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Healthy Tomorrows Partnership for Children Program
For more information on any of these HTPCP projects, please
e-mail your name, address, telephone, and fax numbers with your
specific request to healthyt@aap.org.
ALABAMA
TEENS EMPOWERED THROUGH EDUCATION AND NURTURING
(TEEN) (1996)
Family Oriented Primary Health Care Clinic, Inc, Mobile, AL
The goal of this project is to decrease child abuse and neglect
and reduce repeat teen pregnancy in a targeted population of
400 first-time mothers receiving care in our maternity clinic.
The voluntary program will have outreach workers who will conduct
home visits using an educational curriculum. The mom and the
child will be followed during the child's first five years of
life. The curriculum used will be the Healthy Families America
Program, which has been tried successfully in other parts of
the country. The social worker supervisor will supervise the
family support workers and provide case management services.
Project staff provide home visits to each participant beginning
with weekly visits. The frequency of visits vary based on patient
need. Home visits focus on family strengths, preventive health
schedules, promoting positive parent/child relationships, and
teaching teen mothers to cope with the burdens of parenting.
CONTINUITY OF MEDICAL CARE FOR FOSTER CHILDREN IN
JEFFERSON COUNTY, ALABAMA (2001)
Family Place Pediatric Practice (FPPP), Birmingham, AL
Foster children in Jefferson County, Alabama are particularly
at-risk for inappropriate or substandard care due to a lack
of continuity of care as a consequence of changed providers
and case workers with placement changes. The lack of continuity
of medical care results in several serious problems, including
over-immunizations, under-immunizations, failure to receive
routine laboratory tests or needed referrals to specialized
child care services, and increased risk of missed appointments
and unfinished treatment regimens. In collaboration with the
Jefferson County Department of Human Services, the project will
provide 150 foster children a continuous source and site of
comprehensive medical care, irrespective of any change in the
child's placement. The goals of the project are to provide:
- continuity of medical care for foster children, and
- a pilot study for statewide application.
ALASKA
NEW BEGINNINGS IN NATIVE HEALTH (1994)
Southcentral Foundation, Anchorage, AK
Although the Alaska Native and American Indian population in
the Anchorage area make up less than 10% of the total population,
statistics indicate that this population is responsible for
33% to 40% of the area case load related to child abuse and
neglect. This Healthy Tomorrows Partnership for Children project
will reduce child abuse and neglect by providing home visits
and family support services to an estimated 200 Alaska Native/American
Indian families over the 5-year grant period. Services will
include crisis intervention, provision of emotional support
to parents, informal counseling, role modeling of appropriate
family relationships, enhancement of communication and life
coping skills, and referral to other services as necessary.
A management information system linked with the goals and objectives
will be used to monitor and assess accomplishment of the goals
and objectives.
RURAL TOTS (1996)
REACH Infant Learning Program, Juneau, AK
Comprehensive medical and educational services are very limited
in the remote areas of Southeast Alaska. The REACH Infant Learning
Program provides services to families with children with developmental
disabilities from birth to three years. Rural TOTS will provide
families with locally-based support and offer multidisciplinary
assessments in six remote Southeast Alaska communities by developmental
specialists. A family service coordinator will be hired in Hoonah.
In Haines, the educator position will be expanded so that more
families can be served on a regular basis. The TOTS Team (Team
of Transdisciplinary Services) will travel to six remote communities
to provide assessments to twelve families annually. The team
includes a pediatrician, physical therapist, occupational therapist,
speech therapist, educator, and nutritionist as needed by the
family. The TOTS team will provide training in the communities
during their visit. Twenty-five families will receive comprehensive
and coordinated services during the first year. Sixty additional
families will be served in the following years.
THE CHILDREN'S PLACE: A CHILDREN'S ADVOCACY CENTER
FOR THE MATANUSKA-SUSITNA BOROUGH (1998)
Wasilla, AK
Alaska has the highest rate of substantiated child abuse in
the nation: 38 per 1,000 children compared with the national
average of 12.6 per 1,000. Our local child protection agency
received nearly 1,500 reports of harm in 1997, 20% of them for
sexual abuse. Of these reports, 800 were not investigated due
to staffing shortages. Investigation and prosecution are limited
by staffing shortages, lack of training in the area of forensic
child interviewing, and lack of a coordinated interdisciplinary
team approach to the problem. One way to decrease the trauma
for abused children, maximize the resources we currently have,
and increase the rates of prosecution for child molesters is
by developing a Children's Advocacy Center, which we've named
"The Children's Place." Children's Advocacy Centers
are child-focused, neutral-based facilities where professionals
from many disciplines meet to conduct forensic interviews and
provide medical exams and other services for children who have
been abused. The multidisciplinary approach brings together
all team members involved in child abuse investigations: law
enforcement detectives, child protection social workers (DFYS),
medical examiners, prosecutors, mental health professionals
and child advocates. The goals of this project are: to have
a coordinated multidisciplinary team approach to child abuse
investigations, improve short and long term outcomes for children
and families referred for suspected abuse and neglect, and to
increase community awareness and detection of child abuse and
neglect.
ARIZONA
THE PHOENIX BREATHMOBILE: A MOBILE ASTHMA CLINIC FOR
INNER-CITY CHILDREN (1999)
Phoenix Children's Hospital, Pulmonology Department, Phoenix,
AZ
Asthma is a chronic inflammatory disease of the airways that
if not treated, can cause permanent lung damage or even death.
It is the most prevalent of all childhood chronic illnesses,
resulting in 10 million missed school days each year and a high
incidence of learning disabilities and grade failures. The prevalence
of asthma in Arizona children has risen 23 percent between 1982
and 1992. Maricopa County has the third highest death rate compared
to other US Counties. The problem is particularly acute in inner-city
areas due to environmental conditions and lower socioeconomic
groups. The target population is highly indigent, underinsured
and medically undeserved children in inner-city phoenix. The
primary goals of this program are to decrease asthma-related
morbidity (missed school days, hospital visits, ER visits) and
mortality and to improve "quality of life" in children
with asthma. The secondary goals are to enroll eligible uninsured
children into state Medicaid programs and establishment of medical
homes. The Breathmobile is a mobile medical coach that will
travel to elementary schools. The program will screen 100% of
children in the school districts served and provide asthma diagnosis,
medical treatment, education for children and their parents,
and follow-up services. Case management and 24-hour phone support
for asthma related illness and questions is provided. Eligibility
screening for state Medicaid programs and assistance with the
enrollment process is provided
COMMON/UNITY:CREATING OPTIMISTIC BRIGHT FUTURES FOR
CHILDREN AND THEIR HOMELESS, YOUNG SINGLE PARENTS (2000)
University of Arizona, Tucson, AZ
Common/Unity is a multi-agency, community-wide effort originating
with the Arizona Prevention Center at the University of Arizona.
The project attends to the nationally recognized problems of
child abuse and neglect. Common/Unity is designed to address
the needs of single adolescent parents with little or no support
systems through attention to three factors:
- An inter-generational cycle of poor attachment between parent
and child associated with insufficient or inappropriate parenting;
- Low self-esteem and a sense of non-belonging for the adolescent;
and
- A lack of appropriate support systems.
Based within a safe and affordable apartment complex, 25 to
30 homeless, young single parents and their children will participate
in a village-style community for two years. They will share
common lifestyle, issues, and space. They will receive support
and education in health issues, parenting skills and child development,
life skills, education completion, and community involvement.
Through the use of the nationally recognized Parents as Teachers
curriculum administered in a stable environment, it is the objective
of the Common/Unity project to interrupt the generational cycle
of poor attachment and inappropriate parenting, and to enhance
parental self-esteem by empowering parents to appropriately
care for their child(ren). The village setting will allow these
young parents to assist and support each other to improve their
lives as well as the lives of their children. The project will
serve as an orientation for pediatric residents and nursing
students to community involvement activities.
ARKANSAS
CREATING OPPORTUNITIES TO COMBAT OBESITY IN ARKANSAS
(2001)
Arkansas Children's Hospital, Little Rock, AR
Public health officials in Arkansas have listed childhood obesity
as the state's number two public health problem after tobacco
use. These obesity rates have lead to a dramatic increase in
type 2 diabetes and hypertension in both adolescents and young
adults in Arkansas. The program will provide clinical evaluations
of obese children or who are overweight with co-morbidities,
such as hypercholesterolemia, hypertension, and type 2 diabetes.
Screenings will be provided in populations, which typically
have poor access to health care and are at high risk for obesity.
