Spreading Results

Based on the successes of ABCD consortia, participating states are now beginning to implement a plan for spreading the innovations developed and tested in the demonstration sites statewide. Many have developed key partnerships that will continue beyond the project, including organizations such as provider organizations, state agencies, and other public/private partnerships.  These partnerships enabled states to pool resources to more effectively support providers in practice improvements, first among a limited number of demonstration sties, and then across the states.  This ‘spontaneous lateral spread’ serves to make the case for Medicaid agencies to improve and/or clarify policies that promote child health and development and as an impetus for states to begin addressing creating effecient systems linkages that support families in securing appropriate care and services once needs have been identified.

This section will provide resources to assist states in sustaining and spreading the policy and practice improvements first tested in demonstration sites and designed to improve the quality of pediatric preventive services throughout their states.

Title Description Date Published Resource State
The ABCD Legacy: In the Words of the States (NASHP) This slideshow contains quotes from ABCD team members in 10 different ABCD states discussing the legacy of the program in each state. These quotes were collected between fall 2012 – spring 2013 for the “Success in ABCD: Spotlight on the States” series that appeared in NASHP’s State Health Policy Electronic Newsletter in that time. June 2013 NASHP – Commonwealth
Comments: Six Years of ABCD (Julie Doetsch) This document contains comments from Julie Doetsch, Manager, Child Health Section, Illinois Department of Healthcare and Family Services. In this document Ms. Doetsch discusses the history of the ABCD II & III initiatives in Illinois. This document also discusses provider training and quality improvement, systems and policy changes, and on-going activities that have taken place in Illinois as a result of ABCD. March 2013 State-specific Illinois
7 Years Since ABCD II (Sonni Vierling) This document contains comments from Sonni Vierling, Iowa’s 1st Five Healthy Mental Development State Coordinator. In this document Ms. Vierling discusses the history of Iowa’s ABCD II initiative as well as the work done by Iowa’s 1st Five program on these issues since the project ended in 2006. January 2013 State-specific Iowa
Seven Years of ABCD in Colorado (Eileen Bennett) This document contains comments from Eileen Bennett, Colorado’s ABCD Coordinator. In this document Ms. Bennett discusses the history of ABCD in the state, as well as results and accomplishments achieved through the project. November 2012 State-specific Colorado
Comments: 12 Years of ABCD (Marian Earls) This document contains comments from Dr. Marian Earls, Lead Pediatric Consultant, Community Care of North Carolina. Dr. Earls has been involved with ABCD in North Carolina since its inception with ABCD I in 2000. In this document Dr. Earls discusses the outcomes that North Carolina has achieved through its ABCD work over the past twelve years. November 2012 State-specific North Carolina
Colorado ABCD Website (Colorado ABCD: 2010) This link directs to the Colorado ABCD project homepage. The site includes information for families, health care providers, and community providers. The website also includes information on screening and referral. April 2012 Website Colorado
Minnesota ABCD III Project Website (Minnesota Department of Human Services: 2011) This is a website designed by the Minnesota ABCD III Project Team. It includes links to ABCD III tools and resources developed by the project team, ABCD III upcoming events, and tools and resources from other organizations. April 2012 Website Minnesota
Illinois Healthy Beginnings II Webpage Illinois ABCD III Team (Illinois Chapter, American Academy of Pediatrics: 2012) This is the project webpage for the Illinois ABCD III project. The page is administered by the Illinois Chapter, American Academy of Pediatrics, which administers the project in partnership with the Illinois Department of Healthcare and Family Services. The site provides information on project activities, news and reports, and information regarding Maintenance of Certification Part 4. April 2012 Website Illinois
Improving the Quality of Care and Coordination of Services for Young Children —
ABCD, CHIPRA and Beyond!
