Priority: Access to Supports

Update on PM annual objectives:

NPM 6: Percent of children, ages 9-35 months, who received a developmental screening using a parent-completed screening tool in the past year. The annual objective for reporting year 2023 is 42.5%.

ESM 6.1: Percent of children referred to early intervention who do not complete an evaluation. The annual objective for reporting year 2023 is 34.5%.

For upcoming reporting period, MCH Block Grant dollars will continue to be braided with state General Funds to support approximately 3.0 FTE on the CYSHCN team and .5 FTE on the Health Informatics team at CDPHE; implementation of strategies in the state action plan; and contracts with local public health agencies to implement local action plans that support the CYSHCN population. The funded strategies and associated outcomes are summarized below. For a more detailed description, refer to the full state action plan.

The state action plan for this priority will continue to focus on the following strategies during the upcoming performance period: 1) increase equitable access to and use of speciality care, with a focus on behavioral health; 2) enhance provider and system capacity to bridge healthcare and other partners to connect people to supports they need and want; and 3) use data to identify, illuminate, and address access, utilization, and outcome inequities. The first strategy is included in the Access to Supports narrative in the CYSHCN domain. The second and third strategies for this priority are reflected below.

Strategy 2: Enhance provider and system capacity to bridge healthcare and other partners to connect people to supports they need and want

One focus of this strategy is supporting improved care coordination through implementation of a statewide Social-Health Information Exchange (S-HIE) that increases access to supports for children and families. Because Colorado’s S-HIE infrastructure is a statewide network of interconnected data platforms that share core components, data standards, and common practices, MCH staff will provide consultation to local public health agencies in planning and implementing local implementation efforts for S-HIE that leverage and align with current and future statewide S-HIE infrastructure. This includes participating in the Metro Denver Partnership for Health’s S-HIE Initiative along with the participating local public health agencies (Denver, Jefferson, Boulder and Tri-County Health Department).

Additionally, MCH will continue to fund staff within CDPHE’s Health Information Systems Branch to collaborate with statewide partners such as the Office of eHealth Innovation, the Colorado Department of Human Services, the Colorado Department of Health Care Policy and Financing, Colorado 2-1-1 and Colorado’s Health Information Exchanges to identify opportunities to advance S-HIE. As part of this collaboration, this position will partner with Office of eHealth Innovation’s workgroups to elevate MCH population needs within Health Information Technology (HIT) Roadmap initiatives, including care coordination, telehealth, and digital equity.

The CYSHCN team will monitor and evaluate implementation of the pilot for developmental screening and referral to support a closed loop e-referral mechanism that was launched with the Salud health system in May 2022 and explore expansion of this pilot to other healthcare systems and providers.  The team has engaged two large health care provider systems, Denver Health and Children’s Hospital Colorado, for inclusion in the next phase of the project which will begin in October 2022.

The Early Childhood Screening and Referral Policy Council will continue to focus on advancing policies that remove barriers to children accessing needed developmental services, from screening to evaluation to connection to Early Intervention Colorado and other needed services.

Strategy 3: Use data to identify, illuminate, and address access, utilization, and outcome inequities

MCH staff will engage in several different projects to increase data availability to monitor and improve access to supports in Colorado. This includes collaborating with Colorado’s Medicaid data management team, continuing to review and revise the Medicaid Data Dashboard for Developmental Screening of young children so it represents statewide data. MCH staff will request, analyze and interpret Early Intervention Colorado data to identify disparate outcomes in children referred to Early Intervention Colorado.

MCH-funded staff in the Health Information Systems Branch will partner with the Office of eHealth Innovation to create a plan for increasing availability of information on care coordination referral capacity and demand metrics such as the number of community partners accepting and responding to referrals, number and type of referrals, and total community partner capacity.

CDPHE’s Telehealth and Digital Inclusion Specialist will coordinate, collect, analyze, and interpret digital inclusion data to inform strategies on increasing access to MCH services/programs to disadvantaged populations via technology. This includes conducting qualitative research on telehealth perceptions, digital literacy, and experiences.

The Access to Supports Implementation Team will continue to explore opportunities to create a Community Opportunity Map (for example the Casey Community Opportunity Map) to increase access in Colorado to localized datasets that inform local decision-making on equity strategies that support MCH populations.

Priority: Positive Child & Youth Development

In the upcoming reporting year, the Positive Child and Youth Development priority will continue to include a focus on building nutrition security through increased access to nutrient-rich locally grown food in communities facing the greatest racial/ethnic disparities. MCH Block Grant dollars will continue to support implementation of the 2022-2025 farm to institution/program action plan. Through the convening of the Colorado Farm to ECE Coalition, local public health agencies, and stakeholders, priority staff and coalition partners will develop a CDPHE three-year farm to child action plan that ensures racial/ethnic equity and aligns with the strategies in the action plan for the Positive Child and Youth Development priority.

Nutrition security staff will lead the Colorado Farm to ECE Coalition, and update and finalize the Coalition charter. Staff will continue to review the Farm to ECE roadmap with strategic plan and “farm to” literature reviews to compile information for sharing with partners and stakeholders. Nutrition security staff will participate on the Colorado Food Systems Advisory Council to represent CDPHE programs and communicate Council information and resources to CDPHE programs. 

Nutrition security staff will identify and increase Colorado-specific technical assistance resources to support institutions and programs in initiating a “farm to” program. This includes  convening state and local partners to identify nutrition education resources to support farm to institution and program and the WIC Farmers’ Market Nutrition Program to ensure shared messaging and modifying Colorado’s Farm to ECE training into modules to enable use with different audiences.

The focus during this application year will be to increase the number of ECE facilities and children/youth programs that procure local foods and/or implement gardens in a minimum of four communities. In an effort to reach this goal, priority staff will identify and apply for funding to support additional staffing and project resources to support Farm to ECE and Farm to child/youth programs.

In partnership with the Colorado Farm to ECE Coalition and other community partners, including local public health agencies, priority staff will provide support to at least four communities facing racial and ethnic disparities to identify, study and develop resources to support ECEs/programs and institutions in growing gardens and purchasing local food. Nutrition security staff will also work to build the capacity of staff and partners through offering at least one web-based training on nutrition security and “farm to” strategies.      

In addition to the nutrition security strategies included in the Positive Child and Youth Development action plan, MCH will continue to strengthen cross-sector systems of support to enhance positive child and youth development through the Early Childhood Screening and Referral Policy Council. This collaborative group, co-facilitated by Assuring Better Child and Health and Development (ABCD) and a CYSHCN team member, is comprised of representatives from the Department of Education, Department of Human Services’ Office of Early Childhood, Parent to Parent of Colorado and other organizations that are involved in early childhood systems improvement.

The Policy Council will continue to focus on advancing policies that remove barriers to children accessing needed developmental services, from screening to evaluation to connection to Early Intervention Colorado and other needed services. Given the passage of state legislation during the 2021 session that will directly impact the state’s early childhood services and supports, the policy council will continue to monitor the impact of the changes and provide input to ensure smooth transitions that enhance access to services and supports for young children. The most significant piece of early childhood legislation is the passage of House Bill 1304 that created a new state Department of Early Childhood as of July 2022.

The Early Childhood Screening and Policy Council will also continue to monitor the impact of the change to the eligibility criteria for Early Intervention Colorado and the statutorily mandated creation of the Early Start Program. The program will be housed within Early Intervention Colorado at the new Department of Early Childhood and will provide services and supports to children exhibiting a 25-32% delay and/or child and family risk factors associated with a high probability of developmental delay.