Finally, the program will provide community and physician targeted
education about the complications of obesity and effective methods
of reducing obesity.
CALIFORNIA
PROJECT FOR ATTENTION-RELATED DISORDERS (PARD)
(1989)
San Diego Unified School District, Health Programs Office,
San Diego, CA
Project staff are developing a network to provide diagnostic
and therapeutic intervention services to low-income children
and youth who exhibit symptoms that suggest attention deficit
disorder. The network includes pediatricians, nurses, school
teachers, and school support personnel. Now in the fifth year,
project staff have provided in-service training to 130 school
counselors and counseling aides, 55 school psychologists, and
140 school nurses. In-service training for teachers has been
conducted at over 200 school sites, and 15 pediatricians have
been recruited and trained to participate in the project. The
project has conducted yearly in-service training for community
pediatricians as well. There is monthly training available to
all district personnel and parents. A teacher intervention manual
has been provided to any district teacher requesting assistance.
The project has developed a parent brochure to assist parents
in understanding attention deficit and hyperactivity, its management,
and treatment. To date, over 500 students have been identified
and are receiving services through the project.
ADVOCATES FOR CHILDREN PROJECT (1992)
Pediatric Diagnostic Center/Associates, Ventura, CA
The goal of this project is to reduce child abuse and neglect
in a targeted population of high-risk families. Women giving
birth at Ventura County Medical Center are assessed for child
abuse risk factors, and at-risk families who live in Oxnard,
CA, are invited to participate in the project. Five part-time
family support workers have been recruited from the targeted
community and trained to provide home visitation and intervention
services. A public health nurse supervises the family support
workers and provides case management services. Project staff
plan to recruit 50 families to participate initially and provide
home visits to each, beginning with weekly visits during an
infant's first 3 months at home. The frequency of the home visits
decreases as family functioning improves, and are provided monthly
for a minimum of 2 years. Home visits focus on reducing family
isolation, enhancing the emotional development of the children,
promoting positive parent-child relationships, and increasing
parental self-esteem.
BRIGHTER TOMORROWS: INTERNATIONAL ELEMENTARY SCHOOL
FAMILY CENTER HEALTH PROJECT (1992)
The Children's Clinic, Long Beach, CA
The International Elementary School, a public school serving
multicultural and multiethnic low-income children in downtown
Long Beach, CA, has developed the Family Center to meet health,
social, and legal needs of children and families of the school.
This project has addressed the health components of the Center
by developing a health and fitness educational program for students,
teachers, and parents to improve immunization rates and lifestyle
behaviors, and reduce the rates from delayed diagnosis and care
of treatable diseases. Lead by The Children's Clinic, a local
nonprofit community clinic, this project also provides bimonthly
immunization sessions and an on-site clinic providing screening,
diagnosis, and treatment services. Students and siblings seen
in the clinic receive pharmaceuticals and are eligible for specialty
services at The Children's Clinic. Twenty-four hour telephone
accessibility and inpatient care provides a true "medical home"
and continuity of care. A nonprofit mental health clinic provides
evaluations, treatment, and referrals for psychological and
behavior problems, and the school-wide fitness program is coordinated
through the local YMCA.
EAST COUNTY HEALTHY TOMORROWS GROUP WELL-CHILD CARE
PROGRAM (1992)
East County Community Clinic, El Cajon, CA
East County Community Clinic is the only community clinic available
to an ethnically and economically diverse population of 430,000
people living in this sparsely populated county. Through collaboration
with various health care agencies in the San Diego area, this
project aims to provide family-oriented preventive pediatric
care and to coordinate services with a comprehensive perinatal
program that focuses on existing resources available in the
region. Through an affiliation with The BirthPlace, clinic patients
will receive health education, birthing, and follow-up services
in a group setting. Six to eight parent/child teams meet with
a pediatric provider at the AAP-recommended periodic screening
intervals for examinations, health education, and immunizations
during their first 3 years of life.
HEALTHY TOMORROWS PARTNERSHIP FOR CHILDREN
(1992)
AAP California Chapter 4, Orange, CA
About 26,000 elementary school children in the Santa Ana Unified
School District are without adequate health care and appropriate
resources for necessary follow-up care. The local AAP chapter
is working with Children's Hospital of Orange County, the Santa
Ana Unified School District, and the Orange County Health Department.
Together, they have been developing a comprehensive school health
education and direct service program. These goals have been
accomplished by developing a mobile van clinic staffed by a
bilingual pediatrician and a registered nurse, who are providing
immunizations, well-child physical examinations, and sick visits.
Follow-up care is provided by 26 area pediatricians and many
pediatric subspecialists who have agreed to accept two to three
patient referrals per month. A parent education coordinator
is developing culturally sensitive parent education and leadership/mentor
programs.
THE SAN DIEGO HOMELESS ADOLESCENT HEALTH CARE
PROJECT (1993)
Logan Heights Family Health Center, Inc, San Diego, CA
This project is an effort to bring much needed medical services
to homeless adolescents and their families. A bilingual health
care team will provide comprehensive, case-managed health care
and education on-site in places where these teens live and congregate.
The team will be composed of a pediatrician/project director,
outreach nurse practitioner, health educator, nurse/case manager,
data specialist, and patient accounts representative. In the
first year, the health team will conduct clinics, provide outreach,
create a coalition of community agencies and pediatric professionals
dedicated to serving adolescents, collect and disseminate data
on medical conditions and contagious diseases, and obtain a
detailed risk assessment to monitor clients' knowledge, attitudes,
and behavior. Data will be evaluated annually to assess the
impact of the intervention and will demonstrate increases in:
the number of homeless and near homeless teens receiving health
care and education, the number screened and treated for tuberculosis,
the number using contraceptives, and the number enrolled in
prenatal care. Also, case management meetings involving the
various agencies serving homeless youth will improve coordination
of services and reduce fragmentation.
SAN DIEGO COUNTY DENTAL HEALTH INITIATIVE
(1995)
Children, Youth and Families Health-CHDP Program, San Diego,
CA
The goal of this initiative is to improve the oral health of
San Diego County children. This will be accomplished by developing
systems to assist children who have critical oral health needs
to receive immediate care and by developing education modules
that emphasize the prevention of oral health problems. The dental
referral system will link 200 dentists volunteering their services
with low-income children who have urgent dental needs and no
resources for care. A low-cost, extended-payment program will
also be developed to assist children who have less severe oral
health needs and who can, over time, afford to pay for some
care. Additionally, a preventive component will provide community-based,
culturally appropriate oral health education. To implement this,
partnerships will be developed with community agencies including
the Supplemental Nutrition Program for Women, Infants, and Children
(WIC), Healthy Start and Head Start programs, and state preschools.
HUMBOLDT HEALTHY FAMILIES - A FAMILY HOME VISITING
COLLABORATIVE (1996)
Humboldt County Public Health Department/MCAH Division, Eureka,
CA
This public/private collaborative aims to address high rates
of child abuse and neglect and post-neonatal death by intensively
screening for risk of child abuse and neglect in families at
the time of birth of a newborn. This program assures systematic
referral of families at risk to long-term home visiting services
by coordinating and mobilizing public and private home visiting
agencies. Data collection will track health and social functioning
indicators in families over time, provide evaluation information
about agencies' activities, about the support activities of
the Collaborative and about gaps in services in our community.
Staff training and support activities will assist our rural
community agencies in training professional and paraprofessional
home visiting staff and in developing a common, strengths-based
philosophy of work with families at risk.
8% EARLY INTERVENTION AND CHILD HEALTH IMPROVEMENT
PROJECT HEALTH CARE PROGRAM (1997)
American Academy of Pediatrics CA Chapter, Orange County, CA
The 8% Early Intervention Medical Project Health Care Program
will works in collaboration with the Orange County Probation
Department's 8% Early Intervention Program for high risk youth
and their families and addresses the following concerns: high
risk health behaviors in youthful offenders and their siblings;
the provision of culturally appropriate, age specific, health
education to address high risk behaviors, or other behavioral
that facilitate developmental accomplishments; treatment of
unmet medical needs and the provision of a medical home for
youthful offenders and their siblings; identification and treatment
of learning disability in the population; and the medical needs
of the offenders and provision of treatment for siblings of
the 8% minors. The goal of the of the program is to improve
the health status and functional ability of the entire family.