(NASHP) This webinar highlighted how Illinois, Oregon, South Carolina, and Vermont are using ABCD III and/or CHIPRA quality grants to build on and align current efforts, such as medical home initiatives, health information technology or exchange, performance measurement, and health reform, to transform the delivery of care to children covered by Medicaid and CHIP. This event was sponsored by The Commonwealth Fund and built on a session held during the 2010 NASHP Annual Conference. December 2010 NASHP – Commonwealth
EDOPC Social/
Emotional Screening and Referral training materials
Enhancing Developmentally Oriented Primary Care (Illinois EDOPC, 2009). This resource consists of an outline and the PowerPoint slide images of the Social/Emotional Screening and Referral program, a 1.5 hour Continuing Medical Education training program designed to be presented in the office/clinic setting to all staff by a trained healthcare provider. January 2009 State-specific  Illinois
Statewide Spread Strategy for Arkansas’ ABCD Project Arkansas ABCD Screening Academy Project (2008). Strategies and action steps for Arkansas’ ABCD Project to promote statewide spread of innovations. December 2008 State-specific Arkansas
Brochure promoting The Infant & Toddler Connection of Virginia Virginia Infant and Toddler Connection (2008). 2-page brochure aimed at providers describing the referral options provided by The Infant & Toddler Connection of Virginia, which assists families of infants and toddlers with developmental delays and/or disabilities help their children learn and develop through everyday activities and routines so that they can participate fully in family and community activities. Brochure provides information on referrals and phone numbers for Infant & Toddler Connection offices in various locations around the state. December 2008 State-specific Virginia
ABCD Goals and Strategies Matrix California ABCD Screening Academy Project (2008). Table outlining ABCD Screening Academy project goals, strategies to achieve goals, measures to collect to evaluate progress, baseline data, and whether and what agency has data available. December 2008 State-specific California
Ohio’s Preliminary Statewide Spread Plan for the ABCD Screening Academy Ohio ABCD Screening Academy Project (2008). Ohio’s ABCD Screening Academy Preliminary Spread Plan. These preliminary designs for implementation and spread of structured developmental assessment of young children in Ohio are under review. June 2008 State-specific Ohio
Ohio’s Preliminary Measurement Plan for ABCD Screening Academy Ohio ABCD Screening Academy Project (2008). Ohio’s ABCD Screening Academy Preliminary Measurement Plan. These screening recommendations are under review due to the release of the 2008 AAP Periodicity Schedule. June 2008 State-specific Ohio
Infant & Toddler Connection of Virginia Referral Form Virginia ABCD Screening Academy Project (2008). Referral consent form for physicians to complete when referring a child to early intervention. Includes option for providers to indicate the feedback they want to receive from the early intervention program in response to the referral. March 2008 State-specific Virginia
Iowa Child Health Maintenance Clinical Notes (CHMN) Iowa Care for Kids EPSDT (2007) The resource can be used by providers to ensure that children who require developmental and physical supports are identified early and referred to services. It provides an age-specific format for the clinical examination that emphasizes developmental milestones and provides anticipatory guidance. December 2007 State-specific Iowa
Provider Survey North Carolina ABCD I Project Provider Survey Evaluation. This survey was distributed to family practice and pediatric providers in three categories and analyzed according to a specific protocol. The survey instrument consists of questions designed to measure the provider’s perception of their individual knowledge and attitudes regarding developmental screening tools, early intervention services, and particular federal laws. December 2007 State-specific North Carolina
Infant Toddler Early Intervention Program (ITEIP) Website Washington State Department of Social and Health Resources (2007) This Early Intervention website provides useful information on appropriate developmental milestones as well as services available to parents and providers. December 2007 State-specific Washington
Preliminary design for implementation and spread of structured developmental assessment of young children in Ohio Ohio ABCD Project (2007) Description of preliminary design for implementation and spread of structured developmental assessment of young children in Ohio. December 2007 State-specific Ohio
Impact of Implementing ASQ Developmental Screening in a Pediatric Practice Kevin Marks and Hollie Hix-Small (2007) PowerPoint presentation amended from a doctoral dissertation originally presented by Hollie Hix-Small, PhD. Provides information on why, where, and when to do developmental screening. December 2007 State-specific Oregon
Overview of Lessons Learned from the ABCD Experience in Working with Demonstration Sites Melinda Abrams (July 2007). This PowerPoint presentation from the ABCD Screening Academy Learning Session provides an overview of the process of implementing a strategy for increasing developmental screening rates. July 2007 NASHP-Commonwealth
