A major obstacle for NJ in assessing SHE, SHS and SSE is a lack of published YRBS data due to an inability of the State to get weighted data, which is needed to be part of the National YRBS report. The LEAHP team brainstormed several solutions and the NJDOE representative brought this back to their management. NJDOH along with their YRBS team at Rutgers negotiated with CDC to use a different methodology (number of teen total respondents versus number of schools with respondents) allowing NJ to obtain weighted data and be included in the National sample in 2019 for the first time since 2013.
In September 2018, FHS was awarded a five-year HRSA grant of $445,000/year for the Pediatric Mental Health (PMH) Care Access Program. An additional required 20% non-federal match ($89,000) is currently supported by in-kind staff contribution of time. This grant enhances the existing Department of Children and Families (DCF) administered statewide network of nine regional Hubs, with telehealth technology, to improve access to pediatric mental and behavioral health services. Other key partners include: Hackensack Meridian Health, the American Academy of Pediatrics-NJ Chapter, and Rutgers University Behavioral Health Care. To date, over 182,022 youth less than 18 years of age have been screened and 11,219 mental health consultations/ referrals were completed. Due to COVID-19, the SFY2020 New Jersey workplan indicated that telehealth technology would be piloted at five of the nine regional Hubs that exist statewide and it is now implemented at all nine Hubs throughout the state.
As of April 2021, 47 pediatric practices, representing approximately 90 providers, have been equipped with telehealth technology through this HRSA grant.
Lastly, on November 30, 2020, New Jersey was awarded a five-year Garrett Lee Smith State/Tribal Youth Suicide Prevention from the DHHS Substance Abuse and Mental Health Services Administration (SAMHSA). The project period ends 11/29/25 and the award is for $736,000 per year. Readiness to Stand United Against Youth Suicide: A New Jersey Public Health Community Initiative (NJ R2S Challenge) is a collaborative grant with NJ Department of Children and Families, Office of the Secretary of Higher Education and multiple community-based organizations. The grant will focus on providing support to public schools, colleges and universities to improve awareness and intervention as well as direct services to youth at risk for suicide and youth who have attempted suicide. In addition, existing infrastructure including Training provided by NJ TLC’s, NJ Hopeline and the Children’s System of Care (CSOC) will be expanded through this grant. On April 29, 2021, NJDOH sponsored a kickoff event for the GLS grant, bringing experts in the field of mental health/suicidology to talk to NJ based youth serving professionals about youth suicide prevention. Hiding in Plain Sight: Working Together to Prevent Teen Suicide featured national and State experts. Over 1,300 professionals (pediatricians, nurse practitioners, social workers, guidance counselors, school nurses and other youth serving professionals) attended this half-day conference, larger than any other suicide prevention event held in NJ.
New Jersey Department of Health
Division of Family Health Services
2020 Special Child Health and Early Intervention Services (SCHEIS)
Newborn Screening and Genetic Services
The NSGS Program ensures that all newborns and families affected by an out-of-range screening result receive timely and appropriate follow-up services. In January 2020, legislation was enacted to add the screening of spinal muscular atrophy (SMA). SMA will be added to the NJ newborn screening panel by the end of 2021 bringing the total number of biochemical/bloodspot screenings to 60 disorders for the state of New Jersey. Over 95,000 babies are screened annually, 7,328 babies were referred to our follow-up team in 2020. Because of the critical nature of many of the disorders for which NJ newborns are screened, follow-up staff act on presumptive positive results identified by the Newborn Biochemical Screening (NBS) Laboratory for these disorders during regular business hours, Saturdays, and certain State holidays to maximize timely referral to the appropriate specialists. To ensure NJ’s program is state-of-the-art in terms of screening technologies and operations and is responsive to any current concerns regarding newborn screening, the NSGS program staff meets and communicates regularly with several advisory panels composed of parents, physicians, specialists, and others. The NSGS program is funded by the sale of newborn biochemical bloodspot filter cards.