The project aims to reduce drug use, clinical depression and
suicidal behavior, child abuse and neglect reports, and chronic
debilitating disease and injuries among the target population,
as well as increasing the number of parents receiving parenting
skills education. These goals will be accomplished by linking
with the Deputy Probation Officer, referral of 8% youth and
family to medical services program and a case manager for screening,
implementation of an abuse prevention/intervention plan, the
development of a health plan for each individual and family,
and linkage to a medical home.
THE ANDERSON AND HAPPY VALLEY HEALTHY CHILDREN AND
FAMILIES PARTNERSHIP PROJECT (1997)
Shasta Community Health Center, Redding, CA
Children and their families in the south geographic rural area
of Shasta County, California have long been medically underserved.
This situation has worsened by the downturn in the local economy
driven by the demise of the timber industry in the area. This
has translated into low pre-school immunization and well-child
exam rates, high teen pregnancy rates, and excessively high
rates of spousal and child neglect and abuse. This project allows
Shasta Community Health Center, a community health center based
in Redding, CA, to operate two school-based/linked clinics in
the south Shasta county area in cooperation with "The Anderson
Partnership for Healthy Children." This partnership, a coalition
of public and private organizations, as well as members of the
community, was established to seek creative ways of improving
the health status of the children in Redding. Services are integrated
between agencies to maximize limited resources with oversight
provided by the Partnership's community advisory board. Clinic
services include primary care, medical consultation services,
and coordinated "high risk" family case management. The primary
objectives of the program are to improve well-child care and
decrease rates of teen pregnancy and spousal/child neglect and
abuse. Evaluation measures will be used to monitor each of these
outcomes over time.
SAN DIEGO KIDS HEALTH ASSURANCE NETWORK (SD-KHAN)
(1997)
San Diego, CA
There are approximately 150,000 uninsured low-income children
in San Diego County who do not have access to comprehensive
primary care providers. These children are more likely to be
under immunized, face delays when they require medical care,
as well as be more likely to require hospitalization and have
longer hospital stays. Supported by an efficient automated information
and referral infrastructure, San Diego Kids Health Assurance
Network (SD-KHAN) will improve access to medical care by referring
and matching children to a network of health care providers.
Children from low income families will be provided the opportunity
to establish a medical home with the most appropriate pediatric
providers willing to provide services at no cost, low cost,
extended payment schedule, or discounted insurance premium.
Recruitment of providers, development and maintenance of the
information and referral system, integrating services with California
Healthy Families Program (California's plan to meet the requirement
of the new Title XXII of the Social Security Act) will be carried
out to support the Project Materials developed will include
educational packets for families, form and documentation to
support the automated information and referral system, project
tracking, and evaluation.
INFANCIA FELIZ (1997)
Vista Community Clinic, Vista, CA
Mexican immigrant women experience better than expected perinatal
outcomes, yet by two years of age these children are behind
their peers in most measures of health including immunizations
and well child checkups. Infancia Feliz provides education and
support to the families of Hispanic children in an effort to
improve the child's health status and to determine how to best
provide infant health care services to the largest ethnic group
in our state. Eligible mothers to receive prenatal care through
the Vista Community Clinic are Spanish speaking and between
the ages of 15 and 30, are new comers to the United States,
are first time mothers, have a family income at or below the
poverty level, and deliver a healthy newborn. The project objectives
are:
- to identify, enroll, and provide continuous follow-up care
to all eligible mother-infant pairs through the infant's second
year of life;
- to increase utilization of the infant health care system
for immunization and well child visits;
- to improve the overall health status of project infants;
- to educate mothers about infant health and appropriate utilization
of the infant health care system;
- to provide an accessible continuum of health care from the
prenatal period through the infants first 2 years of life.
The project will provide individual case management , home
visits and health education classes to all participant families,
the project staff plan to provide services to a minimum of 40
mother-infant pairs per year.
TOUCHSTONE SUPPORT NETWORK PROJECT (1998)
Parents Helping Parents, Inc (PHP), Santa Clara, CA
Parents Helping Parents (PHP) is a comprehensive, parent driven
family resource center with 22 years of experience providing support,
information and training for children with special needs, their
families, and the professionals who serve them. The mission for
this project is to foster family/professional collaboration in
order to help children living in Santa Clara, CA, and surrounding
areas who have chronic and/or life-threatening illnesses reach
their full health and developmental potential. Utilizing proven
methods (including parent-to-parent support, peer psychosocial
support, family support group sessions, information, referral
and direction, patient advocacy, care coordination assistance,
sibling support, and parent trainings), the project will build
upon and further promote the belief that children can reach their
full health and developmental potential only if families and professionals
work together. Our goal is to ensure family-centered "medical
homes" (as defined by the American Academy of Pediatrics) for
750 children over the course of the project. We plan to provide
a variety of information, training, support and advocacy services
for their families through our comprehensive, parent-directed
family resource center in order to link the children with medical
homes and enhance family-centered care. The project advisory committee
consists of pediatricians, nurses, social workers, and parents
of children with chronic and/or life-threatening illnesses. In
addition, a culturally/language appropriate, family-friendly binder
will be created for families to use to manage the information
and materials they receive related to their child's care.
ON TRACK VIOLENCE PREVENTION & PEDIATRIC COLLABORATIVE
(2000)
Orange County On Track, Nonprofit Organization, Orange County,
CA
Orange County On Track is a nonprofit organization dedicated
to improving the quality of life for families and children through
a focus on non-violence and respect for all cultures. The On
Track mission is achieved through a public health model in the
following unique ways: 1) Youth-to-Youth Mentoring program,
which trains and matches teen role models with at-risk elementary
school children: 2) Conflict Resolution Training programs; 3)
Tutoring and academic enrichment programs; 4) The On Track magazine,
free to the public; 5) and "Teen Councils" that give culturally
diverse groups of students the opportunity to help develop and
implement solutions for a safer society.
The ON TRACK VIOLENCE PREVENTION AND PEDIATRIC COLLABORATIVE
was designed to expand the On Track Youth-to-Youth Mentoring
and Conflict Resolution Training programs as well as the Teen
Councils to an economically disadvantaged area in the City of
Anaheim, where families do not have the same access to health
care and special programs that are available in more affluent
areas in the city. The primary goal of the Collaborative is
to make life-changing improvements with the identified at-risk
youth and their families in order to lower the risk of their
getting involved in gangs, crime or violence. Also, the goal
is to improve the health status and quality of life for these
children and to create a successful public health model for
other cities.
Based on successful implementation of the On Track programs
in other Orange County cities, the following steps will be followed.
The first step involves identifying at-risk kids as mentees,
then selecting and training qualified youth mentors for the
On Track Youth-to-Youth Mentoring and Conflict Resolution Training
Program. The next step is to match mentors and mentees, prior
to beginning a structured conflict resolution program, which
includes many personal development themes. Youths are then provided
with weekly tutoring by second-year pediatric residents and
other volunteers. During these weekly, year-round, three-and-a-half-hour
meetings at the school site (which is sake for all concerned)
learning activities are interspersed with sports, arts and crafts,
and snacks. All activities take place after school hours, which
are the critical hours for juvenile delinquency, and are on
a voluntary basis. The exception to this is: weekend special
events or small group discussions on firearm injury prevention
and child & adolescent health issues, in addition to leadership
retreats for teens.
KIDS COME FIRST PROGRAM (2001)
YWCA of the West End, Ontario, CA
The Kids Come First project will provide pediatric care for
children in the south/central region of Ontario, an economically
depressed region with 20% of the population at or below the
federal poverty level. Issues of poverty, substandard housing,
high unemployment, low wages, a large number of undocumented
immigrants, and lack of transportation impact health care access
in the community. The project is centered on two Healthy Start
school clusters with pre-kindergarten, elementary and middle
schools in the heart of one of the region's poorest neighborhoods.
The Kids Come First project assists largely immigrant and Hispanic
families to access health care by providing comprehensive services
and screening through a school-linked health center. Its goal
is to improve student and family access to primary medical care
that includes preventative health care screening and acute care
treatment.
CHILDREN'S HEALTH CENTER ANEMIA PROGRAM (2001)
Sonoma County People for Economic Opportunity, Santa Rosa, CA
The Children's Health Center will embark on an anemia prevention
program, combining better access to pediatric care at the neighborhood
level for families and better access to pediatric expertise
on a county level. The program will replicate the outreach model
used for a successful program to improve immunization rates
in low-income children from largely Spanish-speaking families.
