Local MCH Reach

Based on SFY2024 MCH Aid-to-Local applications received 38 of 56 grantees (68%) plan to provide services to the Child population. As related to each objective within Priority 3: 

• 30 of 38 grantees (79%) plan to provide developmental screening services 
• 26 of 38 grantees (68%) plan to provide activities and programs that support the interests, healthy development, and learning of children 
• 24 of 38 grantees (63%) plan to provide quality, comprehensive annual preventive services  

Developmental Screening Initiatives

Objective 3.1: Increase the proportion of children aged 1 month to kindergarten entry statewide who receive a parent-completed developmental screening by 5% annually through 2025.

Development Milestone Cards & Passports: The Bridges Care Coordinators will continue to use the developmental Milestone Cards & Passports with all families on the Bridges program. The milestone cards are great tools for families to understand ways to engage with their child in developmentally appropriate play, while the passport help families track their child developmental progress by providing a document to record ASQ screenings at different age intervals. This document can then be shared by the parents with a variety of partners working with the child.

Early Childhood Systems & Collaboration: In January of 2023, the Kansas Governor shared an executive order to establish an Early Childhood Task Force to review and assess the early childhood systems in Kansas. Part of this order called for an independent agency to review all early childhood systems in Kansas and make recommendations for better alignment. During the next year, Title V programs that focus on early childhood will be working to provide information to the selected independent agency evaluating Kansas Early Childhood systems to see what is working well, but also identifying gaps and barriers that need to be addressed to create a seamless system for families. Based on findings from the review, the Title V early childhood programs will work collaboratively to implement the recommendations.

Local MCH Agencies:  

• CareArc will assess 25% of child clients between 9 and 35 months for developmental milestones using the Ages & Stages Questionnaire 3 (ASQ-3). The current ASQ-3 screening rate is 16.7%. They’ve begun educating front desk and clinical staff on the use of ASQ-3 and meet monthly to assess progress on goals so this increase in screening is achievable.
• Community Health Center of Southeast Kansas (CHC-SEK) will assess 100% of their child clients for developmental needs. This will be done in conjunction with the well-child visit according to the Bright Futures EPDST. To reach school-age children who don’t typically see their doctor unless they’re ill, MCH staff will work with CHC-SEK’s Population Health staff who have access to the Medicaid data base to identify those children who haven’t had a well-child visit and contact them for an appointment. They will assist with transportation and translation if needed. They will provide screening in the community at Kindergarten Roundups, Head Start Enrollment and four Back-to-School events.
• Franklin County Health Department will ask the parents/guardians of at least ten children to complete and ASQ-3 as part of the well-child visit. This is a new activity for the small health department as they will be hiring an APRN to complete well child visits.
• Greeley County Health Department will provide ASQ-3 and ASQ-Social Emotional (SE) for infants at ages 2-, 4-, 6-, and 12-months during immunization appointments, as well as at 18 and 48 months. Their measurable goal is to score 20 ASQ-3 and 20 ASQ-SE by the end of the program year. In addition, 100% of children with a score that indicates further need, will be referred to community partners such as Greeley County Health Services, Russell Child Development Center, or the client's primary care physician.
• Labette County Health Department will increase their rate of ASQ-3 screening for children ages 9-35 months from 70%-85%. They will begin having the parent complete the ASQ-3 at check in to ensure it is not missed due to time constraints once the appointment starts.
• Pottawatomie County Health Department will provide ASQ-3 and ASQ-SE to 100 children during the program year. The assessment will be completed during each immunization visit that coincides with an ASQ screening point.

Healthy Activities for School-Aged Children

Objective 3.2: Increase the proportion of children, 6 through 11 years, with access to activities and programs that support their interests, healthy development, and learning by 10% by 2025.

Development Milestone Cards & Passports: Title V plans to continue dissemination of the Developmental Milestone and Activity Postcards and Developmental Screening Passports previously created through the Early Childhood Comprehensive Service (ECCS) grant for MCH programs’ use with families. The 21 Developmental Milestone Postcards which contain developmental milestones provided by the CDC and age-appropriate activities promoted by Vroom will be evaluated and updated as needed by the newly hired Child and Adolescent Consultant. The cards will be shared with families to start a conversation about a child’s development and to encourage a fun learning experience at home.

Inclusive School and Community Playgrounds: Due to staffing challenges, the Inclusive Playground Call for Proposals, an opportunity for communities, schools, childcare centers and others to apply for support to add or establish inclusive playground equipment was put on hold. Based on funding availability this is expected to occur in FY ‘24. All applicants will be required to have 50 percent match criteria and to share the types of equipment they are wanting to install and how this will allow more children to be able to engage in play within their community, school or childcare center. There will be an application review process put in place, so all applications are reviewed by a committee of at least three members using a scoring rubric. All awardees will be expected to submit a final report and pictures upon project completion.  