History of the North Carolina ABCD Initiative North Carolina ABCD Project. (March 2007). This PowerPoint presentation highlights the success and accomplishments of the North Carolina ABCD initiative, as well as ongoing project replication activities. March 2007 State-specific North Carolina
Informational letter: Billing Developmental services Iowa Department of Human Services, Iowa Medicaid Enterprise (Jan 11, 2007). This resource is an informational release to physicians, nurse practitioners, and screening centers regarding payment for use of standardized screening tools. Payment for a standardized screening tool is not included in the reimbursement for a child’s preventive office visit or E/M service. The letter also describes the appropriate billing codes to use for services. January 2007 State-specific Iowa
Educational Objectives: Assuring Better Child Health and Development (ABCD II) Project Iowa ABCD Project (2006). Educational objectives for a provider training on the revised approach to child health care delivered through the Medicaid EPSDT program. The training was held at Pella Medical Clinic, March 16, 29 & 30, 2006. December 2006 State-specific Iowa
Recommendations to implement the Iowa Medicaid standards for identification of young children with developmental or
social-emotional problems
Iowa’s ABCD II Healthy Mental Development Initiative. (2006). This draft document (for reveiw by providers) is a set of recommendations for protocols and tools to help providers implement standards of care that will appropriately identify developmental and social-emotional concerns in children from birth through 3 years who participate in Medicaid. December 2006 State-specific Iowa
New Office-Based
Resources on Child Development/
Mental Health Issues, flyer
Illinois ABCD Healthy Beginnings. (2006). This announcement details a training presented by EDOCP and the ABCD project. This developmentally oriented continuing medical education (CME) opportunity was designed for pediatricians and family physicians. December 2006 State-specific Illinois
Screening by Primary Care Practitioner: Attitudes, Practices, and Barriers
Katherine Murray, Andrew Barnes, Marjorie Ireland, et al. (Minnesota ABCD Project, 2006). This study assesses the specific techniques and instruments primary care pediatricians and family practitioners use to detect emotional and behavioral problems and describes their beliefs about the prevalence of these problems and barriers to universal screening. (From Abstract.) December 2006 State-specific Minnesota
Utah Medhome Portal Utah Medhome. (2006) This website was developed during the ABCD initiative in Utah. It provides information, tools, and resources to aid Primary Care Physicians in caring for Children with Special Health Care Needs (CSHCN) and providing a Medical Home for all of their patients. (From Website.) December 2006 State-specific Utah
EDOPC Developmental Screening and Referral Enhancing Developmentally Oriented Primary Care (EDOPC). This resource provides an outline and PowerPoint slide images of the Developmental Screening and Referral program, a 1.5 hour presentation designed to be presented in the office/clinic setting to all staff by a trained healthcare provider. December 2006 State-specific Illinois
Empowerment Professional Development Planning Committee Proposal Outline Jane Borst. (Iowa Department of Health, July 7, 2006). This proposal outlines steps to improve the quality of well child services by conducting professional development activities for primary care providers who care for infants and children. This proposal was presented to the Empowerment Professional Development Planning Committee to spread the adoption of the standards for developmental screening to primary health care providers throughout Iowa. This proposal was later awarded $75,000.00. July 2006 State-specific Iowa
Community Care Fact Sheet North Carolina ABCD Project. (June 2006). This newsletter provides an overview of relevant information for Medicaid providers in North Carolina. Through resources such as this newsletter, Community Care provider networks are working to put into place the local systems needed to achieve long-term quality, cost, access and utilization objectives in the management of care for Medicaid recipients. June 2006 State-specific North Carolina
Announcement of new web site available for Medicaid EPSDT/Care
for Kids providers
Iowa Department of Human Services, Iowa Medicaid Enterprise (February 2006). A web site containing useful tools, resources, and links for providing EPSDT services with special emphasis on promoting healthy physical, mental, social, and emotional development of children birth through age three.http://www.iowaepsdt.org/ February 2006 State-specific Iowa
A Practical Guide for Healthy Development Web-resource. Copyright © 2005 by The University of North Carolina at Chapel Hill for its Center for Children’s Healthcare Improvement and by the Vermont Child Health Improvement Program at the University of Vermont.  A Practical Guide for Healthy Development consists of a set of materials and tools designed and tested in the Healthy Development Learning Collaborative, a 12-month quality improvement initiative. December 2005 NASHP-Commonwealth