Program objectives include: 1) increase access to a medical
home to prevent anemia among the target population; 2) decrease
wait times for health supervision visits; 3) decrease anemia
rates; 4) produce a countywide paper on best practices for preventing
anemia; 5) produce a set of health supervision tracking sheets
with accompanying information for parents in English and Spanish.
PEDIATRICIAN EDUCATION PROJECT FOR (PEP) FOR FAMILY
HEALTH (2003)
Division of Community Pediatrics, University of California San
Diego , La Jolla , CA
Lack of health coverage or knowledge of how to use health coverage
precludes families from receiving medical care and beneficial
preventive health information. The goal of PEP is to ensure
children in vulnerable families have access to a medical/dental
home and targeted preventive child health messages to improve
their health, well-being and academic performance. The project
will develop partnerships with employers at-risk of having employees
with uninsured children and provide training, information, and
referrals to children's health coverage and a medical/dental
home. In conjunction with the state chapter of the American
Academy of Pediatrics, the Dyson Initiative, and the San Diego
County; Public Health Services; Children, Youth, and Families
program, PEP will provide presentations and written messages
at the workplace for employees without health coverage for their
children as a job benefit.
THE PEDIATRIC MEDICAL HOME PROJECT AT UCLA
(2003)
David Geffen School of Medicine at UCLA and the Mattel Children’s
Hospital, Los Angeles, CA
The Pediatric Medical Home Project at UCLA will implement a
four-pronged initiative comprising care coordination, Resident
medical education, prospective pediatric health services research
and community awareness and involvement for children with special
health care needs. The project plans to provide care coordination
for children with special health care needs in a medical home
setting to be established according to guidelines established
by the AAP through the outpatient general pediatric program
at UCLA. In addition, it will develop and implement a structured
resident education program to consist of formal lectures and
seminars as well as teaching in the clinical outpatient area.
In addition, prospective pediatric health services research
will be conducted in conjunction with the UCLA School of Public
Health to evaluate the effect of the program on both the awareness
of pediatric residents with regard to medical home concepts
and on the clinical outcomes of the patients enrolled in the
medical home. Finally, the project will increase community awareness
and involvement for children with special health care needs
by developing and strengthening relationships with community
organizations and by compiling and disseminating a community
resource guide. The goal of the project is to provide a medical
home for children with special health care needs in West Los
Angeles now while training pediatricians to provide medical
homes to their patients in the future.
NORTH COAST PEDIATRIC DENTISTRY INITIATIVE
(2004 Oral Health Grant)
California Parenting Institute, Santa Rosa, CA
NCDPI is a collaboration of child health advocates from California's
Sonoma, Lake, and Mendocino counties that consists of Delta
Dental, public health officials, Sonoma, Mendocino and Lake
County First 5 Commissions (created by Proposition 10 to fund
early childhood programs), child advocates, dentists, Tribal
and Indian Health, pediatricians, Head Start, directors of Community
Health Centers, Regional Centers, and parents. This community-driven
collaboration developed out of the desire of parents and service
providers to address a serious gap in services for young children
living in the north coast of California. Thousands of children
living in the region suffer the effects of Early Childhood Caries
(ECC) and are unable to find accessible dentistry with anesthesia.
To solve this problem, NCPDI is creating a community-based surgery
center in the tri-county region. NCPDI's goal is to open an
outpatient care delivery site for children with ECC and children
and adults with developmental disabilities. Providing locally
available, self-sustaining dental surgery services will reduce
long wait times for intervention and eliminate the pain, suffering,
and developmental challenges untreated ECC imposes. The surgery
center will provide restorative dentistry services for children
regardless of their insurance status or ability to pay and will
provide access to dental services to people with special needs
who are unable to utilize regular dentist office services. NCPDI's
long term goal is to reduce the need for surgery by improving
parents' and providers' understanding of the need for oral hygiene
and regular dental visits, through incorporating prevention
efforts into a comprehensive case management program to serve
the families of children receiving services at the surgery center.
NCPDI will also provide a care subsidy program to assist families
in paying for services, particularly families of children who
are uninsured.
CREATING OPPORTUNITIES FOR PHYSICAL ACTIVITY (2005)
Little Company of Mary, Torrance, CA
Creating Opportunities for Physical Activity (COPA) in San Pedro,
California motivates children and families to increase the frequency
of physical activity in their daily lives and expand community
access to public and private recreation and activity sites.
The goals of COPA are to increase the frequency of developmentally
appropriate physical activity in elementary aged school children,
encourage parents/guardians and school staff to become health
champions for themselves and their children, and to involve
community stakeholders to raise the community priority for physical
activity in children through advocacy and improvements in community
infrastructure. The COPA project proposes to engage first through
sixth grade students in an eight week, twice a week after school
intervention designed to increase the frequency of physical
activity in children, expand the mastery of age appropriate
movement skills, improve attitudes about physical activity,
and teach self-assessment skills.
FORTALECIENDO COMUNIDADES (STRENGTHENING COMMUNITIES)
(2006)
Community Action Partnership of Sonoma County, Santa Rosa, CA
The Fortaleciendo Communidades (Strengthening Communities) project
brings together an active group of community members and community
organizations to address health issues among low-income children
due to poor nutrition and lack of adequate physical activities.
The focus of the project is childhood obesity. The project will
address this issue through a multi-faceted approach including
community organizing, working with the schools, parks and recreations,
partnering with health care providers, and strengthening the
nutrition safety net. The goals of this project are to provide
low-income children with access to a culturally competent medical
home, to increase access to health care providers for low-income
children, and to improve community access to healthy foods and
physical activity in the low-income community through the Family
Activity and Nutrition Task Force.
SAN YSIDRO HEALTH CENTER SCHOOL READINESS INITIATIVE (2007)
Centro de Salud de la Communidad de San Ysidro, San Ysidro, CA
A strong need exists for early screening, detection and intervention of conditions that impact children’s health, well-being and ability to learn. The San Ysidro Elementary School District and the South County Special Education Local Planning Area have developed strategies to improve school readiness. These strategies include identifying children with developmental and behavioral conditions prior to starting school and assuring children have a “health care home” for ongoing care. The School Readiness Initiative will implement a comprehensive screening, assessment, and clinical intervention program for children ages 3-5 living in the San Ysidro Elementary School District catchment area. This project will expand the outreach screenings to include developmental screenings. The project will also enhance access to developmental and behavior pediatrics, provide pediatric care coordination services, and establish “health care homes” for children in the community. These new components will address a community need for developmental and behavioral health services and coordination of health care services for at-risk Latino children and families. The ultimate goal of San Ysidro Health Center School Readiness is to ensure children in the San Ysidro Elementary School District catchment area enter school healthy and ready to learn.
THE CHILDREN'S CLINIC MENTAL HEALTH PARTNERSHIP FOR CHILDREN PROGRAM (2008)
The Children's Clinic, Serving Children and Their Families, Long Beach, CA
Approximately 20% of all children experience mental disorders, however only about 21% of those children who need mental health services are able and willing to access them. There are large ethnic and racial disparities with minorities receiving less and lower quality mental health care. The stigma of accessing mental health services, lack of insurance and other financial issues, limitations with carve-out programs or benefit caps, cultural and linguistic barriers, and a shortage of mental health professionals contribute to the disparities. The Children’s Clinic, Serving Children and Their Families (TCC) is developing the Mental Health Partnership for Children program to improve the overall health and wellness of TCC patients by (a) improving screening and identification of mental health disorders, (b) improving access to mental health services for those in need through on-site mental health staff, and (c) increasing collaboration among community agencies.
HEALTH SERVICE OUTREACH, EDUCATION AND PREVENTION FOR WILMINGTON, CALIFORNIA (2008)
Robert F. Kennedy Institute, Wilmington, CA
The residents of Wilmington, Los Angeles are predominately poor, Latino immigrants who have some of the worst health indicators and, correspondingly, lowest health insurance and health service utilization rates of any population in the state. The Robert F. Kennedy Institute (RFKI) of Wilmington will expand its education and outreach efforts in the public school system, where it runs the area’s Healthy Start, to focus on health care and health services in the Latino community. The project will use their highly successful promotora model, in which people from within the target community are trained as outreach facilitators, to begin bringing underserved residents into the health care system. The project goal is to enroll eligible, needy children and families in public health insurance programs and assist them to access locally available services.
COLORADO
HEALTHY START/CHILDREN'S CLINIC (1989)
Fort Collins, CO
This private nonprofit clinic provides access to high-quality,
comprehensive pediatric care for county children from indigent
families, regardless of their ability to pay. Emphasis is given
to collaboration with the local health department to provide
preventive and acute care for children. Clinic staff is comprised
of a pediatrician, nurse practitioners, registered nurses, social
workers, office assistant, receptionist/biller, and director.