Local MCH Agencies:  

• Barton County Health Department (BCHD) will have a messaging campaign to provide education on child safety using Facebook, digital sign (in the lobby and outdoors) and BCHD newsletter. They will post twice a month on the BCHD social media page, twice a month on the digital signs and one article a month in the BCHD newsletter. Conducting a messaging campaign, will allow them to reach families outside of those that come in for services.
• Clay County Health Department nurses will provide recommended immunizations for children during scheduled vaccine visits, including flu and COVID-19 vaccines. 50 children between the ages of 9 through 35 months will receive immunizations which will be documented in DAISEY.
• Crawford County Health Department will assist nurses in four schools with providing education on tobacco use and vaping using Take Down Tobacco and Catch My Breath materials. They will host the Kick Butts poster contest with 5th graders. Posters will educate peers on the risks of tobacco use and be displayed and voted on during the Pittsburg Art Walk.
• Nemaha County Community Health Services (NCCHS) will become a local affiliate of the Dolly Parton Imagination Library and enroll at least 50 eligible children. Social media campaigns, flyers place at local daycares and preschools, and promotion at the community baby shower will help them reach this goal.
• Ottawa County Health Department will partner with the Community Association to Safety and Prevention of Abuse (CASPA) to host two parent/student education sessions during the program year. They will work with USD239 and USD240 to host the events for enrolled families. The education provided will be based on the needs identified by parents in the community. Screen Sanity is an example of education that has been provided by CASPA.
• Pottawatomie County Health Department will be sure their program information is accessible and up to date on 1-800-CHILDREN's website. They will promote 1-800-CHILDREN on their web page and social media pages.
• Sheridan County Health Department is a new MCH applicant this year. They will coordinate the summer food service program for children and provide education on ways to stay healthy. This activity fills a gap in the town of Selden where the City Council of Selden expressed concerns about lower income rates and lack of food service programs compared to the neighboring town of Hoxie.  

Well-Child Preventive Services

Objective 3.3: Increase the proportion of MCH program participants, 1 through 11 years, receiving a quality, comprehensive annual preventive services by 10% annually through 2025.

KanBeHealthy Trainings & Bright FuturesTM: KanBeHealthy (KBH) is the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit that provides comprehensive and preventive health care services for children under age 21 who are enrolled in Medicaid. EPSDT is key to ensuring that children and adolescents receive appropriate preventive, dental, mental health, developmental, and specialty services. Kansas Medicaid utilizes Bright FuturesTM as the EPSDT/KBH standard of care, so all services are expected to be provided in accordance. Kansas Title V programs continue to support and promote the use of the Bright Futures Guidelines. With the hire of a Child/Adolescent Health Consultant work to further educate and encourage the utilization of Bright FuturesTM to MCH partners and local grantees will continue. Additionally, efforts will be focused on building up targeted technical assistance to help MCH partners and local grantees successfully implement all components of Bright FuturesTM. 

Help Me Grow Integration: During FY24 Help Me Grow (HMG) will continue implementation and advancement in coverage of all four core components of the HMG structure: Centralized Access Point, Family & Community Outreach, Child Health Care Provider Outreach, and Data Collection & Analysis.  These four components work cooperatively and interdependently with each other to form the HMG system. Each of the four components are being divided up by the Systems of Supports staff who will be able to focus more solely on each area based on the strengths of their positions, while forming a strong team to move the work forward.

Centralized Access Point: While the Centralized Access Point is already well established in Kansas, there is still collaboration between state agencies that needs to occur regularly to continue to fund and promote this as a statewide access point for all families and consumers. The State Directors within each agency will continue to work together to make sure funding is secure while state staff will continue to promote this with families and providers across the state. The call line is answered 24/7 with interpreter services available for non-English speaking families. In the coming year, Title V will be hosting a presentation for employees and agency partners on 1-800-CHILDREN including what it is and how it can be accessed to encourage others to be part of this resource.  Title V staff will continue to promote and share about this during presentations, public meetings, councils and through promotional fliers. All Title V brochures will continue to list the 1-800-CHILDREN phone number and QR code. As new resources are identified by Title V staff, they will be shared with the Kansas Children’s Service League, who manages the 1-800-CHILDREN line, mobile app and searchable website, so that these new resources can be included.

Family and Community Outreach: Over the next year, partnerships will be established with the new Family Resource Centers and other organizations supporting families. These resource centers and family organizations offer a variety of parental education opportunities that will be promoted by Title V. The Title V team will also continue to offer Systems Navigation Training for Families (see more about this in the CYSHCN Plan).

