Stakeholders involved with Whatcom Taking Action for CYSCN has identified a need for a local mid-level evaluation system. This type of evaluation would provide an intermediate level of evaluation between the screening done by primary care providers and tertiary center diagnostic evaluation.
Goal 1: Improve the health and education status of children with or at risk for developmental-behavioral disorders. Objective 1: Increase and enhance routine developmental screening of young children performed by primary care providers to maximize opportunities for screening and enhance existing screening protocols to include screening for autism and identifying risk for child developmental concerns based on family stress. Objective 2: Support the use of standardized developmental screening (including a family stress component) by child care providers and other early learning professionals working with children birth to five. Objective 3: Increase awareness of parents and the community at large in child development, important milestones and the importance of early intervention. Goal 2: Improve the healthcare system capacity and sustainability for children with or at risk for developmental-behavioral disorders and their families. Objective 1: Implement a sustainable community-based collaborative interdisciplinary mid-level evaluation system for young children with developmental-behavioral concerns that includes family support and service coordination - GIDES (General Interdisciplinary Developmental Evaluation System). Objective 2: Increase local service capacity for functional therapies including occupational therapy, physical therapy, applied behavior analysis, and speech-language therapy. Objective 3: Document successful project components in a publishable workbook format addressing county-level issues that can be utilized by other communities to replicate our programs with measurable outcomes. Goal 3: Improve the well-being of families of children with or at risk for developmental-behavioral disorders. Objective 1: Increase the inclusion of family stress measures in standardized screening practices for young children. Objective 2: Increase local service capacity for family support services. Objective 3: Include family support and service coordination in GIDES (General Interdisciplinary Developmental Evaluation System).
Define and implement the health care and care coordination activities for a General Interdisciplinary Developmental Evaluation System (GIDES). Contract with fiscal consultant to operationalize the interdisciplinary model maximizing available billing sources and minimizing duplication of services. Establish referral and scheduling protocols for GIDES utilizing the existing Single Entry Access to Services (SEAS) infrastructure. Establish the mechanism for family-centered inter-disciplinary care planning and communication protocols among providers of case management of children. Gather data from GIDES implementation and our SEAS intake to demonstrate service capacity gaps and health equity issues. Collaborate with local therapy and family support service provider organizations to develop a strategy map for securing the necessary resources to increase service provision. Engage pediatric primary care and family practice providers with a survey of tools used and ages screened for development of children birth to 5, autism, and family stress. Based on identified needs, provision of education and support to administrative personnel, health professionals and pediatricians around screening activities. Provide technical assistance and training to increase capacity for developmental screening in early learning. Engage stakeholder groups in planning for improved parental and community knowledge around child developmental milestones and the importance of early intervention.
Taking Action is a collaborative effort that includes partners from the Whatcom County Health Department, early intervention providers, pediatric health care and therapy providers, mental health providers, and social services providers. Taking Action maintains a close relationship with partners from statewide agencies and participates in the statewide Medical Home Leadership Network.
Each advisory board and workgroup has an established process for tracking progress towards long term goals and completion of short term objectives. Our Single Entry Access to Services (SEAS) system allows for data collection on the needs and demographic characteristics of families served and community service gaps. Coordination among many community partners allows for the development of procedures for data collection across systems. Regular surveys are distributed to families and providers.
Our main accomplishment during Year 1 was the establishment of our General Interdisciplinary Developmental Evaluation System (GIDES) for children with suspected Autism Spectrum Disorders (ASD). GIDES began accepting clients on June 15, 2015. In Year 1, 118 children were referred to GIDES. Of those, 81 completed a needs intake and navigation services through our Single Entry Access to Services (SEAS) line, 77 received care coordination services, and 43 completed the GIDES Assessment. We have partnered with a local pediatric neurologist, who provides ASD diagnostic services for GIDES clients after they have received the GIDES Assessment. This represents a dramatic increase in our local capacity for ASD diagnosis and prevents many families from having to travel to the nearest major metropolitan area (Seattle) to obtain diagnostic services. Our GIDES model includes not only evaluation, but also service navigation and care coordination services for families. Although the initial implementation of the GIDES system has been successful, several barriers have impacted our ability to provide full GIDES to all children who need an evaluation. Thus far, our efforts have focused on the sub-population of children with suspected ASD and demand for these assessments have exceeded our capacity to provide them, even for this sub-population. Barriers include difficulties securing an administrative home for medical billing, demand, and capacity issues.