In the first 5 years the clinic provided over 33,000 office
visits for over 4,000 children. More than 100 community volunteers
and physicians participate in the project by accepting overflow
and specialty patient referrals. Patients who are not Medicaid-insured
are able to obtain medications by donating $1 to the program.
After-hours and emergency care for clinic patients is provided
through an arrangement with the residency program of Poudre
Valley Hospital. Project services have been expanded to provide
a teen clinic, behavioral modification clinics, a visiting friend/health
advocate program, parenting classes, bike safety classes, and
health education. A chronic care program exists to provide consistent
medicine and follow-up
HEALTHY TOMORROWS FOR DENVER (1992)
Denver Health and Hospitals, Denver, CO
The Denver Health and Hospital (DHH) system is the primary provider
of care for low-income and culturally diverse populations in
Denver, Colorado. Many infants and children with or at-risk
for developmental delays lack access to early intervention and
other services guaranteed under Public Law 102-119. The Healthy
Tomorrows for Denver project provides children aged 0 to 5 and
their families with improved access to early intervention services
by identifying children who need services, increasing system
outreach, facilitating the Denver Child Find process, promoting
family utilization of early intervention services, and developing
a tracking and monitoring system. To achieve these ends, Healthy
Tomorrows for Denver has institutionalized the referral process
from the DHH to Child Find, and provides coordination services
to identified families. In addition, professionals and paraprofessionals
will visit approximately 850 families in their homes to enhance
services through interdisciplinary assessment, individualized
family education plans, service identification and implementation,
and review and evaluation of plans.
BREATHE EASY ASTHMA MANAGEMENT (BEAM) PROJECT
(1999)
The Children's Hospital, Denver, CO
Asthma is the most common chronic childhood illness and the
fourth leading cause of disability in children. In low-income,
ethnic minority populations, the prevalence and severity of
asthma increases dramatically. Even when diagnosed in minority
children, asthma often goes untreated, poorly managed, with
little family education and involvement. Lack of access to care
primarily contributes to poor asthma management and outcomes.
The Breathe Easy Asthma Management Project (BEAM) builds upon
an existing collaboration of school, family and community to
improve asthma identification and management in high-risk preschool
and elementary school children in the Adams County School District
50 in Westminster, Colorado. The program objectives focus on
providing access to a medical home and coordinated, consistent
care through the school-based health center or primary care
provider; education of children and families on effective management
of the physical and psycho-social aspects of asthma; and increased
involvement of school and the community in supporting children
and families with asthma. Evaluation of the BEAM Project will
include process and outcome measures delineating the number
of children enrolled, number of clinical contacts with families,
emergency room visits and hospitalizations; and the number of
teachers and child care providers trained to recognize signs
of asthma, asthma management in the classroom, and referral
procedures. Outcome measures will assess changes in knowledge,
skills, attitudes, behavior, health status, and parent satisfaction
resulting from the project interventions.
HEALTHY TOMORROW'S FOR DENVER'S FAMILIES (HTDF)
(2000)
UCHSC, School of Medicine, Dept of Pediatrics, Kempe Children's
Center, Denver, CO
The growth of kinship care placement in the child welfare system
for maltreated infants and toddlers has increased dramatically
throughout the country as well as in Denver. Because these infants
and toddlers typically enter care with unmet medical, developmental
and emotional needs, the HTDF program was developed to improve
the overall health status of abused and neglected infants who
are place with relatives. Developed by a consortium of programs
serving these young children, and led by the Kempe Children's
Center, the focus is on coordinated case management and an early
behavioral intervention for these infants entering kinship care
in Denver. The program will:
- Provide case management services under the direction of
a primary care physician in order to obtain coordinated pediatric
care;
- Provide developmental and behavioral screening and follow-up
referrals for services; and
- Administer intensive behavioral intervention to a subset
of infants, by experts in infant emotional development from
the Kempe Center.
Extensive linkages and collaboration partners include The Children's
Hospital, Denver Health and Hospitals, Denver Department of
Human Services, Denver Options, and the Colorado Department
of Health. Evaluation of the program includes a pre- and post-test
of the program's effects, including medical, developmental,
and behavioral outcomes. Qualitative data, from various sources
including focus groups, will provide additional understanding
of children, families and the service system.
GROWING CONNECTIONS FOR KIDS (2007)
Denver Health and Hospital Authority, Denver, CO
Growing Connections for Kids is an expansion of an existing collaborative program between the Denver Health and Hospital Authority and Denver Department of Human Services. Through this expansion and the coordinated efforts of both agencies, Growing Connections for Kids will provide improved coordination of care by establishing a medical home for each Denver County foster child in order to address chronic or urgent health needs and ensure continuity of care. The project will track each child’s medical history through Child Health Passports and a database. A nurse care coordinator will monitor and ensure adequate receipt of care for foster children within their medical home. The goals of the project are to: 1) Coordinate health care services for children in foster and kinship care, 2) Ensure every child in foster care has a medical home, 3) Provide increased preventive health care services, and 4) Meet or exceed all federal guidelines regarding health care for children in foster care.
CONNECTICUT
HEALTHY TOMORROWS FOR NEW HAVEN (1990)
City of New Haven, Department of Health, New Haven, CT
This project is an effort to strengthen existing school health
resources to enable the Brennan (elementary school-based clinic
and Troup (middle) school-linked clinic to serve as access points
for children to obtain comprehensive health care. To accomplish
this, a pediatric nurse practitioner was added to the nursing
staff at Brennan and contracts were established to obtain primary
pediatric services and mental health/child development consultation.
In addition, services are offered to newborns and preschoolers
at the site. At Troup, linkages were established between the
full-time school nurse and the Primary Care Center at a local
hospital. All students, regardless of ability to pay, receive
services at both sites, which are located in economically depressed,
geographically isolated areas of the city.
PRENATAL-TO-PEDIATRIC TRANSITION PROJECT (1993)
Fair Haven Community Health Center, New Haven, CT
This Healthy Tomorrows grant will increase coordination among
existing health care resources in order to improve access to
health care for young parents and their families. Emphasis will
be placed on providing expanded bilingual and bicultural health
education and services. Major aspects of the project will include
enhanced prenatal education and pediatric care, improved case
management/social service referrals, and a new parental education
initiative focusing on literacy, using the Reach Out and Read
program. Transportation and translation services will also be
provided as necessary. Participants will be monitored to demonstrate
improved immunization and nutritional status, decreased emergency
room visits, increased parental knowledge of child development,
parenting skills, and optimal use of available health care resources.
PARENTS AND CHILDREN TOGETHER, PACT (2001)
Fair Haven Community Health Center, New Haven, CT
Parents and Children Together (PACT) builds on the successful
Prenatal Group
Program at the Fair Haven Community Health Center (FHCHC) to
provide
additional support for families beyond the prenatal period both
individually and in a group setting. The most vulnerable families have the most difficulty
obtaining
and using health services and gaining support from institutions.
We are
developing new systems to meet the needs of teen-led families,
immigrant families and families living in poverty by providing intensive home-visiting
during
pregnancy and the first two years of life and by extending the
prenatal groups
into group well-child care. The home-visiting program is a collaboration
with
the Minding the Baby Program based at the Yale Child Study Center
and the Yale
School of Nursing. Families are invited and encouraged to participate
in a
variety of neighborhood programs that address healthy infant
and toddler
development, including programs at the local library and childrens
museum, as well as the WIC, Healthy Start and Reach Out and Read programs at
FHCHC. We are also piloting group well-child care with small groups of families
and their
primary pediatric clinicians beginning at the 2-month well-child
visit. This
multi-disciplinary team approach will restructure the well-child
program for
our most needy families with the goal of reducing risk factors
and promoting the
healthy development of our most vulnerable children.
FOOD SMART AND FIT PROGRAM (2007)
Community Health Center, Inc, Middletown, CT
The Food Smart and Fit Program is a new component to the primary care, mental health and dental services offered through the Community Health Center in New Britain. This project will implement a multi-component health promotion, obesity prevention, and policy change intervention for young women (Grades 9-12) in New Britain High School, Connecticut’s largest high school. The program will partner with the school’s existing clinic-based education program that helps students with diabetes manage their disease through setting goals for healthy eating and physical activity. The project coordinator and registered dietician will provide nutritional counseling to obese and overweight girls, including girls with diabetes. The overall goal of the project is to address both individual and environmental dimensions of risk by: 1) Promoting and sustaining behaviors that prevent obesity and promote lifelong health, and 2) Empowering girls to mentor their peers and advocate for a school environment where healthy choices are available.
