1. NEWBORN DEVELOPMENT RISK ASSESSMENT:
Connecting newborns and their families to community resources and supports
September 2017

2. Program Goals and Objectives
To ensure that all infants born in Rhode Island obtain a Newborn Risk Assessment
Newborn Risk Assessment is coordinated, accurate and timely

3. Who receives a developmental risk assessment?
All infants born in Rhode Island maternity hospitals
Infants transferred to RI maternity hospitals if family resides in RI

4. Why do a developmental risk assessment?
IDEA (Individuals with Disabilities Act) “Child Find” requirement for states to seek out children at risk for developmental challenges and intervene early
The Rhode Island system is: 1) Developmental risk assessment followed by family support home visits
(First Connections:4/1/2009)
2) Screening of actual development, resources, supports and home environment
3) Referral to Early Intervention /other community resources

5. What data is collected? It is not just developmental risk anymore
Known developmental risk factors
Newborn immunizations and hepatitis b status for tracking and follow-up
Alternate contact information to reach families in emergencies such as life threatening conditions identified through newborn screening
Community primary care provider for follow-up and care coordination
Breast feeding data

6. What data is collected? cont.’d
Language spoken in the home for written and oral communication with families
Insurance status
Demographic information used in communication, reporting, data analysis
Prenatal care information

7. Developmental Risk Factors
Child Characteristics - APGAR Score - Gestational age - Growth parameters - Hearing screen - HEP B risk - Intensive care
Parental Characteristics - DCYF - Chronic illness - Developmental disabilities - Mental health history - Inadequate prenatal care - Substance use
Parental Demographics - Caregiver’s education - Caregiver’s marital status - Maternal age - # children living in home Established Conditions - Chromosomal anomalies - Developmental disability - Genetic disorder - Inborn error in metabolism - Infectious disease - Sensory disorder - Toxic exposure

8. Where does the data come from?
Mom’s medical record
Delivery sheet
Birth certificate worksheet
Hospital data systems
Hospital staff
Child’s medical record if indicated

9. How is the data used?
Referral to First Connections Home Visiting (**note: referrals at birth are not made to Early Intervention, that is the responsibility of the maternity hospital)
Supports assurance, tracking and follow-up for newborn blood spot, hearing and hepatitis b/c programs
Policy development for newborn and early childhood programs
Analyzing key maternal and child health indicators and trends
Opens records in KIDSNET (integrated child health information system) to assure and promote public health preventive services throughout childhood

10. Developmental Risk Assessment
Data Flow
Data collection is integrated into the electronic birth certificate
Data gets downloaded to KIDSNET
KIDSNET generates electronic home visit referrals based on residence
VR2000
Developmental Risk Assessment
Home Visit Referrals
Birth Certificate
KIDSNET

11. First Connections First Connections
Rhode Island’s Infant and Toddler Home
Visiting Program

12. Goals of the First Connections Home Visiting Program
The overall goal of First Connections, is to improve the health and development of young children and their families through a model of home based, outreach, screening, assessment, referral and follow-up .
First Connections is a low intensity, short term referral and linkage home visiting model.

13. First Connections
The First Connections home visiting model is multidisciplinary. The team providing the services includes a maternal child health nurse,a social worker and a community health worker.

14. First Connections
The First Connections home visiting team provides a comprehensive assessment of mothers,infants and their families,health education and risk reduction counseling;connections with appropriate health care and human services and resources as indicated by screening and assessment and family choice

15. First Connections The Health Assessment includes at a minimum:
Infant Care
Maternal Post-Partum Care
Access to primary health care including medical and mental health services
Breastfeeding, WIC,and other nutritional support
Economic support
Basic Needs
Education and Job Training
Referral to Early Intervention or Evidence Based Home Visiting Programs(EHS, HFA and PAT)
Specialized programs such as substance abuse treatment, interpersonal violence, and depression

17. First Connections Additional support includes :
Developmental Screening and Assessment
Health Education and Coaching, and Risk Reduction
Connections with appropriate health care and human services and resources as indicated by family choice, screening and assessment, and “place”.

18. Kristine Campagna, M.Ed. Chief, Office of Family Home Visiting and Newborn Screening