Assuring Better Child Health Development II: Project Training Iowa ABCD Project (2005). Agendas for three training sessions organized to explain the purpose of the ABCD II project and to assist Dubuque health care and other personnel to gain the knowledge and skills necessary to include standardized screening and referral guidelines in daily practice. December 2005 State-specific Iowa
Iowa’s ABCD II Healthy Mental Development Project: The ABCD II Project Iowa’s ABCD II Project. (2005). This document lists anticipated questions and answers regarding the ABCD II project. This resources seeks to address unanswered questions as to how the early development of young children, and their families, can be coordinated and improved. (From Introduction) December 2005 State-specific Iowa
Early Childhood Mental Health Summer Institute: Creating a Referral Protocol for Head Start Glenace Edwall and Antonia Wilcoxon. (Minnesota Department of Human Services, July 26, 2005). This PowerPoint presentation was delivered at a session at the Early Childhood Mental Health Summer Institute and was designed to educate providers on improving access to follow-up services. July 2005 State-specific Minnesota
ABCD II Early Identification System Standards: Board Approved Recommendations for Implementation in the Demonstration Sites Iowa ABCD Project (January 2005) Formal guidelines for implementation of standardized screening and referral practices used in demonstration sites and to be considered in the eventual development of a statewide system. January 2005 State-specific Iowa
“If it Worked for Us…” William Hensel. (Greensboro, NC: Guilford Access Partnership, Guilford County Department of Public Health, 2004). Letter from William Hensel, Medical Director of the Guilford Access Partnership, to Sherry Hay, North Carolina’s ABCD Coordinator, describing the successes of the ABCD I program implementation. December 2004 State-specific North Carolina
Screening for Perinatal Depression – Informational Notice Illinois Department of Public Aid. (November 30, 2004). This informational notice from IL DPA to practitioners outlines screening protocols for perinatal depression and provides information on DPA’s initiation of reimbursement for screening for perinatal depression and information about consultation services available to providers. November 2004 State-specific Illinois
Letter of Support to Colleagues on Standardized Screening Marian Earls. (Greensboro, NC: Guilford Child Health, Inc., April 2004). This letter from a pilot site provider was sent to peers and colleagues in an effort to promote the use of the Ages and Stages Questionnaire. April 2004 State-specific North Carolina
Setting the Stage for Success, an Introduction for North Carolina Providers (North Carolina ABCD I Project, 2004). This brochure was used as an introductory informational guide for providers on the Ages and Stages Questionnaire. December 2002 State-specific North Carolina
Bright Futures in Practice: Mental Health Michael Jellinek, Chair. (Washington, D.C., National Center for Education in Maternal and Child Health, 2002). This resource is a two-volume set that considers the mental health of children in a developmental context, presents information on early recognition and intervention for specific mental health problems and mental disorders, and provides a tool kit with hands on tools for health professionals and families for use in screening, care management, and health education. (From web overview) December 2002 Peer-reviewed
Child Development Programs in Community Health Centers NASHP (Portland, ME: National Academy for State Health Policy, March 2002) News from the Assuring Better Child Health and Development Program: Child development programs at community health centers. Because of their ability to identify at-risk children and to assess their social and primary care needs, health centers are valuable and essential providers of child development services. This brief discusses health promotion program and parent education programs offered by community health centers.  March 2002 NASHP-Commonwealth
Building State Medicaid Capacity to Provide Child Development Services: Early Findings from the ABCD Consortium Deborah Curtis. (Portland, ME: National Academy for State Health Policy, February 2002). This report is a summary of early findings from a four-state consortium dedicated to strengthening the early child health and development services offered through Medicaid. It outlines how the Consortium states – North Carolina, Utah, Vermont, and Washington – worked to expand or develop early child health and development services. It examines the various strategies used in each state, including how each of them sought to improve developmental screening for infants and toddlers. February 2002 NASHP-Commonwealth
Healthy Babies Kids and Families, Pediatric Communication Tool Vermont ABCD I Project. This form was designed to promote improved care coordination between MCH coordinators, Medicaid providers, and home visiting programs–allowing for a more streamlined approach to improve access to quality services for Medicaid eligible children. February 2002 State-specific Vermont
Overview of lessons learned in Iowa working with demonstration sites Carrie Fitzgerald and Alfred Healy. (2007). PowerPoint presentation for ABCD Screening Academy Learning Session, July 2007. This presentation describes how Iowa implemented its demonstration sites and provides insight into how demonstration site experience can be used in policy improvement and statewide spread of innovations. NASHP-Commonwealth