DISTRICT OF COLUMBIA
PRIMARY HEALTH CARE HOME (1994)
DC Linkage and Tracking, Commission of Public Health, Washington,
DC
The goal of this project is to promote the concept of the Primary
Care Home, where every child has one clinician who insures continuity
of health care services. Project staff will provide in-depth
and culturally sensitive health education and case management
to enable families in the target group to access the medical
and social service systems. Specific objectives include:
- an increase in Medicaid for project participants;
- an increase in the number of children and families who receive
recommended primary care services in accordance with Year
2000 goals;
- an increase in immunization rates for children less than
2 years of age, and
- an increase in lead screening rates for children who are
at environmental risk.
Comprehensive evaluation will occur, using an experimental
and control group.
MAKING DREAMS POSSIBLE FOR HISPANIC TEENS
(1994)
Mary's Center for Maternal and Child Care, Inc, Washington,
DC
This project aims to improve the health, educational, and psychosocial
well-being of 200 Hispanic low-income uninsured teens in the
District of Columbia, with an emphasis on teen pregnancy prevention.
Each year 35 pregnant teens and their newborns will receive
bilingual/bicultural services including early pre and postnatal
care, reproductive health, home visiting, STD/HIV screening
and counseling, primary pediatric care and immunizations, intensive
case management, and developmental screening. The center will
also provide parenting training with an emphasis on child development,
stimulation techniques, and the prevention of child abuse and
neglect. In addition, the project will provide community outreach
and education focused on pregnancy prevention.
HEALTH STREET (1999)
Upper Cardozo Community Health Center, Washington, DC
Health Street is a collaborative project between the pediatric
clinic of the Upper Cardozo Community Health Center, a Federally
Qualified Health Center (FQHC) and the Latin-American Youth
Center, a non-profit multi-cultural agency which promotes the
social and economic development of Latinos and other minority
groups. This partnership will attract and maintain high-risk
adolescents in a culturally sensitive and linguistically appropriate
medical home that provides comprehensive medical and mental
health services for participants and their families. Health
Street was established to address the unmet health and behavioral
health needs of adolescents and their families in Wards 1 and
2 of Washington, DC, two of the most racially, ethnically and
linguistically diverse areas of the city. Health Street objectives
are:
- to provide comprehensive preventive and curative health
care to adolescents in a teen health clinic;
- to offer a full range of family centered behavioral health
services to include individual and group counseling by a licensed
social worker, and referrals to other community mental health
and substance abuse services;
- to offer peer health counseling to adolescent clients;
- to expand access to primary and mental health services through
outreach to schools and other local community organizations.
TEEN PROGRAM AT MARY'S CENTER FOR MATERNAL AND
CHILD CARE, INC (2002)
Mary Center for Maternal and Child Care, Inc, Washington, DC
The purpose of the Mary's Center Teen Program is to address
the problem of pregnancy prevention among low-income immigrant
teens - primary Latinas - in the District of Columbia. The Teen
Programs' holistic approach employs the following strategies:
- voluntary case management and counseling services for female
teens ages 13-21 and their male partners;
- twice monthly low-cost Saturday Teen Clinics where teens
receive physicals, annual exams, pregnancy testing, family
planning, and STD/HIV testing from pediatricians;
- preparation of individual education plans and referrals
to education resources such as English as a Second Language
classes;
- peer educators receive weekly training and present health
education sessions at local high schools;
- regular health education events such as monthly birthday
celebrations that includes a guest speaker on a health education
topic; and
- monthly activities (such as special HIV testing days) coordinated
between the Teen Program and Mama and Baby Bus that can assist
hard-to-reach teens. The bus can serve as a non-threatening
mechanism to help bring teens into a primary care setting
to access the regular health care services they need.
All services are available in both Spanish and English. Through
an arrangement with another community clinic, some translation
services are available for other languages when needed at the
clinic.
DELAWARE -- NOT AVAILABLE
FLORIDA
CITRUS SMILES: PROMOTING ACCESS TO PEDIATRIC DENTAL
CARE (2002)
Citrus County Health Department, Inverness, FL
Access to dental care for low-income families in Citrus County,
Florida is extremely limited and poses a significant health
problem. Only 22% of Medicaid-eligible children in Citrus County
visit a dentist annually. This project will expand dental health
services to low-income children. This will be accomplished by
increasing staffing of the Citrus County Health Department Dental
Clinic, offering conscious sedation to extremely anxious and
fearful children in need of dental services, and providing a
comprehensive oral health education program for parents and
caregivers. Goals of the program are to:
- remove barriers that prevent access to dental care,
- provide parents and caregivers with appropriate knowledge
regarding age-appropriate oral hygiene practices, and
- increase the number of dental health services available
to low-income children.
PARTNERSHIP AGAINST LEAD (PAL) (2002)
Florida International University (FIU), North Miami, FL
Several communities in South Florida have been identified as
at-risk areas for lead poisoning because of risk factors such
as percentage of housing units built before 1950, poverty levels,
income levels, number of children under 6 years of age, and
number of children enrolled in Medicaid. The disparities observed
are a result of a high percentage of linguistically isolated
households and other cultural factors that need to be addressed.
The goals and objectives of "Project PAL" are to:
- motivate health care providers to routinely screen children
under 6 years of age for lead poisoning;
- establish a partnership among providers, health care professionals,
educational institutions, and other community organizations
and individuals to provide initial and follow-up services
to at-risk children; and
- decrease lead exposure in the home by educating children
about the sources of lead and hand-mouth behaviors.
CARIDAD HEALTH CLINIC (CHC) – PEDIATRIC PREVENTIVE
CARE PROJECT (PPCP) (2003)
Caridad Health Clinic, Boynton Beach, FL
The Caridad Health Clinic provides free medical and dental care
and support services to children and adults of migrant farm
workers and their families and strives to improve the health
status of low-income minority children, thereby increasing their
chance of becoming healthy, productive adults. The Pediatric
Preventive Care Project will provide prevention, early detection
and treatment of disease in the children of migrant farm workers
and other indigent children. CHC will screen at least 1,000
children at risk of Type 2 Diabetes Mellitus (DM). If diagnosed,
the project will provide glucose monitoring, diabetic testing
supplies and medication, as necessary, or referral to specialty
care. Parents will be educated on recognizing the symptoms of
Type 2 DM, the importance of healthy food choices, and exercise.
All services will be delivered in a user friendly, culturally
appropriate and language specific manner.
MEDICAL HOME FOR HOMELESS FAMILIES: THE JACKSONVILLE
HOMELESS FAMILY HEALTH PROJECT (2004 General Grant)
Each night in Jacksonville, hundreds of families are either
homeless or on the verge of becoming homeless. Often compounding
their loss of housing, the families and children suffer from
many social, economic, and mental and physical health problems.
The University of Florida, Department of Pediatrics, and the
Duval County Health Department are forming a collaboration to
provide services to the Sulzbacher Center, the only homeless
shelter for families and children in Jacksonville. The goals
of the program are to: 1) improve the health of homeless children
and families through access to comprehensive health, mental
health, and social services; and 2) provide a temporary Medical
Home for the children during their homeless episode, connecting
them to a permanent Medical Home once they resettle.
THE VILLAGE FIT KIDS PROJECT (2005)
The Village South, Inc. Miami, FL
Children of substance abusers are at high-risk for behavioral,
psychosocial and mental health problems and the opportunity
to intervene in relation to these problems is often overlooked.
The Village Fit Kids Project proposes to develop a child-centered
case management model, which will be integrated into a residential
treatment program for substance-abusing parents (including pregnant
and post-partum women) and their children, ages 0 to 12. The
project will include mental health and developmental screening
and assessment, mental health promotion groups, substance abuse
and violence prevention groups, and service planning coordination.
Services provided to parents include weekly education groups
delivered as part of their participation in residential treatment.
GEORGIA
IMPROVING HEALTH CARE ACCESS FOR HISPANIC FAMILIES
(1991)
Mercy Mobile Health Care, Atlanta, GA
Mercy Mobile Health Care is the only hospital-affiliated provider
of medical/health care outreach and education to Atlanta's multicultural
community, which has more than doubled in population since 1980.