The Newborn Screening Follow-Up staff contact primary care providers, specialty care providers and parents to ensure timely evaluation, confirmatory testing and to obtain a final diagnosis. Results received from the NBS Laboratory range from low risk to critical and are handled accordingly. The majority of the results reported are considered to be low risk (> 6,000) which involves sending letters to parents, making telephone calls to physicians and hospitals, and utilizing multiple resources to locate babies for further testing. Time for follow-up on low-risk results ranges from two to eight weeks until cases are closed. In 2020, there were approximately 900 results referred to our Follow-up team which required aggressive actions to ensure that those babies received prompt medical intervention and treatment. As per protocol, critical cases must be reported to physicians and specialists within three hours from receipt from the NBS Laboratory, however, the NSGS team has averaged approximately 30 minutes to report. Time for follow-up on critical results ranges from one week to twelve months until cases are closed. These cases are left open longer due to the complexity of the disorders that often require multiple office visits/diagnostic tests to be completed to accurately confirm diagnoses. The NSGS team confirmed 155 classic cases during FY20.
The nature of the work this program does is illustrated through this success story:
In September 2020, a baby was born with a variant of a disorder that needed to be addressed within 10 days of birth to avoid a life-threatening outcome. Our NBS team, Karyn Dynak and Ondia Barron, received the critical results at 4 days of life, and together with our consulting specialist determined that “all the levers needed to be pulled.” This was truly an around the clock effort with phone calls at 1am to the specialist. Ms. Barron worked around the clock from Friday through Monday engaging with police and the Department of Children and Families to find the family who had two different addresses listed (in different municipalities) and were nowhere to be found. The family was located early that Monday morning via text messaging and the baby was seen that day, later diagnosed with the variant, began receiving care and is doing well today!
New Jersey has mandated newborn pulse oximetry screening to detect Critical Congenital Heart Defects (CCHD) since 2011. Pulse Oximetry results are now captured by the New Jersey’s Birth Certificate system, the Vital Information Platform (VIP). The Pulse Oximetry Module collects information used to identify children at risk for CCHD, which may not be apparent at birth. NJ is the first state in the nation to integrate the CCHD screening with their birth defects registry. The Newborn Screening staff work in collaboration with the BDAR staff to educate hospitals about the screening protocol, ensure compliance with the screening mandate, and the reporting of any confirmed diagnoses. All infants with failed screens were reported by each birthing facility to the BDAR. As pulse oximetry is a screening tool and not a diagnostic tool, the BDAR staff follow up to ensure that these babies’ congenital cardiac conditions have also been correctly reported. NSGS program staff review information monthly from the Pulse Oximetry Module to determine the final diagnosis of a child who failed the screening test. This review involves determining whether the child has been diagnosed with a CCHD by reviewing BDAR registrations and contacting the hospital that performed the screening. As of June 2020, NJDOH has received a total of 41 reports for previously unsuspected critical congenital heart defects detected through the screening program. As part of our quality assurance methods, the BDAR data is compared to the VIP to ensure that all babies who failed the screening are registered.
Figure 1. CCHD and NON-CCHD Babies “Saved” by Pulse Oximetry Screening by Year
Early Hearing Detection and Intervention
The New Jersey Early Hearing Detection and Intervention (EHDI) Program abides by the national public health initiative “'1-3-6' Guidelines” seeks to ensure that all babies born in New Jersey receive newborn hearing screening before the age of one month, complete diagnostic audiologic evaluation prior to three months of age for infants that do not pass their hearing screening and enroll in early intervention by no later than six months of age for children diagnosed with hearing loss. Hospitals continue to be successful in ensuring that newborns receive hearing screening prior to hospital discharge, ensuring that children who did not pass their initial screening receive timely and appropriate follow-up remains an area for continued efforts. The New Jersey EHDI program offers technical support to hospitals on their newborn hearing screening and follow-up programs. New Jersey EHDI tracks the number of infants screened and how many children are identified with hearing loss in a timely manner. New Jersey EHDI works with health care providers, local and state agencies that serve children with hearing loss, and families to ensure that infants and toddlers receive timely hearing screening and diagnostic testing, appropriate habilitation services, and enrollment in intervention programs designed to meet the needs of children with newly identified hearing loss.