Child Health Care Provider Outreach: This component supports early detection and intervention efforts while supporting providers in connecting families to appropriate community resources in their area. Providers are supported and encouraged to screen children birth through five using the Ages and Stages Questionaries' (ASQ), so any child showing a delay can immediately be referred to the right community resource for assistance.

The Title V team will continue working on the development of a provider HMG Technical Assistance (TA) Center. Assistance will be given to providers based on the format of the National Care Coordination Standards (see cross-cutting section for more information). This is a collaborative effort between the Systems of Support and the KS-SHCN teams, with the goal that once complete, the providers will be able to call in and receive support connecting families to the appropriate resources they need utilizing the holistic care coordination (HCC) model followed by the KS-SHCN team. The holistic care coordination model looks at the family's needs through a social determinant of health lenses so barriers to quality care can be addressed.

Data and Analysis: Data collection and analysis will assist with ensuring all other components are working effectively, help to identify gaps or barriers, and guide quality improvement work. There are a few different Title V data systems that collect data needed for HMG. Title V is currently part of a data trust agreement where a variety of information can be shared among state agency partners for a more complete picture of the early childhood systems and supports. This is known as the Early Childhood Integrated Data (ECID) approach. Title V will continue to be part of ECID and will make data requests as needed to support and strengthen the HMG system.   

Community Hubs: The community level infrastructure of HMG is building out community hubs or networks of early childhood service providers within communities. During FY24 the System of Support team will work collaboratively with community partners to develop HMG community hubs. Lessons learned from the successful Kansas Perinatal Community Collaboratives, using the collective impact approach, will be used to help additional communities in Kansas establish HMG hubs. A work plan will be developed that will identify community readiness, lead entity, and partners. The work plan will outline steps and activities to assist communities in the development of their unique HMG hub while linking them to the state level HMG supports.

Local MCH Agencies:

• Barton County Health Department will increase the times education on well-child visits is provided. In the last full program year, well-child visits were a documented client education topic 130 times. The goal is to increase this by 10% to 143 instances of well-child visit education. Education on well-child visits will occur during visits for lead screening and visits for women with children.
• Finney County Health Department will provide 50 well-child visits during the program year.
• Labette County Health Department will educate 100% of families on the importance of having an annual well-child visit. This is an increase from 90%. Educational handouts will be given to the family upon check in and the MCH nurse will discuss it with the client during the visit.
• Pawnee County Health Department will provide ten well-child visits with anticipatory guidance being provided to the caregiver using Bright futures information. Pawnee County provided eight health assessments during SFY 2022.
• Rooks County Health Department will provide at least 30 comprehensive well-child visits across Rooks, Norton, and Graham counties. This is an increase from 13 that were documented in DAISEY in program year 2022.
• Stafford County Health Department will provide ten well-child visits using Bright Futures guidelines and recommended tools.
• Sumner County health Department will increase the number of well-child visits they have documented in DAISEY from 1 to 50, using Bright Futures guidelines. They will promote availability of the service on social media and print media in the community.

Other Child Initiatives

Finance Policy Work: KDHE applied and was accepted into the Infant and Early Childhood Mental Health Financing Policy Project (IECMH-FPP) 2023 cohort. The IECMH-FPP supports states’ advancement of IECMH financing policies that will contribute to the healthy development of very young children, with emphasis on a full continuum of developmentally appropriate supports and services inclusive of promotion, prevention, assessment, diagnosis, and treatment. The IECMH-FPP is unique in its tight focus on financing of IECMH services, and an intentional focus on IECMH policy leaders in states. It is designed to be driven by and responsive to the needs of state-level policy influencers who are responsible for holding the vision of an IECMH system and driving progress forward. The Kansas Team includes members from KDHE, the United Methodist Health Ministry Fund, Kansas Association for Infant and Early Childhood Mental Health, Kansas Inservice Training System, Kansas Department for Aging and Disability Services, Kansas Department for Children and Families, Kansas State University, and Kansas Head Start Association. The Team is using a IECMH-FPP Planning Guide to identify goals and will track the action steps planned and completed in working toward desired policy change. While not solidified or prioritized, the following policy enhancement opportunities have been identified:

• Crosswalk DSM to DC: to support a variety of providers for service delivery
• Utilize the CCBHC delivery model and global payments to enhance capacity of the system, access to care, and increase workforce of early childhood mental health service providers
• Maximize use of non-licensed providers and expand the list of those who can provide services
• Increase capacity of the system by expanding delivery of services in community-based settings, childcare facilities, and home-based settings.