This Healthy Tomorrows grant will enable the program to establish
monthly mobile pediatric screening clinics in three Hispanic/Asian
neighborhoods. Project staff will identify children with special
health needs who lack a regular source of care, will make appropriate
referrals, and will provide families with full assistance to
complete the referrals. The mobile clinics will be supported
by a network of bilingual health promoters who will be recruited
from targeted communities and trained to deliver health care
information in a culturally sensitive manner. The promoters
will identify families with medical needs and assist them in
accessing health services, including enrolling them in the Medicaid
and WIC programs. Another project objective will be to increase
the cultural sensitivity of local health care providers who
serve large numbers of Hispanic patients.
GRADY FIRST STEPS TO HEALTHY FAMILIES (1992)
Grady Memorial Hospital, Atlanta, GA
This project provides primary and secondary child abuse prevention
services to first-time mothers under the age of 21 who deliver
at Grady Memorial Hospital. An early identification worker screens
all targeted women and conducts an assessment for child abuse
risk factors. High-risk families receive home-based family support
services for 3 to 5 years, while low-risk families receive intervention
through telephone follow-up for at least 3 months. Culturally
competent, trained personnel offer emotional support and parenting
education. Staff also works to establish linkages between new
mothers and community/medical resources.
COBB HEALTH FUTURES ALLIANCE (1993)
Cobb County Board of Health, Marietta, GA
Developed to encourage a comprehensive system of primary health
care for children and adolescents who do not have insurance,
this grant will provide salary support for an additional pediatrician
who will work with project staff to expand and extend health
related services to children and adolescents in Cobb County,
Georgia. This will be accomplished by: expansion of clinic hours;
establishing 24-hour physician coverage; developing capacity
for hospital admissions and inpatient follow-up; and establishing
a structure for integration of services. In addition, parents
of the Alliance children will be partners in the evaluation
process and will participate in focus groups and a survey on
client satisfaction.
GUAM
GUAM FLUORIDE VARNISH PROGRAM (2004 Oral Health
Grant)
Department of Public Health and Social Services Dental Program
Division of Public Health, Hagatna, Guam
The goals of the program are to reduce the incidence of caries
in children less than 6 years of age, and to educate families
on the importance of good oral health. To achieve these goals,
the program will encourage and educate physicians who care for
children in the well-child clinics to apply fluoride and varnish
to their young patients with the help of nurses and other medical
staff. Dentists will collaborate with the physicians and staff
in developing ways to provide better dental care for children
in the medical setting. Children from WIC and Health Start programs
will receive oral exams and placement of fluoride, if needed,
and parents will receive dental health education.
HAWAII
PARENT-PEDIATRIC PARTNERSHIPS: SUPPORTING FAMILIES
TO STRENGTHEN THE VULNERABLE BUT INVINCIBLE (1989)
Hawaii Dept of Health,
Zero-to-Three Hawaii Project, Honolulu, HI
This project is a partnership between families and their medical
home to develop a demonstration model for care coordination
for environmentally at-risk infants and toddlers. The families
are being served as part of the eligible population under PL
102-119, with an IFSP developed for each child. The target group
includes many different ethnicities and immigrants. A primary
objective this year is to develop a plan for project expansion
and continuation after the end of federal funding of the project.
There is also a priority to find ways to expand the age group
being served to include at least all preschool children. A major
focus of activity during this year will be entering all the
children into the tracking system that is now operational. Another
major activity will be the establishment of procedures to participate
in third-party billing. Initial plans are to link the billing
system with the tracking system. A proposal is currently being
developed that will include the project in a longitudinal evaluation
study of outcomes for children and families served under Part H.
ENHANCED COMMUNITY HEALTH OPTIONS KO'OLAULOA
HEALTHY TOMORROWS (1994)
State of Hawaii, Dept of Health,
Maternal and Child Health Branch, Honolulu, HI
The Ko'olauloa Healthy Tomorrows Project will address the system
problems that currently exist and improve access to child health
services for families residing in the area. This goal will be
realized through increased and coordinated outreach services,
promotion of an integrated system of comprehensive health care,
improved continuity of care through home visiting, increased
paternal participation in accessing health care, and the provision
for developmental/psychological assessments of at-risk children.
The project will work with the existing health care system and
the community to provide a community-based, family-centered
comprehensive and culturally relevant system of care.
INTEGRATED PEDIATRIC BEHAVIORAL HEALTH PROJECT (2004
Behavioral & Mental Health Grant)
Kalihi-Palama Health Center, Honolulu, HI
This program will integrate mental health services into the
pediatric primary care setting to improve pediatric access to
behavioral health services and children's overall quality of
health. The project will consist of four innovative elements:
1) coordination of care between primary care and behavioral
health teams through a care manager; 2) the use of behavioral
health consultants for initial and on-going assessments; 3)
brief interventions by the behavioral consultant for children
in need; and 4) outreach for higher risk or noncompliant patients.
IDAHO
MALHEUR MATERNITY PROJECT (1991)
Valley Family Health Care, Inc, Payette, ID
The Malheur Maternity Project (MMP) is an existing program that
provides perinatal care to mostly uninsured and Medicaid-insured,
low-income women who live in the western Treasure Valley, a
region of more than 10,000 square miles that includes portions
of eastern Oregon and western Idaho. The Healthy Tomorrows grant
enables the project to hire a part-time project manager and
a case manager. The addition of these two staff members enables
the project to add coordinated postpartum and infant care follow-up
services and to serve an additional 80 women each year. The
project manager develops and maintains a current directory of
locally available maternal and child health services. Current
objectives are to increase the number of women beginning prenatal
care in their first trimester from 50% to 60%, to increase the
number of patients receiving nutrition counseling from 40% to
60%, to increase the number of patients receiving documented
postpartum care and infant follow-up care from 72% to 90%, to
continue to reduce the ratio of low birthweight babies, and
to decrease to less than 50% the number of repeat patients of
MMP who have close conceptual spacing of less than 2 years.
HOME VISITOR SERVICES FOR PREGNANT/PARENTING SUBSTANCE
ABUSERS (1995)
YWCA of Pocatello, Pocatello, ID
This project will develop, implement, and evaluate in-home services
for pregnant or parenting substance abusers. The program will
emphasize early identification and intervention, followed by
intensive and prolonged visits. Participants will also be referred
to local community agencies to provide coordination of services
such as: health care, substance abuse counseling, child development
programs, and employment development and training.
TREASURE VALLEY CHILDREN'S MENTAL HEALTH PROJECT (2005)
Warm Springs Counseling Center, Boise, ID
The Treasure Valley Children's Mental Health Project (TVCMPHP)
will increase access to mental health services for high risk,
low-income children by enhancing the capacity of primary care
physicians to serve these children. TVCMHP will train primary
care physicians in best practice, research-based protocols and
evaluation/assessment tools regarding mental health issues.
A clinical psychologist/case manager will coordinate contact
between participating physicians and the consulting psychiatrist(s),
with bi-lingual evaluation available in Spanish. Monthly training
sessions will offer continuing education credits for physicians
in children's mental health issues and will include bi-monthly
updates on new psychotropic medications.
STARTING POINTS FOR IDAHO YOUTH (2006)
Mountains States Group, Inc., Boise, ID
Low-income youth in Idaho's rural and frontier counties lack
health insurance coverage. Often their families are not aware
of their eligibility or know how to enroll in state coverage
programs. Starting Points for Idaho Youth is a direct service
project that adds the partnership of SERVE Idaho and
builds on the success of the Covering Kids and Families in Idaho
Project and Coalition. This project will increase the rates
of insured low-income youth in five rural and frontier Idaho
counties. The goals of the project are to create new and innovative
strategies to reach uninsured youth with information about state
health coverage programs and to enroll 1,500 eligible youth
in rural Idaho counties in the state's health insurance coverage
programs.
ILLINOIS
RESOURCES, EDUCATION, AND CARE IN THE HOME (REACH)
FUTURES (1989)
Maternal/Child Health Nursing, University of Illinois at Chicago,
Chicago, IL
A maternal/child health promotion model has been established
through collaboration between the University of Illinois Hospital,
the Chicago Department of Health, and the community action agency,
West Side Futures. The model has been developed and used to
recruit, train, and employ nine community residents who, under
the supervision of professional nurses, conduct home visits
for a minimum of 20 months during the prenatal and postneonatal
period. Project staff have established an innovative, multiagency
service delivery model that aims to insure early detection of
neonatal and postneonatal morbidity and reduce preventable postneonatal
mortality in a high social risk, low-income, inner-city Chicago
community. The service team promotes primary health care through
home-based health assessments, individualized culturally sensitive
child care instruction, and peer resource groups focused on
family support and healthy lifestyles.