Specialized Pediatric Services Program (SPSP)
The SPSP consists of eight Child Evaluation Centers (CECs), of which four CECs house Fetal Alcohol Syndrome/Fetal Alcohol Spectrum Disorder (FAS/FASD) Centers, and three CECs provide Newborn Hearing Screening (NBHS) Follow-up. In addition, there are three Pediatric Tertiary Care (PTC) Centers, and five Cleft Lip Cleft Palate Craniofacial (CLCPC) Centers. The goal of the SPSP is to provide access to comprehensive, coordinated, culturally competent pediatric specialty and sub-specialty services to families with CYSHCN that are 21 years old or younger. With support from the State and Title V funds, health service grants are distributed to multiple agencies throughout NJ.
Early Identification and Monitoring
Within the EIM Program is the BDAR. Dating back to 1928, New Jersey is proud to have the oldest requirement in the nation for the reporting of birth defects. Over the years, our Registry has become a population-based birth defects registry of children with all defects (as of 1985); added Autism Spectrum Disorders (ASD) as reportable diagnoses (2007); expanded the mandatory reporting age for children diagnosed with birth defects to age 6; added severe hyperbilirubinemia as a reportable condition if the level is 25mg/dl or greater; and become an invaluable surveillance and needs assessment data for service planning and research. All 49 birthing hospitals and hundreds of non-hospital-based practices report to the BDAR through our on-line registry. Annually, we receive an average of 5,600 registrations. In 2021, we will begin having non-New Jersey hospitals begin to register New Jersey-resident babies. A nurse abstractor has been contracted to register for the Children’s Hospital of Philadelphia (CHOP). This will greatly improve our ability to register high-risk babies whose mother were sent to CHOP for delivery.
New Jersey continues to have one of the highest rates of autism in the United States. According to the Centers for Disease Control and Prevention’s (CDC) 2016 prevalence figures published in the Morbidity and Mortality Weekly Report (MMWR) on March 27, 2020, cited NJ as having the highest prevalence rate of approximately one in 31.4 based on studies from four counties (Union, Hudson, Essex, and Ocean). This prevalence rate is not significantly different than the 2014 rate of 1 in 34.
The Autism Registry is the largest mandated autism registry in the country with over 40,000 children registered as of March 2021, and annually registers an average of 3,200 children. We are the only registry in the country that includes children up to the age of 22 and refers them to case management services. We serve as a model registry and continue to provide technical assistance with other states considering a registry. The Autism Registry provides quality prevalence information for the entire state, information about racial and ethnic disparities, and examines known perinatal risk factors and how they influence the New Jersey prevalence rates.
In the upcoming year, EIM will be redesigning of the Birth Defects and Autism Reporting System (BDARS) and rewriting the Autism Registry rules and regulations. The changes to the BDARS include a statewide search to reduce duplication, reduction of questions, and more checkoff lists for common comorbidities, symptoms, and behaviors. As NJ has the statutory authority to capture fetal deaths due to birth defects at 15 weeks’ gestation and over, a module within BDARS is being developed and will be implemented in 2021 to capture and report those fetal deaths to the CDC. These changes will improve the accuracy of our data and improve our overall surveillance efforts. The new Autism Registry rules will propose registering a child with autism within six months of diagnosis or entry into a practice for previously diagnosed children. Timely reporting ensures that children diagnosed with autism are quickly linked to Early Intervention Services and/or SCHS Case Management. While some families are eager to have their child’s condition diagnosed so that they can move forward with treatment, some families need time to come to terms with a diagnosis. Providers are given six months to work with families so that they are less apprehensive about having their child registered and open to seeking services.
