1. Pamela High MD 1 Pei Chi Wu MD 1 Stacey Aguiar MPH 2 Blythe Berger PhD 2 Autism CARES Meeting Bethesda, MD July 16, 2015

2.  The Rhode Island EPSDT Schedule aligns with AAP Bright Futures Guidelines recommending  formal standardized developmental screening at 9, 18 & 30 months  autism screening at 18 & 24 months.

3.  The RI Department of Education (RIDE) Race to the Top Early Learning Challenge Grant  The RI Department of Health (HEALTH)  Community partners including RI AAP  Supporting primary care practices with technical assistance and funding to implement a system of electronic, standardized developmental screening aligning with EPSDT standards.

4. 1. Technical Assistance to implement standardized screening using the SWYC (Survey of Wellness in Young Children) 2. A one year user license for CHADIS (Child Health and Development Interactive System) to conduct electronic screening. Parents can complete screens at home or in the office online using computers, smart phone and tablets. The system scores screens and providers can view results in real time. 3. Tablets to access and use CHADIS in the office 4. Bonuses and TA to increase developmental screening rates 5. Support to link families to available, accessible services

5.  Practices were identified that had a patient population of either 1. >25% on Medicaid & >25 Medicaid kids ages 0-3 yrs….. OR 2. 50 Medicaid kids ages 0-3 yrs  79 practices were thus identified with  about 375 primary care providers  serving 13,174 Medicaid children birth to 3 years old (of 27,679 total children birth to 3 in RI),  with a target of reaching 90% of these children screened  by October of 2016.

6.  Receives referrals electronically from practices  Calls family to follow-up & gather information  Refers family to resources  Follows up to make sure family has engaged in services  The resource communicates with referring provider

7.  KIDSNET is RI's confidential, computerized child health information system  KIDSNET collects data for every child born in RI including birth records, immunization, newborn bloodspot screening, WIC, lead poisoning, Early Intervention, Newborn Developmental Risk Assessment, hearing, Family Visiting and birth defects

8. A Public Health Program – not an electronic medical record Integrated Child Health Information System for maternal and child health programs Facilitates the collection and appropriate sharing of health data by authorized users for the provision of timely and appropriate preventive health services and follow up

9. 7 Universal: Newborn Developmental Risk Newborn Bloodspot Screening Newborn Hearing Assessment Immunization Childhood Lead Poisoning Vital Records Child Outreach 10 Targeted: WIC Early Intervention Family Visiting Birth Defects CEDARR** (information and referral about services and supports for children enrolled in Medicaid who have disabilities and special needs) Healthy Weight Asthma Early Childhood Developmental Screening Foster Care* Head Start ** *No Web access **in development

11. Data Sources Family Visiting Electronic Web-based Screening (Child Health and Development Interactive System-CHADIS, Patient Tools)

12. Primary Care provider subscribes to service Parent completed tools (Survey of Well-Being in Young Children-SWYC, Ages and Stages Questionnaire – ASQ, M-CHAT)

15. Data Sources Electronic Web-based Screening Child Outreach (Child Find)

19.  Developmental screening data will be available soon in KIDSNET.  Ultimately, we will link KIDSNET to the RIDE's database to be able to track long term outcomes

20.  16 practices at 16 sites are fully using electronic screening  HEALTH has begun conversations with several other pediatric practices around participating in the project

21.  January 2015 – 28 referrals from 6 practices  February 2015 - 23 referrals from 7 practices  March 2015- 59 referrals from 7 practices  April 2015 - 53 referrals from 10 practices  May 2015 – 61 referrals from 11 practices  June 2015 – 62 referrals from 7 practices