INFANT AND FAMILY FOLLOW-UP PROGRAM (1991)
The Pritzker School of Medicine, University of Chicago, Chicago,
IL
The Infant and Family Follow-up Program, which was established
in 1989, and funded by Healthy Tomorrows in 1991, provides comprehensive
medical and social service support for high-risk infants born
at the University of Chicago Perinatal Network Hospitals. Its
objectives are:
- to identify, enroll, and provide continuous follow-up of
all eligible infants and their families until the infant is
5 years of age;
- to strengthen the coordination of services and establish
a partnership with the various agencies that impact the families;
- to provide social and psychosocial support for enrolled
families until their children are 5 years of age; and
- to track and monitor the families to ensure comprehensive
and continuous care.
Eligible infants have birthweights less than 1,500 grams or
documented presence of any risk factors for poor neurobehavioral
outcomes. Pediatric-aged siblings may receive primary pediatric
care and pediatric developmental service as needed. Half-day
clinics are held twice a week. Annually, about 200 very low
birthweight (less than 1,500 grams) infants and infants at high-risk
for poor neurobehavioral outcome are expected to enter the program
with their families. The project will provide preconception
prenatal care and family planning services through parent support
group sessions. Families will be closely monitored to assure
family planning enrollment, and compliance with methods will
be emphasized. The ultimate goal of this program is to promote
building healthy family environments for infants and, at the
same time, prevent repeat low-birthweight births in their families.
PEDIATRIC CARE for INFANTS of PARENTING TEENS: A
COLLABORATIVE MEDICAL DEVELOPMENTAL APPROACH (1996)
Illinois Masonic Medical Center, Chicago, IL
Parenting teens are a vulnerable group who often lack the skills
and motivation for accessing and utilizing health care for their
infants. Efforts to engage young mothers in comprehensive follow-up
programs at delivery are complicated by increasingly early discharge
times, sending young mothers and their infants into the community
poorly prepared to cope with the stresses of motherhood. The
program is a collaborative effort of the Pediatric Ambulatory
Care Center and the Developmental Center of Illinois Masonic
Medical Center in Chicago and will provide pediatric care for
the infants of 100 parenting teens annually. In a group well
child care setting, infants will receive pediatric care and
young mothers will participate in activities to facilitate responsive
mother-child relationships. Central to the program is a plan
for intensive individual case management as well as a linkage
of the teen parents to community-based comprehensive services.
Evaluation will focus on decreasing rates of emergency room
visits, hospitalization and injury as well as enhancing parent
skill and competence.
TEENS EDUCATION LEARNING AND LEADING (TELL)
(1997)
University of Illinois at Chicago, Chicago, IL
Adolescent childbearing presents challenges that impact the
entire family, as well as the broader community. Experience
has demonstrated that successful interventions are those that
promote a broad-based family and community specific response.
However, traditional health care delivery systems tend to offer
individual rather than family care. This approach focuses on
the health and concerns of the adolescent mother and child in
isolation from their social, economic, and cultural context.
The TELL program will develop, implement, and evaluate a model
which promotes healthy lifestyles for the parenting adolescent
within the socio-cultural context of the family. The model uses
a community-based, interdisciplinary team that includes trained
adolescent "peer" health advocates, experienced community
workers (adult health advocates), and family and health care
professionals. The team provides parenting support, health education,
and health screenings in the school, in the home, and in other
community settings. Essential components of the project are
the adolescent health advocate training, home visits to prevent,
or detect infant morbidity, integration within the school to
promote school attendance and graduation ,and linkages to family
and community resources to increase self-sufficiency. Key objectives
include enhancing adolescent self-esteem, improving infant outcomes
at one year, delaying subsequent pregnancies among program participants,
and preventing first pregnancies among peer health advocates.
PEDIATRIC DEAF ACCESS PROGRAM (2000)
Sinai Family Health Centers, Chicago, IL
Access Community Health Network, the Chicago area's largest
community health center organization, is currently establishing
a Pediatric Deaf Access Program with support from the Healthy
Tomorrows Program. The program goal is to serve deaf children
and children of deaf parents with comprehensive community-based
pediatric services, accessible to all, on a sliding-scale basis
regardless of insurance status or ability to pay. The program
strategies include:
- Provision of outreach and school linkage,
- Provision of pediatric care with sign language interpretation;
- Creation of access to program services for low income and
uninsured patients in a predominantly African-American area;
- Definition of a cost-effective, replicable program model;
and
- Heightening of professional awareness of the need for pediatric
services accessible to deaf parents and deaf children. A hearing-impaired
nurse practitioner, skilled in sign language, will work with
the director of the Pediatric Deaf Access Program.
PARENT-RUN EVENING PRESCHOOL (PREP) (2000)
Chicago Youth Programs, Inc, Chicago, IL
Physical threats, inconsistent nutrition, poverty, and instability
in caregiving arrangements can impair the emotional, intellectual,
and social development of children. Inner-city parents are often
highly stressed due to poor living conditions, large family
sizes, single-parent households, and violent neighborhoods.
In addition, many parents were, or are, teenage mothers who
were themselves raised by teenage mothers. As a result, few
learned effective parenting skills. The Parent-Run Evening Preschool
(PREP) provides a unique opportunity in a supportive environment
for inner-city mothers to gain work-related skills and improve
their parenting skills as child care providers in an evening
preschool program. Mothers receive training in topics such as
discipline techniques, child development, and injury prevention.
Under the supervision of an individual trained in child development,
mothers learn appropriate childcare techniques as a provider
for the evening preschool program, which includes early childhood
enrichment activities such as counting, color identification,
and learning the alphabet. The program not only prepares children
for school, but also involves the mothers in their children's
education. Key objectives of the program include:
- Improvement in parenting skills;
- Improvement in maternal self-esteem; and
- Improvement in the children's school readiness.
ERIE FAMILY HEALTH CENTER HEALTHY TOMORROWS PROJECT (2006)
Erie Family Health Center, Inc, Chicago, IL
Erie Family Health Center will launch a new innovative oral
health program at one of Erie's three primary health care sites,
Erie Helping Hands Health Center. The new oral health program
will serve the largely Latino low-income children and pregnant
women population in the Albany Park community of Chicago. The
Erie Family Health Center proposes a tri-fold strategy to prevent
oral health disease among the low-income Latino children and
pregnant women through prevention, treatment and education.
The goals of the project are to increase access to comprehensive
oral health services for new patients, provide an age-appropriate
anticipatory guidance curriculum to Erie's medical providers,
provide comprehensive oral health prevention education to community
members, and improve the oral health status of low-income children
by reducing cavity burden and improve oral health status of
pregnant women by addressing periodontal disease.
INDIANA
COMMITTED TO KIDS PEDIATRIC WEIGHT-MANAGEMENT PROGRAM (2007)
Clarian Health Partners, Inc, Indianapolis, IN
The
Committed to Kids Pediatric Weight-Management Program is implementing a school-based weight management program for 9-13 year olds to promote wellness as a mechanism to prevent excess weight and diseases related to being overweight. This program will serve two middle schools at high risk for being overweight due to economic, social, and environmental factors within the community. Program staff will work with parents, pediatricians, school-based health clinic staff, and health educators to implement a 12-week after school program that features nutrition, education sessions, and physical activities. The goals of the program are to: 1) Identify safe and effective methods for achieving and maintaining weight loss, 2) Acquire knowledge of the basic principles of good nutrition and healthy eating patterns, 3) Increase awareness of eating behaviors and activity patterns, 4) Learn alternative behaviors to promote long-term health, and 5) Gain the physiologic and kinesthetic awareness necessary to adopt activity patterns that promote long-term health.
IOWA -- NOT AVAILABLE
KANSAS
HEALTHY CHILDREN PROJECT (1995)
Wichita Primary Care Center, Wichita, KS
This community-based, family-oriented, school health center
will address the deteriorating health status of school-age children
from six elementary and two middle schools in the Wichita area.
The center will provide primary care and dental and mental health
services to over 3,600 children in its first year; transportation
will be provided, if necessary. Schools were chosen based on
the students' poor health and economic status. Cities in Schools,
a dropout prevention program and partner in the project, has
a full-time site coordinator at each school. As part of a multidisciplinary |