BDARS staff continue to educate and inform physicians and health facilities about the Registry, how they can register children with autism living in NJ, and the rules regarding the Registry. Registry staff have visited and trained staff from medical centers specializing in child development, developmental evaluations, and behavioral health. Staff will continue to create reports and resources for both providers and families. Now that the registry data is sufficiently robust, the first Annual Autism Registry report has been completed and is awaiting approval for publication. This report provides the public with important statistics and information about autism in New Jersey.
Family Centered Care Services
Family Centered Care Services, Special Child Health Services Case Management Units (SCHSCM)receive referrals for all children registered with the BDARS. SCHS CM offers CM services through resource & referral for the CYSHCN from the ages of birth through 21 years. Through FCCS, NJ remains successful in linking children registered with the BDARS with services offered not only through the SCHS CMUs, but CECs including the Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders (FAS/FASD) Centers, and Newborn Hearing Screening Follow-up; Cleft Lip Cleft Palate Craniofacial (CLCPC) Centers; Pediatric Tertiary Care (PTC) Centers; Family WRAP; and Catastrophic Illness in Children Relief Fund (CICRF). With CDC Surveillance grant funding, the system is undergoing enhancements to support tracking of CYSHCN referred to SCHS CM and monitoring of services offered and/or provided to determine client outcomes.
FCCS’s intergovernmental and interagency collaboration is ongoing among federal, state, and community partners and families including, but not limited to: Social Security Administration; NJ State Departments of Children and Families, Labor, Banking and Insurance, the Boggs Center/Association of University Centers on Disabilities, NJ Council on Developmental Disabilities, and community-based organizations such as Autism NJ, NJAAP, NJ Hospital Association, and the disability specific organizations such as the Arc of NJ, SPAN, and the COCC. Consultation and collaboration with NJDOH’s other programs such as EIS, RWPD, MCH, WIC, FQHC, HIV/AIDS, STD and Tuberculosis, as well as Public Health Infrastructure Laboratories, and Emergency Preparedness affords FCCS with opportunities to communicate and partner in supporting CYSHCN and their families.
CMU staff continue to build upon a quality improvement (QI) initiative initially launched in 2014 to enhance consistency in documentation within individual service plans across the SCHS CMUs, and to improve upon the Case Management Referral System’s (CMRS) data gathering capability. Information garnered from this initiative was anticipated to enhance NJ’s efforts to improve performance on the Six Core Outcomes for CYSHCN, as well as, to promote targeted improvement in CMRS documentation in the following two areas; transition to adulthood and access to a medical home. Staff used the 2014 findings as a baseline to compare with NJ and the nation’s performance as reported on the National Survey, and comparison data has been collected annually since 2015. Results are discussed in Plan for the Application Year – National Performance Measure (NPM) #11 and NPM #12.
All 21 CMUs continue to use CMRS to track and monitor services provided to the children and their families. The system electronically notifies a CMU when a child living in their county has been registered and referred to their unit. CMRS provides the ability for CMs to create and modify an Individual Service Plan (ISP), track services, document each contact with the child and child's family, and register previously unregistered children. It provides the State Title V program with the opportunity for desktop review, referral, and linkage to care. As newly referred cases are entered into the database, CMRS continues to provide the ability to track access to care, ensures more measurable and readily tracked outcomes. Although reconfiguring data, reporting tracking systems, and report development, is a challenge, our biggest challenge remains the state staff vacancies for critical positions.
Early Intervention
Many children are also referred to our New Jersey Early Intervention Services (NJEIS) NJEIS has over 5,000 practitioners providing Developmental Intervention (DI), Speech Therapy (ST), Physical Therapy (PT), and Occupational (OT.) Over 1.5 million services are provided annually. At any point in time NJEIS is serving over 15,000 children and serves over 30,000 families annually as children enter and leave the program at age three. Although NJEIS is not funded by MCH Block grant funds, they do manage a budget of 200 million dollars per year and are an invaluable partner in our CYSCHN program.
To Top
Narrative Search