OPIP has received Notice of Award for funding from the Health Resources and Services Administration (HRSA) and Maternal Child Health Bureau (MCHB) on Transforming Pediatrics for Early Childhood (TPEC), a 4-year cooperative agreement focused on improving equitable access to a continuum of early childhood development (ECD) services in primary care settings for children birth-to-five, and improving the capacity of practices and workforce to deliver high-quality ECD services that address the holistic needs of children and families. Click here to see OHSU’s announcement of the award and interview with OPIP Director Colleen Reuland.
The Oregon TPEC model, 2022 – 2026, will begin by focusing efforts on four diverse primary care pilot sites in the Portland Metro area, serving over 9,000 families with children birth-to-five, while also engaging local and state policymakers to address the sustainability, workforce strengthening, and care coordination needs that will ensure high-quality ECD more broadly.
By engaging primary care, local systems leaders, and state policymakers, this project aims to employ a community-based approach which is displayed in Figure 1, including these 4 components:
- A Learning Collaborative with Patient-Centered Primary Care Home (PCPCH) sites, including learning sessions, facilitation support, and action periods (Blue section).
- Engagement of local system-level leaders and stakeholders responsible for services in the region (Yellow section).
- Engagement of state-level policymakers responsible for policies that impact region-specific systems (Green section).
- Development of tools and trainings to support spread of ECD service delivery beyond pilot sites
A Needs Assessment relying on Oregon’s Children’s Health Complexity data, as well as Oregon Health Authority (OHA) Transformation Quality Metrics, PCPCH standards, other Coordinated Care Organization (CCO) requirements, and Early Learning policies and goals, will help identify population needs in relation to early developmental health and well-being in the region and help guide the work of improving the ECD continuum of services.
Within each component of the work, specific strategies will include:
- Focusing on placement of ECD experts into pediatric practices, ECD-specific solutions for sustaining these ECD experts, policy & financing solutions/barriers, and ECD workforce needs aligned with opportunities identified by the Needs Assessment.
- Ensuring that health equity and social and structural determinants of health are addressed, with a specific focus on the priority populations identified in the Needs Assessment, aligned with the OHA’s health equity definition, and identified using child health complexity data.
- Ensuring strategic collection, distillation and/or use of data indicators that guide and inform. improvement efforts and are strategically aligned with local and state policy and payment reform opportunities and levers.
Within the overarching structure, focused on increasing access and quality of ECD services across the PCPCHs, there are also two deeper tracks of work within each of the four primary care sites, specifically focused on training and supporting ECD expert(s) and the clinic staff who have care coordination responsibilities. Figure 2 provides a detailed description of the proposed Learning Collaborative structure and methodology, by time-period and key activities; the four primary care pilot sites will participate in these Learning Collaboratives beginning 2023.
The overarching goals of the Learning Collaborative are to ensure data collection and analysis, training, and effective implementation supports that will ultimately lead to:
- Increase the number of ECD experts trained and placed in these pediatric settings that intentionally service children with health complexity insured through Medicaid/CHIP.
- Increase the quality and continuum of ECD services provided in practice-level settings for children overall, and intentionally for children with health complexity (the combination of medical and social complexity). This includes, but is not limited to, a focus on early Social-Emotional health, follow-up to developmental and Social-Emotional screening, screening for social determinants of health and connection to services, and the care coordination and linkage to services required for each topic area.
- Increase the knowledge and competency of the primary care staff.
- Share learnings across sites about the successes and barriers encountered in practice-level implementation and in connection to and capacity of community ECD services. Summaries of learnings will include how these efforts address health inequities, opportunities and barriers to sustaining efforts, and workforce and services gaps identified.
The Transforming Pediatrics for Early Childhood (TPEC) project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $3,991,229.00 with zero percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.